Digital Commons Network^™

Community-Based Participatory Research: Defining Community Stakeholders, Laurene M. Tumiel-Berhalter, Robert Watkins, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Community-based participatory research requires the participation of community stakeholders to inform the process. The West Side Community Asthma Project, a community-based participatory research program to study the effects of the environment on asthma conducted in Buffalo, N. Y, identified a stakeholders group of community leaders and activists. Creative strategies have been implemented to reach out to other community residents to invite them to participate in the participatory process.

The Case Of South African And Chilean Health Systems: Comparison Of Financial, Economic And Health Indicators, Alberto Coustasse, Peter Hilsenrath, Patricio Silva Rojas

Management Faculty Research

The purpose of this study is to identify similarities and differences between healthcare systems of South Africa and Chile. The World Health Report 2000, the Human Development Index, and financial indicators were used for comparison. Chile showed better performance than South Africa in most of the measures used. Significant progress has been made in South Africa, bringing better education, healthcare and housing to the deprived black majority. However, the HIV/AIDS epidemic, weighs heavily on health indicators. Chile decentralized its health services and implemented economic reforms during the 1980's and has had steady improvement in its healthcare indicators. Finally, these counties …

Colorectal Cancer And Meat Consumption: Recent Views From Epidemiology, Rachel Horner

International Journal of Global Health and Health Disparities

Colorectal cancer is the second leading cause of cancer death in the United States and the third most commonly diagnosed form of cancer in men and women (CDC 2003). The risk for developing colorectal cancer increases with age (90 percent of cases occur in individuals over 50) and with personal or familial predisposition to cancer. Numerous studies over the years also show connections between lifestyle factors-such as eating a diet high in saturated fat and low in fruits and vegetables, smoking and not exercising regularly-and the incidence of this cancer. However, the links between certain dietary factors and the risk …

Ethical Approaches To Gathering Information From Children And Adolescents In International Settings: Guidelines And Resources, Katie D. Schenk, Jan Williamson

HIV and AIDS

This publication provides practical guidance to help program managers and researchers understand and uphold ethical standards when planning and implementing information-gathering activities among children and adolescents, and promotes discussion of ethical issues among people of different backgrounds and training who gather information for different purposes. The publication, which is divided into three parts, is intended to be helpful to anyone who plans, manages, implements, analyzes, or funds any program or research activity that requires gathering information from children and adolescents, including monitoring and evaluation. Part 1 presents key issues that must be considered from the earliest stages of planning and …

Effect Of Cirrhosis On Antibiotic Efficacy In A Rat Model Of Pneumococcal Pneumonia, Laurel C. Preheim, Keith M. Olsen, Mei Yue, Mary U. Snitily, Martha J. Gentry-Nielsen

United States Public Health Resources

A rat model was used to study the effects of cirrhosis on antibiotic therapy of pneumococcal pneumonia. Cirrhotic and control male Sprague-Dawley rats were infected transtracheally with type 3 Streptococcus pneumonia. Treatment began 18 h later with phosphate-buffered saline (PBS), azithromycin (50 mg/kg), trovafloxacin (50 mg/kg), or ceftriaxone (100 mg/kg) injected subcutaneously twice daily for 5 days. Antibiotic concentrations were measured by high-performance liquid chromatography. Azithromycin, trovafloxacin, and ceftriaxone were all equally effective at preventing mortality in both cirrhotic and normal rats. Free fraction area under the curve to minimum inhibitory concentration ratio (AUC/MIC) and maximum calculated serum concentration …

Reducing The Transmission Of Hiv And Sexually Transmitted Infections In A Mining Community: Findings From The Carletonville Mothusimpilo Intervention Project: 1998 To 2001, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam, Yodwa Mzaidume, Bareng Rasego, Solly Moema

HIV and AIDS

The Horizons program, in collaboration with the Center for Scientific and Industrial Research, the South African Institute for Medical Research, and the London School of Economics, conducted an intervention study in the mining town of Carletonville, South Africa to examine the social determinants of the HIV epidemic, and to assess the impact of a targeted program of HIV and STI prevention and service delivery. The project did not reduce STI prevalence or HIV prevalence, as changing sexual behavior is far more complex than educating individuals about HIV. The report recommends interventions to support behavioral change education, STI treatment, the role …

Graduate Public Health Education In Africa: An Innovative Distance-Learning Model, Emmanuel Rudatsikira, Patricia Johnston, Richard Hart

International Journal of Global Health and Health Disparities

This article describes the development and implementation of a distance graduate public health education program in Africa by Loma Linda University, Loma Linda, California, U.S.A. The program started in March 2000 and ended in September 2003 with formal teaching sessions on-site held twice a year at the University of Eastern Africa, Kenya. The instruction was given in English and French. Of the cohort of 67 students from 20 African countries who started the program, 57 received an M.P.H. degree and six received a certificate in public health. The experiential learning model allowed students to immediately put into practice what they …

Programming For Hiv Prevention In South African Schools: A Report On Program Implementation, Priscilla Reddy, Shegs James, Ann P. Mccauley

HIV and AIDS

An evaluation study conducted in KwaZulu Natal, South Africa, provides important insights into whether learners who participated in a fact-based, interactive course had more knowledge about HIV risks, prevention, and care practices; more positive attitudes toward prevention practices and people living with HIV and AIDS; and a higher prevalence of reported safe behaviors than comparable learners who did not participate in the course. Results show that the Life Skills Grade 9 Curriculum had a positive impact of students’ knowledge of HIV/AIDS, attitudes about abstinence, and intention to use condoms. There was, however, no evidence of increased adoption of such protective …

Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru

Reproductive Health

The Somali community living in Kenya (and in their native Somalia) has practiced the severest form of female genital cutting (FGC)—infibulation—for centuries. To understand the context within which the practice takes place, and how its complications are managed, the Population Council’s Frontiers in Reproductive Health Program undertook a diagnostic study that confirmed that FGC is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice: religious obligation, family honor, and virginity as a prerequisite for marriage; an aesthetic preference for infibulated genitalia was also mentioned. The study also found that the health …

Technical Assistance And Training For Procosi Operations Research Program, Bolivia, Fernando Gonzales Salguero, Ricardo Vernon

Reproductive Health

In September 1999, PROCOSI, a Bolivian network of 24 nongovernmental organizations that provide health services, invited the Population Council Frontiers in Reproductive Health (FRONTIERS) program to provide technical assistance for designing and conducting operations research aimed at increasing the quality and impact of their reproductive health programs. In collaboration with PROCOSI, FRONTIERS conducted four training workshops on design of operations research projects, qualitative research methods, utilization and dissemination of research results, and preparing research reports. Technical assistance on other topics, such as developing research instruments, creating databases, and using EpiInfo for transcribing and analyzing data was provided on-site to each …

Development Of Dose Coefficients For Radionuclides Produced In Spallation Targets, Phillip W. Patton, Mark Rudin

Transmutation Sciences Physics (TRP)

Dose coefficients permit simple determination of radiation dose associated with various exposure scenarios, and ultimately permit radiation safety personnel to assess the health risks to workers in a nuclear facility. Specifically, radiation safety personnel use dose coefficients to determine the radiation dose incurred to a tissue or organ system from a given exposure. These parameters are often expressed in terms of Annual Limits on Intake (ALIs) and Derived Air Concentrations (DACs).

The research consortium comprised of representatives from several universities and national laboratories has successfully generated internal and external dose conversion coefficients for twenty radionuclides produced in spallation neutron sources. …

Understanding The Hiv/Sti Risks And Prevention Needs Of Men Who Have Sex With Men In Nairobi, Kenya, Washington Onyango-Ouma, Harriet Birungi, Scott Geibel

HIV and AIDS

Despite increasing awareness of the role men who have sex with men (MSM) can play in the dynamics of HIV transmission in Africa, research on MSM in Kenya has been limited. In response to this gap, researchers from the Institute of African Studies at the University of Nairobi and the Horizons and FRONTIERS programs of the Population Council undertook a study of MSM in Nairobi. The overall goals of the study were to understand the extent to which MSM are at risk of HIV and other STIs, identify the factors associated with risk behaviors, and identify MSM sexual health needs …

Trends In The Timing Of First Marriage Among Men And Women In The Developing World, Barbara Mensch, Susheela Singh, John B. Casterline

Poverty, Gender, and Youth

The timing of first union merits investigation not only because of the close temporal link between marriage and the onset of childbearing, but also because the age when men and women marry has implications for the organization of family life and for gender relations within society. This paper begins by reviewing the contributions of various social science disciplines to an understanding of the timing of marriage. Using current status data from 73 countries provided by the United Nations Population Division and retrospective data from 52 Demographic and Health Surveys conducted between 1990 and 2001, we then examine recent trends in …

The Causes Of Stalling Fertility Transitions, John Bongaarts

Poverty, Gender, and Youth

An examination of fertility trends in countries with multiple DHS surveys found that in the 1990s fertility stalled in mid-transition in seven countries: Bangladesh, Colombia, Dominican Republic, Ghana, Kenya, Peru, and Turkey. An analysis of trends in the determinants of fertility revealed a systematic pattern of leveling off or near leveling in a number of determinants, including contraceptive use, the demand for contraception, and wanted fertility. Findings suggest no major deterioration in contraceptive access during the stall, but levels of unmet need and unwanted fertility are relatively high and improvements in access to family planning methods would therefore be desirable. …

Building Assets For Safe, Productive Lives: A Report On A Workshop On Adolescent Girls' Livelihoods, Population Council

Poverty, Gender, and Youth

For the 1.5 billion adolescents currently living in developing countries (325 million of them living on less than US$1 a day), the transition to becoming economically productive is particularly pivotal. Girls face numerous challenges in making this transition successfully, since in many settings females have less access than males to critical resources such as secondary school education, credit, land, training, and technology, and their labor is often unrecognized and unremunerated. A growing number of organizations and institutions have been using a livelihoods approach (which centers around the capabilities, assets, and activities required for gaining a means of living) to reach …

Trends In The Timing Of First Marriage Among Men And Women In The Developing World [Arabic], Barbara Mensch, Susheela Singh, John B. Casterline

Poverty, Gender, and Youth

The timing of first union merits investigation not only because of the close temporal link between marriage and the onset of childbearing, but also because the age when men and women marry has implications for the organization of family life and for gender relations within society. This paper begins by reviewing the contributions of various social science disciplines to an understanding of the timing of marriage. Using current status data from 73 countries provided by the United Nations Population Division and retrospective data from 52 Demographic and Health Surveys conducted between 1990 and 2001, we then examine recent trends in …

Accelerating Reproductive And Child Health Program Development: The Navrongo Initiative In Ghana, James F. Phillips, Ayaga A. Bawah, Fred N. Binka

Poverty, Gender, and Youth

Successive global health and development agendas have been embraced by African governments—Alma Ata in 1978, the Bamako Initiative in 1987, the 1994 Cairo International Conference on Population and Development, and more recently the Millennium Development Goals (MDGs)—only to be followed by widespread implementation failure. This paper presents an approach to program development in Ghana that is using research to accelerate policy implementation. Originally launched in 1994 as a participatory pilot project of the Navrongo Health Research Centre, a controlled experimental study was initiated in 1996 to assess the fertility and child-survival impact of alternative community health and family planning service …

The Effect Of Community Nurses And Health Volunteers On Child Mortality: The Navrongo Community Health And Family Planning Project, Brian Wells Pence, Philomena Nyarko, James F. Phillips, Cornelius Debpuur

Poverty, Gender, and Youth

This report presents the child mortality impact of a trial of primary health-care service-delivery strategies in rural Ghana. After adjustment for sociodemographic factors, under-five mortality in areas with village-based community-nurse services fell by 16 percent during the five years of program implementation compared with mortality before the intervention. Reductions were observed in infant (6 percent), early child (20 percent), and late child (41 percent) mortality. Community involvement and training of a local health volunteer were associated with an 11 percent increase in mortality, primarily driven by a 124 percent increase in early child mortality. Areas with both nurses and volunteers …

Active Life Expectancy And Functional Limitations Among Older Cambodians: Results From A 2004 Survey, Zachary Zimmer

Poverty, Gender, and Youth

This study’s aims are to: (1) determine the prevalence of functional limitations among older adults in Cambodia using activities of daily living (ADLs); (2) compare limitation prevalence with other countries in the region; (3) estimate active life expectancy; (4) examine standard correlates of functional status and assess whether they are associated with limitation in expected ways. Elderly Cambodians appear more likely to report limitations than their counterparts in neighboring countries. A contribution of the analysis is the examination of a basic measure of health among a population that until recently has been isolated from the rest of the world.

Population And Sustainability, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Sustainability refers to the preservation of human-valued natural capital—the resources that provide environmental services—at a level sufficient to assure the well-being of future generations. This Population Council working paper assess the effects on the total and per capita availability of those services. The degradation of environmental services—exemplified by the overuse of aquifers or (at a global level) of the atmospheric carbon sink—is a significant threat to sustainable development, one that is often exacerbated by population growth. The critical management issue in such cases is the design of effective governing institutions to restrain service demand and safeguard supply. Uncertainties arising from …

Education Of Adult Children And Mortality Of Their Elderly Parents In Taiwan, Zachary Zimmer, Linda G. Martin, Mary Beth Ofstedal, Yi-Li Chuang

Poverty, Gender, and Youth

Research shows an older adult’s education is strongly associated with mortality. But in societies such as Taiwan, where families are highly integrated, the education of family members may be linked to survival. Such may be the case in settings where there are large gaps in levels of education across generations and high levels of resource transfers between family members. This Population Council study employs 14 years of longitudinal data from Taiwan to examine the combined effects of education of older adults and their adult children on mortality outcomes of older adults. Results indicate that educational levels of both parent and …

Prise En Charge Du Manganisme D’Origine Professionnelle : Consensus D’Un Groupe International D’Experts, Claude Ostiguy, Paul Asselin, Sylvain Malo, Daniel Nadeau, Philippe Dewals

Rapports de recherche scientifique

Click here for the English version of this report

Contexte

Au cours des dernières années, plusieurs travailleurs exposés aux fumées de manganèse ont développé des symptômes évoquant un manganisme d’origine professionnelle. La CSST (la Commission de la santé et de la sécurité du travail), qui est l’organisme d’indemnisation de la province de Québec, faisait face à une situation dans laquelle elle ne disposait pas de techniques normalisées pour la prévention primaire, secondaire et tertiaire du manganisme, menant à la possibilité d’un différend médico-légal, de même qu’à la possibilité d’iniquité pour les travailleurs et les employeurs.

Objectif

Grâce à la définition …

Management Of Occupational Manganism: Consensus Of An Experts' Panel, Claude Ostiguy, Paul Asselin, Sylvain Malo, Daniel Nadeau, Philippe Dewals

Rapports de recherche scientifique

Cliquez ici pour la version française de ce rapport

Contexte

Au cours des dernières années, plusieurs travailleurs exposés aux fumées de manganèse ont développé des symptômes évoquant un manganisme d’origine professionnelle. La CSST (la Commission de la santé et de la sécurité du travail), qui est l’organisme d’indemnisation de la province de Québec, faisait face à une situation dans laquelle elle ne disposait pas de techniques normalisées pour la prévention primaire, secondaire et tertiaire du manganisme, menant à la possibilité d’un différend médico-légal, de même qu’à la possibilité d’iniquité pour les travailleurs et les employeurs.

Objectif

Grâce à la définition …

Réduction Du Bruit Dans Les Centres De La Petite Enfance Par La Réduction Du Temps De Réverbération : Analyses Et Études De Cas, André L'Espérance, Alex Boudreau, François Gariépy, Philippe Bacon

Rapports de recherche scientifique

Click here for the English version of this report

Selon différentes études, les niveaux de bruit dans les locaux et les aires de jeu des Centres de la petite enfance (CPE) sont parfois élevés et peuvent avoir des répercussions sur la santé. La fatigue auditive et le stress sont les deux principaux effets négatifs. De plus, les niveaux de bruit élevés peuvent entraîner de l’irritabilité, un inconfort de communication, une réduction de l’intelligibilité de la parole et même un ralentissement de l’apprentissage verbal chez les enfants.

Plusieurs solutions ont déjà été identifiées et mises en place pour réduire le bruit …

Women's Participation In Disaster Relief And Recovery, Ayse Yonder, Sengul Akcar, Prema Gopalan

Poverty, Gender, and Youth

Too little attention has been given to the gender-differentiated effects of natural disasters, that is, women’s losses relative to men’s, how women’s work time and conditions change (both in terms of care-giving and income-generating work), or how disaster-related aid and entitlement programs include or marginalize affected women. The detailed case studies from three earthquake-stricken areas in India and Turkey that are contained in this issue of SEEDS help fill this information gap. They provide examples of how low-income women who have lost everything can form groups and become active participants in the relief and recovery process. Readers learn how women …

Reciprocal Effects Of Health And Economic Well-Being Among Older Adults In Taiwan And Beijing, Kristine R. Baker, Mary Beth Ofstedal, Zachary Zimmer, Zhe Tang, Yi-Li Chuang

Poverty, Gender, and Youth

The objectives of this Population Council study are threefold: 1) to examine whether socioeconomic status disparities in health are found in non-Western settings; 2) to assess whether socioeconomic status gradients in health endure into older ages; and 3) to evaluate the direction of causality between health and socioeconomic status. Findings provide evidence for reciprocal effects of economic well-being and health among older adults in both Taiwan and Beijing. Those with higher levels of economic well-being have lower levels of functional limitation over time, and those with higher levels of functional limitation have lower levels of economic well-being over time. Consistent …

The Impact Of Childhood Mortality On Fertility In Six Rural Thanas Of Bangladesh, Mian Bazle Hossain, James F. Phillips, Thomas K. Legrand

Poverty, Gender, and Youth

This Population Council working paper examines the causal structure of the relationship between child mortality events and subsequent fertility during a time of rapid decline in fertility in Bangladesh. Results lend support to the hypothesis of an insurance effect, while demonstrating that its demographic significance is likely to be less prominent than that of replacement behavior. Findings indicate that the insurance motive remains intact even after total fertility declined to fewer than three children per woman. The well-documented role of gender bias as a determinant of child health and survival is also a factor in child-replacement decisionmaking. Although the rapid …

The Changing Context Of Sexual Initiation In Sub-Saharan Africa, Barbara Mensch, Monica J. Grant, Ann K. Blanc

Poverty, Gender, and Youth

This working paper investigates the links between changing age at marriage and premarital sexual behavior in 27 sub-Saharan African countries in which Demographic and Health Surveys were conducted between 1994 and 2003. Using multiple-decrement life tables to examine the competing risks of premarital sex and marriage without prior sexual experience, we answer the largely unaddressed question of how reductions in the prevalence of early marriage have affected the likelihood of initiating premarital sex. Our analysis reveals that although the age of first sexual activity has either remained the same or increased, a shift in the context of sexual debut from …

Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

How Many Years Of Life Could Be Saved If Malaria Were Eliminated From A Hyperendemic Area Of Northern Ghana?, Ayaga A. Bawah, Fred N. Binka

Poverty, Gender, and Youth

For some time, Chinese government policies have treated rural and urban areas very differently, and a by-product of China’s rapid development seems to be an even greater differentiation between urban and rural social and economic life. Over the next several decades, in part because of rapid fertility declines and in part as a result of mortality declines at older ages, China and other developing countries will experience enormous increases in the proportion of older adults and the proportion of the “oldest-old.” It is reasonable to expect that these age structure changes will alter the provision of health care, making an …