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Full-Text Articles in Medicine and Health Sciences

Prevention Of Trafficking And The Care And Support Of Trafficked Persons In The Context Of An Emerging Hiv/Aids Epidemic In Nepal, Celine Daly Jan 2001

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 …


The Case For Microbicides: A Global Priority, Kathy Attawell Jan 2001

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 Jan 2001

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 …


Acceptability Of The Female Condom After A Social Marketing Campaign In Campinas, Brazil, Horizons Program Jan 2001

Acceptability Of The Female Condom After A Social Marketing Campaign In Campinas, Brazil, Horizons Program

HIV and AIDS

The female condom is a relatively new product that is intended to serve the dual role of protecting against unwanted pregnancy and sexually transmitted infections (STIs). Recent research has found moderate to high levels of initial trial and acceptance of the female condom among women. However, information is lacking about its continued use, particularly among women at high risk of HIV and other STIs. The female condom was registered in Brazil in January 1997 and since then has been available commercially through DKT, a social marketing organization. In addition to socially marketed female condoms, the Brazilian Ministry of Health has …


Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah Jan 2001

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 …


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 Jan 2001

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 …


Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque Jan 2001

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 …


Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health Jan 2001

Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health

Reproductive Health

Aproximadamente la mitad de los partos en Honduras son atendidos en un hospital. Sin embargo, los hospitales generalmente no ofrecen servicios de planificación familiar a las pacientes en el posparto o el postaborto. En 1999, la Secretaría de Salud de Honduras (SSH) y el Population Council iniciaron un proyecto de dos años con el fin de ampliar el acceso a la consejería y a los servicios de planificación familiar después de un parto o de haber recibido tratamiento por un aborto incompleto. La intervención se realizó basándose en un proyecto previo del Population Council que mostró que el 30 por …


Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed Jan 2001

Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed

Reproductive Health

In September 1997, the Population Council and Lusaka’s University Teaching Hospital (UTH) launched a 15-month study to identify and explore the range of issues relating to the introduction of emergency contraception (EC) within a developing country context. The study allowed clinic-based family planning providers to accumulate enough first-hand experience to be able to identify strategies for overcoming difficulties associated with the introduction or delivery of EC services. One issue on most participants’ minds was the need to expand the delivery of EC services toward young women, especially out-of-school women, who are harder to reach. Participants recommended that future research activities …


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 Jan 2001

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 …


Poverty And Public Services In Developing-Country Cities, Paul C. Hewett, Mark R. Montgomery Jan 2001

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 Jan 2001

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 Jan 2001

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 …


Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur Jan 2001

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 …


Household Size And Composition In The Developing World [Arabic], John Bongaarts Jan 2001

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 …


The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar Jan 2001

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 …


Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya Jan 2001

Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya

Reproductive Health

Sexually transmitted infections (STIs), including HIV, currently have high salience on the health care agendas of many countries, including India. Strategies for their control are ideally based on a number of well-recognised principles. These include: assessments of the burden of disease; the availability of interventions at policy and programme levels, to influence behaviour change and technical ‘solutions’; and the calculated cost-effectiveness of these interventions. In the case of India, data to inform these principles are often lacking in the case of STI control. In this paper we have reviewed the evidence base for STI control in the Indian context. The …


Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health Jan 2001

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 Jan 2001

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 …


South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health Jan 2001

South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health

Reproductive Health

In 2000, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and 7 affiliated peer education programs. The 12 centers, located in urban, peri-urban, and rural areas, offer very different services. The two centers of the KwaZulu-Natal Department of Health focus on providing reproductive health (RH) information and services to adolescents. The six centers of the Youth and Adolescent Reproductive Health Project provide a broader range of youth-friendly RH services, including counseling and life skills education, as well as modest recreational activities. The four centers run by loveLife have large …


Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health Jan 2001

Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health

Reproductive Health

After initiating health sector reforms in 1994, the Bénin government established the Integrated Family Health Project, known as PROSAF. Funded by the U.S. Agency for International Development, PROSAF operates in the Borgou region, which is mostly rural and has the country’s most severe health problems. PROSAF managers wanted to understand why local people were not using health services, despite their poor health. As noted in this brief, managers requested that the African Population and Health Research Centre (APHRC) study the way households and communities make decisions on health care. In a study conducted in 2000 with support from the Population …


Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health Jan 2001

Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

In 1999, the Honduran Ministry of Health (MOH) revised national guidelines on women’s health services delivery to allow nurse auxiliaries to insert IUDs, give DMPA injections, and take Pap smears. This policy change addresses low contraceptive use among rural women and reflects findings from a 1998 Population Council study that showed that nurse auxiliaries can safely and successfully provide these services. Under the previous guidelines, rural women had limited access to long-term family planning methods. In 2000, the Population Council and the MOH assessed the effectiveness and cost of using a simple leaflet, distributed by nurse auxiliaries, to market the …


Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health Jan 2001

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 …


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 Jan 2001

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: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health Jan 2001

Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of …


Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health Jan 2001

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 …


South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health Jan 2001

South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health

Reproductive Health

To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, …


Zambia: Peer Educators Can Promote Safer Sex Behaviors, Frontiers In Reproductive Health Jan 2001

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 Jan 2001

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 …


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 Jan 2001

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 …