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Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council

Reproductive Health

The health status of women, men, and children in sub-Saharan Africa remains the poorest in the world. Moreover, virtually every country in the region is suffering mediocre economic growth or economic decline, thereby reducing the ability of their health care systems to respond adequately, and increasing dependence on external donor assistance. In terms of reproductive health (RH), the region is faced with high levels of unwanted fertility; high levels of maternal, child, and infant morbidity and mortality; and an almost exponential growth in HIV prevalence. Access to and quality of RH services remains poor in most countries, thereby maintaining unmet …

Reproductive Decisionmaking In The Context Of Hiv/Aids In Ndola, Zambia, Naomi Rutenberg, Ann E. Biddlecom, Frederick A.D. Kaona

Reproductive Health

Family planning (FP) programs are increasingly being considered as a logical focal point for STD and HIV/AIDS prevention services because they serve large numbers of women at risk, address the sensitive issue of sexual behavior and fertility control, and the methods for preventing unwanted pregnancy and disease can be the same. FP programs, by providing contraceptive methods, are currently one of the few sources of assistance in the sub-Saharan African region for preventing perinatal transmission of HIV, while the promotion of barrier methods contributes to the prevention of heterosexual transmission. Given this potential, research is needed to understand how the …

Investing In Youth: Testing Community-Based Approaches For Improving Adolescent Sexual And Reproductive Health, Tamara Fetters, Fines Munkonze, Julie Solo

Reproductive Health

The world is now sustaining the largest number of youth in human history; today there are nearly 900 million 10–19-year-olds and their health and livelihood issues are becoming increasingly important to policymakers worldwide. In Zambia, as in many other countries, young people face severe problems, including limited access to jobs, secondary education, and health care. The social, economic, and peer pressures that youth face often lead to high levels of sexual activity, often with subsequent negative impacts on their sexual and reproductive health. In spite of the magnitude of the reproductive health problems facing youth, they still have limited access …

Strengthening The Evaluation And Research Unit Of The Zimbabwe Family Planning Council (1995–1998), Lewis Ndhlovu, Hazel M.B. Dube, Caroline S. Marangwanda

Reproductive Health

The Evaluation and Research Unit (ERU) plays a crucial role in supporting the research activities of the Zimbabwe National Family Planning Council (ZNFPC). Research activities are conducted in addition to analysis of service statistics and compilation of quarterly and annual reports. With a staff capacity of five and inadequate research skills existing in other units, the ERU finds it difficult to manage and monitor the diverse activities of the organization. To address these problems, a buy-in was signed between the Zimbabwe Government and USAID in May 1995. The objectives were to assist the ZNFPC in conducting operations research studies and …

Demand For And Cost-Effectiveness Of Integrating Rti/Hiv Services With Clinic-Based Family Planning Services In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Sithokozille Simba, Hazel M.B. Dube, Rick Homan, Barbara Janowitz, Ahmed Latif, Peter R. Mason

Reproductive Health

The current spread of HIV/AIDS poses a major threat to individual lives and national economies in many sub-Saharan African countries. The region also has some of the highest levels of other reproductive tract infections (RTIs) in the world. Some of these RTIs increase the risk of sexual transmission of HIV infection. Thus, the control of RTIs is seen not only as an important reproductive health care strategy to alleviate symptoms of infection and long-term gynecological, obstetric, and neonatal complications, but also as a key strategy in reducing the spread of HIV/AIDS. As a result, all national health care programs in …

Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan

Reproductive Health

This book on family planning in India includes detailed empirical data and analysis of the various dimensions of quality of care in different regions of the country. Focus areas include: women’s perceptions of the care they receive; observations of provider-client interactions; barriers to quality of service delivery; existing interregional variations; contraceptive choice and interpersonal relations; technical quality of care; and the effect of the target system on the work style of outreach staff. All elements of the quality-of-care framework elaborated by Judith Bruce are well documented and their relationships to broader program constraints are clearly identified. The overall impression one …

Investigación Operativa En Planificación Familiar: Lecturas Selectas, James R. Foreit, Tomas Frejka

Reproductive Health

Desde que existen los programas de planificación familiar existe la investigación sobre este tema. En el nivel teórico, los investigadores examinan el efecto de la fertilidad sobre la salud y el desarrollo socioeconómico y estudian los determinantes de la fecundidad para los individuos y la poblaciones. En el nivel de las políticas, los estudios exploran el papel que juegan los programas de planificación familiar en la modificación de la fecundidad y la salud. El desarrollo de nuevos anticonceptivos se acompaña de pruebas clínicas y pre-introductorias en el contexto de los programas. Se llevan a cabo encuestas para medir los cambios …

L'Approche De L'Analyse Situationnelle Pour L'Évaluation Des Services De Planification Familiale Et De Santé De La Reproduction: Manuel De Recherche, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba

Reproductive Health

Une bonne prestation de services de planification familiale mettant l'accent à la fois sur l'accès et la qualité est la clé des objectifs interdépendants de satisfaction des besoins individuels et la réalisation du succès programmatique. L'analyse de situation (AS) fournit un lien nécessaire entre le responsable de programme et la cliente qu'il essaie de servir. Les données recueillies par l’AS offrent une image représentative du fonctionnement des composantes et permettent de «voir» l'expérience de la cliente. Les analyses situationnelles aident le responsable de programme à atteindre le plus grand but en termes de gestion—celui d’une administration efficace d'un service de …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah

Reproductive Health

This report aims to explain the discrepancies in crisis-related research results in Indonesia, and to recommend methodologies to enhance future crisis-related monitoring and surveillance. The discussion aims to identify where the discrepancies are in the readily available data, and how these discrepancies can be explained. The report does not attempt to clarify the impact that the economic crisis is having on the health status of women and children in Indonesia. Recommendations are made to deal with the following findings: Aggregation of data may hide important crisis impacts; attribution of identified changes to the economic crisis may be misleading; differences in …

Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda

Reproductive Health

This project was designed to disseminate, expand use, and promote institutionalization of a program to train healthcare professionals to address domestic violence. The program was developed and implemented by the Instituto Mexicano de Investigación de Familia y Población (IMIFAP), a nongovernmental organization that promotes reproductive health. IMIFAP designed an 18-hour workshop, entitled “Health Services Respond to Domestic Violence,” to sensitize health professionals to domestic violence issues and develop strategies for recognizing and managing cases of domestic violence. Following the workshop, strong and significant increases in knowledge about domestic violence and its management in primary healthcare services were found. Workshop participants …

Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon

Reproductive Health

The goal of this project was to inform physicians, pharmacists, and female factory workers about emergency contraception (EC) through mailings of booklets and posters. These materials were developed in a previous operations research project conducted by the Instituto Mexicano de Investigación de Familia y Población and supported by the Population Council INOPAL III project with funding from USAID. The study found that recipients generally liked the print materials and welcomed information about EC. Within three weeks of receiving the materials, many reported that they had taken immediate action to make EC available and/or to educate others about EC. This project …

Mexico: Protecting Informed Consent, Elsa Santos, Silvia Elena Llaguno, Ricardo Vernon

Reproductive Health

The objective of this three-month project in Mexico was to disseminate information among key audiences about: 1) the right of women to choose contraceptive methods in a free and informed manner; and 2) the laws and institutions available to help redress any violations of this right. Four publications on these topics, developed by a previous project funded by Population Council/INOPAL III, were reproduced and distributed to 2,750 people in the following target audiences: women of reproductive age; reproductive health service providers; national and state commissions of human rights, complaints offices in public hospitals, feminist and human rights organizations; and legal …

Peru: Providers' Compliance With Quality Of Care Norms, Federico R. Leon

Reproductive Health

Peru's Ministry of Health (MOH) introduced changes in its family planning service delivery strategy and set quality-of-care goals purported to ensure informed choice of methods and respect for the users’ reproductive intentions and rights. This study was designed to assess the extent to which providers comply with the guidelines in their daily routine. The study found that among the strongest elements of care are interpersonal relationships and free choice of methods. However, shortcomings were observed in screening for contraindications and information given to the client. The report includes a number of recommendations, including offering providers IEC materials, training, and supervision …

Reproductive Health Indicators: Moving Forward, Kelly Blanchard, Batya Elul, Saumya Ramarao

Reproductive Health

This report is designed to help researchers, program managers, policymakers, and advocates sift through and evaluate which potential indicators might be useful in a particular programmatic context. It was initially prepared as a background manuscript for a Population Council meeting on reproductive health indicators held in Cairo in March 1998. The manuscript has since been modified to incorporate ideas and comments expressed at that meeting, as well as to include input from other Population Council colleagues.

Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri

Reproductive Health

At the International Conference on Population and Development (ICPD) in 1994, the nations of the world agreed to give special attention to girls’ education, women’s health, infant survival, and women’s empowerment, and to provide comprehensive reproductive health (RH) services to enable couples to achieve their reproductive goals. The government of India launched a reproductive and child health program in October 1997. This book begins a review of the processes underway to operationalize the program. It brings together several important initiatives at various stages of development and examines key policy and program issues based on empirical research and field experience. The …

Recherche Par Traçage Sur La Réintroduction Des Émissions D'Immeubles En Milieu Urbain, Ted Stathopoulos, Louis Lazure, Patrick Saathoff

Rapports de recherche scientifique

Click here for the English version of this report

Mesure Du Monoxyde De Carbone Dans L'Échappement Des Moteurs Diesels, Michel Grenier

Rapports de recherche scientifique

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Comparing Alternative Products In The Provision Of Emergency Contraception, John P. Skibiak, Yusuf Ahmed, M. Ketata

Reproductive Health

This report is the third in a series of summaries produced in connection with the operations research project “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the project explores the many issues surrounding the introduction and delivery of emergency contraception services in a developing country context. The study compares the introduction of two different emergency contraception pills—the combined oral contraceptive PC-4, introduced in Zambia in 1997, and the progestin-only contraceptive Postinor-2, introduced by this study in the following year. Client histories showed only minor differences in the attitudes of emergency contraception users …

Postabortion Care: Lessons From Operations Research, Dale Huntington, Nancy J. Piet-Pelon

Reproductive Health

This book focuses on one central but until now intransigent aspect of women’s health: How to reduce the toll of death and morbidity associated with unsafe abortion. For the first time in the history of international decision-making, Cairo established a consensus on abortion. This was reaffirmed in the 1999 United Nations General Assembly statement. Where abortion is illegal, many women use herbal remedies, take modern drugs in unsupervised ways, attempt to physically self-induce, or seek help from abortion providers working outside the law. Where abortion is illegal, women are exposed to painful, dangerous procedures and many fall so sick that …

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …

Body Weight And Mortality Among Adults Who Never Smoked, Pramil N. Singh

Loma Linda University Electronic Theses, Dissertations & Projects

Most prospective studies identify an increased mortality risk for adults of high body mass index (> 27 kg/m²) that is commonly attributed to the effects of excess body fat, and also identify an increased mortality risk for adults of low body mass index (< 21 kg/m²), an association that, if causal among healthy adults, is without adequate pathophysiologic support.

In this dissertation, I have conducted three studies that continue the investigation of adiposity in relation to mortality among never-smoking adults of the California Seventh-day Adventist population. Among never-smoking adults of the Adventist Mortality Study (1960-1985), the relation between …

Designing An Analytic Deliberative Process For Environmental Health Policy Making In The U.S. Nuclear Weapons Complex, Seth Tuler, Thomas Webler

RISK: Health, Safety & Environment (1990-2002)

Using a National Research Council Report as a centerpiece, Drs. Tuler and Webler evaluate the effectiveness of a conceptual approach to risk policy-making.

Development And Testing Of A Quantitative Food Frequency Questionnaire For Use In Gujarat, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, Pesi N. Sinor, Hemali Mehta, Fali S. Mehta

Faculty Publications

Objective: To develop and test a quantitative, interviewer-administered food frequency questionnaire (FFQ) to ascertain nutrient intakes of individuals in northern India. Design: A 92-item FFQ was developed based on food use and market surveys of the study area. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 6 randomly selected days over 1 year. Two FFQs were administered, one each at the beginning and end of the 1-year period. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by computing differences between nutrient intakes estimated by the two methods. Setting: Rural villages …

Centred Voices : A Study Of The Lived Experience Of Women's Health Centre Coordinators, Jodie L. Moyle

Theses: Doctorates and Masters

The purpose of this phenomenological study is to explore and describe the lived experience of women's health centre coordinators. In addition to the intrinsic value of telling these women's stories, this research provides data which can he used to strengthen the economic, political, organisational and social position of women’s health centres and the women who work in them. Four women managers from regional urban women's health centres in Australia were interviewed about their subjective experiences with respect to their current working roles. Interviews were audio taped, transcribed and coded to produce themes and to preserve anonymity. Data was analysed using …

The Guillain-Barre Syndrome And The 1992-1993 And 1993-1994 Influenza Vaccines, Tamar Lasky, Gina J. Terracciano, Laurence Magder, Carol Lee Koski, Michael Ballesteros, Denis Nash, Shelley Clarke, Penina Haber, Paul D. Stolley, Lawrence B. Schonberger, Robert T. Chen

Publications and Research

Background
The number of reports of influenza-vaccine-associated Guillain-Barré syndrome to the national Vaccine Adverse Event Reporting System increased from 37 in 1992-1993 to 74 in 1993-1994, arousing concern about a possible increase in vaccine-associated risk.

Methods
Patients given a diagnosis of the Guillain-Barré syndrome in the 1992-1993 and 1993-1994 influenza-vaccination seasons were identified in the hospital-discharge data bases of four states. Vaccination histories were obtained by telephone interviews during 1995-1996 and were confirmed by the vaccine providers. Disease with an onset within six weeks after vaccination was defined as vaccine-associated. Vaccine coverage in the population was measured through a random-digit-dialing …

Vol. 21 No. 4 (1998): Pacific Studies Full Issue, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Pacific Studies is published two times a year by The Jonathan Nāpela Center for Hawaiian and Pacific Studies, Brigham Young University Hawai‘i #1979, 55–220 Kulanui Street, Lāʻie, Hawai‘i 96762, but responsibility for opinions expressed in the articles rests with the authors alone. Subscription rate is US$40.00 yearly, payable to The Jonathan Nāpela Center for Hawaiian and Pacific Studies. The Jonathan Nāpela Center for Hawaiian and Pacific Studies (formerly The Pacific Institute) is an organization funded by Brigham Young University Hawai‘i. The Center assists the University in meeting its cultural and educational goals by undertaking a program of teaching, research, and …

Books Received And Book Notices, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Book Listing for the Vol 21, No 4 Edition of the Pacific Studies Journal

Stachybotrys: Is Nevada At Risk?, Terrylynn C. Foley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Stachybotrys chartarum (atra) is a toxigenic fungus that is known to adversely impact the health of animals. Until recently, there have only been a few documented clinical reports linking Stachybotrys chartarum to human health effects. Scientists are increasingly convinced that Stachybotrys and its metabolites are responsible for several adverse health effects experienced by people all over the world, although conclusive proof has yet to be established. All the physical requirements needed for indoor Stachybotrys sporulation and growth is provided through water leaks (plumbing, roof or ceiling), flood events, nutrient sources (cellulose and nitrogen), pH, and temperature(23° - 28°C). Stachybotrys has …

A Cross-Sectional Study Examining Lifestyle And Rheumatoid Arthritis, Leslie Nazaroff

Loma Linda University Electronic Theses, Dissertations & Projects

Objective. Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the synovial joints. RA affects 0.5-2% of the population. Though it is predominantly a progressive disease, adjunct therapy may slow the destructive pathway or alleviate affiliated symptoms. This study examined the effects of lifestyle (diet and exercise) and self-efficacy on symptoms of RA as measured by disease activity and health satisfaction.

Methods. Seventy-five RA patients (77% female) from the Loma Linda University Faculty Medical Offices, Rheumatology Department completed self-assessment surveys on their lifestyle practices and RA affliction. Disease symptoms and activity were assessed with the Arthritis Impact Measurement …