Public Health Commons^™

Population And Development: An Introductory View, Geoffrey Mcnicoll

Poverty, Gender, and Youth

A brief overview of the relationships between population change and economic development, written for readers unfamiliar with the subject. The paper touches on the scale and pace of world development, the economic consequences of population size and rate of growth, patterns of demographic transition, and the scope for policy measures aimed at speeding that transition.

Population And Development: An Introductory View [Arabic], Geoffrey Mcnicoll

Poverty, Gender, and Youth

A brief overview of the relationships between population change and economic development, written for readers unfamiliar with the subject. The paper touches on the scale and pace of world development, the economic consequences of population size and rate of growth, patterns of demographic transition, and the scope for policy measures aimed at speeding that transition.

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 …

Adolescents And Youth In Pakistan 2001-2002: A Nationally Representative Survey, Zeba Sathar, Minhaj Ul Haque, Azeema Faizunnissa, Munawar Sultana, Cynthia B. Lloyd, Judith A. Diers, Monica J. Grant

Poverty, Gender, and Youth

Published by the Population Council's Islamabad office, this is the first comprehensive survey of Pakistani youth. The report provides an unprecedented view of young people's experiences with and attitudes about education, employment, families, and marriage. The report findings confirm the large differences in the current situation of adolescents and youth, males versus females, from different strata of residence and economic status. Addressing these requires government intervention, changes in attitude, and input from the media, women and youth groups, and members of civil society.

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 …

« Mon Père Pensait Autrement » : Des Garçons Nigérians Réfléchissent À L'Égalité Entre Les Sexes, Françoise Girard

Poverty, Gender, and Youth

L’une des leçons émergeant des programmes pour adolescents dans le monde entier concerne la nécessité de créer des cadres où les jeunes hommes peuvent remettre en question ce qui est souvent considéré comme incontestable, par exemple ce que signifie « être un homme ». Ce numéro décrit le programme nigérian « Conscientiser les adolescents de sexe masculin » (CMA, Conscientizing Male Adolescents). Contrairement à beaucoup de programmes visant les adolescents de sexe masculin, qui mettent l’accent sur des activités à court terme destinées à prévenir la maladie et les grossesses non désirées, le modèle proposé par CMA est un programme …

The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton

Poverty, Gender, and Youth

The detrimental consequences of the AIDS epidemic for older adults in sub-Saharan Africa suggest the need to investigate their characteristics, living situations, and well-being. In this study, we examine the living arrangements of persons aged 60 and older in 16 countries. Data come from the household roster component of recent Demographic and Health Surveys. The focus is on the tendency of the elderly to live with children and grandchildren, and we examine distributions and determinants. Results show that older adults in sub-Saharan Africa live in a variety of household arrangements. Men are more likely to be living in a nuclear …

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 …

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, …

Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences [Arabic], John Bongaarts

Poverty, Gender, and Youth

This study summarizes patterns of educational differentials in wanted and unwanted fertility at different stages of the fertility transition based on data from DHS surveys in 57 less developed countries. As the transition proceeds, educational differentials in wanted fertility tend to decline and differentials in unwanted fertility tend to rise. An assessment of fertility patterns in more and less developed countries with low fertility concludes that these differentials are likely to remain substantial when less developed countries reach the end of their transitions. This finding implies that the educational composition of the population remains a key predictor of overall fertility …

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.

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 …

Women's Denial Of Having Experienced Female Genital Cutting In Northern Ghana: Explanatory Factors And Consequences For Analysis Of Survey Data, Elizabeth F. Jackson, Patricia Akweongo, Evelyn Sakeah, Abraham Hodgson, Rofina Asuru, James F. Phillips

Poverty, Gender, and Youth

Although many cross-sectional social surveys have included questions about female genital cutting status and correlated personal characteristics, no longitudinal studies have been launched that permit investigation of response biases associated with such surveys. This paper reports on a longitudinal study of women aged 15 to 49 in rural northern Ghana. The self-reported circumcision status of women interviewed in 1995 was compared with the status they reported when they were interviewed again in 2000 after the government began enforcing a law banning the practice and public information campaigns against it were launched. In all, 13 percent of respondents who reported in …

Marriage In Transition: Evidence On Age, Education, And Assets From Six Developing Countries [Arabic], 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.

Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand

Reproductive Health

The Population Council has been providing technical assistance and conducting Operations Research (OR) studies in family planning and reproductive health for over two decades. These studies are designed to identify problems and test strategies to resolve those problems, providing program managers, administrators, and policymakers with the information they need to improve service-delivery systems. The ultimate goal is that strategies tested through OR will be adopted, leading to changes in policy or operational procedures at institutional, national, or international levels. These changes are what we refer to as impact. The purpose of the new approach to evaluation described in this Evaluation …

Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert

Reproductive Health

This paper presents the results of an extensive review of the literature pertaining to the relationship between vaginal lubrication and the acceptability of microbicides, spermicides, and male and female condoms. The review highlights the need for research that better elucidates norms, preferences, and practices regarding lubrication during sex within and across countries. The second part of the report presents the results of the first phase of a qualitative study on lubrication during sex showing that diverse personal and cultural factors shape preferences and practices and may ultimately affect the acceptability of microbicides. The immediate challenge is to provide women with …

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 …

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 …

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 …

Transportation: A Crucial Issue For Adult Day Care In Vermont, Francis G. Caro, Regula H. Robnett, Jennifer Higgins

Gerontology Institute Publications

Transportation arrangements are an integral but fragile element in the effectiveness of adult day care services in Vermont and nationwide. Almost by definition, adult day center participants generally cannot drive due to cognitive and/or physical limitations. Since adult day care services are congregate in nature and serve community-residing elders, this long-term care option is feasible only when there are arrangements to transport elders to and from service centers. Transportation is therefore a major issue for adult day care services.

The aim of this report is to call attention to transportation issues in adult day care services in Vermont. The report …

Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta

HIV and AIDS

While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …

Ndola Demonstration Project: A Midterm Analysis Of Lessons Learned, Horizons Program

HIV and AIDS

This report summarizes baseline and midterm findings of an intervention pilot study conducted by Horizons, LINKAGES, National Food and Nutrition Commission, District Health Management Team, Hope Humana, and the Zambia Integrated Health Program in Ndola District, Zambia. The aim of the research is to investigate how integrating services for the prevention of mother-to-child transmission (PMCT) of HIV into low-resource maternal and child health (MCH) and antenatal care (ANC) settings influences women’s ability to make and implement informed decisions about HIV. The intervention strengthened routine services and introduced HIV voluntary counseling and testing and PMCT counseling and services into the MCH/ANC …

Frontiers Capacity Building: An Overview, James R. Foreit

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program is a cooperative agreement with USAID to improve family planning and reproductive health service delivery through operations research (OR). Frontiers builds on more than 20 years of research to improve family planning service delivery programs. A major goal of Frontiers is to transfer skills in OR so that public and private agencies in developing countries can conduct OR and apply research findings to reproductive health programs and policies. OR addresses problems in operational effectiveness, access, quality, and efficiency by investigating facets of programs that managers can control and change. As concluded in …

Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim

Poverty, Gender, and Youth

Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …

Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang

Poverty, Gender, and Youth

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …

How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May

Poverty, Gender, and Youth

Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …

The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth

Poverty, Gender, and Youth

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …

Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim

Poverty, Gender, and Youth

In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …

Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh

Poverty, Gender, and Youth

To the extent that research on Vietnamese adolescents has been conducted, it has been concerned with unprotected and unsanctioned sexual activity and its health consequences, namely abortion and sexually transmitted diseases, especially HIV. The question we pose is whether this concern is warranted. Is the population community justified in focusing its attention on early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young people’s lives that should give us greater pause? The paper reviews the literature on adolescent sexual behavior in Vietnam and analyzes data …

The Effect Of Gender Differences In Primary School Access, Type, And Quality On The Decision To Enroll In Rural Pakistan, Cynthia B. Lloyd, Cem Mete, Zeba Sathar

Poverty, Gender, and Youth

The paper explores the effect of primary school access, type, and quality on the decision to enroll in rural Pakistan using a 1997 survey especially designed for this purpose. A unique contribution of the paper is the construction of gender-specific dimensions of school accessibility and school quality according to school type (i.e., public vs. private). Within the same village, girls and boys often face starkly different options for schooling in terms of distance, type, and quality. Public primary schools are segregated by sex; private schools, whose numbers have grown rapidly in recent years in response to rising demand and the …