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Articles 31 - 60 of 66
Full-Text Articles in Medicine and Health Sciences
Household Size And Composition In The Developing World [Arabic], John Bongaarts
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 …
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
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 …
Poverty And Public Services In Developing-Country Cities, Paul C. Hewett, Mark R. Montgomery
Poverty And Public Services In Developing-Country Cities, Paul C. Hewett, Mark R. Montgomery
Poverty, Gender, and Youth
This paper examines the availability of basic public services such as water supply and sanitation in the cities and towns of developing countries, using data drawn from the Demographic and Health Surveys. Inadequate provision of public services can compromise health, hinder economic growth, and stymie efforts to reduce poverty. We find that wide rural-urban gaps remain in service delivery, and that smaller cities-where about half of urban residents live-are notably under-served by comparison with larger cities.
Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow
Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow
Poverty, Gender, and Youth
This edition of Quality/Calidad/Qualité discusses the Manuela Ramos Movement and its efforts to improve women’s health and well-being through a range of empowerment strategies in rural Peru. A joint project with USAID, named Reprosalud, demonstrates how combining the resources of an international donor with local women’s organizations allows a more organic and multifaceted family planning program to develop. Such programs can produce impressive improvements on a number of indicators, including contraceptive use.
Household Size And Composition In The Developing World, John Bongaarts
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 …
The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar
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 …
Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health
Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health
Reproductive Health
To support the Government of Ghana’s plan to expand community-based distribution (CBD) programs, the Planned Parenthood Association of Ghana (PPAG) and the Population Council conducted a study in 1999 of the CBD programs of 13 nongovernmental agencies. The study also assessed in depth PPAG’s CBD program, which is the country’s largest and oldest. Data sources included interviews with 301 CBD agents, 27 supervisors, and 20 clinicians in rural and urban areas in 16 districts; observations of 51 PPAG agents interacting with 6 clients each; and 15 focus group discussions with community members, former CBD agents, and CBD clients. CBD programs …
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Reproductive Health
Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …
Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Dale Huntington, Mary Philip Sebastian, Nirmala Sevlam, Barbara Mensch, Sahar Hegazi
Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Dale Huntington, Mary Philip Sebastian, Nirmala Sevlam, Barbara Mensch, Sahar Hegazi
Reproductive Health
The Population Council's Frontiers in Reproductive Health Program and the Policy and Research Division are collaborating with CARE India to conduct an operations research study to examine the feasibility and impact of adding livelihood counseling and training, savings activities, and follow-up support to the ongoing reproductive health program for adolescents. The short-term objective is to foster the development of alternative socialization processes for adolescent girls that encourage positive sexual and reproductive health behaviors. As noted in this project update, the study will produce a replicable model for CARE India and other agencies to use in adding livelihood activities to adolescent …
Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health
Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health
Reproductive Health
The Kenya Adolescent Reproductive Health Project (KARHP) was launched in October 1999 in Busia and Vihiga districts as a three-year operations research study to determine the feasibility, cost, and effectiveness of implementing systematic interventions that address the reproductive health (RH) needs of adolescents aged 10–19 years. This USAID-funded project is part of the Population Council’s Frontiers in Reproductive Health Program’s global operations research. PATH (Program for Appropriate Technology in Health) is implementing the project, in collaboration with the Ministries of Health, Education, and Home Affairs, Heritage, and Sports. The objective of the study is to establish the effectiveness of interventions …
Zambia: Peer Educators Can Promote Safer Sex Behaviors, Frontiers In Reproductive Health
Zambia: Peer Educators Can Promote Safer Sex Behaviors, Frontiers In Reproductive Health
Reproductive Health
Zambian adolescents are at high risk of unwanted pregnancy, sexually transmitted infections (STIs), and HIV infection due to early sexual initiation, low use of contraceptives and condoms, and other high-risk sexual behaviors. During 1996–1998, CARE Zambia and the Population Council conducted a study to test community-based approaches to improve adolescent sexual and reproductive health. CARE Zambia talked to adolescents in four communities outside Lusaka. Using participatory learning and action techniques, researchers identified factors leading to high-risk sexual behaviors, including lack of economic, recreational, and educational opportunities for youth. This information helped to design the study. Two interventions—condom distribution by peer …
Zambia: Los Educadores Juveniles Pueden Promover Comportamientos Sexuales Más Seguros, Frontiers In Reproductive Health
Zambia: Los Educadores Juveniles Pueden Promover Comportamientos Sexuales Más Seguros, Frontiers In Reproductive Health
Reproductive Health
Los adolescentes de Zambia corren un alto riesgo de embarazos no deseados, infecciones de transmisión sexual (ITS) e infección por el VIH debido a la iniciación sexual temprana, el bajo uso de anticonceptivos y condones, y otros comportamientos sexuales de alto riesgo. Durante 1996–98, CARE Zambia, con el apoyo del Population Council, realizó un estudio para probar estrategias comunitarias para mejorar la salud sexual y reproductiva de los adolescentes. CARE Zambia habló con los adolescentes de cuatro comunidades ubicadas fuera de Lusaka. Los investigadores identificaron, mediante técnicas de aprendizaje y acción participativos, un gran número de factores que producen comportamientos …
From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan
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 …
Interventions To Reduce Hiv/Aids Stigma: What Have We Learned?, Lisanne Brown, Lea Trujillo, Kate Macintyre
Interventions To Reduce Hiv/Aids Stigma: What Have We Learned?, Lisanne Brown, Lea Trujillo, Kate Macintyre
HIV and AIDS
Stigma is a common human reaction to disease. Throughout history many diseases have carried considerable stigma, including leprosy, tuberculosis, cancer, mental illness, and many sexually transmitted diseases. HIV/AIDS is only the latest disease to be stigmatized. This paper reviews 21 interventions that have explicitly attempted to decrease AIDS stigma both in the developed and developing countries and 9 studies that aim to decrease stigma related with other diseases. The studies selected met stringent evaluation criteria in order to draw common lessons for future development of interventions to combat stigma. This paper assesses published and reported studies through comparison of audiences, …
Making A Difference For Children Affected By Aids: Baseline Findings From Operations Research In Uganda, Laelia Gilborn, Rebecca Nyonyintono, Robert Kabumbuli, Gabriel Jagwe-Wadda
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 …
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
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 …
Hiv Voluntary Counseling And Testing Among Youth Ages 14 To 21: Results From An Exploratory Study In Nairobi, Kenya, And Kampala And Masaka, Uganda, Horizons Program, Kenya Project Partners, Uganda Project Partners
Hiv Voluntary Counseling And Testing Among Youth Ages 14 To 21: Results From An Exploratory Study In Nairobi, Kenya, And Kampala And Masaka, Uganda, Horizons Program, Kenya Project Partners, Uganda Project Partners
HIV and AIDS
HIV voluntary counseling and testing (VCT) programs increase safe sexual behavior and use of care and support services among adults. By helping clients learn their HIV serostatus and creating a personalized HIV risk-reduction plan, VCT can provide the information and support necessary to change risky behaviors that could lead to HIV infection or transmission. Counseling and a risk-reduction plan are the key features distinguishing VCT from other HIV testing services. VCT has become a widely advocated HIV/AIDS prevention strategy among adults. Sixty percent of all new HIV infections in sub-Saharan Africa, however, occur among young people ages 10–24. Because few …
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
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 …
Transitions To Adulthood In The Context Of Aids In South Africa: Report Of Wave I, Naomi Rutenberg, Cathrien Kehus-Alons, Lisanne Brown, Kate Macintyre, Anthea Dallimore, Carol E. Kaufman
Transitions To Adulthood In The Context Of Aids In South Africa: Report Of Wave I, Naomi Rutenberg, Cathrien Kehus-Alons, Lisanne Brown, Kate Macintyre, Anthea Dallimore, Carol E. Kaufman
HIV and AIDS
This is a prospective study of reproductive behavior and sexual health of adolescents in South Africa as well as their education and employment experiences, family and environmental conditions, and other factors in their lives that may influence their sexual behavior and choices. This report is designed to inform educators, policymakers, and the public in South Africa and beyond of the initial findings of the study, with the ultimate goal of helping to design and refine policies and programs that will improve opportunities and capacities of adolescents and may contribute to changing behaviors and choices. The report focuses on describing the …
Prevention Of Trafficking And The Care And Support Of Trafficked Persons In The Context Of An Emerging Hiv/Aids Epidemic In Nepal, Celine Daly
HIV and AIDS
This study is a collaborative effort between the Asia Foundation (Kathmandu) and the Horizons project of the Population Council (New Delhi) to document the current intervention models and community-based study of human trafficking in the context of an emerging HIV/AIDS epidemic in Nepal. To address the human rights component of trafficking, the three components of this study focus on the rights and needs of trafficked persons as well as those who are vulnerable to trafficking. An analysis and assessment of the effectiveness of laws, policies, and interventions in the apprehension, prosecution, and conviction of alleged traffickers is not included in …
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 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
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 …
Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health
Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health
Reproductive Health
El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …
Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon
Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon
Reproductive Health
Using the results of a previous operations research study, the Ministry of Health of Honduras recently changed the National Women’s Health Service Delivery Guidelines to explicitly authorize nurse auxiliaries to insert IUDs, deliver Depo-Provera, and take Pap smears. These services are new to the rural communities served by rural health centers (RHCs). The objective of this project was to test whether the demand for these newly introduced services would increase if a promotional brochure was distributed in the surrounding communities by the RHC’s clients among potentially interested friends in these communities. The study found that the intervention that was tested …
Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar
Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar
Reproductive Health
The Honduran Ministry of Health (MOH) and the Population Council’s INOPAL III Project tested the acceptability of postpartum/postabortion contraception at the Escuela Hospital, the largest in the country. The project showed that more than 30 percent of the women seen for a delivery or a complication due to abortion, were interested in adopting a contraceptive method prior to discharge from the hospital. Given the success of the project, the MOH asked the Population Council’s FRONTIERS program for technical and financial support to extend those services to five additional hospitals in the country. Important improvements were found for the four indicators …
Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur
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 …
Operations Research In Reproductive Health And Family Planning At The Cairo Demographic Center, Magdi A. Ibrahim, James R. Foreit, M.E. Khan
Operations Research In Reproductive Health And Family Planning At The Cairo Demographic Center, Magdi A. Ibrahim, James R. Foreit, M.E. Khan
Reproductive Health
This report evaluates the effectiveness of a two-year training program at the Cairo Demographic Center to increase the number of researchers using operations research (OR), and to help institutionalize the ability of the Center to offer training in operations research in reproductive health. It also provides feedback for OR curriculum development. The project trained researchers with program and policymaking responsibilities and provided participants with the experience of designing an OR project, and built participants’ skills in communicating research results to managers. Participant evaluations showed that, overall, the course met its objectives. The training that the students received in OR has …
Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health
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, …
Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health
Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health
Reproductive Health
En 1999, la Secretaría de Salud de Honduras (SSH) modificó las Normas de Atención Integral a la Mujer a fin de autorizar a las auxiliares de enfermería a prestar los servicios de inserción de DIU, aplicación del inyectable DMPA y toma de Papanicolaou. Este cambio en las normas aborda el problema de la baja prevalencia en el uso de anticonceptivos en áreas rurales. El cambio también refleja los hallazgos de un estudio anterior, realizado por el Population Council, que mostró que las auxiliares de enfermería pueden proporcionar estos servicios de manera segura y con buena calidad. Anteriormente, las mujeres en …
An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku
An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku
Reproductive Health
Maendeleo Ya Wanawake (MYWO), with technical assistance from the Program for Appropriate Technology in Health (PATH), has been implementing an Alternative Rite of passage programme as part of its efforts to eradicate the practice of female genital mutilation (FGM) in five districts in Kenya. This study addressed the factors that influence some families and individuals to adopt the Alternative Rite while others, exposed to the same messages discouraging FGM, decide not to. It also evaluated the effect of the training component of the Alternative Rite on the girls who participated.