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Factors Influencing Immunization Status In Primary Care Clinics, David Page, Jan Meires, Amy B. Dailey

Health Sciences Faculty Publications

Background and Objectives: National standards and goals for childhood immunization rates are well established. Yet, despite clear standards and goals, physicians do not achieve the desired rate (90%) for immunization coverage. This study examined factors related to immunization status for 2-year-old children in pediatric and family practice settings.

Methods: Specially trained personnel used computer software to audit 2,552 records from 42 practices in Northeast Florida throughout 1997–1999. Immunization records were judged as either complete or incomplete, and factors related to immunization status were studied. Clinic type and 18 immunization practice standards were reviewed for effect on immunization status.

Results: The …

Participant Blinding And Gastrointestinal Illness In A Randomized, Controlled Trial Of An In-Home Drinking Water Intervention, John M. Colford, Judy R. Rees, Timothy J. Wade, Asheena Khalakdina, Joan F. Hilton, Isaac J. Ergas, Susan Burns, Anne Benker, Catherine Ma, Cliff Bowen, Daniel C. Mills, Duc J. Vugia, Dennis D. Juranek, Deborah A. Levy

Journal Articles: Epidemiology

We conducted a randomized, triple-blinded home drinking water intervention trial to determine if a large study could be undertaken while successfully blinding participants. Households were randomized 50:50 to use externally identical active or sham treatment devices. We measured the effectiveness of blinding of participants by using a published blinding index in which values >0.5 indicate successful blinding. The principal health outcome measured was "highly credible gastrointestinal illness" (HCGI). Participants (n=236) from 77 households were successfully blinded to their treatment assignment. At the end of the study, the blinding index was 0.64 (95% confidence interval 0.51-0.78). There were 103 episodes of …

Satisfaire Aux Besoins De Santé Des Hommes Qui Ont Des Rapports Sexuels Avec D’Autres Hommes Au Sénégal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle

HIV and AIDS

A study conducted in Dakar, Senegal by researchers from the National AIDS Council, Cheikh Anta Diop University, and the Horizons program obtained information on the needs, behaviors, knowledge, and attitudes of men who have sex with men (MSM). This study offers important insights into the sexuality of MSM, their vulnerability to STI/HIV, and the role of violence and stigma in their lives. The results also highlight the lack of sexual health services and information available to cover the specific needs of MSM. The results of this study were summarized during a meeting held in April 2001 in Dakar and raised …

Jadelle® Levonorgestrel Rod Implants: A Summary Of Scientific Data And Lessons Learned From Programmatic Experience, Irving Sivin, Harold A. Nash, Sandra N. Waldman

Formulation/Product Development

This scientific monograph provides a comprehensive summary of the clinical characteristics of Jadelle levonorgestrel (LNG) rod implants, as observed during clinical trials conducted by the Population Council. The monograph also reviews lessons learned about how to provide Jadelle, based partly on conclusions gleaned from the extensive experience with Norplant, the earlier implant system, and suggests practical ways in which to introduce Jadelle into family planning programs.

Access To Treatment For Hiv/Aids: Report Of A Meeting Of International Experts, Johannes Van Dam, Sherry Hutchinson

HIV and AIDS

As of December 2001, the number of people living with HIV/AIDS is estimated at 40 million, and most live in the developing world. Advances in the development and availability of antiretroviral (ARV) drugs have led to a paradigm shift in most of the industrialized world, where highly active ARV therapy has resulted in a significant reduction in the prevalence of AIDS-related morbidity and mortality. In most of the developing world, however, the focus of national programs and international support continues to be on prevention and care in the absence of ARV treatment. While the moral imperative to provide the best …

Ndola Demonstration Project: A Midterm Analysis Of Lessons Learned, Horizons Program

HIV and AIDS

This report summarizes baseline and midterm findings of an intervention pilot study conducted by Horizons, LINKAGES, National Food and Nutrition Commission, District Health Management Team, Hope Humana, and the Zambia Integrated Health Program in Ndola District, Zambia. The aim of the research is to investigate how integrating services for the prevention of mother-to-child transmission (PMCT) of HIV into low-resource maternal and child health (MCH) and antenatal care (ANC) settings influences women’s ability to make and implement informed decisions about HIV. The intervention strengthened routine services and introduced HIV voluntary counseling and testing and PMCT counseling and services into the MCH/ANC …

Frontiers Capacity Building: An Overview, James R. Foreit

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program is a cooperative agreement with USAID to improve family planning and reproductive health service delivery through operations research (OR). Frontiers builds on more than 20 years of research to improve family planning service delivery programs. A major goal of Frontiers is to transfer skills in OR so that public and private agencies in developing countries can conduct OR and apply research findings to reproductive health programs and policies. OR addresses problems in operational effectiveness, access, quality, and efficiency by investigating facets of programs that managers can control and change. As concluded in …

Social Networks And Hiv Transmission: The Contextual Dynamics Of Hiv Risk Behaviors, Karen L. Robinson

International Journal of Global Health

Despite advances in public health, biomedical, and social sciences, the Human Immunodeficiency Virus (HIV), which causes Acquired Immune Deficiency Syndrome (AIDS), continues to proliferate. HIV is spread by exposure to infected blood, semen, or vaginal secretions. HIV transmission most commonly occurs because of sexual activities, through the sharing of contaminated needles and other drug paraphernalia, and less frequently, from infected mothers to their newborns (CDC, 2001). From the first reported in case in June 1981 through June 2001, the Center for Disease Control and Prevention (CDC) has reported 793,026 cases of AIDS. The CDC estimates that 650,000 to 900,000 Americans …

Assessment Of Validity Of The National Public Health Performance Standards: The Local Public Health Performance Assessment Instrument., Joyce Beaulieu, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The National Public Health Performance Standards Program (NPHPSP) has developed performance standards measurement instruments, based on the 10 "Essential Services of Public Health" that are being tested in several states. This article is a report on the face and content validity of the instrument designed for local public health systems. Judgments about the face validity of the standards were obtained in a survey of local public health systems that had used the instrument in a test state. The validity of each standard was addressed along the following dimensions: the importance of the standard as a measure of the Essential Service; …

Report On A Formative Evaluation Conducted For The Youth Against Tobacco Counter Marketing Campaign, Lorelei Cropley, F Mitchell, Peter B. Anderson

Educational Leadership, Counseling, and Foundations

This paper reports the formative evaluation findings of a tobacco counter-marketing campaign and recommendations based on those findings. Focus groups were used w determine reactions to four messages for the Youth Against Tobacco (YAT) campaign. Participants aged eleven to eighteen years old, who resided in the metropolitan New Orleans area. were selected from area schools usiNg convenience sampling. Results indicated that while reactions w the messages were positive overall, some aspects of the messages seemed too complex to be used effectively in the campaign. These results helped to guide modification and selection of messages prior to use in the campaign.

Safety Behaviour In The Construction Industry, Nick Macdonald, Victor Hrymak

Reports

The influences on safety standards and employee safety behaviour was analysed on 18 large construction sites on the island of Ireland. The safety management and documentation of these sites was also analysed. The results are discussed at length together with comprehensive recommendations for the industry.

Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim

Poverty, Gender, and Youth

Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …

Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya

Reproductive Health

The goal of this study was to determine the sustainability of the postabortion care (PAC) training and service delivery intervention introduced in the Hospital Nacional Daniel Alcides Carrión in Lima, Peru, and the extent to which the outcomes of the intervention have continued. The objectives of the study were to assess changes over time in the following outcomes: the use of manual vacuum aspiration for incomplete abortion, provision of family planning information to postabortion patients, acceptance of contraception by postabortion patients prior to discharge, provision of medical care information to patients, length of hospital stay, and resources used by the …

Capacitación Y Apoyo De Científicos En Población De Países En Desarrollo: Un Informe De Panel—Resumen Y Recomendaciones, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd

Poverty, Gender, and Youth

Desde su inicio, el Population Council ha reconocido la importancia y el valor que tiene la capacitación del científico en población de países en desarrollo. A partir de 1952, el programa de becas en ciencias sociales del Council ha logrado mantener sus objetivos habiéndo otorgado aproximadamente 1500 becas hacia la capacitación pre- y pos-doctoral en estudios de población. Aunque la demanda de científicos en población continúa firme, el campo ha cambiado considerablemente desde aquellos primeros años, de modo que una reevaluación del programa se tornó necesaria. La Fundación Mellon en el año 2000 otorgó fondos para un proyecto de evaluación …

Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang

Poverty, Gender, and Youth

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …

How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May

Poverty, Gender, and Youth

Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …

The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth

Poverty, Gender, and Youth

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …

Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim

Poverty, Gender, and Youth

In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …

Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh

Poverty, Gender, and Youth

To the extent that research on Vietnamese adolescents has been conducted, it has been concerned with unprotected and unsanctioned sexual activity and its health consequences, namely abortion and sexually transmitted diseases, especially HIV. The question we pose is whether this concern is warranted. Is the population community justified in focusing its attention on early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young people’s lives that should give us greater pause? The paper reviews the literature on adolescent sexual behavior in Vietnam and analyzes data …

The Effect Of Gender Differences In Primary School Access, Type, And Quality On The Decision To Enroll In Rural Pakistan, Cynthia B. Lloyd, Cem Mete, Zeba Sathar

Poverty, Gender, and Youth

The paper explores the effect of primary school access, type, and quality on the decision to enroll in rural Pakistan using a 1997 survey especially designed for this purpose. A unique contribution of the paper is the construction of gender-specific dimensions of school accessibility and school quality according to school type (i.e., public vs. private). Within the same village, girls and boys often face starkly different options for schooling in terms of distance, type, and quality. Public primary schools are segregated by sex; private schools, whose numbers have grown rapidly in recent years in response to rising demand and the …

'Bus Fare, Please': The Economics Of Sex And Gifts Among Adolescents In Urban South Africa, Carol E. Kaufman, Stavros E. Stavrou

Poverty, Gender, and Youth

Force or coercion are often a part of sexual relationships in South Africa, especially among adolescents. This coercion is also often pinioned by an economic exchange: gifts or favours for sex. Studies have pointed out the negative consequences of the exchanges which are often characterised by large age differences (‘sugar daddies’) or power imbalances. Perhaps more pervasive but largely ignored, gift-giving in same-age relationships also may be associated with sexual leverage, an exchange which somehow entitles one partner physical and sexual rights to the other’s body. The circumstances surrounding gifts and favours may shape young women’s and men’s sexual experiences, …

Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline

Poverty, Gender, and Youth

The objective of this research is to examine the association between social organization and reproductive behavior in one setting in sub-Saharan Africa. The particular focus is on the effects of social organization on the diffusion of innovative reproductive ideas and behaviors. Social diffusion is assumed to be strongly affected by patterns of informal social interaction, and these in turn are assumed to be determined in part by the social organization of local communities (gender relations, employment activity, voluntary organizations). The research draws on data collected in six communities in southern Ghana. The analysis reveals a weaker than expected association between …

Universal Sexuality Education In Mongolia: Educating Today To Protect Tomorrow, Delia Barcelona, Laura Laski, Caitlin Gerdts

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité demonstrates how Mongolia developed a national plan to a provide a comprehensive sexual and reproductive health curriculum and media for adolescents. Among the lessons learned from the Mongolian experience were the following: 1) questions about unwanted sexual relations and sexual roles were the most pressing among adolescents, especially girls; 2) printed media are efficient and inexpensive; and 3) parental opposition was almost nonexistent in certain settings—often they expressed gratitude for this education.

Are We Not Peasants Too? Land Rights And Women's Claims In India, Bina Agarwal

Poverty, Gender, and Youth

This edition of SEEDS explores the critical elements in securing effective and independent land rights for women in South Asia. The author presents a range of cooperative strategies for enabling women to retain and cultivate the land and shows how micro-credit and other programs can be redirected to increase the amount and productivity of land women control. Recognizing that new policies and political will are required to foster and sustain such experiments, the author ends with a summary of how women are organizing to place women’s access to land at the center of national and global agendas.

Grandparent Care In The United States: Comparisons By Race And Ethnicity, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to compare information on grandparent caregivers in the United States among members of five different racial and ethnic groups. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household.2 Data from the 2000 Census 5% Public Use Microdata Sample are used in our calculations. The …

Grandparent Care In The African-American Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on African-American grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: skipped-generation households, in which a …

Working Paper: Elders In Massachusetts Prefer Paid Caregivers, Francis G. Caro

Gerontology Institute Publications

Older Massachusetts residents would rather have paid professionals provide their long-term care than their own children, according to a recent UMass Poll of 461 Massachusetts residents.

Women, Poverty, Access To Health Care, And The Perils Of Symbolic Reform, Mary Anne Bobinski, Phyllis Griffin Epps

Faculty Articles

This article looks at health care through gendered eyes. We sift though available data on access to health care, health status, and health treatments to determine whether men and women experience health care differently in the United States. While we do not doubt that overt gender-based discrimination occasionally occurs in health care, this article focuses on the importance of unintended consequences and unconscious bias. We also explore the impact of symbolism about women's roles on the process of health care reform. The results have important implications for policy makers, advocates, and health care providers.

The United States has a large …

Formation Et Soutien Pour Les Scientifiques Démographiques Des Pays En Développement: Rapport Du Groupe D'Experts—Sommaire Et Recommandations, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd

Poverty, Gender, and Youth

Dès sa fondation, le Population Council a reconnu l’importance et la valeur de former des scientifiques démographiques provenant des pays en développement. Depuis 1952, le programme de bourses d’études en sciences sociales du Council fait foi de son engagement dans ce domaine : environ 1 500 bourses ont été attribuées pour des stages de doctorat et post-doctorat en études démographiques. Les scientifiques démographiques sont toujours aussi en demande mais le domaine a considérablement changé depuis l’avènement du Population Council. Compte tenu de ces développements, la Fondation Mellon a financé, en 2000, un projet visant à évaluer les besoins futurs de …

Training And Support Of Developing-Country Population Scientists: A Panel Report—Summary And Recommendations, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd

Poverty, Gender, and Youth

From its earliest days, the Population Council has recognized the importance and value of training population scientists from developing countries. Since 1952, the Council’s social science fellowship program has sustained a commitment to this goal; approximately 1,500 fellowships have been awarded for pre- and postdoctoral training in population studies. While the demand for population scientists remains strong, the field has changed substantially since those early years and a review of the program was needed. The Mellon Foundation funded a project in 2000 to assess future needs for training and support of population scientists from developing countries and assembled an international …