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Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health Jan 2001

Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health

Reproductive Health

Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …


An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed Jan 2001

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 Jan 2001

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 …


Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon Jan 2001

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 Jan 2001

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 …


Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya Jan 2001

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 …


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 Jan 2001

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 Jan 2001

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 …


Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health Jan 2001

Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health

Reproductive Health

To support the Government of Ghana’s plan to expand community-based distribution (CBD) programs, the Planned Parenthood Association of Ghana (PPAG) and the Population Council conducted a study in 1999 of the CBD programs of 13 nongovernmental agencies. The study also assessed in depth PPAG’s CBD program, which is the country’s largest and oldest. Data sources included interviews with 301 CBD agents, 27 supervisors, and 20 clinicians in rural and urban areas in 16 districts; observations of 51 PPAG agents interacting with 6 clients each; and 15 focus group discussions with community members, former CBD agents, and CBD clients. CBD programs …


Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health Jan 2001

Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

En 1999, la Secretaría de Salud de Honduras (SSH) modificó las Normas de Atención Integral a la Mujer a fin de autorizar a las auxiliares de enfermería a prestar los servicios de inserción de DIU, aplicación del inyectable DMPA y toma de Papanicolaou. Este cambio en las normas aborda el problema de la baja prevalencia en el uso de anticonceptivos en áreas rurales. El cambio también refleja los hallazgos de un estudio anterior, realizado por el Population Council, que mostró que las auxiliares de enfermería pueden proporcionar estos servicios de manera segura y con buena calidad. Anteriormente, las mujeres en …


West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health Jan 2001

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, …


Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health Jan 2001

Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

La Organización Mundial de la Salud ha estipulado que la detección y tratamiento de sífilis para todas las mujeres embarazadas resulta eficaz en función de los costos si al menos el 0.1 por ciento de ellas están infectadas. Para atender el problema de la alta tasa de sífilis entre mujeres embarazadas (6.5–7.3%), el Concejo de la Ciudad de Nairobi (CCN) introdujo en 1989 la detección y tratamiento de sífilis materna en sus clínicas de atención prenatal. Sin embargo, su enfoque centralizado—que requiere llevar las muestras de sangre recolectadas a un laboratorio central para hacer la prueba—era ineficiente. Por lo tanto, …


Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health Jan 2001

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 …


Ecological Degradation, Rural Poverty, And Migration In Ethiopia: A Contextual Analysis, Markos Ezra Jan 2001

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 …


Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health Jan 2001

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 …


Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health Jan 2001

Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health

Reproductive Health

El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …


Ecuador: Utilice La Mercadotecnia Comercial Para Aumentar La Sustentabilidad, Frontiers In Reproductive Health Jan 2001

Ecuador: Utilice La Mercadotecnia Comercial Para Aumentar La Sustentabilidad, Frontiers In Reproductive Health

Reproductive Health

Muchas organizaciones no gubernamentales venden anticonceptivos a través de detallistas con el fin de generar ingresos y mejorar el acceso a estos productos. En 1998, el Centro Médico de Orientación y Planificación Familiar (CEMOPLAF) empleó a 25 agentes de ventas en 14 ciudades ecuatorianas; estos agentes vendieron productos, incluyendo métodos anticonceptivos y pruebas de embarazo de uso doméstico. Esos productos se vendieron a farmacias, médicos, otros distribuidores y a puntos de venta no tradicionales. La venta de anticonceptivos fue la principal fuente de ingresos de CEMOPLAF en 1997. Las ventas habían crecido rápidamente en el periodo 1996–97, pero los gerentes …


Indonesia: Train Journalists To Write About Reproductive Health, Frontiers In Reproductive Health Jan 2001

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 …


Extending Operations Research To Social Marketing Programs, Teresa De Vargas Jan 2001

Extending Operations Research To Social Marketing Programs, Teresa De Vargas

Reproductive Health

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


Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar Jan 2001

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 …


Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi Jan 2001

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 Jan 2001

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 …


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 Jan 2001

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 …


Determinants Of Educational Attainment Among Adolescents In Egypt: Does School Quality Make A Difference? [Arabic], Cynthia B. Lloyd, Sahar El Tawila, Wesley H. Clark, Barbara Mensch Jan 2001

Determinants Of Educational Attainment Among Adolescents In Egypt: Does School Quality Make A Difference? [Arabic], Cynthia B. Lloyd, Sahar El Tawila, Wesley H. Clark, Barbara Mensch

Poverty, Gender, and Youth

The paper explores empirically the relationship between school quality in Egyptian preparatory (middle) schools and the likelihood of school dropout either during preparatory school or before the completion of secondary school. Despite strong empirical evidence for the many positive social and economic returns associated with more years of schooling, there has been little research exploring how the quality of particular schools might influence grade levels attained. The authors address this research gap using detailed data on Egyptian preparatory schools (grades 6-8, the last three years of the eight years of basic schooling) that are linked with a national survey of …


Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque Jan 2001

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 …


Household Size And Composition In The Developing World [Arabic], John Bongaarts Jan 2001

Household Size And Composition In The Developing World [Arabic], 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 …


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 Jan 2001

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 …


Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur Jan 2001

Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur

Poverty, Gender, and Youth

For three decades, the Expanded Programme on Immunization (EPI) has been promoted as one of the key child health interventions in developing countries. Vaccines for six childhood diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, and tuberculosis) have been shown to be efficacious in preventing disease-specific morbidity and mortality, yet not all commentators are convinced that the EPI reduces all-cause child mortality. Numerous studies have found that measles vaccination programs substantially reduce all-cause child mortality, but recent findings from Guinea-Bissau suggest that diphtheria, pertussis, and tetanus (DPT) vaccine may increase all-cause child mortality. The present study uses five years of data from …


Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer Jan 2001

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 …


The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar Jan 2001

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 …