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Full-Text Articles in Medicine and Health Sciences
An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed
An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed
Reproductive Health
The Egyptian Ministry of Health and Population and FRONTIERS discussed the need for investigating service delivery aspects of the Egyptian NORPLANT® program. This study emerged from those consultations. The study provides a comprehensive assessment of the program: how services are administered and used through the ongoing Introduction Program as it approaches five years of operation. The report lists major findings with program implications and offers recommendations regarding quality of care; tracking and locating NORPLANT® users; program sustainability; and information, education, and communication strategies.
An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu
An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu
Reproductive Health
Within South Africa there is much interest in expanding youth center programs, particularly in the nongovernmental sector, in part because of recognition that the HIV/AIDS crisis is disproportionately affecting young South Africans. This study was designed to give implementing agencies and donors a broad view of how the youth centers function, who they reach, and the quality of information and services. The assessment underscored the importance of monitoring the performance of programs and understanding who is being reached with what interventions. Youth centers that focus on providing recreational facilities attract a large number of clients, often boys who are repeat …
Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade
Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade
HIV and AIDS
Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. …
Hiv And Partner Violence: What Are The Implications For Voluntary Counseling And Testing?, Carolyn Knapp
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 …
A Case Study Of Nairobi City Council's Decentralised Syphilis Screening Programme In Antenatal Clinics, Baker Ndugga Maggwa, Ian Askew, Elizabeth Mugwe, Bilhah Hagembe, Rick Homan
A Case Study Of Nairobi City Council's Decentralised Syphilis Screening Programme In Antenatal Clinics, Baker Ndugga Maggwa, Ian Askew, Elizabeth Mugwe, Bilhah Hagembe, Rick Homan
Reproductive Health
It has long been known that syphilis is one of the more serious sexually transmitted infections (STI), especially during pregnancy when, if untreated, at least 60 percent of infected women will experience an adverse pregnancy outcome. There has been renewed interest in its control and prevention because of its proven link with HIV transmission. In 1992, the Nairobi City Council (NCC) pilot-tested a decentralized approach to syphilis screening and management in a sample of their antenatal clinics. A case study was carried out to assess the effectiveness, readiness, and cost effectiveness of the NCC’s antenatal care program, with a focus …
Ecuador: Use Commercial Marketing To Increase Sustainability, Frontiers In Reproductive Health
Ecuador: Use Commercial Marketing To Increase Sustainability, Frontiers In Reproductive Health
Reproductive Health
Many nongovernmental organizations sell contraceptives through retail outlets to generate income and expand access to these products. In 1998 Centro Médico de Orientación y Planifación Familiar (CEMOPLAF) employed 25 sales agents in 14 cities throughout Ecuador. These agents sold products, including contraceptive methods and home pregnancy tests, to pharmacies, physicians, other distributors, and nontraditional outlets. Contraceptive sales were CEMOPLAF’s largest source of revenue in 1997. Sales had grown rapidly during 1996–97, but CEMOPLAF managers did not know whether product sales were profitable. With support from the Population Council and Family Health International, CEMOPLAF made a detailed analysis of product sales …
Indonesia: Train Journalists To Write About Reproductive Health, Frontiers In Reproductive Health
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 …
Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi
Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi
Reproductive Health
The Special Studies Program was implemented as part of the Pilot Health Project in the West Bank and Gaza to provide small grants to Palestinian researchers, research organizations, and advanced graduate students to conduct research that examines critical reproductive health topics related to maternal and child health care, including family planning. The research implemented under the Special Studies Program covered a range of topics including male involvement in reproductive health, clients' satisfaction with family planning programs, the relationship between early marriage and the delivery of premature infants, factors affecting compliance for iron supplementation, and diabetes mellitus during pregnancy. The research …
An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz
An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz
Reproductive Health
Since its inception, the Zimbabwe National Family Planning Council’s (ZNFPC) community-based distribution (CBD) program has made significant and well-documented contributions to the demand for and use of family planning in Zimbabwe. Data from several studies have shown, however, a steady decline in this contribution and that the CBD agents spend more time resupplying existing clients than recruiting new acceptors. Moreover, the CBD program urgently needs to be able to address the AIDS crisis in the country. ZNFPC has undertaken this review to guide it in making appropriate decisions about the future direction of the program, allowing CBDs to have a …
Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque
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 …
Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed
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 …
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
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 …
Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya
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 …
Ecological Degradation, Rural Poverty, And Migration In Ethiopia: A Contextual Analysis, Markos Ezra
Ecological Degradation, Rural Poverty, And Migration In Ethiopia: A Contextual Analysis, Markos Ezra
Poverty, Gender, and Youth
The interrelationships between ecological degradation, poverty, and rural out-migration in Ethiopia are examined using data from a Household and Community Survey conducted in 1994-95. The survey, which covered a sample of 2,000 households, collected retrospective data on changes in household composition, including migration of household members, during the period 1984 to 1994. The study hypothesizes that the decision to out-migrate in the impoverished rural areas of northern Ethiopia is influenced by a combination of factors based on individual, household and community characteristics. A multilevel analysis is applied to determine the role of these factors in the decision. The findings show …
Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett
Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett
Poverty, Gender, and Youth
There is accumulating evidence that social diffusion processes affect the pace of the adoption of modern contraception in societies undergoing fertility transition. In settings where mortality has declined and many other social and economic changes are underway, decisions about contraception are fraught with uncertainty and risk. In such circumstances, couples may rely on other persons for information and guidance. In this paper, we examine the influence of informal social networks on the contraceptive behavior of reproductive-age women, using longitudinal data collected in six communities in southern Ghana. Our results confirm the hypothesis that adoption of modern contraception is strongly affected …
The End Of The Fertility Transition In The Developed World, John Bongaarts
The End Of The Fertility Transition In The Developed World, John Bongaarts
Poverty, Gender, and Youth
By the late 1990s fertility in the developed world had declined to 1.6 births per woman, a level substantially lower than projected in the 1980s. This study examines recent trends and patterns in fertility in the developed world with particular emphasis on the effects and implications of changes in the timing of childbearing. The main objective is to demonstrate that while fertility in these countries is indeed low, women’s childbearing levels are not as low as period measures such as the total fertility rate suggest. To obtain a full understanding of the various dimensions of fertility change, several indicators are …
Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend
Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend
Reproductive Health
The International Conference on Population and Development in 1994 led to an upsurge in interest in implementing reproductive health (RH) programs worldwide. The urgency to act has led to the development of disparate activities in several developing countries including India. While programs have been growing in numbers, their quality is in question. A fundamental problem has been lack of capacity at all levels of the health service system to respond to the paradigm shift articulated by the advocates of the reproductive health and rights agenda. To redesign programs, considerable research must be undertaken to understand the health needs and sociocultural …
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
Reproductive Health
To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …
Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer
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 …
Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain
Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain
Reproductive Health
Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC …
Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah
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 …
Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health
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 …
Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health
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 …
South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health
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, …
South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health
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 …
Reproductive Tract Infections: A Guide For Programme Managers, Sarah Hawkes, Anjali Nayyar, Johannes Van Dam, Kevin R. O'Reilly, Bidia Deperthes, Dinesh Agarwal
Reproductive Tract Infections: A Guide For Programme Managers, Sarah Hawkes, Anjali Nayyar, Johannes Van Dam, Kevin R. O'Reilly, Bidia Deperthes, Dinesh Agarwal
Reproductive Health
Reproductive tract infections (RTIs) including sexually transmitted infections represent a silent worldwide pandemic that adversely impacts the reproductive health (RH) of women and men. Various community- and hospital-based studies in India have provided insights into the magnitude of the problem. The International Conference on Population and Development (1994) emphasized integration of RH services to meet the needs of men and women especially with prevention and management of RTIs/STIs. The emergence of HIV and the identification of STIs as a risk factor for the spread of HIV have further lent a sense of urgency for a programmatic response to address this …
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.
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 …