Public Health Commons^™

Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez

Reproductive Health

Recent years have been characterized by an increasing consensus that, in order to support women's goals and aspirations, health programs directed to the improvement of women's and children's health must consider men's perspectives. Although family planning (FP) is often viewed as the woman's responsibility, men have an important role in decisions of whether FP will be practiced and which method will be used. Even though gender relations in the Philippines are often characterized as being relatively egalitarian, there are several reasons for believing that male involvement in FP is highly relevant for this country. Studies indicate that not only are …

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior, Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago. METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey. RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …

Devolpment Of A Scale To Assess Home Health Care Aides' Ability To Recognize Depression In Older Adults, Tina M. Nerney

Community & Environmental Health Theses & Dissertations

Depression afflicts 20% to 40% of people 65 and older. Depression in older adults is frequent and chronic. The challenge of a hospital stay and the knowledge of having a long term disability may increase the risk for a depressive episode. In today's health care environment older adults are being released from hospitals after a short length of stay and are frequently dependent on home health services for assistance with activities of daily living. Home health care aides are given the responsibility of providing these services to the older adult in the home environment and need to be aware of …

Where Do Elderly Veterans Obtain Care For Acute Myocardial Infarction: Department Of Veterans Affairs Or Medicare?, S M. Wright, J Daley, E S. Fisher, G E. Thibault

Dartmouth Scholarship

To examine Department of Veterans Affairs (VA) and Medicare hospitalizations for elderly veterans with acute myocardial infarction (AMI), their use of cardiac procedures in both systems, and patient mortality. DATA SOURCES: Merging of inpatient discharge abstracts obtained from VA Patient Treatment Files (PTF) and Medicare MedPAR Part A files. A retrospective cohort study of male veterans 65 years or older who were prior users of the VA medical system (veteran-users) and who were initially admitted to a VA or Medicare hospital with a primary diagnosis of AMI at some time from January 1, 1988 through December 31, 1990 (N = …

Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez

Reproductive Health

A Situation Analysis (SA) was conducted in seven local government health centers as part of a larger project studying the feasibility of integrating RTI services within the existing Family Planning/Reproductive Health Program of the Department of Health (DOH). The SA was part of a series of baseline activities conducted by the Family Planning Operations Research and Training Project as part of its study on Integrating RTI Management in Local Government Unit Health Centers. It was conducted by Population Council, Manila, for the DOH. Participating health centers were located in a large and highly urbanized community, a medium-sized city, and two …

Beliefs And Practices About Reproductive Tract Infections: Findings From A Series Of Philippine Fgds, Marilou Palabrica-Costello, Carmeli Marie Chaves, Chona R. Echavez, Cecilia Conaco, Mariano Santiago

Reproductive Health

The past decade has been characterized by increasing concern about the medical, social, and economic problems associated with reproductive tract infections (RTIs). The goal of preventing and curing RTIs is now being prioritized by public health agencies in the developing world. Very little research has been conducted on the problem of RTIs in the local context, and it would be helpful for program managers if the knowledge and beliefs now being held about RTIs were more clearly delineated. Knowing more about the way in which these illnesses are viewed by the community, about traditional practices for preventing and curing RTIs, …

Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings

Reproductive Health

In Kenya, as throughout the world, the health consequences of unsafe abortion for women of reproductive age are significant. Hospital-based studies in Nairobi have shown that unsafely induced abortion accounts for as much as 35 percent of pregnancy-related mortality and at least 50 percent of hospitals’ gynecological admissions. The concept of postabortion care (emergency treatment, postabortion family planning counseling and services, links between emergency abortion treatment services and comprehensive reproductive health care) has gained wide acceptance as one model of providing comprehensive care to women suffering from abortion complications. Integration of these three components is rarely found in public health …

Using A Rapid Assessment Approach To Evaluate The Quality Of Care In An Integrated Program: The Experience Of The Family Health Division, Ministry Of Health, Botswana, Lucy Sejo Maribe, Baker Ndugga Maggwa, Ian Askew, Kate Miller

Reproductive Health

To strengthen existing efforts by the Government of Botswana in responding to the HIV/AIDS epidemic, USAID provided financial and technical assistance through the Botswana Population Assistance (BOTSPA) project. BOTSPA’s goal was to improve the quality and availability of family planning (FP) and sexually transmitted infection (STI) services through designing, implementing, and monitoring activities that would lead to the eventual institutionalization and sustainability of high-quality FP and STI/HIV/AIDS services. The Ministry of Health requested assistance from the Africa OR/TA Project II to develop and test an approach for routinely measuring the quality of service delivery and assessing skills retention by staff …

Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew

Reproductive Health

Sub-Saharan Africa is confronting an HIV/AIDS epidemic and virtually all health programs in the region are seeking ways of preventing and reducing the spread of this virus. To compound the problem, the presence of certain sexually transmitted infections (STIs) is known to increase risk of the sexual transmission of HIV. The sub-Saharan region is believed to have some of the highest levels of STIs in the world, thus controlling STIs is not only an important reproductive health care strategy in itself but also a key strategy in reducing the spread of HIV. The strongest evidence to support this has come …

Traditional Family Planning In Bangladesh, Alan Gray, Jamil H. Chowdhury, Bruce Caldwell, Ahmed Al-Sabir

Reproductive Health

“Traditional” methods of family planning (FP) generally are methods such as withdrawal and periodic abstinence that do not require contraceptive substances or devices, or clinical procedures. In 1991, approximately 38 million couples worldwide relied on withdrawal to prevent pregnancy, and 30-35 million relied on periodic abstinence. Together, these constituted one-quarter of all users of temporary methods of FP worldwide. In Bangladesh, the proportion using periodic abstinence or withdrawal was more than 20 percent of users of temporary methods. The reasons for use of traditional methods have not been investigated in Bangladesh, because of overriding attention to modern methods. Given that …

Improved Reproductive Health And Std Services For Women Presenting To Family Planning Services In North Jakarta. Final Report Of Activities, Meiwita B. Iskandar, Catherine Vickers, Subadra Indrawati, Siti Nurul Qomariyah

Reproductive Health

The overall goal of this study was to develop an integrated program of reproductive tract infection/sexually transmitted disease (RTI/STD) clinical services within two family planning clinics in low-income neighborhoods in North Jakarta. Multiple training programs to introduce a standardized clinical evaluation for the detection, treatment, and management of RTI/STDs were conducted. Prior and subsequent to training, observations of health care provider (HCP) and client interactions were conducted to evaluate behavior changes among HCPs. Each consenting client received a standardized reproductive health history, a pelvic exam, and provided specimens for laboratory testing to detect RTIs. Through universal screening of the participants …

Emergency Contraception As An Element In The Care Of Rape Victims, Ricardo Vernon, Raffaela Schiavon, Silvia Elena Llaguno

Reproductive Health

In most states in Mexico, abortion is excluded as a crime in pregnancies resulting from rape. However, legislation does not specify the norms by which women can obtain a legal abortion, which makes it difficult to choose this alternative. A partial solution to unwanted pregnancies from rape would be to provide emergency contraception (EC). Psychologists were trained to provide information on EC to women who reported a rape at four public ministry agencies specialized in sexual crime. In addition, 11 medical backup referral centers were established. To scale up the strategy, workshops were provided to representatives from State Attorney General …

An Assessment Of Clinic Based Family Planning Services In Kenya: Results From The 1995 Situation Analysis Study, Lewis Ndhlovu, Julie Solo, Robert A. Miller, Kate Miller, Achola Ominde

Reproductive Health

This study’s objective was to assist the Kenya Ministry of Health (MOH), the National Council for Population and Development (NCPD), NGOs, and donor agencies in planning the expansion and improvement of family planning (FP) and other reproductive health (RH) services provided in Kenya. Data on the functioning of program subsystems and the quality of care provided were collected in May 1995 from 254 maternal and child health/family planning (MCH/FP) facilities throughout the country using a situation analysis approach. The study sample included a representative sample of facilities from the MOH and NGO sectors. It also included a census of all …

Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey

Reproductive Health

In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and …

Reproductive Behavior Among Muslims In Uttar Pradesh, M.E. Khan, Bella C. Patel

Reproductive Health

Muslims form the largest minority group in India, according to the 1991 census, constituting about 12 percent of the country's population. India has the second largest Muslim population in the world. The growth rate of the Muslim population in India during the last three decades is somewhat higher than the non-Muslim population. The present paper, based on a large sample survey carried out in Uttar Pradesh, India, compares the reproductive behavior of Hindus and Muslims. An attempt has been made to examine the determinants of their differential fertility and family planning behavior.

Measuring Hospital Use Without Claims: A Comparison Of Patient And Provider Reports., R E. Clark, S K. Ricketts, G J. Mchugo

Dartmouth Scholarship

We compared the validity of hospital admission and length of stay reports from patients, outpatient providers, and hospitals, and we examined possible sources of error. Data were collected from people enrolled in a randomized trial of treatment for severe mental illness and substance use disorders, from community mental health centers (CMHCs), and from hospitals. Reports for each of the 74 study participants covered two-year time periods beginning and ending at various times between 1989 and 1993. We compared reports from the various sources and constructed a hybrid with data from all three sources. Using parametric and non-parametric statistics, we compared …

Postpartum Safety And Satisfaction Following Early Discharge, Dawn M. Guthrie, J. Ivan Williams, Ellen Hodnett, Janet Rush

Kinesiology and Physical Education Faculty Publications

Two Ontario sites were involved in the evaluation of an obstetrical discharge program. Before program implementation a group of eligible women were enrolled as the preprogram control group (n = 542). During the program, eligible women who agreed to early discharge (ED) became the ED group (n = 319), and those opting not to go home early but consenting to participate in the evaluation became the concurrent group (n = 456). All groups were mailed a self-administered postpartum questionnaire. On demographic characteristics, safety and satisfaction, the ED group was comparable to the concurrent group. Hospital readmission rates did not differ …

When Are Research Findings Ready For Use?, Judith A. Floyd

Nursing Faculty Research Publications

No abstract provided.

Reintroducing Dmpa To The Philippine Family Planning Program: A Longitudinal Study Of Continuing Users And Drop-Outs, Population Council

Reproductive Health

In 1994, the Population Council, Manila, conducted an operations research (OR) project entitled “DMPA Monitoring and Follow-up Studies.” The activity was undertaken to provide accurate and timely support to the DMPA Reintroduction Program of the Department of Health. Commonly known as Depo-Provera, DMPA stands for Depo-Medroxy Progesterone Acetate, an extremely effective injectable contraceptive given every three months. This report focuses on the survey component of these studies which aims to comprehensively examine the influence on DMPA use of factors classified into the following eight major areas: socioeconomic and demographic characteristics; reproductive history; contraceptive history; adoption of DMPA; quality of care …

Proceedings Of The Operations Research Training Workshop For Program Managers And Researchers, January 15-21, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This document contains the proceedings of the training workshop on operations research (OR) for program managers and researchers held January 15-21, 1996, in Mindoro, Philippines. The workshop was co-sponsored by the Family Planning Service of the Department of Health and the Family Planning Operations Research and Training Program of the Population Council, Manila. Representatives from the health and population offices of ten local government units (LGUs) worked with a select group of researchers to evolve a list of relevant topics for operations research (OR) and develop a concept paper on a chosen OR topic. The LGUs represented in the workshop …

Unsafe Abortion In Kenya: Findings From Eight Studies, Khama Rogo, Ann Leonard

Reproductive Health

One of the most topical areas in reproductive health today is the consequences of induced and often unsafe abortion. Safe motherhood initiatives continue to highlight the contribution of unsafe abortion to the persistent high rates of maternal mortality and morbidity in sub-Saharan Africa. In some countries, unsafe abortion is responsible for up to half of all maternal mortality and morbidity, with adolescents constituting a significant proportion of those procuring unsafe abortions. In Kenya, concern about the problem of incomplete and septic abortion has increased, particularly on the part of service providers who must treat women suffering from the complications of …

Learning About Sexuality: A Practical Beginning, Sondra Zeidenstein, Kirsten Moore

Poverty, Gender, and Youth

“Learning About Sexuality: A Practical Beginning” is divided into three main parts. The first includes approaches that program staff, activists, and researchers are taking to understand people’s experiences of sexuality. The second explores the explicit and implicit links among health-seeking behavior, contraceptive practice, reproductive health, and sexuality. The chapters in part three focus on activities that challenge entrenched attitudes and behavior about sexuality that have real and potentially harmful effects on women’s and men’s reproductive health. The book features program and research work in all regions of the world with women, men, girls, and boys. The chapters are written by …

Profile Of Clients Of Different Providers Of Family Planning Services In Egypt [Arabic], Population Council, Spaac

Reproductive Health

No abstract provided.

Inopal Ii Final Report, Population Council

Reproductive Health

The goal of the Population Council's “Investigación Operacional en Planificación Familiar y Atención Materno-Infantil para América Latina y el Caribe” (INOPAL) program was to conduct operations research and provide technical assistance to improve the coverage, quality, and sustainability of family planning (FP) services in Latin America and the Caribbean. INOPAL II was the successor to INOPAL I (1984–1989). Like its predecessor, INOPAL II was supported by a contract from the USAID Office of Population, when it was replaced by a new USAID-funded project, INOPAL III. INOPAL II objectives included: expanding access to FP services, improving the operations of programs by …

Indonesia: Utilization Of Completed Operations Research Studies, Meiwita B. Iskandar, Subadra Indrawati

Reproductive Health

In the past eight years, many operations research (OR) programs were implemented in Indonesia to increase the availability, accessibility, and acceptability of services desired by family planning (FP) users. OR has also been employed to improve quality and sustainability by studying the performance, efficiency, and effectiveness of services delivered by providers. Nonetheless, relatively little is known about the true effects of OR studies in identifying and solving program problems in order to support the planning and coordinating of a particular program. Measuring utilization of OR results is not simple. In 1989, USAID signed its last bilateral assistance agreement with the …

Proceedings Of The Operations Research Training Workshop: Mainstreaming Nfp In The Public Sector, August 15-18, 1996, Family Planning Service, Philippine Federation For Natural Family Planning, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This report summarizes the proceedings of the “Operations Research Training Workshop: Mainstreaming Natural Family Planning in the Public Sector,” held August 15-18, 1996, in Boracay, Aklan, Philippines. The workshop was sponsored by the Philippine Federation for Natural Family Planning (NFP), the Family Planning Service of the Department of Health, and the Family Planning Operations Research and Training (FPORT) Program of the Population Council, Manila. Program managers and health officials were trained in operations research (OR) to enhance their understanding and appreciation of OR and its role in integrating NFP technology in the public health sector. Results of several diagnostic and …

Dmpa Injectable Use: Findings From The 21-Month Dmpa Monitoring Study, Population Council

Reproductive Health

This report presents the results of the DMPA Monitoring Study undertaken by the Population Council, Manila, as a technical assistance project for the DMPA Reintroduction Program of the Department of Health. The primary objective is to provide data on DMPA utilization and continuation rates to project the logistical needs of the program during the next three years. Data on availability of DMPA supplies and IEC (information, education, and communication) materials relating to DMPA were also monitored to provide some measure of effectiveness of the program's distribution system. The study covers a 21-month observation period from April 1994 to December 1995 …

Proceedings Of The Operations Research Workshop For Lgu Health And Population Officials And Researchers, August 9-13, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This report summarizes the results of the training workshop for health and population officials and researchers who gathered in Boracay, Aklan, Philippines, on August 9-13, 1996, to discuss the tenets and applications of operations research (OR). This workshop was co-sponsored by the Family Planning Service of the Department of Health (DOH) and the Family Planning Operations Research and Training Program of the Population Council, Manila. Fourteen local government units (LGUs) were represented in the workshop: Benguet, Cagayan, Ilocos Sur, Tarlac, Quezon City, Capiz, Negros Oriental, Bacolod, Misamis Oriental, Davao del Sur, Davao City, Maguindanao, North Cotabato, and South Cotabato. They …

The Dmpa Service Provider: Profile, Problems And Prospects—Philippines, Maria Carmela Patron, Marilou P. Costello

Reproductive Health

This report presents the results of interviews conducted with 60 trained DMPA service providers from seven of the ten local government units (LGUs) covered by Phase I of the Philippine Department of Health's DMPA Reintroduction Program. DMPA, or Depot-medroxyprogesterone acetate, is an injectable contraceptive commonly known as Depo-Provera. The interviews were undertaken as part of the DMPA Monitoring and Follow-up Studies sponsored by the Population Council under the Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. While the monitoring study and the follow-up survey focused on DMPA users and dropouts, this study centered on the service …

Patient Satisfaction Among Users Of The After Hours Program, Helen L. Larocco

Community & Environmental Health Theses & Dissertations

The problem of increasing health care costs and decreasing access to health care services is a major crisis in the U.S. today. One factor contributing to the rising cost of health care is the inappropriate use of emergency rooms, (ERs). In response to escalating costs a local health care corporation implemented a telephone triage program called the After Hours Program, (AHP). The goal of the program was to reduce inappropriate utilization of emergency rooms, and to educate patients to recognize and treat specific health problems independently, i.e., home treatment.

A program evaluation was completed in which different dimensions of patient …