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A Question Of Scale? The Challenge Of Expanding The Impact Of Non-Governmental Organisations' Hiv/Aids Efforts In Developing Countries, Jocelyn Dejong

HIV and AIDS

There are currently more than 36 million people living with HIV/AIDS globally, and in 1999 5.3 million individuals were newly infected with the virus. AIDS activities initiated by nongovernmental organizations (NGOs) have been highly influential on thinking and strategies found within the HIV/AIDS sector. Yet NGOs often experience particular difficulties in increasing the scale of their activities to reach larger numbers of people, to have an impact at levels higher than the community, and to address the broader social determinants of HIV/AIDS. Perceiving the urgent need for NGOs to expand the scale of their activities in the face of an …

Hiv And Partner Violence: What Are The Implications For Voluntary Counseling And Testing?, Carolyn Knapp

HIV and AIDS

Millions of women around the world face two great threats to their health and well-being: HIV/AIDS and violence by an intimate partner. One of the strongest associations between the two is the role that violence and the threat of violence play in limiting a woman’s ability to negotiate safer sex with a partner. A similar fear of violence also discourages women who receive HIV voluntary counseling and testing (VCT) from telling partners about test results. This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Researchers …

Reducing Hiv Infection Among Youth: What Can Schools Do? Key Baseline Findings From Mexico, South Africa, And Thailand, Holley Stewart, Ann P. Mccauley, Simon Baker, Martha Givaudan, Shegs James, Iwin Leenen, Susan Pick, Priscilla Reddy, Usasinee Rewthong, Patchara Rumakom, Dilys Walker

HIV and AIDS

Although many program planners see schools as a convenient location for HIV-prevention programs, there is controversy about whether school programs can ever be strong enough to go beyond improving knowledge and attitudes to increasing the adoption of safe sexual behaviors. Evaluations of school programs in Mexico, South Africa, and Thailand focus on this question: Can school HIV programs change behavior? In each country, local organizations have worked with educators on teacher training and course design to ensure high-quality school interventions. Researchers surveyed students’ knowledge, attitudes, norms, and reported behavior before the intervention, immediately after the intervention, and again several months …

Assessment Of Clinical Partner Violence Screening Tools, Ann L. Coker, Brian O. Pope, Paige H. Smith, Maureen Sanderson, James R. Hussey

CRVAW Faculty Journal Articles

Objective: to compare the Women’s Experience with Battering Scale (WEB) with the Index of Spouse Abuse-Physical Scale (ISA-P) as screening tools to identify intimate partner violence (IPV).

Methods: We conducted a large cross-sectional survey of women age 18 to 65 attending one of two family practice clinics from 1997 to 1998. All women completed both the WEB and the ISA-P and a telephone interview. We figured agreement estimates between the two tools, used stratified analyses to evaluate attributes of those more likely to screen as battered or physically assaulted, and compared associations between the WEB and ISA-P and a range …

Hormonal And Barrier Methods Of Contraception, Oncogenic Human Papillomaviruses, And Cervical Squamous Intraepithelial Lesion Development, Ann L. Coker, Laura C. Sanders, Sharon M. Bond, Tsilya Gerasimova, Lucia Pirisi

CRVAW Faculty Journal Articles

We assessed the influence of hormonal (oral, injectable, or levonorgestrel [Norplant, Wyeth-Ayerst, Philadelphia, PA]) and barrier methods of contraception on the risk of cervical squamous intraepithelial lesions (SIL), while adjusting for high-risk (HR) HPV infection. Subjects were women receiving family planning services through the state health department clinics from 1995 to 1998. We selected 60 cases with high-grade cervical/SIL (HSIL) and 316 with low-grade cervical/SIL (LSIL) and controls (427 women with normal cervical cytology) and analyzed cervical DNA for HR-HPV, using Hybrid Capture I (Digene; Gaithersburg, MD).When assessing ever use, duration, recency, latency, and age at first use, neither oral …

Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing Programs In Dar Es Salaam, Tanzania, Suzanne Maman, Jessie K. Mbwambo, Margaret Hogan, Gad P. Kilonzo, Michael D. Sweat, Ellen Weiss

HIV and AIDS

This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Men and women both perceive HIV testing as a way to plan for the future but are motivated to undergo testing by a number of different individual, relationship, and environmental factors. The women in our study described more barriers to HIV testing than did men, and women who have communicated with their partners about VCT before seeking services are significantly more likely to share their HIV test results than those who have not talked with their …

The Case For Microbicides: A Global Priority, Kathy Attawell

HIV and AIDS

The HIV/AIDS epidemic continues to spread, undermining development, reversing health gains, and exacerbating poverty. It will be some time before a vaccine is available and accessible, thus there is an urgent need to identify additional prevention options, in particular a method that women control, which could save millions of lives. This report from the Population Council and International Family Health presents the case for microbicides—products used vaginally to prevent infection from HIV and other STIs in women and their sexual partners—and discusses recent progress and developments, outstanding challenges, and the action required to ensure that products will be made available …

Making A Difference For Children Affected By Aids: Baseline Findings From Operations Research In Uganda, Laelia Gilborn, Rebecca Nyonyintono, Robert Kabumbuli, Gabriel Jagwe-Wadda

HIV and AIDS

Many organizations and programs have begun to provide services and support to AIDS-orphaned children in East and southern Africa. Typical program components include the provision of school fees and supplies, supplementary feeding, home-visiting programs in which community members visit and assist affected children, and vocational training. However, few of these programs have been formally evaluated for impact. This paper reports on baseline findings from a study of two programs for AIDS-affected children and their families implemented by PLAN International in the Luwero and Tororo districts of Uganda. One program, referred to as orphan support, provides educational, health, and nutritional assistance …

Setting Limits: Medical Technology And The Law, George P. Smith Ii

Scholarly Articles

The allocation and rationing of health care resources is, no doubt, one of the most pressing issues confronting contemporary society. These issues considered from a micro and a macro level of economic analysis are linked inextricably to utilitarianism which, in turn, relies upon a cost-benefit analysis which balances reasonable individual needs against the availability of medical resources within the larger community. From an ethical viewpoint, the cost-benefit approach to the distribution of health care resources is impractical because it seeks to reduce (or convert) all health benefits to dollar amounts, thereby seeking very awkwardly to convert quality of life benefits …

Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah

Reproductive Health

With the reform movement in Indonesia, the FRONTIERS project recognized the new opportunities for influencing public debate and informing public opinion on reproductive health issues and undertook a project for disseminating the results of contemporary research on reproductive health. The project had three main objectives: 1) to increase print media coverage of critical reproductive health issues by enhancing journalists’ role as responsible communication agents; 2) to contribute to public debate on emerging reproductive health issues in order to influence policy development and guide program management; and 3) to increase public awareness of key health issues, with a particular focus on …

Women, Communities, And The Prevention Of Mother-To-Child Transmission Of Hiv: Issues And Findings From Community Research In Botswana And Zambia, Laura Nyblade, Mary Lyn Field-Nguer

HIV and AIDS

This paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about the barriers to using voluntary counseling and testing services; the stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission of HIV. A separate Population Council publication (“Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations”) offers recommendations for community involvement strategies that will encourage program planners to …

Comment Promouvoir L'Utilisation Des Résultats D'Une Analyse Situationnelle À L'Échelle Nationale: Expérience Du Sénégal, Adama Ndoye, Bineta M'Bow, Cheikh Bamba Diop, Mady Cisse, Macoumba Thiam, Diouratie Sanogo, Mbacke Niang

Reproductive Health

Avec cette dissémination des résultats de l’Analyse Situationnelle (AS) de 1998 le Ministère de la Santé réalise la troisième activité de ce genre. Au sortir de la dissémination, plusieurs enseignements sont tirés: Une bonne préparation de l’activité est nécessaire et, dans ce sens, la place de l’atelier de planification et l’établissement concerté d’un calendrier des activités par les niveaux national et régional sont prépondérants. L’organisation pratique des ateliers de dissémination doit compter avec l’utilisation des professionnels de la santé des régions et des médias locaux. Cette initiative a permis de crédibiliser les résultats ce qui a favorisé leur appropriation par …

Communication Skills Of Autistic Malaysian Children Undergoing The Aba Programme, Chithra K. M. Krishnan Adiyodi

Student Works (2000-2009)

The aim of this research was to diagnose the communication ability of a group of ten children with autism who were undergoing the Applied Behaviour Analysis programme at a NASOM Autistic Educational Centre in Klang. The research also set out to show that these children were able to use in their daily life the skills that they have learnt in the programme. The ability of these children to communicate before and after the intervention was noted by using a Behavioural Language Assessment Form. through interviews with teachers and in the observations of the researcher. It was found that some communication …

Trends In Indian Health 1998-99, Division Of Program Statistics, Staff Office Of Planning, Evaluation And Research, Indian Health Service.

Native Health Database Full Text

The IHS Trends in Indian Health attempts to fulfill the basic statistical information requirements of parties that are interested in the IHS. The tables and charts contained in the IHS Trends in Indian Health describe the IHS program and the health status of American Indians and Alaska Natives residing in the IHS service area.

Client Preferences And Acceptability For Medical Abortion And Mva As Early Pregnancy Termination Method In Northwest Ethiopia, Mulatu A. Woldetsadik, Tegbar Y. Sendekie, Mary T. White, Desaleng T. Zegeye

Population and Public Health Sciences Faculty Publications

Background

Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. Medical abortion for termination of early abortion is said to safe, effective, and acceptable to women in several countries. In Ethiopia, however, medical methods have, until recently, never been used. For this reason it is important to assess women's preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services.

Methods

A prospective …

Massachusetts Adult Tobacco Survey: Tobacco Use And Attitudes After Seven Years Of The Massachusetts Tobacco Control Program, Technical Report & Tables 1993 — 2000, Lois Biener, Amy Nyman, Anthony M. Roman, Catherine A. Flynn, Alison B. Albers

Center for Survey Research Publications

The Massachusetts Tobacco Control Program was launched in October of 1993. At that time, the Center for Survey Research conducted the Massachusetts Tobacco Survey (MTS), a comprehensive survey of adults and teens living in Massachusetts. The purpose of the survey was to collect baseline data on the prevalence of tobacco use among adults and teens in the Commonwealth and on issues related to the likelihood of smoking cessation or initiation. The survey also assessed the prevalence of restrictive smoking policies, and attitudes about tobacco control measures. The baseline data serve as a standard against which the impact of various programs …

September 11th And Beyond: What Is The Role For Public Health?, Susan J. Koch

International Journal of Global Health

As Maureen McCue so aptly describes in this second issue of the International Journal of Global Health, public health professionals can and often do play a crucial role in responding to natural disasters like Hurricane Mitch. But with the world still shuddering from the events on September 11th when over 5,000 people were killed in terrorist attacks on the World Trade Center and the Pentagon, public health professionals and those who educate them are now also compelled to examine and expand their roles in responding to a new global threat - now evident to all.

Environmental Health Research And Student Training Project, Transylvania, Romania, Catherine Zeman, Diane Depken

International Journal of Global Health

Nitrate/nitrite impacts human health through a number of mechanisms via involvement in potentially detrimental biochemical processes. In the acute sense, nitrite interacts with the iron components of the hemoglobin molecule, the functional, biochemical unit of the red blood cell responsible for carrying oxygen throughout the body. These iron components are essential for the normal bonding of the hemoglobin molecule with oxygen and when chemically altered, result in a form of hemoglobin known as methemoglobin. When somewhere between 3-15% of the hemoglobin in the blood is reduced to methemoglobin an individual is said to have methemoglobinemia due to the low oxygen …

Letter Of Welcome, Susan Koch

International Journal of Global Health

As Associate Vice President of Academic Affairs at the University of Northern Iowa and co-founder of the UNI Global Health Corps, it is a great pleasure for me to take this opportunity to both reflect back on the founding of our organization here at the University of Northern Iowa and to look toward the future, as the Global Health Corps continues to grow and have an important impact, not only on UNI students and faculty, but also as a model for developing globally oriented programs in higher education everywhere.

From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan

Poverty, Gender, and Youth

With access to safe, legal abortion under severe constraint or debate in many parts of the world, less attention has been paid to the issue of quality of abortion care. This issue of Quality/Calidad/Qualité explores two programs that operate in very different settings but with a shared commitment to providing high-quality abortion care in a context of broader reproductive health services: the Clinique d’Orthogénie of Broussais Hospital in France and Parivar Seva Sanstha in India. In both programs, each woman or girl who arrives for abortion receives crucial basic care, including: appropriate medical treatment to ensure complete abortion and safe …

Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

La Organización Mundial de la Salud ha estipulado que la detección y tratamiento de sífilis para todas las mujeres embarazadas resulta eficaz en función de los costos si al menos el 0.1 por ciento de ellas están infectadas. Para atender el problema de la alta tasa de sífilis entre mujeres embarazadas (6.5–7.3%), el Concejo de la Ciudad de Nairobi (CCN) introdujo en 1989 la detección y tratamiento de sífilis materna en sus clínicas de atención prenatal. Sin embargo, su enfoque centralizado—que requiere llevar las muestras de sangre recolectadas a un laboratorio central para hacer la prueba—era ineficiente. Por lo tanto, …

Influencing Reproductive Health Policy And Programs In The Philippines: Implementing An Advocacy Model For Utilization Of Operations Research, Saniata Masulit, Marilou P. Costello, Sahar Hegazi

Reproductive Health

This project tested a model of operations research (OR) dissemination and utilization targeting program managers in Mindanao, the second largest island of the Philippines. The model combines capacity-building with the use of innovative advocacy approaches to disseminate OR results, by creating a network of policy champions who will advocate the use of OR findings through a variety of strategies after they have been provided with information on the advocacy issue and their presentation skills enhanced. The project demonstrated that this type of network could lead to significant program changes, but also revealed that there is no single strategy or approach …

Indonesia: Train Journalists To Write About Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

After government control over the media was liberalized in 1998, Indonesian journalists had a new mandate to explore new issues and foster public debate. Several studies had found evidence that women’s health worsened from 1997–99, yet media coverage of this topic was limited. To increase press coverage of reproductive health (RH) topics, the Population Council conducted an 18-month media project in collaboration with the State Ministry for Women’s Empowerment and other key agencies. The project focused on improving RH knowledge and reporting skills among 22 print journalists. Project staff monitored RH coverage in 22 major newspapers, magazines, and tabloids. After …

Household Size And Composition In The Developing World, John Bongaarts

Poverty, Gender, and Youth

This study uses data from recent household surveys in 43 developing countries to describe the main dimensions of household size and composition in the developing world. Average household size varies only modestly among regions, ranging from 5.6 in the Near East/North Africa to 4.8 in Latin America. These averages are similar to levels observed in the second half of the nineteenth century in Europe and North America. About four out of five members of the household are part of the nuclear family of the head of the household. Household size is found to be positively associated with the level of …

Household Size And Composition In The Developing World [Arabic], John Bongaarts

Poverty, Gender, and Youth

This study uses data from recent household surveys in 43 developing countries to describe the main dimensions of household size and composition in the developing world. Average household size varies only modestly among regions, ranging from 5.6 in the Near East/North Africa to 4.8 in Latin America. These averages are similar to levels observed in the second half of the nineteenth century in Europe and North America. About four out of five members of the household are part of the nuclear family of the head of the household. Household size is found to be positively associated with the level of …

Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque

Poverty, Gender, and Youth

The principal aim of this study is to assess the strength in Pakistan of a set of hypothesized obstacles to practicing contraception. Our concern is those factors that prevent women from translating a desire to avoid becoming pregnant into contraceptive practice, a common predicament in Pakistan in recent decades. We analyze survey data collected in Punjab province in 1996 that contain unusually detailed measurement of various perceived costs of practicing contraception, as well as focused measurement of fertility motivation. The framework guiding the research specifies six major obstacles to contraceptive use: the strength of motivation to avoid pregnancy, awareness and …

Whose Education Counts? The Impact Of Grown Children's Education On The Physical Functioning Of Their Parents In Taiwan, Zachary Zimmer, Albert I. Hermalin, Hui-Sheng Lin

Poverty, Gender, and Youth

Research has identified education as an important predictor of physical functioning in old age. Older adults in Taiwan tend to experience close ties to family members and high rates of adult child coresidence, much more so than is typical in Western cultures. These circumstances might imply additional health-related benefits stemming from the education of grown children. This association could arise in a number of ways, for instance through the sharing of health-related information between child and parent, the quality of caregiving efforts, monetary assistance for medical and other services, or through other psychosocial avenues. In this study, a nationally representative …

Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur

Poverty, Gender, and Youth

For three decades, the Expanded Programme on Immunization (EPI) has been promoted as one of the key child health interventions in developing countries. Vaccines for six childhood diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, and tuberculosis) have been shown to be efficacious in preventing disease-specific morbidity and mortality, yet not all commentators are convinced that the EPI reduces all-cause child mortality. Numerous studies have found that measles vaccination programs substantially reduce all-cause child mortality, but recent findings from Guinea-Bissau suggest that diphtheria, pertussis, and tetanus (DPT) vaccine may increase all-cause child mortality. The present study uses five years of data from …

Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer

Poverty, Gender, and Youth

Using data from Demographic and Health Surveys, this study examines living arrangements of older adults in 43 developing countries and compares patterns by gender, world regions, and macro-level measures of socioeconomic development. Indicators include household size, headship, relationship to head, and coresidence with spouse, children, and others. Unweighted regional averages and OLS regressions determine whether variations exist. Average household sizes are large, but a substantially higher proportion of elderly adults live alone than do individuals in other age groups. Females are more likely than males to live alone and are less likely to live with a spouse or to head …

The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar

Poverty, Gender, and Youth

This paper assesses whether audio computer-assisted self-interviewing (audio-CASI), a technique designed in the United States to collect data on sensitive behaviors, is a feasible method of survey data collection in a developing-country setting and whether it produces more valid reporting of sexual activity and related behaviors than traditional survey methods. The analysis is based on interviews with nearly 4,400 unmarried adolescents aged 15-21 in Nyeri, a rural district of Kenya that was selected because previous research had indicated a wide discrepancy in the reporting of premarital sexual behavior between boys and girls. The study was based on a quasi-experimental design …