Public Health Commons^™

Facing An Epidemic: An Analysis Of Hiv/Aids, Antiretroviral Drug, And International Response To The Aids Pandemic, Michael Tate

Annual Undergraduate Conference on Health and Society

More than 33 million people are living with HIV/AIDS around the globe with 68% of all cases occurring in sub-Saharan Africa. The global prevalence rate is shocking considering that the disease was relatively unknown just 30 years ago. After reviewing medical, health policy, and health statistical journals, I will argue in this paper that international aid to nations struggling with AIDS needs to be redirected and refocused on supplying antiretroviral therapy to afflicted nations because ARV has been proven to be effective in managing the disease in countries that can afford the costs of treatment. International aid to countries that …

Medicines That Kill, Lina Ahmed Abushouk

Annual Undergraduate Conference on Health and Society

The prevalence of counterfeit drugs on the African continent has been increasing at an alarming rate. “Medicines that Kill” is a research paper that attempts to analyze the factors that make African countries particularly susceptible to this global threat. Nigeria, a country that has had some of the highest rates of counterfeit drugs in the world, is the main case study for this paper. Its efforts to combat the issue are compared and contrasted with those of Tanzania and Kenya in an attempt to understand what aspects of the issue are unique to Africa and the methods that have been …

Preventing Hepatitis B-Induced Liver Cancer: Implications For Eliminating Health Disparities, Moon S. Chen Jr.

Journal of Health Disparities Research and Practice

If the definition of eliminating of a health disparity were signified by the absence of any differences in incidence or mortality between a population’s experiences with a health problem, then the only health disparity that has ever been eliminated is smallpox because with zero cases of smallpox in the world, no health disparities exist because of smallpox. The eradication of smallpox is perhaps the only historical example where the elimination of a health disparity has been achieved. Principles and lessons learned, particularly through the intersection of science and policy that could be applied to the elimination of other health disparities …

Determinants Of Depressive Symptoms Among Women On Public Assistance In Louisiana, Theresa C. Davidson, Joachim Singelmann

Journal of Health Disparities Research and Practice

Depression can be a significant barrier in the welfare-to-work transition of poor women. Fortunately, support from social networks can lessen symptoms and facilitate entry into the workplace. Inconsistency in the literature concerning the effects of social networks on the poor suggests further research is needed. Thus, we examine the level and determinants of depressive symptoms among participants in the Temporary Assistance to Needy Families program. Having a good job, being in good health, married, and black, and living in rural areas inhibit symptoms of depression. Remaining on TANF and having several children increases symptom levels. Those who report that they …

Healthcare Reform Hangs In The Balance, Lawrence O. Gostin

O'Neill Institute Papers

In this timely new briefing, Professor Lawrence O. Gostin, University Professor and Faculty Director, O’Neill Institute for National and Global Health Law, Georgetown University writes:

Prior to Tuesday’s arguments, I believed that the Supreme Court would uphold the health insurance purchase mandate by a comfortable margin. But now I believe that health care reform hangs in the balance. Here are the key arguments on which the future of President Obama’s health care reform depends: a greater freedom, cost-shifting, the health care market, acts versus omissions, limiting principles, the population-base approach, and what is necessary and proper. If the Court strikes …

Why The Affordable Care Act's Individual Purchase Mandate Is Both Constitutional And Indispensable To The Public Welfare, Lawrence O. Gostin

O'Neill Institute Papers

Integral to the Affordable Care Act's (ACA’s) conceptual design is the individual purchase mandate, which requires most individuals to pay an annual tax penalty if they do not have health insurance by 2014. Despite the vociferous opposition, the mandate is the most “market-friendly” financing device because it relies on the private sector. Ironically, less market-oriented reforms such as a single-payer system clearly would have been constitutional.

It is common sense for everyone to purchase health insurance and thus gain security against the potentially catastrophic costs of treating a serious illness or injury. However, Congress’ method of ensuring that everyone has …

Role Of Community Health Centers In Providing Services To Low-Income Women, Peter Shin, Jessica Sharac

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Because of their location and ability to serve populations with complex health and social needs, CHCs reduce disparities in access to care and generate significant costsavings. This brief examines the role CHCs play in mitigating disparities for one population subgroup, low-income women of childbearing age (defined as age 15-44), and the challenges that they will need to overcome to build upon their success in delivering care to vulnerable populations. Key findings include:

• CHCs serve approximately one in five (21.5%) low-income women of childbearing age nationally.
• The number of women of child-bearing age receiving health center services at CHCs increased by …

Community Health Centers: The Challenge Of Growing To Meet The Need For Primary Care In Medically Underserved Communities, Peter Shin, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Uncertainty about the magnitude and timing of economic returns associated with spending on public health services has contributed to policy debates about the optimal role of the federal government in financing these services.

Firearms, Youth Homicide, And Public Health, Robert S. Levine, Irwin Goldzweig, Barbara Kilbourne, Paul Juarez

Sociology Faculty Research

Homicide is seven times as common among U.S. non-Hispanic Black as among non-Hispanic White youth ages 15 to 24 years. In 83% of these youth homicides, the murder weapon is a firearm. Yet, for more than a decade, the national public health position on youth violence has been largely silent about the role of firearms, and tools used by public health professionals to reduce harm from other potential hazards have been unusable where guns are concerned. This deprives already underserved populations from the full benefits public health agencies might be able to deliver. In part, political prohibitions against research about …

Should Marijuana Be Decriminalized? [An Annotated Bibliography], Christina M. Costa

Undergraduate Research Award

No abstract provided.

Public Health Spending, Preventable Outcomes, And Medical Cost Offsets: Questions For Health Reform, Glen P. Mays

Health Management and Policy Presentations

Uncertainty continues to surround the health and economic effects that can be expected from increased federal spending on public health and prevention strategies. Recent research provides some insight into the question of whether spending on public health strategies can offset the need for future spending on medical care.

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

Using First Nations Children's Perceptions Of Food And Activity To Inform An Obesity Prevention Strategy, Ashlee-Ann E. Pigford, Noreen D. Willows, Nicholas L. Holt, Amanda S. Newton, Geoff D.C. Ball

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Do Indigenous Australians Age Prematurely? The Implications Of Life Expectancy And Health Conditions Of Older Indigenous People For Health And Aged Care Policy, Philippa R. Cotter, John R. Condon, Tony Barnes, Ian P.S. Anderson, Leonard R. Smith, Teresa Cunningham

Aboriginal Policy Research Consortium International (APRCi)

Objective. To assess whether Indigenous Australians age prematurely compared with other Australians, as implied by Australian Government aged care policy, which uses age 50 years and over for population-based planning for Indigenous people compared with 70 years for non-indigenous people.

Methods. Cross-sectional analysis of aged care assessment, hospital and health survey data comparing Indigenous and non-indigenous age-specific prevalence of health conditions. Analysis of life tables for Indigenous and non-indigenous populations comparing life expectancy at different ages.

Results. At age 63 for women and age 65 for men, Indigenous people had the same life expectancy as non-indigenous people at age 70. …

Growing Up Our Way : The First Year Of Life In Remote Aboriginal Australia, Sue Kruske, Suzanne Belton, Molly Wardaguga, Conceptual Narjic

Aboriginal Policy Research Consortium International (APRCi)

In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child rearing, development, behavior, health, and wellbeing between each infant’s birth and first birthday. We found significant differences in parenting behaviors and childrearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Getting Real With Youth-Friendly Services In Africa: Report Of A Satellite Session At The Xix International Aids Conference, Population Council

HIV and AIDS

Overview of an AIDS 2013 satellite session which aimed to engage young people with and react to the study findings and in the light of the findings, discuss and share their perspectives, experiences and concerns about how responsive existing policies, programs and services are to the HIV prevention and impact mitigation needs of young Africans.

Prevalence And Correlates Of Hiv Infection In A Cohort Of Male Injection Drug Users In Delhi, Waimar Tun, Vartika Sharma, Mary Philip Sebastian, Ira Madan, Amita Yadav, Meredith Sheehy, Dean Lewis, Ibou Thior, Avina Sarna

HIV and AIDS

Baseline assessment of HIV infection among male injection drug users to understand the correlates of HIV infection and high risk injection practices and sexual behavior in Delhi, India.

Attitudes, Beliefs, And Practices Of Providers And Key Opinion Leaders On Emergency Contraception In India, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECP) among providers in public and private facilities and pharmacies in India. The objectives of the study were to: assess providers' knowledge of ECP's biological mechanism; understand providers' knowledge and attitudes about ECP's safety, effectiveness, and availability as an OTC drug; and identify providers' definitions of “repeated use” and profiling women who are “repeated users” of ECP. This study's findings show that most providers, including doctors and some KOLs, were incorrectly informed about ECP's mechanism of action. Service guidelines are necessary for accurate and …

Hiv/Aids In The Muslim-Majority Countries: Formula For Low Prevalence, Kaoru Yamaguchi

Political Science Theses and Capstones

The Muslim-majority countries long had been considered to be free of HIV/AIDS epidemic because of their strict religious and moral codes. However, the HIV prevalence rates are increasing in some Islamic states, and even more or so rapidly in a several cases that it is no longer valid to assume the Islamic religion protects its followers from the risks of contracting HIV. Contrary to the popular belief concerning the prevention of the HIV/AIDs epidemic, data collected from well-recognized international organizations such as the WHO and Freedom House indicate that democratization, strong government leadership, and wider and equal human rights for …

Household Survey To Evaluate The Zambia-Led Prevention Initiative: Baseline Report, Zambia-Led Prevention Initiative

HIV and AIDS

With an estimated HIV prevalence of 14.3 percent among men and women age 15–49, Zambia is one of the sub-Saharan African countries most affected by the HIV and AIDS pandemic. The Zambia-led Prevention Initiative Program (ZPI) was developed by a consortium led by FHI360, with the Population Council as the evaluation partner. This study determined baseline levels of key indicators related to HIV, gender-based violence, and reproductive health. Additionally, the baseline findings provide critical insights into key areas for interventions in Zambia and highlights variability in the populations across provinces and between males and females that provide valuable guidance for …

The Reproductive Health Of Young People In Egypt, Nahla G. Abdel-Tawab, Noha Roushdy, Maia Sieverding

Poverty, Gender, and Youth

This Population Council brief presents results from the Survey of Young People in Egypt (SYPE) on reproductive health (RH). The SYPE results underscore the need for: the assessment of state and civil society initiatives to transmit RH information; a national, comprehensive, age-appropriate reproductive health module to be integrated into the educational program; a national campaign on HIV/AIDS and other sexually transmitted infections that targets young people of reproductive age; the integration of female circumcision into a broader approach to youth reproductive health and bodily rights; specialized reproductive health services for married adolescent girls; and further research on sexuality and reproductive …

Challenges Facing The Egyptian Education System: Access, Quality, And Inequality [Arabic], Caroline Krafft

Poverty, Gender, and Youth

This brief analyzes and summarizes young people's responses to the 2009 Survey of Young People in Egypt (SYPE) to identify the greatest challenges facing the Egyptian educational system, focusing specifically on primary through secondary schooling. Results show that access to school has improved, but some youth, especially females in rural Upper Egypt, remain outside the school system and are increasingly marginalized. The Egyptian school system is delivering low-quality education that is irrelevant to the labor market and has problems with repetition, absenteeism, and drop out which reduce the efficiency of the education system. Unequal distribution of resources in the education …

Social Protection In Egypt: A Policy Overview, Maia Sieverding, Irene Selwaness

Poverty, Gender, and Youth

The need to address the shortcomings of Egypt’s current social protection system as part of a broader process of developing a new social contract between the Egyptian government and its citizens has been noted for a number of years. With a new government recently put in place, Egypt is now at a potential turning point in terms of implementing unfinished reforms to the system or proposing alternative ones. The aim of this paper is therefore to provide an overview and assessment of current public social protection mechanisms and suggest directions for new policy measures. The social and health insurance systems …

The Impact Of Water Supply And Sanitation On Child Health: Evidence From Egypt, Rania Roushdy, Maia Sieverding, Hanan Radwan

Poverty, Gender, and Youth

Using a combination of qualitative and quantitative data, this working paper investigates whether access to improved sources of water and sanitation is an effective “treatment” for the incidence of diarrhea among children under five years of age in Egypt. Both components of the study indicate that widespread access to improved sources of drinking water and toilet facilities exists across Egypt; however, service quality remains a significant problem in many areas. In particular, cuts in water supply—and the resulting practice of storing water—are quite common; a sizable percentage of flush toilet facilities are not connected to the public sewer system; and …

Is Early Childhood Care And Education A Good Investment For Egypt? Estimates Of Educational Impacts, Costs, And Benefits [Arabic], Caroline Krafft

Poverty, Gender, and Youth

This summary details the impact of early childhood education in Egypt. The results show that early childhood care and education has an impact on educational attainment that is both statistically significant and sizeable. Such interventions increase overall educational attainment by approximately one year, primarily due to decreased primary and preparatory drop out. The impact on educational attainment is reflected in improved school performance, such as higher test scores, decreased grade repetition, and improvements in school tracking, during the early years. Investments in early childhood education can be a powerful approach to improving educational outcomes, and the research suggests that increases …

Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey

Reproductive Health

An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and …

Introduction Of Emergency Contraceptive Pills (Ecps) Through Lady Health Workers (Lhws) Program In Pakistan: Findings Of An Evaluation Study, Arshad Mahmood, Yasir Bin Nisar

Reproductive Health

This report documents the findings from a five-day study tour of Pakistani officials to Bangladesh, organized by the Population Council, to afford an opportunity for representatives of both the Ministry of Health and Population Welfare to learn from the experience of Bangladesh in introducing emergency contraceptive pills (ECPs) through their National Public Health System. One of the recommendations was to enhance the availability of emergency contraception in Pakistan by making it available through outlets of the health system, especially through the network of the community-based Lady Health Workers (LHWs). There is a high unmet need for ECP in LHW areas, …

Assessment Of Management Information System [Mis] Of National Program For Family Planning And Primary Health Care [Lhw Program], Arshad Mahmood, Syeda Saman Naz

Reproductive Health

This assessment by the Population Council is based on a random sample of 154 Lady Health Workers (LHWs) from three provinces of Pakistan. The aim is to strengthen the routine LHW-MIS (management information system) in the districts so that it can contribute to the improvement of the district health system by providing reliable evidence. Further, based on the findings of the current assessment, the districts managers/decisionmakers should be able to continuously improve the LHW-MIS through applying a problem-solving approach. The report details recommendations for program management, including: 1) providing all necessary MIS tools to each LHW; 2) providing basic equipment …