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Full-Text Articles in Medicine and Health Sciences

Needs And Risks Facing The Indonesian Youth Population, Desti Murdijana Jan 1998

Needs And Risks Facing The Indonesian Youth Population, Desti Murdijana

Reproductive Health

Youth are the leaders of tomorrow, but right now they face a formidable collection of problems that will determine the quality of their future lives and the lives of us all. Education, jobs, substance abuse, violence, sexuality, and marriage are examples of adolescent issues that demand special attention from researchers, youth activists and advocates, parents, and policymakers. In attempting to address these complex issues, we must be willing to confront ignorance, controversy, and cultural obstacles. Clear and focused policy and strategies must play a basic role in tackling these issues facing Indonesian adolescents. This paper provides a concise situation analysis …

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The Impact Of Monetary Crisis And Natural Disasters On Women's Health And Nutrition, Meiwita B. Iskandar Jan 1998

The Impact Of Monetary Crisis And Natural Disasters On Women's Health And Nutrition, Meiwita B. Iskandar

Poverty, Gender, and Youth

This paper analyzes the short-term effects of the monetary crisis and natural disasters in Indonesia on women's health and nutritional status, and activities to monitor and address these problems. The monetary crisis which was announced in January 1998 hit the highest monthly inflation rate of 13 percent in February. Natural disasters that have plagued Indonesia since early 1997, including droughts and forest fires, have been projected to cause famines and an increased likelihood of infant and adult mortality. The economic crisis also directly impacts millions of workforce members threatened by the downsizing of thousands of businesses and factories, in the …

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Incentive Schemes For School Attendance In Rural Bangladesh, Sajeda Amin, Gilda Sedgh Jan 1998

Incentive Schemes For School Attendance In Rural Bangladesh, Sajeda Amin, Gilda Sedgh

Poverty, Gender, and Youth

This paper examines the impact of two incentive schemes on school attendance in rural Bangladesh: a food-for-education program for poor primary school children and a female secondary school scholarship scheme. The data come from an in-depth village study, before and after the programs went into effect. Both programs provide direct financial incentives to families to send their children to and keep them in school. The data also allow for an assessment of an informal school program sponsored by BRAC, a national non-governmental institution, at the study sites. School enrollment in the target population increased more rapidly than would have been …

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Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett Jan 1998

Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett

Poverty, Gender, and Youth

Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d’Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda …

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The Uncharted Passage: Girls' Adolescence In The Developing World, Barbara Mensch, Judith Bruce, Margaret E. Greene Jan 1998

The Uncharted Passage: Girls' Adolescence In The Developing World, Barbara Mensch, Judith Bruce, Margaret E. Greene

Poverty, Gender, and Youth

Adolescence is a formative time of transition to adulthood. What happens between the ages of 10 and 19 shapes how girls and boys live out their lives as women and men—not only in the reproductive arena, but in the social and economic realm as well. Yet, despite its impact on human development, adolescence has been sidelined as a research and policy subject in developing countries. While all adolescents deserve our attention, the needs of adolescent girls in the developing world are particularly pressing. This monograph focuses on these girls, presenting statistics to examine the social and economic context of their …

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Covert Contraceptive Use: Prevalence, Motivations, And Consequences, Ann E. Biddlecom, Bolaji M. Fapohunda Jan 1998

Covert Contraceptive Use: Prevalence, Motivations, And Consequences, Ann E. Biddlecom, Bolaji M. Fapohunda

Poverty, Gender, and Youth

This paper examines women’s covert use of contraceptives, that is, use without the knowledge of their husbands. Covert use may highlight conflict between husbands and wives about family planning, or it may reflect behaviors that spouses find difficult to discuss together. This study addresses three questions: 1) How is covert use measured in different settings? 2) How prevalent is it? and 3) What are the factors underlying covert use? We examine these questions by drawing on existing studies and detailed survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and a subsample of …

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Women's Lives And Rapid Fertility Decline: Some Lessons From Bangladesh And Egypt, Sajeda Amin, Cynthia B. Lloyd Jan 1998

Women's Lives And Rapid Fertility Decline: Some Lessons From Bangladesh And Egypt, Sajeda Amin, Cynthia B. Lloyd

Poverty, Gender, and Youth

In some of the more traditional parts of the world, fertility is falling steadily, sometimes rapidly, in environments where women’s lives remain severely constrained. The recent experiences of Bangladesh and Egypt, both predominantly Muslim countries, are illustrative in this regard. Since the late 1970s, rural and urban areas in both countries have experienced steady declines in fertility, with recent declines in rural Bangladesh similar to those in rural Egypt, despite lower levels of development and higher rates of poverty. This paper provides an in-depth exploration of the demographic transition in these two societies as seen through the dual lens of …

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The Impact Of An Integrated Micro-Credit Programme On Women's Empowerment And Fertility Behavior In Rural Bangladesh, Fiona Steele, Sajeda Amin, Ruchira Tabassum Naved Jan 1998

The Impact Of An Integrated Micro-Credit Programme On Women's Empowerment And Fertility Behavior In Rural Bangladesh, Fiona Steele, Sajeda Amin, Ruchira Tabassum Naved

Poverty, Gender, and Youth

This paper examines the impact of participation in women’s savings and credit groups organized by Save the Children USA on women’s empowerment, contraceptive use, and fertility in a rural area of Bangladesh. The data are drawn from a panel survey conducted in 1993, shortly before the groups were formed, and in 1995 after interventions began. This quasi-experimental design enables us to identify the characteristics of women who chose to join savings groups. The findings show that those who joined tend to more educated and more socially independent than are women who did not. Thus, to control for selection bias, preintervention …

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Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom Jan 1998

Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom

Poverty, Gender, and Youth

The association of migration with the spread of AIDS in sub-Saharan Africa is well documented, yet the social and behavioral mechanisms underlying this relationship remain poorly understood. Using data from the 1993 Kenya Demographic and Health Survey, this paper examines whether migrants are more likely than nonmigrants to have multiple recent sexual partners and not to use condoms with those partners. Results indicate that migation is a critical factor in high-risk sexual behavior and that its importance varies by gender and by the direction of movement. Independent of marital and cohabitation status, social milieu, awareness of AIDS, and other crucial …

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Fertility And Reproductive Preferences In Post-Transitional Societies, John Bongaarts Jan 1998

Fertility And Reproductive Preferences In Post-Transitional Societies, John Bongaarts

Poverty, Gender, and Youth

Conventional theories have little to say about the level at which fertility will stabilize at the end of the transition although it is often assumed that replacement fertility of about 2.1 births per woman will prevail in the long run. However, fertility has dropped below the replacement level in virtually every population that has moved through the demographic transition. If future fertility remains at these low levels populations will decline in size and age rapidly.This paper attempts to contribute to the understanding of levels and trends of post-transitional fertility by examining the causes of discrepancies between reproductive preferences and observed …

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The Onset Of Fertility Transition In Pakistan, Zeba Sathar, John B. Casterline Jan 1998

The Onset Of Fertility Transition In Pakistan, Zeba Sathar, John B. Casterline

Poverty, Gender, and Youth

Recent trends in fertility and contraceptive prevalence indicate that the marital fertility transition in Pakistan, which has been anticipated for three decades, has begun in the 1990s. Before that decade, the total fertility rate had exceeded 6 births per woman for at least three decades, and fewer than 10 percent of married women practiced contraception. The most recent survey data, collected in 1996- 97, show a total fertility rate of 5.3 births per woman and a contraceptive prevalence rate of 24 percent. Underlying this development are macroeconomic trends that have led to widespread economic distress at the household level, and …

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The Changing Social Environment For Adolescents In Kassena-Nankana District Of Northern Ghana: Implications For Reproductive Behavior, Barbara Mensch, Daniel Bagah, Wesley H. Clark, Fred N. Binka Jan 1998

The Changing Social Environment For Adolescents In Kassena-Nankana District Of Northern Ghana: Implications For Reproductive Behavior, Barbara Mensch, Daniel Bagah, Wesley H. Clark, Fred N. Binka

Poverty, Gender, and Youth

This study reports on a primarily qualitative investigation of adolescent reproductive behavior in the Kassena-Nankana District, a rural isolated area in northern Ghana, where traditional patterns of marriage, family formation, and social organization persist. The study is based on in-depth interviews and focus groups with adolescents, parents, chiefs and traditional leaders, teachers, youth leaders, and health workers, supplemented by quantitative data from the 1996 wave of a panel survey of reproductive-aged women conducted by the Navrongo Health Research Centre. The social environment faced by adolescent boys and girls in the Kassena-Nankana District and its links to reproductive behavior are described. …

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The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain Jan 1998

The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain

Poverty, Gender, and Youth

Since 1982, the Maternal and Child Health and Family Planning Extension Project has compiled longitudinal panel data on rural women’s contact with household service providers who visit homes to discuss family planning and offer services to women on request. This study tests the hypothesis that home-based services reinforce customs of purdah (female seclusion) by sustaining the dependency and isolation of the women served by the program. Results show that household services improve women’s status. This effect is largely attributable to the impact of outreach on effective fertility regulation. Findings do not support the hypothesis that household service delivery is detrimental …

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Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline Jan 1998

Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline

Poverty, Gender, and Youth

Theories of the fertility transition now routinely reserve a place for diffusion effects. Two fundamental behavioral mechanisms account for such effects: social learning and social influence. Social learning refers to the acquisition of information from others. The information might have to do with a new technology or with the health, social, and economic consequences of decisions. In the case of fertility, individuals might learn from others about the availability of a new contraceptive, or about health side effects of certain contraceptives, or about the apparent gains and losses from having fewer children and investing in their schooling. Social influence refers …

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What Can Be Done To Foster Multisectoral Population Policies? Summary Report Of A Seminar, Population Council, Overseas Development Council Jan 1998

What Can Be Done To Foster Multisectoral Population Policies? Summary Report Of A Seminar, Population Council, Overseas Development Council

Poverty, Gender, and Youth

The 1994 International Conference on Population and Development in Cairo was a watershed moment in the definition of population policies. The meeting put an end to the unproductive debate on which is more instrumental in achieving voluntary fertility decline: providing family planning (FP) services or improving social and economic development. The answer was that both are essential. The Cairo meeting also defined the most desirable services and the kind of development that was most empowering, particularly with respect to achieving reproductive choice. Despite this strong dual message from Cairo, only the call for a move away from a narrow vision …

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Continuing The Strengthening Of Situation Analysis Methodology: An Africa-Focused Approach, Robert A. Miller Jan 1998

Continuing The Strengthening Of Situation Analysis Methodology: An Africa-Focused Approach, Robert A. Miller

Reproductive Health

In 1995, the Population Council’s Africa OR/TA Project II proposed a three-year subproject to organize and strengthen the Situation Analysis methodology that had been developed by the first Africa OR/TA Project in 1989. This subproject proposed to concentrate on three areas of continuing importance in the African context: wider use of the established database to explore program issues in reproductive health (RH); synthesis of the knowledge that has been collected about African family planning (FP) programs into a monograph analyzing program issues, patterns of services, and their implications; and continued assistance in training and data processing on field studies. These …

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The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark Jan 1998

The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

In Kenya, adolescent girls fare poorly relative to boys in an educational system characterized by enormous growth, deteriorating quality, and rising costs. Girls are more likely than boys to drop out of school prematurely and are less likely to do well on the primary school leaving exams that come at the end of grade eight. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 36 primary schools in which those adolescents reside, this paper investigates the effect of school quality on the likelihood of dropping out from primary school in three districts of Kenya. In …

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On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney Jan 1998

On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

Demographers have known since the 1940s that standard measures of period fertility, such as the widely used total fertility rate, are distorted by changes in the timing of childbearing. Period fertility rates are depressed during years in which women delay childbearing and inflated in years when childbearing is accelerated. This problem is usually ignored because there has been no generally accepted method for solving it. This study proposes a method for removing the tempo distortions from the total fertility rate. The key assumption of the method is that period effects, rather than cohorts effects, are the primary force in fertility …

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Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll Jan 1998

Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Five categories of possible government influence on a nation’s fertility are explored: (1) through publicly funded programs that explicitly seek to affect family-size outcomes (2) through the legal order and system of public administration (3) through measures that affect economic opportunity, social mobility, and gender relations; (4) through public-sector expenditures and transfer payments keyed to age or family status; and (5) through the state’s supplanting of local beliefs and traditions with the symbols of national identity and through the parallel expansion of cultural frames of reference. Aside from the first of these, intentions to influence fertility are either incidental or …

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Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia Jan 1998

Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia

Poverty, Gender, and Youth

This is the first of several editions of Quality/Calidad/Qualité that describe methodologies designed to assist family planning program managers and staff to self-assess the quality of services they are providing. These tools give program sponsors an opportunity to identify shortfalls in their service environment and propose solutions. This issue focuses on AVSC International's COPE (client-oriented, provider-efficient) methodology, a self-assessment tool that has now been used in 35 countries around the world. The report examines the experience of the National Family Planning Association of Kenya, provides some lessons learned, and demonstrates that these self-assessment exercises are, in fact, resulting in system-wide …

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Integrating Rti Service With Primary Health Care, Population Council Jan 1998

Integrating Rti Service With Primary Health Care, Population Council

Reproductive Health

The reproductive health (RH) movement worldwide has brought reproductive tract infections (RTIs) under sharp focus as an urgent health need of women. While RTIs are preventable or treatable, they are often the cause of infertility, ectopic pregnancy, cervical cancer, fetal loss, low birth-weight infants, infant blindness, and neonatal pneumonia. The adverse health effects of RTIs, particularly STIs, is much higher for women than men. Recent research has demonstrated that RTIs are closely linked to other areas of health care like family planning (FP), safe motherhood, child survival, and HIV prevention. Hence, each could significantly contribute to the reduction and control …

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Clinic-Based Family Planning And Reproductive Health Services In Africa: Findings From Situation Analysis Studies, Kate Miller, Robert A. Miller, Ian Askew, Marjorie C. Horn, Lewis Ndhlovu Jan 1998

Clinic-Based Family Planning And Reproductive Health Services In Africa: Findings From Situation Analysis Studies, Kate Miller, Robert A. Miller, Ian Askew, Marjorie C. Horn, Lewis Ndhlovu

Reproductive Health

The United States Agency for International Development (USAID) supported publication of “Clinic-Based Family Planning and Reproductive Health Services in Africa: Findings from Situation Analysis Studies.” The book reflects USAID's commitment to improving quality of reproductive health (RH) care and expanding access for underserved groups. Nowhere are these efforts more important than in Africa, where use of family planning (FP) and other measures of RH status are lowest among the world’s regions. Providing high-quality health services that meet couples' reproductive needs is a socially just and humane goal in itself. Moreover, higher-quality services can be expected to result in better outcomes …

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Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad Jan 1998

Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad

Reproductive Health

This paper offers a broad definition of quality of care and presents a comprehensive conceptual framework for the assessment of quality of reproductive health services and methodological approaches for its measurement. It presents three studies that were conducted between 1990 and 1991 by members of the regional Reproductive Health Working Group from Egypt, Jordan, and Tunisia. The studies provide examples of applications of the framework and its measurement using multiple data sources. Selected findings are presented to illustrate comparative results between countries. Based on the lessons learned from the studies, examples of reproductive health interventions that may improve the quality …

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Advances And Challenges In Postabortion Care Operations Research: Summary Report Of A Global Meeting, Dale Huntington Jan 1998

Advances And Challenges In Postabortion Care Operations Research: Summary Report Of A Global Meeting, Dale Huntington

Reproductive Health

The Global Meeting on Postabortion Care: Advances and Challenges in Operations Research was held at the Population Council’s New York office on January 19–21, 1998, to review progress made by three regional operations research (OR) projects in improving delivery of postabortion care. The resources of the three OR contracts were pooled, and, in collaboration with Ipas and the Ebert Program, approximately 65 researchers, senior program managers, and government officials from Africa, Latin America, the Middle East, and Southeast Asia were convened. Three objectives guided the planning of the meeting: review progress in the development of OR methodologies pertaining to postabortion …

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Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council Jan 1998

Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council

Reproductive Health

Much literature has been written about improving the quality of reproductive health (RH) care at service delivery points (SDPs) because women deserve quality services, and as a means of increasing use of family planning (FP) and other RH services. There are six fundamental dimensions of quality of care: choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to encourage continuity, and an appropriate constellation of services. Improving these elements is thought to increase client satisfaction, resulting in an increase in contraceptive use and eventually fertility decline. Existing research has not convincingly demonstrated this link between quality of …

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Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller Jan 1998

Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller

Reproductive Health

The Planned Parenthood Association of Ghana (PPAG) is one of the most active nongovernmental organizations delivering reproductive health (RH) services in Ghana, focusing particularly on youth issues and services. USAID suggested to the Population Council’s Africa OR/TA Project II staff that PPAG might benefit from technical assistance. A large and well-funded IPPF program to promote sexual health among youth of the Volta Region offered a good opportunity to begin OR work. Earlier, the program was envisioned as a demonstration educational program of five years duration. Further discussions suggested that this program was unlikely to be duplicated anywhere, because of its …

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Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob Jan 1998

Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob

Reproductive Health

The national family planning and maternal child health (FP-MCH) program in Bangladesh has raised FP acceptance among couples of reproductive age significantly. A major challenge still facing the program, however, is strengthening its reproductive health (RH) component. The Population Council launched a pilot project to examine the feasibility of strengthening comprehensive reproductive tract infection (RTI) and sexually transmitted disease (STD) services at the Health and Family Welfare Center level. The project had three phases. First, a needs assessment was conducted. Then the components of the intervention were identified, designed, and implemented. And at the third phase, an evaluation was carried …

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Strengthening The Utilization Of Family Planning Operations Research: Findings From Case Studies In Africa, Julie Solo, Annamaria Cerulli, Robert A. Miller, Ian Askew, Elizabeth Pearlman Jan 1998

Strengthening The Utilization Of Family Planning Operations Research: Findings From Case Studies In Africa, Julie Solo, Annamaria Cerulli, Robert A. Miller, Ian Askew, Elizabeth Pearlman

Reproductive Health

The goal of undertaking operations research (OR) on family planning (FP) and reproductive health (RH) services is to strengthen the ability of programs and policies to maximize access to and quality of these services. This report addresses the need for a greater understanding of how information from OR studies is utilized. The Africa OR/TA Project II undertook a study to assess the extent to which information from OR studies conducted under the Africa OR/TA Project I (1988–1993) was utilized. The study also examined the factors influencing how study results were utilized. Case studies of several OR projects were undertaken to …

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Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab Jan 1998

Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab

Reproductive Health

As more work in the area of male involvement in reproductive health (RH) is expected in Egypt, it is important that researchers and donor agencies become aware of existing studies, topics covered, and main research findings so duplication can be avoided. It is also important that policymakers and program managers learn about the results of existing studies so they can use those results in designing more effective policies to increase male involvement in Egypt. To address this need, the Population Council’s ANE OR/TA Project organized a seminar on “Disseminating Results of Research on Male Involvement in Reproductive Health in Egypt” …

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Analysis Of Price Change On The Perceptions And Use Of Dmpa Among Clients Using Reproductive Health Services In Uttar Pradesh, India, Leila Caleb-Varkey, John Townsend, Sneh Vishwanath, Sudha Tiwari Jan 1998

Analysis Of Price Change On The Perceptions And Use Of Dmpa Among Clients Using Reproductive Health Services In Uttar Pradesh, India, Leila Caleb-Varkey, John Townsend, Sneh Vishwanath, Sudha Tiwari

Reproductive Health

Depo-medroxy Progesterone Acetate (DMPA) is a progesterone-only injectable contraceptive that has been approved by the Government of India for provision in the commercial sector, where it is marketed under the brand name Depo-Provera. In 1996, it was available at rates between Rs. 140 to Rs. 180 per injection. At this price it is often beyond the reach of many women wanting a safe and effective contraceptive. In January 1996, DMPA was provided to women in three cities of Uttar Pradesh through Parivar Seva Sanstha’s (PSS) clinics at Rs. 150. In July 1996, as part of operations research (OR), the price …

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