Medicine and Health Sciences Commons^™

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 …

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 …

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

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 …

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 …

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.

Operations Research In Reproductive Health And Family Planning At The Cairo Demographic Center, Magdi A. Ibrahim, James R. Foreit, M.E. Khan

Reproductive Health

This report evaluates the effectiveness of a two-year training program at the Cairo Demographic Center to increase the number of researchers using operations research (OR), and to help institutionalize the ability of the Center to offer training in operations research in reproductive health. It also provides feedback for OR curriculum development. The project trained researchers with program and policymaking responsibilities and provided participants with the experience of designing an OR project, and built participants’ skills in communicating research results to managers. Participant evaluations showed that, overall, the course met its objectives. The training that the students received in OR has …

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.

Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa

Reproductive Health

The Hospital Roosevelt is Guatemala’s largest hospital, and serves as a referral and training facility for the entire country. Within the Hospital Roosevelt, the Department of Obstetrics and Gynecology established a Reproductive Health Unit (RHU) to offer family planning information and services to obstetrics inpatients and OB/GYN outpatient clients, and to serve as a training site for medical residents completing their OB/GYN rotations. Hospital administrators requested assistance from the Frontiers in Reproductive Health (FRONTIERS) program to help establish a fee schedule for the RHU, with the goal of paying its own personnel costs after one year of operation. The FRONTIERS …

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 …

Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon

Reproductive Health

Using the results of a previous operations research study, the Ministry of Health of Honduras recently changed the National Women’s Health Service Delivery Guidelines to explicitly authorize nurse auxiliaries to insert IUDs, deliver Depo-Provera, and take Pap smears. These services are new to the rural communities served by rural health centers (RHCs). The objective of this project was to test whether the demand for these newly introduced services would increase if a promotional brochure was distributed in the surrounding communities by the RHC’s clients among potentially interested friends in these communities. The study found that the intervention that was tested …

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 …

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 …

An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku

Reproductive Health

Maendeleo Ya Wanawake (MYWO), with technical assistance from the Program for Appropriate Technology in Health (PATH), has been implementing an Alternative Rite of passage programme as part of its efforts to eradicate the practice of female genital mutilation (FGM) in five districts in Kenya. This study addressed the factors that influence some families and individuals to adopt the Alternative Rite while others, exposed to the same messages discouraging FGM, decide not to. It also evaluated the effect of the training component of the Alternative Rite on the girls who participated.

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 …

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 …

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 …

Eating, Nutrition And Of Health Diagnostic Of The Elementary Schools Of The Communities Of Guambo And The Rinconada, Province Of Imbabura 2002-2001, Ruth Muriel

Theses and Dissertations

The rural communities of the province of Imbabura present multiple problems of environmental, educational, and economic kind. Previous studies show that the rural communities of the Ecuadorian population present serious problems of health and nutrition, among those that excel are: poliparasitosis, respiratory infections and diarrheal, malnutrition, deficiency of micro nutrients, sanitary deficiency, scarce economic resources and low level of instruction. All these factors have caused a decrease in the productive capacity of the country and affected their level of development. In addition, delay exists in size in the students, which leads to a decrease in the capacity for physical work, …

History, Culture And Alcohol: Drinking Patterns In Poland And Australia, Barbara Wolska

Theses: Doctorates and Masters

It is a widely held view in Poland that for centuries those in power have promoted heavy drinking among their subjects in order to achieve their various goals and that this contributed to the development of Polish drinking patterns. There is some empirical evidence that the political economy of alcohol in Poland promoted heavy drinking among the Polish population. Drinking alcohol in Poland was an important aspect of social situations. The most popular beverage was vodka(s). Social pressure to drink in the extreme was attributed to the tradition of hospitality. Cultural norms encouraged very heavy drinking among men and imposed …

Toward Improved Support For Research On Delivery Of Home- And Community-Based Long-Term Care, Francis G. Caro

Gerontology Institute Publications

Stronger and more consistent support is needed for research on long-term care. A greater investment in research will strengthen the ability of public and private organizations to provide effective and efficient assistance to people with disabilities and their informal caregivers. This paper provides a rationale for stronger research funding for the field and outlines several options to strengthen research.

Advance Directives And Communication Styles In A Lower Rio Grande Valley Health Facility, Armando G. Dominguez

Theses and Dissertations - UTB/UTPA

This study explores physicians' decision-making communication styles at end-of-life and advance directives in a hospital. Participant observation, case studies and a survey questionnaire are used. Egalitarian communication style is found to have moderate reliability. A .6969 coefficient, is measured by Cronbach's Alpha model. Authoritative communication style, yields a less than moderate alpha coefficient of .4278. Regression analysis using these two variables as the independent variables obtains insignificant results. However, sixty-three percent of the respondents speak Spanish moderately or very little. Eighty percent of the surveyed sample do not have training to administer advance directives. Twenty-two percent of the respondents have …

Attitudes As Barriers In Breast Screening: A Prospective Study Among Singapore Women, Paulin Tay Straughan, Adeline Seow

Research Collection School of Social Sciences

Health care systems do not exist in isolation, but rather, as part of the larger social and cultural mosaic. In particular, perceived attitudes are major obstacles in health promotion exercises. This problem is especially true for non-white populations where little is known about the prevailing social and cultural perceptions towards western biomedical prescriptions. To further our understanding of Asian women's acceptance of mammograms, three attitudinal indexes are conceptualised, constructed and validated. Data fi om a prospective survey showed the significance of fatalistic attitudes, perceived barriers and perceived efficacy of early detection in predicting women's acceptance of a free mammogram at …

Update - November 2000, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- An Unlikely Reverence: The story of Centura Health, a partnership between Seventh-day Adventist and Roman Catholics
-- Child Prostitution in Thailand: Epidemic and Ethics

Alternatives To Incarceration For Substance Abusing Female Defendants/Offenders In Massachusetts, 1996-1998, Carol Hardy-Fanta, Sylvia Mignon

Publications from the Center for Women in Politics and Public Policy

In July 1997, the Massachusetts State Legislature, recognizing the challenge presented by the problem of substance abuse for women in the criminal justice system, authorized funds to the Department of Public Health’s Bureau of Substance Abuse Services for a study of substance using female offenders to be conducted by the John W. McCormack Institute at the University of Massachusetts Boston. Since March 1998, a group of researchers at the McCormack Institute and the Criminal Justice Center at UMass Boston has gathered and analyzed a wealth of quantitative and qualitative information on women offenders in Massachusetts.

This information includes data from …

The Long Road Called Goodbye (Excerpt), Charlotte A. Akin

Biography

Part clinical case study, part family journal, The Long Road Called Goodbye is a powerful and moving account of one family's thirteen-year struggle with Alzheimer's. This engaging informative book is a closely documented clinical study that reads like a novel, filled with all the feelings, crises, and conflicts experienced by patient and family. It is a story of love, loyalty, perseverance, strength, and dignity. The Long Road Called Goodbye makes a major contribution to the care of AD patients and their families. The book will be of interest to professionals who work with Alzheimer's patients, including physicians, staff at care-giving …

Peer Support As A Protective Factor In The Impact Of War On Adolescents In Lebanon, Nadine S. Fakhran

All-Inclusive List of Electronic Theses and Dissertations

Children exposed to situations of war have been shown to develop behavioral as well as psychological difficulties. Researchers have observed, however, that not all children manifest these difficulties in reaction to war situations. Therefore, scientists have attempted to look at resilient children, investigating protective and vulnerability factors in the child's environment. One such protective factor is social support. Although there have been several studies on social support, those studies have tended to focus on family support. There seems to be a void in the literature on the effects of peer support on post-traumatic stress reactions in children. The present study …

Medical Students And Their Attitudes Toward Abortion: An Assessment Of Which Factors Influence Medical Students' Willingness Or Unwillingness To Perform Abortions, Katherine M. Krupa

Sociology & Criminal Justice Theses & Dissertations

The purpose of this research is to determine which factors, if any, influence medical students' willingness or unwillingness to perform abortions. Ample research has been conducted evaluating both the general population's and college students' attitudes toward abortion; however, limited research has been collected on medical students. The present research study attempts to fill this void. The following research questions will be reviewed and evaluated throughout the current study: (1) What personal factors if any influence medical students' willingness or unwillingness to terminate a pregnancy; (2) Are medical students willing to perform abortions for the reasons that women are requesting them; …

Becoming Advocates For Battered Women, Julie G. Stewart

Nursing Faculty Publications

Through her research, an advanced practice nurse has identified five stages through which abused women proceed on their way to freedom. The author calls on all clinicians to become advocates for battered women by recognizing them in clinical practice and helping them find the road to a life of safety, peace, and restored self-esteem.

The Relationship Between Health Attitudes, Beliefs, Health Locus Of Control And Use Of Breast Cancer Screening Modalities In Elderly Hispanic Women, Debra Kay Gillett, Rosamaria Ortiz

Theses and Dissertations - UTB/UTPA

A non-experimental design was used to examine the relationship between health attitudes, beliefs, locus of control and the use of breast cancer screening modalities in elderly Hispanic women in this pilot study. Leininger's Theory of Culture Care Diversity and Universality and the Health Belief Model were the supporting theoretical frameworks. Research was conducted at the Amigos del Valle senior centers in Hidalgo County and included 52 English-speaking elderly Hispanic volunteer participants. Instruments used for data collection were the Health Care Attitudes and Beliefs Scale and the Multidimensional Health Locus of Control Scale. Results of this study revealed that there appears …