Medicine and Health Sciences Commons^™

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..

School Functioning And Violent Behavior Among Young Adolescents: A Contextual Analysis, Amanda Birnbaum, Leslie A. Lytle, Peter J. Hannan, David M. Murray, Cheryl L. Perry, Jean L. Foster

Department of Public Health Scholarship and Creative Works

This paper examines associations between overall school functioning and the frequency of violent behaviors among young adolescents (ages 10–14). The sample included 16 middle schools participating in an unrelated intervention study (on nutrition) in Minneapolis, Minnesota. A School Functioning Index developed to characterize schools’ overall stability, performance, and demographics was constructed using data from public archives and school administrator surveys. Data on violent behaviors and other variables were collected in student surveys in fall 1998 and spring 1999. We used multilevel modeling to assess the effect of school functioning on violent behavior after adjusting for known individual-level covariates of violent …

Testing Balanced Counseling To Improve Provider-Client Interaction In Guatemala's Moh Clinics, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Julio Garcia Colindres, Benedicto Vasquez, Carlos Morales

Reproductive Health

The job aids–assisted Balanced Counseling Strategy adopted by Guatemala’s Ministry of Health required specific instructions for use by nonprofessional providers and an intervention that assured provider compliance with the behavioral requirements of the new paradigm. Results show that the trained providers outperformed the controls in quality of care at each level of session length, but used nine extra minutes per session on average. Nonprofessional providers can take advantage of the job aids–assisted Balanced Counseling Algorithm and substantially improve their quality of care. Extra time invested in counseling new family planning clients will be easily absorbed insofar as they continue to …

An International Comparison Of Breast Cancer Survival: Winnipeg, Manitoba And Des Moines, Iowa, Metropolitan Areas, Kevin M. Gorey

Social Work Publications

PURPOSE: Extending previous Canadian-United States cancer survival comparisons in large metropolitan areas, this study compares breast cancer survival in smaller metropolitan areas: Winnipeg, Manitoba and Des Moines, Iowa.

METHODS: Manitoba and Iowa cancer registries, respectively, provided a total of 2,383 and 1,545 women with breast cancer (1984 to 1992, followed until December 31, 1997). Socioeconomic data for each person's residence at the time of diagnosis was taken from population censuses.

RESULTS: Socioeconomic status and breast cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Des Moines, residents of the …

Associations Between Perceived Family Meal Environment And Parent Intake Of Fruit,Vegetables, And Fat, Kerri N. Boutelle, Amanda Birnbaum, Leslie Lytle, David M. Murray, Mary T. Story

Department of Public Health Scholarship and Creative Works

Objective

To describe the family mealtime environment and assess associations with adult fruit, vegetable, and fat intake.

Design

Telephone survey.

Participants

A convenience sample of 277 adults in the Minneapolis/St. Paul area were recruited through 4 schools. The sample was 85% female and 70% married. The mean number of children in the household was 2.6 (range 1 to 9).

Variables Measured

Adult fruit and vegetable intake, fat intake, and perceptions of the mealtime environment.

Analysis

Descriptive and mixed-model linear regression.

Results

Participants reported that the television was frequently on during dinner meals and almost one third felt that their family …

Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig

Reproductive Health

This project provides convincing empirical evidence on the impact of quality of care on contraceptive use and fertility behavior through analysis of a unique longitudinal data set from rural Bangladesh. The findings from this project add important new and methodologically rigorous evidence to the emerging literature on the implications of service quality on contraceptive behavior. The results reaffirm the importance of female fieldworker outreach—both in terms of quality and the number of visits—on contraceptive use dynamics in rural Bangladesh. In addition to these substantive findings, the study makes important methodological contributions in assessing the impact of programmatic variables—especially quality of …

Policy And Program Implications Of The Matching Grants Program In The Philippines, Marilou Palabrica-Costello, Nimfa Ogena, Alejandro N. Herrin

Reproductive Health

In 1999, the Philippines Department of Health, with support from USAID and technical assistance from Management Sciences for Health (MSH), implemented the matching grants program (MGP) as a component of the local government performance program. The MGP aims to improve the capability of municipalities and component cities to expand service delivery, and to achieve significant increases in rates of fully immunized children, vitamin A supplementation, tetanus toxoid immunization for women, as well as in the use of family planning methods, especially modern methods. Upon the request of the USAID Mission, the Frontiers in Reproductive Health program worked closely with MSH …

Improving Postpartum Care Among Low Parity Mothers In Palestine, Center For Development In Primary Health Care (Cdphc)

Reproductive Health

In an effort to improve the health status of Palestinian women and their children in the West Bank and Gaza, USAID, in collaboration with the Palestinian Ministry of Health and a number of NGOs, designed and funded a 28-month pilot activity, the Pilot Health Project (PHP), that was expected to have a positive impact on the health of women and children. This report describes the results of the intervention designed to measure the effectiveness of a second home visit on low-parity women in 1) improving their knowledge and practices regarding their own health as well as the health of their …

Assessment Of Pilot Health Project Outcome Indicators: West Bank/Gaza, Laila Nawar, Dale Huntington, Ibrahim Kharboush, Nancy Ali, Mahmoud Shaheen

Reproductive Health

The Pilot Health Project (PHP) was designed to address Palestinian women’s most pressing reproductive health needs. This report presents results from a single cross-sectional study that was conducted by the Health, Development, Information and Policy Institute (HDIP) between May and August 2000 in order to determine the baseline measures for the PHP’s key outcome indicators among healthcare providers and clients in the PHP clinics. Based on the findings reflected by the study, a number of recommendations were made that need to be followed up and implemented by the Improved Village and Community Health Services Project. These include the need for …

Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health

Reproductive Health

Many public, NGO, and private-sector service-delivery systems are suitably matched to the requirements of providing injectable contraceptives in India, including the ability to ensure choice and service delivery quality. This operations research study was designed to demonstrate the feasibility of providing injectable contraceptives in private medical practices and to contribute to the body of scientific literature on the acceptability of this method in India. DKT India and EngenderHealth formed a partnership with the Population Council’s Frontiers in Reproductive Health program to conduct this study in Gujarat. The ability to generate recommendations is limited, however, by the special characteristics of the …

Actions That Protect: Promoting Sexual And Reproductive Health And Choice Among Young People In India, Shireen J. Jejeebhoy, Mary Philip Sebastian

Reproductive Health

This paper synthesises the evidence on the sexual and reproductive health situation of young people in India, and explores what we know about underlying factors that place them at risk of or protect them from unsafe and unwanted sexual and reproductive health experiences. The picture that emerges suggests that substantial proportions of young people experience risky or unwanted sexual activity, do not receive prompt or appropriate care, and experience adverse reproductive health outcomes. Contextual factors such as poverty, gender imbalances and lack of education or livelihood opportunities clearly increase the vulnerability of youth. Other factors at the family, community and …

Changing Family Planning Scenario In India: An Overview Of Recent Evidence, K.G. Santhya

Reproductive Health

Over the decades, there has been a substantial increase in contraceptive use in India. The direction, emphasis and strategies of the Family Welfare Programme have changed over time. However, meeting the contraceptive needs of considerable proportions of women and men and improving the quality of family planning services continue to be a challenge. The 1990s witnessed a growing recognition of this, and several innovative policy and programme initiatives have been launched to address these issues. This paper reviews and synthesises evidence from surveys and studies conducted in the 1990s and thereafter on contraceptive use dynamics and the unmet need for …

Creation Of A Unified Management Information System For Three Ngos In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

The goal of the Pilot Health Project (PHP) has been to improve the health status of Palestinian women and children. To further this goal, the Health, Development, Information and Policy Institute (HDIP) was given the responsibility to develop a management information system (MIS) for the collection, storage, processing, and dissemination of information for PHP clinics. In cooperation with the Palestinian Ministry of Health (MOH) and various healthcare providers and MIS professionals, HDIP worked through a carefully organized and highly participatory process to design and develop the MIS for the PHP. This report reviews that process and presents the features of …

Non-Consensual Sexual Experiences Of Young People: A Review Of The Evidence From Developing Countries, Shireen J. Jejeebhoy, Sarah Bott

Reproductive Health

Although there is increasing evidence of risky consensual sex among young people in developing countries, non-consensual sexual experiences among them have rarely been studied and few interventions have been designed to protect them from the risks of such experiences. However, what is available suggests that coercion and unwantedness may play a considerable role in the sexual relations of young people—girls and young women but also boys and young men. The implications of non-consensual sexual experiences for young people’s rights, their health and development and the risks they pose in the transition to adulthood are enormous. This review collates what is …

Wage Work And Marriage: Perspectives Of Egyptian Working Women, Sajeda Amin, Nagah Hassan Al Bassusi

Poverty, Gender, and Youth

This paper explores young working women’s perceptions of marriage and work in contemporary Egypt at a time when an increase in age at marriage was evident from national survey data. Data from two nationally representative labor surveys, the Labor Force Sample Survey of 1988 and the Egypt Labor Market Survey of 1998, show that working conditions and employment opportunities declined significantly for young women even as their educational attainment increased. Indepth interviews were conducted with young women working in a range of salaried jobs in three locations: a rural village in Mansoura, a periurban district near Cairo, and in the …

Primary Schooling In Sub-Saharan Africa: Recent Trends And Current Challenges, Cynthia B. Lloyd, Paul C. Hewett

Poverty, Gender, and Youth

At the dawn of the twenty-first century we estimate that more than 37 million young adolescents aged 10-14 in sub-Saharan Africa will not complete primary school. Our estimates are based on data from nationally representative Demographic and Health Surveys from 26 countries, collectively representing 83 percent of the sub-Saharan youth population. This number is nearly twice the entire population of children aged 10-14 in the United States, virtually all of whom will complete primary school. Reducing the number of uneducated African youth is a primary objective of the United Nations as laid out in the Millennium Development Goal for education, …

My Father Didn't Think This Way': Nigerian Boys Contemplate Gender Equality, Françoise Girard

Poverty, Gender, and Youth

One of the lessons emerging from adolescent programs around the world is the need to create settings where young men can question things that are often seen as unquestionable, such as what it means to be a man. This issue explores the Conscientizing Male Adolescents (CMA) program in Nigeria which, unlike many programs targeting adolescent boys that emphasize short-term activities aimed at preventing disease and unwanted pregnancy, is a long-term program focusing on sexism and critical-thinking skills. An initial evaluation indicates that such programs affirm that we do know how to engage young men, and that historically reinforced gender attitudes …

Wage Work And Marriage: Perspectives Of Egyptian Working Women [Arabic], Sajeda Amin, Nagah Hassan Al Bassusi

Poverty, Gender, and Youth

This paper explores young working women’s perceptions of marriage and work in contemporary Egypt at a time when an increase in age at marriage was evident from national survey data. Data from two nationally representative labor surveys, the Labor Force Sample Survey of 1988 and the Egypt Labor Market Survey of 1998, show that working conditions and employment opportunities declined significantly for young women even as their educational attainment increased. Indepth interviews were conducted with young women working in a range of salaried jobs in three locations: a rural village in Mansoura, a periurban district near Cairo, and in the …

How Indicators Of Socioeconomic Status Relate To Physical Functioning Of Older Adults In Three Asian Societies, Zachary Zimmer, Napaporn Chayovan, Hui-Sheng Lin, Josefina N. Natividad

Poverty, Gender, and Youth

In developed countries, socioeconomic status has been identified as one of the most important demographic and social determinants of older adult health. The relationship has not been well studied or contrasted across much of the developing world. Yet, with population aging occurring rapidly in much of Asia, understanding the factors that distinguish between those in better and worse health becomes important. To this end, the current study has two main aims. It first examines the degree to which two measures commonly used to indicate socioeconomic status, education and income, relate to the physical functioning of older adults in three Asian …

Marriage In Transition: Evidence On Age, Education, And Assets From Six Developing Countries, Agnes R. Quisumbing, Kelly Hallman

Poverty, Gender, and Youth

Marriage is an event of great social and economic significance in most societies. Despite the centrality of marriage in an individual’s life history, the literature on marriage patterns pays little attention to men. This paper examines trends in schooling, age, and assets at marriage for both men and women, and spousal differences in these variables in six countries-Bangladesh, Ethiopia, Guatemala, Mexico, the Philippines, and South Africa-using comparable data sets and methodologies.

Public Health And National Security In The Global Age: Infectious Diseases, Bioterrorism, And Realpolitik, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Racism Or Realpolitik? U.S. Foreign Policy And The Hiv/Aids Catastrophe In Sub-Saharan Africa, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

The Feasibility Of Computer-Assisted Survey Interviewing In Africa: Experience From Two Rural Districts In Kenya, Paul C. Hewett, Annabel Erulkar, Barbara Mensch

Poverty, Gender, and Youth

This paper explores the use of an audio computer-assisted self-interviewing (audio-CASI) methodology in a household survey of adolescents in two districts of Kenya. Computer software was developed as part of a research project comparing audio-CASI with traditional methods of interviewing about sensitive behaviors, including sexual initiation, risky sexual behavior, coerced sex, and drug and alcohol use. The paper describes the experience of carrying out a household-based study using computers and explores the technical challenges faced by the data collection teams. Few problems emerged with the computer hardware and software, despite the difficult interviewing conditions. The adolescent respondents easily adapted to …

Population Policy: A Concise Summary, Paul Demeny

Poverty, Gender, and Youth

Population policies are deliberately constructed or modified institutional arrangements and/or specific programs through which governments influence, directly or indirectly, demographic change. For any given country, the aim of population policy may be narrowly construed as bringing about quantitative changes in the membership of the territorially circumscribed population under the government’s jurisdiction. Governments’ concern with population matters can also extend beyond the borders of their own jurisdictions. Thus, international aspects of population policy have become increasingly salient in the contemporary world. Additions to the population are primarily the result of individual decisions concerning childbearing. Within the constraints of their social milieu, …

One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo

Reproductive Health

This report presents a one-year assessment of quality-of-care improvements in Peru, following provider training on the job aids–assisted Balanced Counseling Strategy. Results showed significant enhancement of quality of care, an increase in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) …

Consistency In The Reporting Of Sexual Behavior Among Adolescent Girls In Kenya: A Comparison Of Interviewing Methods, Paul C. Hewett, Barbara Mensch, Annabel Erulkar

Poverty, Gender, and Youth

This paper explores the consistency in reporting of sexual behavior in a household survey of adolescents aged 15-21 in the Kisumu district of Kenya. Respondents were randomly assigned to different interviewing modes: face-to-face interviews, paper-and-pencil self-administered interviews, and audio computer-assisted self-interviewing (ACASI). The analysis focuses on the reporting of sexual behavior by adolescent girls in the face-to-face and ACASI modes and compares responses to a variety of questions about sexual activity, including sexual initiation, risky sexual behavior, and coerced sex. All sexual behavior questions were asked of each adolescent girl even if she answered “no” to the initial question about …

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Empowering Communities To Respond To Hiv/Aids: Ndola Demonstration Project On Maternal And Child Health: Operations Research Final Report, Hope Humana, Linkages, National Food And Nutrition Commission, Ndola District Health Management Team, Horizons Program, Zambia Integrated Health Project

HIV and AIDS

A pre–post intervention study conducted in Zambia by Horizons and local NGOs and governmental organizations demonstrated that HIV voluntary counseling and testing (VCT) and infant feeding counseling (IFC) to mothers attending maternal and child health (MCH) clinics are vital components of any mother-to-child transmission (MTCT) reduction strategy, whether or not antiretrovirals (ARVs) are available. These interventions enable mothers to make informed and healthy decisions. Data from the Ndola Demonstration Project yielded encouraging results from efforts to improve the capacity of mothers to make informed decisions about their own health and the health of their infant. The interventions succeeded in raising …

The Observatory Of The Americas As A Network In Environmental And Worker Health In The Americas, Carlos Eduardo Siqueira, Fernando Martins Carvalho

C. Eduardo Siqueira

This article reviews the scope of several Observatories found by a search in the Internet through the Google search engine. After examining these observatories, it describes the aims and initial accomplishments of the Observatory of the Americas as a network of professionals and activists from different countries in the Americas. The article concludes with a discussion of the pattern identified among these observatories: they may be clearinghouses or networks, or both.