Medicine and Health Sciences Commons^™

Empowering Young Mothers In India: Results Of The First-Time Parents Project, K.G. Santhya, Nicole Haberland

Poverty, Gender, and Youth

In India, sexual activity among girls and young women typically takes place within marriage. Nationally, as many as 30 percent of adolescent girls aged 15–19 are married, presumably sexually active, and under pressure to bear a first child early in the marriage. While sexual activity for the majority of adolescent Indian girls occurs within the socially sanctioned institution of marriage, marital sex is not inherently safe, voluntary, or pleasurable. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 8 describes the Population Council’s efforts to support married adolescent girls. The Council, in partnership with the Child in Need Institute …

Assessing The Multiple Disadvantages Of Mayan Girls: The Effects Of Gender, Ethnicity, Poverty, And Residence On Education In Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz

Poverty, Gender, and Youth

Although access to primary education in Guatemala has increased in recent years, particularly in rural areas, rates of primary-school completion and literacy for young people remain among the lowest in Latin America, and problems such as late entry, grade repetition, and early dropout persist. Adult literacy is estimated to be 85 percent in Latin America as a whole, compared with 70 percent in Guatemala. Although indigenous peoples in Latin America generally have less schooling than nonindigenous peoples, ethnic differences are greatest in Guatemala, where indigenous (Mayan) adults have less than half the level of schooling of nonindigenous (Ladino) adults. Recent …

Influencing Girls’ Lives: Acceptability And Effectiveness Of A Livelihoods Skill Building Intervention In Gujarat, Shveta Kalyanwala

Poverty, Gender, and Youth

There are 66 million adolescent females aged 13–19 in India. Their lives are characterized by limited education, lack of economic and social opportunities, early marriage and childbearing, and limited influence on decisions affecting their lives. Although programs in India have aimed to empower adolescent girls, they have largely focused on enhancing life skills and awareness. Programs to address women’s social and economic disadvantages have focused exclusively on adult women. To respond to the absence of programs devoted specifically to the social and economic empowerment of adolescent girls and young women, the Population Council partnered with the Self-Employed Women’s Association (SEWA) …

Sexuality And Hiv Education: Time For A Paradigm Shift, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

For decades, curriculum-based sexuality education has been a cornerstone of school- and community-based efforts to improve young people’s sexual and reproductive health, and more recently to prevent HIV infection. Unfortunately, public discourse about sex education has been mired in polarizing debates that distract attention from determining how sex and HIV education programs might best achieve the shared goals of many different constituencies. A recent comprehensive review of the impact of school-based sexuality and HIV education programs in developed and developing countries found that two-thirds of the programs reduced the risk associated with one or more reported sexual behaviors. This finding …

Girls Left Behind: Redirecting Hiv Interventions Toward The Most Vulnerable, Judith Bruce

Poverty, Gender, and Youth

As we enter the third decade of the HIV pandemic in sub-Saharan Africa, young women—often adolescent girls—are the new face of the disease. In particular, HIV/AIDS is threatening those girls and young women with limited social and economic assets—those who are unable to avoid, manage, or leave unsafe sexual relationships inside and outside of marriage. Girls at risk of sexual exploitation are not a small minority; they are counted in the hundreds of millions. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 23 explores: structural determinants of risk, failure to reach the most vulnerable, moving ahead with the …

Obtaining More Accurate And Reliable Information From Adolescents Regarding Sti/Hiv Risk Behaviors, Barbara Mensch, Paul C. Hewett

Poverty, Gender, and Youth

To investigate the quality of self-reported data on sexual behavior, Population Council researchers conducted a study in a rural district of Malawi. They implemented a randomized experiment to assess whether audio computer-assisted self-interviewing (ACASI) produces more valid data on sexual behavior than face-to-face interviews. The Malawi study builds on an experiment conducted as part of a household-based survey of Kenyan adolescents. In Kenya and Malawi, there is clear evidence that mode of interviewing and probing of various sexual partnerships affect the reporting of sexual activity. According to Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 25, ACASI is …

Evaluación De Las Múltiples Desventajas De Las Niñas Mayas: Efectos Del Género, El Origen Étnico, La Pobreza Y El Lugar De Residencia Sobre La Educación En Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz

Poverty, Gender, and Youth

Aunque el acceso a la educación primaria en Guatemala se incrementó en los últimos años, especialmente en las áreas rurales, los índices de finalización de escuela primaria y de alfabetismo corespondeientes a personas jóvenes continúan estando entre los más bajos de Latinoamérica, y persisten otros problemas como el ingreso tardío, la repetición de cursos y el abandono temprano. Se estima que el índice de alfabetismo entre adultos es del 85 por ciento en Latinoamérica en general, comparado con sólo un 70 por ciento en Guatemala. Aunque los pueblos indígenas en Latinoamérica por lo general tienen menos escolaridad que los no …

Les Filles Sont Oubliées : Rediriger Les Interventions En Matière De Vih Vers Les Plus Vulnérables, Judith Bruce

Poverty, Gender, and Youth

Alors que nous entrons dans la troisième décennie de la pandémie de VIH en Afrique subsaharienne, les jeunes femmes, le plus souvent les adolescentes, sont le nouveau visage de la maladie. Le VIH/SIDA menace en particulier les jeunes femmes et les adolescentes qui se trouvent dans des situations sociaux-économiques peu favorables, celles qui ne peuvent éviter, gérer ni échapper à des relations sexuelles à risque au sein même du mariage or hors mariage. Les filles présentant un risque d'être exploitées sexuellement ne représentent pas une petite minorité; on peut les compter par centaines de millions. Promouvoir des transitions vers l'âge …

Las Niñas Rezagadas: Dirigir Las Intervenciones De Vih Hacia Las Más Vulnerables, Judith Bruce

Poverty, Gender, and Youth

Al ingresar en la tercera década de la pandemia del VIH en el África subsahariana, las mujeres jóvenes—a menudo adolescentes—conforman el nuevo rostro de la enfermedad. En especial, el VIH/SIDA amenaza a aquellas niñas y mujeres jóvenes con limitados posibilidades sociales y económicas; quienes que no pueden evitar, controlar o abandonar las relaciones sexuales inseguras, dentro y fuera del matrimonio. Las niñas que están en riesgo de ser explotatas sexualmente no constituyen una pequeña minoría; se calculan en cientos de millones. Promoción de transiciones a la vida adulta: Sanas, seguras y productivas N° 23 explora: los determinantes estructurales de riesgo, …

State Agency Promising Practices: Employment First! Making Integrated Employment The Preferred Outcome In Tennessee, Jean Winsor, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Tennessee Division of Mental Retardation Services (DMRS) implemented the Employment First! initiative in 2002. The goal of Employment First was to make employment the first day service option for adults receiving supports funded by DMRS, Medicaid, or the state. Employment First set the standard that employment was the preferred service option for adults with mental retardation and developmental disabilities (MR/DD).

State Agency Promising Practice: Shifting Resources Away From Sheltered Workshops In Vermont, Jennifer Sullivan Sulewski, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Over six years, regulations in Vermont gradually restricted and eventually prohibited the use of state funds for sheltered workshops or enclaves. Concurrent with the change in funding regulations, the state worked with providers to convert the remaining sheltered workshops in Vermont.

State Agency Promising Practice: Working Together To Convert The Last Sheltered Workshop In Vermont To Individualized Supports, Jennifer Sullivan Sulewski, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Vermont’s Division of Disability and Aging Services (DDAS) and Division of Vocational Rehabilitation (DVR) worked with a local service provider to convert its congregate day services to community employment. Implementation Between 1987 and 2002, DDAS and DVR worked with several providers to close down sheltered workshops and move people into community supports.

State Agency Promising Practice: Integrated Employment Outcomes Through Person-To-Person Technical Assistance: New Hampshire, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

New Hampshire implemented an innovative technical assistance model that promoted organizational change to expand individual employment opportunities. This person-to-person change began at the micro level but “trickled up” through organizations across the state. In 2000, realizing that the state’s growth in integrated employment had stalled, the Bureau of Developmental Services invested aggressively in expanding its intervention strategy by recruiting a community provider to work directly through the bureau. The bureau hired John Vance-the director of ACCESS, a small individualized support organization in New Hampshire-half-time to provide individualized technical assistance to providers across the state. As part of the bureau, Vance …

State Agency Promising Practices: Washington State’S Working-Age Adult Policy, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Washington’s Division of Developmental Disabilities (DDD) has recently issued a new policy which went into full effect on July 1, 2006. This policy “designates employment supports as the primary method of furnishing state-financed day services to adult participants.” Emphasizing community employment as the primary service option, the policy further states that: “services for persons under the age of 62 that do not emphasize the pursuit or maintenance of employment in integrated settings can be authorized only by exception to policy” (WA DHSH, DDD, “County Services for Working Age Adults” Policy 4.11). Initially adopted in 2004, this policy does not eliminate …

State Agency Promising Practice: The Tennessee Employment Consortium (Tec) - A Statewide Collaboration For Change, Jean Winsor, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Tennessee Employment Consortium (TEC) is a statewide organization focused on increasing the number of Tennesseans in integrated employment. The consortium comprises volunteers from the state’s Division of Mental Retardation Services (DMRS) and Division of Rehabilitation Services (DRS), the Tennessee Council on Developmental Disabilities, the ARC of Tennessee, the Center on Disability and Employment at the University of Tennessee, community rehabilitation providers (CRPs), family members, and other stakeholders. TEC’s ability to organize collaborative activities across state agencies, advocacy organizations, and CRPs has played an important role in increasing integrated employment outcomes.

Socioeconomic Position And Incident Mobility Impairment In The Cardiovascular Health Study, Cheryl K. Nordstrom, Ana V. Diez Roux, Richard Schulz, Mary N. Haan, Sharon A. Jackson, Jennifer L. Balfour

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

We investigated if personal socioeconomic position (SEP) factors and neighborhood characteristics were associated with incident mobility impairment in the elderly.

Methods

We used data from the Cardiovascular Health Study, a longitudinal, population-based examination of coronary heart disease and stroke among persons aged 65 and older in the United States.

Results

Among 3,684 persons without baseline mobility impairment, lower baseline SEP was associated with increased risk of incident mobility disability during the 10-year follow-up period, although the strengths of these associations varied by socioeconomic indicator and race/sex group.

Conclusion

Among independent-living elderly, SEP affected development of mobility impairment into …

Towards Messages That Matter: Understanding And Addressing Hiv And Srh Risks Among Married Young People In India, Armin Jamshedji-Neogi, Renu Kapoor, Jayashree Kumar, Ashwini Bhalerao Gandhi, Lakshmi Murthy, K.G. Santhya, Shireen J. Jejeebhoy, Saswata Ghosh, Vijaya Nidadavolu, Nicole Haberland, Komal Saxena, M.A. Jose

Poverty, Gender, and Youth

Although there is increasing interest in young people's sexual and reproductive health (SRH) situations and needs in India, married young people have received little attention as a vulnerable group with distinct needs because marriage is assumed to be safe and because married youth are assumed to face none of the stigma that their unmarried counterparts experience in accessing SRH services. However, emerging evidence shows that within this subpopulation, married young women and men constitute groups with distinct risks of HIV and other poor SRH outcomes. There remains a need to better understand their unique vulnerabilities and to design programs that …

Changing Transitions To Adulthood In Vietnam's Remote Northern Uplands: A Focus On Ethnic Minority Youth And Their Families, Bussarawan Teerawichitchainan, Hac Van Vinh, Nguyen Thi Phuong Lan

Poverty, Gender, and Youth

Ethnic minorities, who tend to live in remote mountainous areas, account for 15 percent of Vietnam’s 84 million total population and, according to a recent estimate, 61 percent of them are poor. Evidence suggests that despite recent efforts by the Government of Vietnam to promote poverty reduction in remote areas, a majority of ethnic minorities have not yet experienced positive change, contrary to their Kinh (ethnic Vietnamese) neighbors who have enjoyed substantial improvement in living standards. To identify program interventions that promote healthy human development and, in turn, positively affect Vietnam’s economic growth, it is crucial to have a comprehensive …

Hiv-Positive Inmates Released From Nevada’S Prisons In 2001: Results From Matching Health Division And Corrections’ Databases, Paul G. Devereux, Kristen Clements-Nolle, Sharon Clodfelter, Jessey Bargmann-Losche, Miguel Feroro, Wei Yang

Nevada Journal of Public Health

It is estimated that about one quarter of all HIV-infected individuals in the United States are released from a correctional facility each year. To better understand the needs of inmates with HIV exiting the prison system, a partnership with the Nevada State Health Division (NSHD), the Nevada Department of Corrections (DOC), and the University of Nevada, Reno School of Public Health was formed to examine this population using information contained in existing databases. An analysis of DOC data matched with the data from the HIV/AIDS Reporting System (HARS) maintained by the NSHD identified 2,802 HIV-negative inmates (2,451 males and 350 …

Unruly Corporeality: Aids, Immigration And The Imagined Australian Body, Zoë Anderson

Reconstruction: Studies in Contemporary Culture

Particular bodies within the Australian nation can be seen to threaten to disrupt and destabilize dominant notions of cultural citizenship. Understood through intricate intersections of ethnicity, gender and sexuality, 'Australianness' - and its correlation to the geographical nation - is constantly monitored. Crucial here is the manner in which boundaries of whiteness, and 'true Australianess', are reconstituted, fuelling avoidance of the ambiguities of national belonging and ensuring the enduring pathologisation of the 'un'Australian. In particular, discursive associations between HIV/AIDS and the 'foreign' as perceived contaminates to the nation operate to reinforce these understandings. Here, the threat of disease both informs, …

Theorizing Threat: An Investigation Of Contentious Embodiment, Jennifer Musial, Emily Van Der Meulen

Reconstruction: Studies in Contemporary Culture

[First paragraph]

In early summer 2006, we had a phone conversation that generated interest in this topic. Emily was reminiscing about her experiences at the Washington, D.C. March for Women's Lives in April of 2004. The March, a demonstration for reproductive justice, brought out feminists and anti-abortion protestors alike. Emily remembered seeing African-American men holding signs that equated abortion to the airplane attacks in New York City on September 11, 2001. This sparked curiosity: how does abortion become equated with "terrorism"? [1] One answer to this question is that a woman who has an abortion is said to commit "body-terrorism" …

Premarital Sex And Schooling Transitions In Four Sub-Saharan African Countries, Ann E. Biddlecom, Richard Gregory, Cynthia B. Lloyd, Barbara Mensch

Poverty, Gender, and Youth

Using data from the 2004 National Survey of Adolescents conducted in Burkina Faso, Ghana, Malawi, and Uganda, this Population Council working paper investigates the timing of two key transitions in adolescence—school exit and premarital sex—among those who remain enrolled in school at the beginning of adolescence (age 12). Girls appear more vulnerable to dropout once they become sexually mature and once they engage in premarital sex. While girls were found to be less likely than boys, at any given age and controlling for other covariates, to have had premarital sex (except in Ghana), school enrollment and the timing of school …

Casamento Infantil No Contexto Da Epidemia Do Vih, Judith Bruce

Poverty, Gender, and Youth

Da forma como a epidemia do VIH cresceu, transformou-se em muitos contextos numa doença de mulheres joven. Na África subsariana, 75% dos 6,2 milhões de jovens com idades entre os 15–24 que vivem com o VIH são mulheres. Ao mesmo tempo, o casamento infantil, apesar de estar a diminuir, continua. Em certos locais africanos, um número elevado de raparigas encontra-se em risco de casarem ainda crianças e muitos milhões de jovens esposas casaram ainda crianças. Para entender melhor estes fenómenos com semelhanças em comum—casamento infantil e epidemia do VIH—o Population Council adoptou uma abordagem em vários níveis. Um nível de …

Éducation Sexuelle Et Vih : Il Est Temps De Changer De Méthodologie, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Pendant des décennies, l’éducation sexuelle basée sur un curriculum a été la pierre angulaire des efforts en fournis par les écoles et les communautés pour améliorer la santé sexuelle et génésique des jeunes, et plus récemment pour prévenir le VIH. Malheureusement, le discours public sur l'éducation sexuelle s’est égaré dans des débats polarisés qui ont détourné l'attention de la manière dont les programmes d'éducation sexuelle et VIH peuvent atteindre le mieux possible les objectifs partagés par différentes circonscriptions. Une étude exhaustive récente de l'impact des programmes d'éducation sexuelle et VIH dispensés par les écoles dans les pays développés et en …

Educación Sobre Sexualidad Y Vih: Tiempo Para Un Cambio De Paradigma, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Durante décadas, la educación sexual basada en un programa de estudio fue la piedra angular de los esfuerzos de la escuela y de la comunidad para mejorar la salud sexual y reproductiva de los jóvenes y, en forma más reciente, para prevenir la infección de VIH. Desafortunadamente, el discurso público sobre educación sexual ha estado envuelto en debates contradictorios que sirven para distraer la atención en lugar de determinar en que manera los programas de educación sobre sexualidad y VIH podrían alcanzar mejor los objetivos compartidos de las distintas partes. Una reseña exhaustiva que se realizó recientemente sobre el impacto …

Jovens Abandonadas: Redireccionar As Intervenções De Vih No Sentido Das Mais Vulneráveis, Judith Bruce

Poverty, Gender, and Youth

No início da terceira década da pandemia do VIH na África Subsariana, as mulheres jovens—muitas vezes adolescentes—são o novo rosto da doença. O VIH/SIDA está a ameaçar, sobretudo, raparigas e jovens com rendimentos sociais e económicos limitados—as que não conseguem evitar, controlar ou sair de relações sexuais inseguras dentro e fora do casamento. As jovens em risco de exploração sexual não são uma pequena minoria, contam-se entre elas centenas de milhões. Promover Transições para a Idade Adulta: Saudáveis, Seguras e Produtivas Nº 23 explora: determinantes estruturais de risco, falta chegar às mais vulneráveis, avançar com os meios que temos e …

Le Contexte De L’Initiation Sexuelle En Évolution Dans La Région Subsaharienne De L’Afrique, Barbara Mensch

Poverty, Gender, and Youth

L'ampleur de l'épidémie du SIDA en Afrique subsaharienne expose particulièrement les jeunes femmes au risque de l'infection par le VIH et requiert une meilleure compréhension des comportements reproductifs, y compris l'initiation sexuelle et les relations sexuelles pré-maritales. La croissance des relations sexuelles pré-maritales est une conséquence inévitable des mariages tardifs dans les pays en développement, en particulier à cause du fait que la période pendant laquelle les filles sont sexuellement mûres et non mariées est prolongée quand le mariage est retardé. Un récent projet du Population Council a fait des recherches sur les liens entre le changement d'âge au mariage …

Leave No Woman Behind, Ethiopia: Baseline Report, Annabel Erulkar, Tekle-Ab Mekbib, Helen Amdemikael, Garry Conille

Poverty, Gender, and Youth

“Leave No Woman Behind, Ethiopia” is an experimental project being implemented in rural areas of Ethiopia’s Amhara region. The project uses the mobilization of women into groups and adult literacy as an entry point for reproductive health education and referrals. Measurement of the program’s impact is being undertaken using a quasi-experimental research design including baseline and endline surveys in six Kebele Associations in rural Amhara. This report presents findings from the baseline survey conducted among more than 3,000 girls and women aged 10–45 in rural Amhara region. The results cover a broad range of topics including education, work, livelihoods, social …

Addressing The Sexual And Reproductive Health Needs Of Young People: Perspectives And Experiences Of Stakeholders From The Health And Non-Health Sectors, K.G. Santhya, Shireen J. Jejeebhoy, Saswata Ghosh, Nicole Haberland

Poverty, Gender, and Youth

In India, recent policies have underscored the right of adolescents and youth to sexual and reproductive health (SRH) counseling and services. Despite recent policies and programs, little information is available on the extent to which policy recommendations and program strategies have been implemented, and the extent to which services serve the disparate needs of married and unmarried young women and men. Also, there is limited evidence about the extent to which health-care providers at different levels of service delivery and stakeholders from other sectors are involved in providing SRH and HIV/AIDS-related information and services to young people, or their perceptions …

Ethnic Differentials In Parental Health Seeking For Childhood Illness In Vietnam, Bussarawan Teerawichitchainan, James F. Phillips

Poverty, Gender, and Youth

The recent introduction of user fees for Vietnam’s primary healthcare services has generated concern that economic policies may adversely affect health-seeking behavior and health outcomes of the poor, particularly among impoverished families who are members of socially marginalized minority groups. This Population Council working paper examines this debate by analyzing parental recall of illness and care-seeking for sick children under age 5 recorded by the 2001–02 Vietnam National Health Survey. Ethnic differentials are evident in all geographic and income levels, although adverse effects of minority status are most pronounced among poor households in remote areas. Results suggest that social equity …