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Zimbabwe: Les Méthodes De Dépistage Des Iar Chez Les Femmes Sont Chères Et Inefficaces, Population Council

Reproductive Health

Les Infections de l’Appareil Reproductif (IAR) sont courantes au Zimbabwe. Beaucoup d’IAR augmentent le risque d’infection au Virus de l’Immunodéficience Humaine. En 1998, le Conseil National de Planification Familiale du Zimbabwe (ZNFPC) a entrepris une recherche opérationnelle afin d’évaluer la faisabilité de l’intégration du diagnostic des IAR et des services de traitement dans son menu de services. La population étudiée consistait en 1634 clientes de trois cliniques du ZNFPC. Chaque cliente a été interrogée sur les douleurs au bas ventre, les pertes vaginales et autres symptômes d’IAR. Elles ont ensuite été examinées pour des signes cliniques d’IAR, et ont subi …

Reproductive Tract Infections: A Set Of Factsheets, Population Council

Reproductive Health

Reproductive tract infections (RTIs) are being increasingly recognized as a serious global health problem with impact on individual women and men, and their families and communities. RTIs can have severe consequences, including infertility, ectopic pregnancy, chronic pelvic pain, miscarriage, and increased risk of HIV transmission. For effective prevention and management of RTIs, accurate information is necessary and should be widely available. In addition to a brief introduction to RTIs, this document contains 13 factsheets addressing medical and social issues on a variety of topics related to RTIs. The document, produced by the Population Council with support from the Ford Foundation, …

Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu

Reproductive Health

Quality of services is playing an increasingly important role in many family planning (FP) programs. In 1995, a national Situation Analysis Study of 254 health facilities was conducted in Kenya to assess the status and quality of FP services in the country. An in-depth survey of a subsample of 28 health facilities was conducted the following year. From these facilities, 1,834 women were interviewed about their experiences with services at facilities when they sought antenatal, child health, and FP services. The goal of the survey was to examine the links between quality of care in FP services and contraceptive behavior. …

Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council

Reproductive Health

The health status of women, men, and children in sub-Saharan Africa remains the poorest in the world. Moreover, virtually every country in the region is suffering mediocre economic growth or economic decline, thereby reducing the ability of their health care systems to respond adequately, and increasing dependence on external donor assistance. In terms of reproductive health (RH), the region is faced with high levels of unwanted fertility; high levels of maternal, child, and infant morbidity and mortality; and an almost exponential growth in HIV prevalence. Access to and quality of RH services remains poor in most countries, thereby maintaining unmet …

Reproductive Decisionmaking In The Context Of Hiv/Aids In Ndola, Zambia, Naomi Rutenberg, Ann E. Biddlecom, Frederick A.D. Kaona

Reproductive Health

Family planning (FP) programs are increasingly being considered as a logical focal point for STD and HIV/AIDS prevention services because they serve large numbers of women at risk, address the sensitive issue of sexual behavior and fertility control, and the methods for preventing unwanted pregnancy and disease can be the same. FP programs, by providing contraceptive methods, are currently one of the few sources of assistance in the sub-Saharan African region for preventing perinatal transmission of HIV, while the promotion of barrier methods contributes to the prevention of heterosexual transmission. Given this potential, research is needed to understand how the …

Investing In Youth: Testing Community-Based Approaches For Improving Adolescent Sexual And Reproductive Health, Tamara Fetters, Fines Munkonze, Julie Solo

Reproductive Health

The world is now sustaining the largest number of youth in human history; today there are nearly 900 million 10–19-year-olds and their health and livelihood issues are becoming increasingly important to policymakers worldwide. In Zambia, as in many other countries, young people face severe problems, including limited access to jobs, secondary education, and health care. The social, economic, and peer pressures that youth face often lead to high levels of sexual activity, often with subsequent negative impacts on their sexual and reproductive health. In spite of the magnitude of the reproductive health problems facing youth, they still have limited access …

Strengthening The Evaluation And Research Unit Of The Zimbabwe Family Planning Council (1995–1998), Lewis Ndhlovu, Hazel M.B. Dube, Caroline S. Marangwanda

Reproductive Health

The Evaluation and Research Unit (ERU) plays a crucial role in supporting the research activities of the Zimbabwe National Family Planning Council (ZNFPC). Research activities are conducted in addition to analysis of service statistics and compilation of quarterly and annual reports. With a staff capacity of five and inadequate research skills existing in other units, the ERU finds it difficult to manage and monitor the diverse activities of the organization. To address these problems, a buy-in was signed between the Zimbabwe Government and USAID in May 1995. The objectives were to assist the ZNFPC in conducting operations research studies and …

Demand For And Cost-Effectiveness Of Integrating Rti/Hiv Services With Clinic-Based Family Planning Services In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Sithokozille Simba, Hazel M.B. Dube, Rick Homan, Barbara Janowitz, Ahmed Latif, Peter R. Mason

Reproductive Health

The current spread of HIV/AIDS poses a major threat to individual lives and national economies in many sub-Saharan African countries. The region also has some of the highest levels of other reproductive tract infections (RTIs) in the world. Some of these RTIs increase the risk of sexual transmission of HIV infection. Thus, the control of RTIs is seen not only as an important reproductive health care strategy to alleviate symptoms of infection and long-term gynecological, obstetric, and neonatal complications, but also as a key strategy in reducing the spread of HIV/AIDS. As a result, all national health care programs in …

Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan

Reproductive Health

This book on family planning in India includes detailed empirical data and analysis of the various dimensions of quality of care in different regions of the country. Focus areas include: women’s perceptions of the care they receive; observations of provider-client interactions; barriers to quality of service delivery; existing interregional variations; contraceptive choice and interpersonal relations; technical quality of care; and the effect of the target system on the work style of outreach staff. All elements of the quality-of-care framework elaborated by Judith Bruce are well documented and their relationships to broader program constraints are clearly identified. The overall impression one …

Investigación Operativa En Planificación Familiar: Lecturas Selectas, James R. Foreit, Tomas Frejka

Reproductive Health

Desde que existen los programas de planificación familiar existe la investigación sobre este tema. En el nivel teórico, los investigadores examinan el efecto de la fertilidad sobre la salud y el desarrollo socioeconómico y estudian los determinantes de la fecundidad para los individuos y la poblaciones. En el nivel de las políticas, los estudios exploran el papel que juegan los programas de planificación familiar en la modificación de la fecundidad y la salud. El desarrollo de nuevos anticonceptivos se acompaña de pruebas clínicas y pre-introductorias en el contexto de los programas. Se llevan a cabo encuestas para medir los cambios …

L'Approche De L'Analyse Situationnelle Pour L'Évaluation Des Services De Planification Familiale Et De Santé De La Reproduction: Manuel De Recherche, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba

Reproductive Health

Une bonne prestation de services de planification familiale mettant l'accent à la fois sur l'accès et la qualité est la clé des objectifs interdépendants de satisfaction des besoins individuels et la réalisation du succès programmatique. L'analyse de situation (AS) fournit un lien nécessaire entre le responsable de programme et la cliente qu'il essaie de servir. Les données recueillies par l’AS offrent une image représentative du fonctionnement des composantes et permettent de «voir» l'expérience de la cliente. Les analyses situationnelles aident le responsable de programme à atteindre le plus grand but en termes de gestion—celui d’une administration efficace d'un service de …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah

Reproductive Health

This report aims to explain the discrepancies in crisis-related research results in Indonesia, and to recommend methodologies to enhance future crisis-related monitoring and surveillance. The discussion aims to identify where the discrepancies are in the readily available data, and how these discrepancies can be explained. The report does not attempt to clarify the impact that the economic crisis is having on the health status of women and children in Indonesia. Recommendations are made to deal with the following findings: Aggregation of data may hide important crisis impacts; attribution of identified changes to the economic crisis may be misleading; differences in …

Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda

Reproductive Health

This project was designed to disseminate, expand use, and promote institutionalization of a program to train healthcare professionals to address domestic violence. The program was developed and implemented by the Instituto Mexicano de Investigación de Familia y Población (IMIFAP), a nongovernmental organization that promotes reproductive health. IMIFAP designed an 18-hour workshop, entitled “Health Services Respond to Domestic Violence,” to sensitize health professionals to domestic violence issues and develop strategies for recognizing and managing cases of domestic violence. Following the workshop, strong and significant increases in knowledge about domestic violence and its management in primary healthcare services were found. Workshop participants …

Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon

Reproductive Health

The goal of this project was to inform physicians, pharmacists, and female factory workers about emergency contraception (EC) through mailings of booklets and posters. These materials were developed in a previous operations research project conducted by the Instituto Mexicano de Investigación de Familia y Población and supported by the Population Council INOPAL III project with funding from USAID. The study found that recipients generally liked the print materials and welcomed information about EC. Within three weeks of receiving the materials, many reported that they had taken immediate action to make EC available and/or to educate others about EC. This project …

Mexico: Protecting Informed Consent, Elsa Santos, Silvia Elena Llaguno, Ricardo Vernon

Reproductive Health

The objective of this three-month project in Mexico was to disseminate information among key audiences about: 1) the right of women to choose contraceptive methods in a free and informed manner; and 2) the laws and institutions available to help redress any violations of this right. Four publications on these topics, developed by a previous project funded by Population Council/INOPAL III, were reproduced and distributed to 2,750 people in the following target audiences: women of reproductive age; reproductive health service providers; national and state commissions of human rights, complaints offices in public hospitals, feminist and human rights organizations; and legal …

Peru: Providers' Compliance With Quality Of Care Norms, Federico R. Leon

Reproductive Health

Peru's Ministry of Health (MOH) introduced changes in its family planning service delivery strategy and set quality-of-care goals purported to ensure informed choice of methods and respect for the users’ reproductive intentions and rights. This study was designed to assess the extent to which providers comply with the guidelines in their daily routine. The study found that among the strongest elements of care are interpersonal relationships and free choice of methods. However, shortcomings were observed in screening for contraindications and information given to the client. The report includes a number of recommendations, including offering providers IEC materials, training, and supervision …

Reproductive Health Indicators: Moving Forward, Kelly Blanchard, Batya Elul, Saumya Ramarao

Reproductive Health

This report is designed to help researchers, program managers, policymakers, and advocates sift through and evaluate which potential indicators might be useful in a particular programmatic context. It was initially prepared as a background manuscript for a Population Council meeting on reproductive health indicators held in Cairo in March 1998. The manuscript has since been modified to incorporate ideas and comments expressed at that meeting, as well as to include input from other Population Council colleagues.

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri

Reproductive Health

At the International Conference on Population and Development (ICPD) in 1994, the nations of the world agreed to give special attention to girls’ education, women’s health, infant survival, and women’s empowerment, and to provide comprehensive reproductive health (RH) services to enable couples to achieve their reproductive goals. The government of India launched a reproductive and child health program in October 1997. This book begins a review of the processes underway to operationalize the program. It brings together several important initiatives at various stages of development and examines key policy and program issues based on empirical research and field experience. The …

Comparing Alternative Products In The Provision Of Emergency Contraception, John P. Skibiak, Yusuf Ahmed, M. Ketata

Reproductive Health

This report is the third in a series of summaries produced in connection with the operations research project “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the project explores the many issues surrounding the introduction and delivery of emergency contraception services in a developing country context. The study compares the introduction of two different emergency contraception pills—the combined oral contraceptive PC-4, introduced in Zambia in 1997, and the progestin-only contraceptive Postinor-2, introduced by this study in the following year. Client histories showed only minor differences in the attitudes of emergency contraception users …

Vol. 21 No. 4 (1998): Pacific Studies Full Issue, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Pacific Studies is published two times a year by The Jonathan Nāpela Center for Hawaiian and Pacific Studies, Brigham Young University Hawai‘i #1979, 55–220 Kulanui Street, Lāʻie, Hawai‘i 96762, but responsibility for opinions expressed in the articles rests with the authors alone. Subscription rate is US$40.00 yearly, payable to The Jonathan Nāpela Center for Hawaiian and Pacific Studies. The Jonathan Nāpela Center for Hawaiian and Pacific Studies (formerly The Pacific Institute) is an organization funded by Brigham Young University Hawai‘i. The Center assists the University in meeting its cultural and educational goals by undertaking a program of teaching, research, and …

Books Received And Book Notices, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Book Listing for the Vol 21, No 4 Edition of the Pacific Studies Journal

The Potential Demographic Impact Of Hiv/Aids In The Pacific, Dennis A. Ahlburg, Heidi J. Larson, Tim Brown

Pacific Studies

The number of HIV infections and cases of AIDS reported in the Pacific Island nations is growing steadily. Since many, if not all, of the risk factors for HIV infection are present in the Pacific, without change in behaviors that place people at risk of infection the potential exists for an HIV/AIDS epidemic. This article shows that such an epidemic would considerably increase mortality and slow but not reverse population growth in many Pacific Island countries. As yet, well-designed, multisectoral responses to the threat of an epidemic are lacking. The longer such responses are delayed, the larger will be the …

Contributors: Vol 21 No. 4, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Contributors list of Vol. 21 (1998): Pacific Studies Full Issue 4

The Meeting Of Pain And Depression: Comorbidity In Women, Marta Meana

Psychology Faculty Research

The higher prevalence of depression in women is coupled with a higher prevalence of pain complaints. Growing evidence suggests that the comorbidity of these conditions is also proportionately higher in women than men. This paper critically reviews the empirical findings relating to gender differences in comorbid pain and depression as well as findings in support of hypothesized etiologic factors that could explain why women may be more susceptible than men to comorbidity. The empirical evidence for biogenic, psychogenic, and sociogenic explanatory models is presented, and an integration of these models is proposed as a guideline to both research and clinical …

Establishing Norms For A Mexican Group Using Ricketts, Steiner And Arnett Analyses, Mauricio Gonzalez Balut

Loma Linda University Electronic Theses, Dissertations & Projects

Most existing cephalometric analyses are based on norms for the Caucasian population. Therefore, they cannot be properly applied for Mexican or Hispanic patients. Ethnic variations in the normal positions of the maxilla and mandible influence and alter the diagnosis and treatment plan for each of the different type of malocclusions. Previous studies have addressed the difference between the Caucasian norms and the Hispanic norms, this indicates the variety of their skeletal, dental and facial features.

It is the purpose of this study to establish specific cephalometric standards for the native Mexican group, using the Steiner and Ricketts analyses along with …

Cardiac Rehabilitation: Gender Differences In Factors Influencing Participation, Lani Lieberman, Marta Meana, Donna E. Stewart

Psychology Faculty Research

This study investigates gender differences in the barriers and incentives that are most influential in the coronary patient's decision to participate in cardiac rehabilitation (CRPs) and suggests strategies to counter these barriers. Patient surveys were administered to consecutive English-speaking attenders and referred nonattenders to a cardiac rehabilitation center at a university healthcare system in Toronto, Canada. A survey questionnaire, constructed from a literature review and advice from key informants, examined potential factors affecting decisions to engage in CRPs. One129 attenders at a CRP and 61 referred nonattenders completed the questionnaire. Physician recommendation was reported to be the most important factor …

Educational Attainment, Non-English Language Usage, And Ability To Communicate In English In 30 Massachusetts Cities/Towns, Edward C. Besozzi, Carole C. Upshur

Gastón Institute Publications

Data regarding an individual's ability, or the ability of members of a household to speak English, primary language spoken at home, educational attainment, and the level of literacy proficiency should be taken into consideration when designing and implementing policies regarding health care initiatives and the publication of health care information. This report highlights data collected from three sources: 1) The National Adult Literacy Survey; 2) The 1990 Federal Census; and 3) The Massachusetts Institute for Social and Economic Research.

Nursing Home Ownership And Public Policy: An Historical Analysis, K. R. Kaffenberger

Graduate Doctoral Dissertations

In the early days of the United States, care of the disabled elderly outside the home meant the public almshouse. By the 1920s, private, nonprofit homes for the aged were prevalent. More recently, private, for-profit facilities have grown to dominate the field.

For-profit ownership has been controversial. Underlying the controversy is the concern that quality might be lowered in order to enhance profit.

This study asks why most nursing homes are privately owned and why most privately owned nursing homes are operated for profit. It does so with reference to The Nonprofit Economy, in which Burton Weisbrod describes a …