Medicine and Health Sciences Commons^™

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

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

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

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 …

Out Of Africa: Origins Of The Taenia Tapeworms In Humans, Eric P. Hoberg, Nancy L. Alkire, Alan De Queiroz, Arlene Jones

Harold W. Manter Laboratory of Parasitology: Faculty and Staff Publications

Phylogenetic and divergence date analyses indicate that the occurrence of Taenia tapeworms in humans pre-dates the development of agriculture, animal husbandry and domestication of cattle (Bos spp.) or swine (Sus scrofa) Taeniid tapeworms in Africa twice independently colonized hominids and the genus Homo prior to the origin of modern humans. Dietary and behavioural shifts, from herbivory to scavenging and carnivory, as early Homo entered the carnivore guild in the Pliocene/Pleistocene, were drivers for host switching by tapeworms to hominids from carnivores including hyaenids and felids. Parasitological data provide a unique means of elucidating the historical ecology, foraging behavior …

The Unequal Cancer Burden: Efforts Of The Centers For Disease Control And Prevention To Bridge The Gap Through Public Health, Nancy C. Lee

Public Health Resources

Despite the broad advances made in cancer research and interventions in the last quarter of a century, inequality still persists as we confront challenges arising from the unequal burden of cancer among Americans. Some racial and ethnic minorities, people with low incomes, those in rural areas, and other medically underserved populations suffer disproportionately from cancer. We know, for example, that African Americans are about 34% more likely to die of cancer than whites and more than two times more likely to die of cancer than Asian/Pacific Islanders, American Indians, or Hispanics.

Disparities also exist among the major racial and ethnic …

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

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

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

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

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

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

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

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

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

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 …

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, …

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 …

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 …

Extending Operations Research To Social Marketing Programs, Teresa De Vargas

Reproductive Health

CEMOPLAF of Quito, Ecuador sells reproductive health products to pharmacies and other outlets to contribute to its sustainability. However, the nonprofit agency lacked basic information regarding the program’s profitability, niche, and quality. Operations research was conducted to provide this information, including a financial analysis of the marketing program and two market research studies. Each study included a capacity-building component so that CEMOPLAF could conduct similar research in the future without technical assistance. A regional conference attended by nongovernmental organizations provided an opportunity to share sustainability tools and lessons learned.

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 …

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 …

Book Review. Gostin On Public Health Law, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

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 …

What Is Diabetes? Are You At Risk?, Laura Prestwich

All Current Publications

No abstract provided.

Healthy Lifestyle - Eating For You, Laura Prestwich

All Current Publications

No abstract provided.

Be In Control - Living With Diabetes, Laura Prestwich

All Current Publications

No abstract provided.

How To Get The Calcium You Need, Unknown Unknown

All Current Publications

No abstract provided.