Public Health Commons^™

Informing The Medical Community In Guatemala About Emergency Contraception, Edgar Kestler, Lilian Ramirez

Reproductive Health

The general purpose of this project was to increase the awareness of and access to emergency contraception (EC) among the medical community in Guatemala. Specific project objectives included: 1) training three physicians as trainers in all aspects of EC; 2) adapting and disseminating scientific literature and informational materials about the method and about EC programs in Latin America and worldwide; and 3) training at least 250 participants about the characteristics of emergency contraception, its mechanisms of action, and counseling techniques. The project concluded with several lessons for improving dissemination and policy, including: the dissemination workshops had a positive effect on …

Scaling Up A Successful Counseling Model In Guatemala, Guatemalan Association Of Female Physicians (Agmm)

Reproductive Health

This project aimed to improve clients’ ability to make an informed choice of contraceptive methods by scaling up the use of the balanced counseling strategy in public service delivery institutions in Guatemala. To reach this end, the project provided technical assistance to Calidad en Salud (Quality in Health), the leading reproductive health project in Guatemala, to train service providers in public institutions about the counseling methodology. The project successfully introduced the balanced counseling strategy in Guatemala and, as a result, has improved the informed choice of contraceptives in the country.

Effects Of Igss' Job Aids-Assisted Balanced Counseling Algorithms On Quality Of Care And Client Outcomes, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Gustavo Gutierrez, Veronica Davila, Carlo Boniato, Alex Rios

Reproductive Health

This study identified a need to improve the quality of care at the main maternity hospital of the Social Security Institute (IGSS) in Guatemala. Problems included very short counseling sessions, counseling not focused on clients’ needs, redundancy in the role of physicians and social workers as providers, skewed method mix, and low client return rate for method resupply. The intervention, using Balanced Counseling Algorithms, changed the counseling behavior of physicians and social workers and enhanced the quality of family planning care. The report includes recommendations for continuing these improvements: monitoring provider implementation of the job aids–assisted Balanced Counseling Algorithms, monitoring …

Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Dale Huntington, Mary Philip Sebastian, Barbara Mensch, Wesley H. Clark, Aditya Narain Singh, Sohini Roychowdhury, M.E. Khan, Nirmala Selvam, Bella C. Patel, Sandhya Barge, Y.P. Gupta, Lovleen Johri, Gita Biswas, Manohar Shenoy

Reproductive Health

The Population Council’s Frontiers in Reproductive Health (FRONTIERS) program and Policy Research Division, in collaboration with CARE India, conducted an operations research study in Allahabad, Uttar Pradesh to examine the feasibility and impact of adding livelihood counseling and training, savings formation activities, and follow-up support to an ongoing reproductive health program for adolescents. The short-term objective of the study was to foster development of alternative socialization processes for adolescent girls that encourage positive sexual and reproductive health behaviors. The study also aimed to produce a replicable model for CARE and other agencies to use in adding livelihood activities to adolescent …

Promotion Of Lactation Amenorrhea Method Intervention Trial, Kazakhstan, Shamil Tazhibayev, Toregeldy Sharmanov, Ayan Ergalieva, Oksana Dolmatova, Orynkul Mukasheva, Aina Seidakhmetova, Raikhan Kushenova

Reproductive Health

In order to expand the benefits of breastfeeding as a birth spacing option for women in the Republic of Kazakhstan, the Kazakh Academy of Nutrition at the Academy of Preventive Medicine in Almaty conducted an operations research study to test the effectiveness of lactational amenorrhea method (LAM) promotion among women in Kazakhstan, as part of the Population Council’s Frontiers in Reproductive Health Small Grants Program. Results show that the intervention programs implemented in experimental baby-friendly hospitals (BFHs) and ordinary hospitals (OHs) improved women’s knowledge, skills, and desire to breastfeed The report concludes that training activities should be strengthened and all …

Developing A Supervision Instrument For Postabortion Care In Guatemala, Bolivia And Mexico, Carlos Brambila

Reproductive Health

The main objective of this project was to develop and test a supervision instrument and corresponding guidelines to collect information about postabortion care (PAC) services and to provide constructive feedback to service providers and program managers. The instrument and guidelines were designed to be used by technical supervisors to monitor performance and engage providers in continuous quality improvement of PAC services. As part of the project activities, existing postabortion care supervision practices were reviewed and analyzed, and, during a one-week workshop in December 2002, an international technical committee produced a first version of the instrument and guidelines. These materials were …

Youth Behavioral Risks And Psychosocial Resources In Peru's Alternative-Development Zones, Federico R. Leon, Mary L. Claux

Reproductive Health

Alternative-development programs are being offered to the population of seven regions of central-eastern Peru involved in coca cropping. The youth of these regions are above the national average in risk of pregnancy and sexually transmitted infections, use of alcohol and drugs, and violence against women. This study sought to identify and describe protective factors expected to function as counterforces to such risks; develop reliable indicators and provide a baseline concerning the risk behaviors and protective factors; compare youth by gender, developmental stage, urbanization, and geography to determine whether segmented interventions are required; and recommend specific intervention strategies. The results of …

Culturally Appropriate Information, Education And Communication Strategies For Improving Adolescent Reproductive Health In Cusco, Peru, Marco Florez-Arestegui Cornejo, Rosalinda Barreto Silva

Reproductive Health

The project Culturally Appropriate Information, Education and Communication Strategies for Improving Adolescent Reproductive Health in Cusco, Peru was designed in response to the evident lack of information and education on adolescent reproductive health in the country and, in particular, in the rural areas of the department of Cusco. Research revealed that a great need for sexual and reproductive health information still exists among indigenous adolescents in the rural areas of the region and that sexual education programs have to be sustainable. This report recommends that the Ministry of Education train more teachers in sexual and reproductive health topics, taking into …

Improving Health Care Providers' Knowledge, Attitudes, And Practices In Reproductive Health In Rural Romania, Elaine Claire Himelfarb

Reproductive Health

To support new health reform initiatives undertaken by the Romanian Ministry of Health and Family, and in support of the USAID Romania strategy for improving women’s reproductive health, Project Concern International/Romania (PCI/R) was awarded a two-year grant to implement a reproductive healthcare project, Healthy Parents-Healthy Children (HP-HC). This project trained family physicians and nurses in rural dispensaries in techniques to improve pre- and postnatal care, including training on modern contraception, cervical and breast cancer screening, treating menopause and its symptoms, and the encouragement of healthy lifestyles. The goal of this OR project was to test the efficacy of interventions to …

Involving Men In Maternity Care: South Africa, Busi Kunene, Mags Beksinska, Simphiwe Zondi, Nobuhle Mthembu, Saiqa Mullick, Emma Ottolenghi, Immo Kleinschmidt, Susan E. Adamchak, Barbara Janowitz, Carmen Cuthbertson

Reproductive Health

The Reproductive Health Research Unit University of the Witwatersrand, South Africa, in partnership with the FRONTIERS Program of the Population Council, and the KwaZulu-Natal Department of Health conducted a three-year operations research study titled “Men in Maternity” in the Ethekwini district. The intervention was clinic-based and included two broad strategies: improving antenatal care services by strengthening the existing antenatal package and service monitoring and supervision; and introducing couple counseling by providing training to health providers, inviting partners of antenatal women to attend counseling twice during pregnancy and once post delivery, and providing information to couples with a new antenatal booklet. …

Tulane University Final Report, M. Celeste Marin, Anastasia J. Gage, Suhaila Khan

Reproductive Health

The Frontiers in Reproductive Health (FRONTIERS) program is a 10-year cooperative agreement between the United States Agency for International Development (USAID) and the Population Council in partnership with Family Health International and Tulane University School of Public Health and Tropical Medicine. This report summarizes the main activities undertaken by Tulane University under its subagreement with the Population Council on the FRONTIERS project from 1998–2004. As a partner, Tulane furthered progress toward all three of the program’s intermediate results: contributing innovative interventions tested to improve reproductive health through the small grants program; helping research staff take a more proactive approach to …

Etude Expérimentale Sur L'Offre De Services À Base Communautaire De Santé De La Reproduction Au Sénégal: Une Étude De Cas Dans Le District Sanitaire De Kébémer, Diouratie Sanogo, Mady Cisse, Adama Ndoye, Laty G. Ndoye, Ousmane Faye, Balla Mbacke Mboup

Reproductive Health

La Division de la Santé de la Reproduction (DSR) du Ministère de la Santé et de l'Action Sociale du Sénégal, en partenariat avec le programme FRONTIERS in Reproductive Health du Population Council et le Management Sciences for Health, a mené une étude visant à déterminer l'acceptabilité et la faisabilité des modèles de services à base communautaire expérimentés du point de vue de leur acceptabilité, de leur faisabilité, de leur efficacité, de leur performance, et de leur coût et rentabilité. L'objectif général de cette étude était de contribuer à l'élaboration d'un programme intégré rentable visant à accroître l'accessibilité et la disponibilité …

Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan

Reproductive Health

CARE International, with technical support from the Frontiers in Reproductive Health Program completed a study in Ethiopia and Kenya designed to test the effectiveness of education activities using behavior change communication (BCC) approaches and advocacy activities by religious and other key leaders to abandon female genital cutting (FGC). In Ethiopia, the increased knowledge of harmful FGC effects and human rights issues translated to a positive attitude in support of FGC abandonment and an intention not to cut their daughters in the future. In Kenya, the analysis indicated mixed results in attitude and intended behavior change.

Experience From A Community-Based Education Program In Burkina Faso: The Tostan Program, Djingri Ouoba, Zakari Congo, Nafissatou J. Diop, Molly Melching, Baya Banza, Georges Guiella, Inge Baumgarten

Reproductive Health

This study describes a project that tested the feasibility and effectiveness of replicating the village empowerment program (VEP) developed by the Senegalese NGO, TOSTAN, in Burkina Faso. Although originally developed for empowering women, the program implemented in Burkina Faso also involved men because of their key role in such decisions. Frontiers in Reproductive Health, with funding from USAID and the GTZ Supra Regional Project for the Elimination of FGC, supported the adaptation, implementation, and evaluation of the VEP model in 23 villages in the province of Bazega/Zoundwéogo. In the existing social climate among the Burkinabé, where there is widespread awareness …

The Tostan Program: Evaluation Of A Community Based Education Program In Senegal, Nafissatou J. Diop, Modou Mbacke Faye, Amadou Moreau, Jacqueline Cabral, Helene Benga, Fatou Cisse, Babacar Mane, Inge Baumgarten, Molly Melching

Reproductive Health

This operations research project evaluated the effect and impact of a basic education program, developed by TOSTAN, a nongovernmental organization based at Thiès, Senegal. The basic education program consisted of four modules: hygiene, problem-solving, women’s health, and human rights. Through these four themes, emphasis was placed on enabling the participants, who were mostly women, to analyze their own situation more effectively and thus find the best solutions for themselves. The GTZ Supra Regional Project for the Elimination of Female Genital Cutting funded implementation of the program in 90 villages in Kolda Region, and the Population Council’s Frontiers in Reproductive Health …

Medicalization Of Female Genital Cutting Among The Abagusii In Nyanza Province, Kenya, Carolyne Njue, Ian Askew

Reproductive Health

This study sought to understand the role that health providers play in the medicalization of female genital cutting (FGC) among the Abagusii community in western Kenya, among whom the practice continues to be almost universal. Interviews with service providers and their clients revealed an overwhelming belief that FGC fulfills a traditional cultural obligation among the Abagusii, and that it limits a woman’s sexual desire and confers respect on girls. New approaches are needed within this community to present FGC as violating human rights and national laws, as well as threatening girls’ and women’s health. The study recommends measures such as …

Encuestas De Voluntad De Pago Para Fijar Precios De Productos Y Servicios De Salud Reproductiva: Manual De Usuarios, Karen G. Fleischman Foreit, James R. Foreit

Reproductive Health

Social programs need to balance volume (coverage) and income (sustainability). The law of supply and demand states that we can not obtain coverage and support at the same time, because when prices rise, demand decreases. This manual presents willingness-to-pay (WTP) surveys that allow program managers to simulate changes in demand related to price, without actually changing prices. The Population Council, with The Futures Group International, developed these surveys that can be used for existing and new products and services, collect responses from clients with no formal education with sensitivity to their individual characteristics, and provide conservative estimates that accurately predict …

Female Circumcision In Indonesia. Extent, Implications And Possible Interventions To Uphold Women's Health Rights, Meiwita P. Budiharsana, Lila Amaliah, Budi Utomo

Reproductive Health

In Indonesia, the practice of female circumcision (FC) has long existed, but information concerning where and how it is carried out has been limited. The specific aims of the study conducted by the Population Council Jakarta were to provide research-based information on FC customary practices and their socio-cultural determinants, and if possible, to assess any long-term physical and psychological consequences. Study findings indicate that in general Muslim communities support the continuation of FC practice, because they perceive it as both a societal custom and a religious duty. The report strongly recommends that key donor agencies pressure the Ministry of Health …

Safe Motherhood Demonstration Project, Western Province: Final Report, Charlotte E. Warren, Wilson Liambila

Reproductive Health

Since March 2000, the Population Council and the University of Nairobi have been assisting the Kenya Ministry of Health to implement Safe Motherhood activities in Western Kenya. The purpose of this project was to increase utilization of quality maternal services in the selected districts and, in an effort to improve pregnancy outcomes, focused on improving quality of antenatal care, essential obstetric care, clean and safe delivery, postpartum care, postabortion care, and management issues at all levels. In addition, the project focused on strengthening referral practices and addressing factors responsible for delays by pregnant women in making decisions on when, where, …

Did A Rising Tide Lift All Boats? The Nih Budget And Pediatric Research Portfolio, Daniel P. Gitterman, Robert S. Greenwood, Keith C. Kocis, Rick Mayes, Aaron N. Mckethan

Political Science Faculty Publications

This paper examines National Institutes of Health (NIH) pediatric research spending in absolute terms and relative to the doubling of the NIH overall budget between fiscal years 1998 and 2003. Pediatric spending increased by an average annual rate of 12.8 percent during the doubling period (almost on par with the NIH average annual growth rate of 14.7 percent). However, the proportion of the total NIH budget devoted to the pediatric portfolio declined from 12.3 to 11.3 percent. We offer recommendations for implementing existing commitments to strengthen the pediatric research portfolio and to protect the gains of the doubling period.

Making Motherhood Safer In Egypt, Karima Khalil, Farzaneh Roudi-Fahimi

Reproductive Health

Fewer Egyptian women die of maternal causes today than they did 10 or 15 years ago, due in large part to the national safe motherhood program. Nevertheless, maternal mortality is still relatively high, and the country faces challenges in reducing it further. Many of these challenges involve addressing the delays women face when they need essential obstetric care. In Egypt and other countries, most maternal deaths could be avoided if women had timely access to high-quality emergency obstetric services. Although Egypt’s level of maternal mortality is relatively high by international standards, recent evidence suggests that a woman’s lifetime risk of …

Male Sexuality And Masculinity: Implications For Stis/Hiv And Sexual Health Interventions In Bangladesh, Sharful I. Khan

Theses: Doctorates and Masters

My thesis concerns male sexuality as revealed by men living in contemporary urban and rural Bangladesh. I pursue what men think it means to be a man. dimensions of manliness and manhood, and male influences in the construction of male/female relationships. Significant meanings men attribute to sexual acts, pleasure, pain,. risk and safety in multiple social realities, particularly in the era of HIV/AIDS, were explored. A social constructionist perspective guided my research. Using qualitative research methods, I conducted 50 in-depth interviews with men aged between 18 and 58 years from diverse socio-occupational backgrounds. Twenty key informants included religious leaders. traditional …

Mental Health Of Incarcerated Juveniles In Nevada: Final Report, Nevada Institute For Children's Rerearch And Policy, University Of Nevada, Las Vegas, Jennifer Petsonius, Denise Tanata, Michelle Chino Dr

Nevada Institute for Children's Research and Policy Reports

The prevalence of mental health problems in the juvenile offender population is substantially higher than that of the general population (Cocozza & Skowyra, 2000). Studies estimate that one in five juvenile offenders has serious mental health problems, which is nearly twice the rate of occurrence of mental illness in children and adults in the general population (NMHA Fact Sheet #l). However, there have been several methodological problems encountered in previous research. These include the use of inconsistent definitions and measurements of mental illness; the use of biased, nonrandom samples, a reliance on retrospective case report data, and the use of …

Maine Employer Experience And Perceptions Related To Providing Health Insurance: 2003 Summary Report, Gino Nalli, Elizabeth Kilbreth

Disability & Aging

No abstract provided.

Hiv Risk Behaviors In Adults With Serious Mental Illness: Testing The Imb Theory Of Hiv Risk Reduction, Leslie D. Bjork

All-Inclusive List of Electronic Theses and Dissertations

The Human Immunodeficiency Virus (HIV) has proliferated substantially since its initial identification in 1981. Studies ofHIV seroprevalence indicate a recent statistical surge in rural AIDS cases relative to urban locales (McKinney, 1998; Stephenson, 2000). Data also suggest adults with severe and persistent mental illness (SPMI) evidence higher behavioral risk for HIV infection than individuals in the general population (Carey, Carey, & Kalichman, 1997; McKinnon, Carey & Cournos, 1997). This study examined HIV risk behaviors in rural adults with SPMI, including analyses of sexual behaviors, psychiatric severity, and substance problems. In addition, Fisher and Fisher's (1992) Information-Motivation-Behavior (1MB) theory ofHIV risk …

The Relationship Of Health Beliefs And Health Value In Cardiovascular Outcomes, Kimberley Schaub

All-Inclusive List of Electronic Theses and Dissertations

Despite extensive theoretical information regarding Schwarzer's Health Action Process Approach the utility of the model pas yet to be explored within a chronic illness population. Using Schwarzer's Health Action Process Approach (Schwarzer, 1992), the purpose of this study was to investigate cardiovascular outcomes based on health beliefs and health value. Participants were eighty-one adults ages 42-87 with cardiovascular disease recruited from a cardiac rehabilitation program in Central Indiana. Participants completed instruments that assessed (a) health beliefs, (b) health value and, (c), quality of life. Measurements of physiological outcome (resting heart rate, distance walked, and metabolic equivalent) were also obtained. A …

Barriers To Lesbian Health Care, Paula Bowles

Masters Theses & Specialist Projects

The primary purpose of this research was to examine a sample of sixteen lesbian women regarding the barriers to lesbian health-care. From this information several interpretive findings regarding lesbian health-care are made. Data were gathered via indepth interviews with each individual lesbian. The data suggest that most lesbian women do not reveal their sexual orientation to their primary-care physician for fear of reprisal. Most of the women interviewed do feel they receive adequate health-care from their physician. The women who participated in this project did so confidentially and were assigned pseudonyms. They were asked questions on a variety of topics, …

2001 Michigan Hospital Cqi/Tqm Study, Colleen L. Croxall

Wayne State University Dissertations

In recent years, there has been significant interest in the application of total quality management/continuous quality improvement (TQM/CQI) within health care organizations. The health care industry, in its quest to improve outcomes with fewer resources, began to look at CQI/TQM as a possible solution. To date, the most comprehensive and enthusiastic response to efforts to improve quality while containing or lowering costs is reflected in hospitals' commitment to continuous quality improvement/total quality management (CQI/TQM). The health care industry, particularly hospitals, has embraced the concepts of CQI/TQM with the belief that adoption will lead to an improvement in both the quality …

Socio-Economic And Demographic Factors Associated With Injecting Drug Use Among Drug Users In Karachi, Pakistan, A. Agha, S. Parviz, M. Younus, Zafar Fatmi

Community Health Sciences

Objective: To identify the socio-economic and demographic factors associated with injecting drug users (IDUs) in Karachi.

Methods: We recruited 242 IDUs (taking drugs through sub-dermal routes) and 231 non-IDUs (taking drugs other than sub-dermal routes) from February through June 1996. IDUs were interviewed regarding sociodemographic factors, economic condition, and social network (marital status, living with spouse). In addition, information regarding location of drug users within the city (districts of Karachi) and current history of sexually transmitted diseases (STDs) were gathered. Moreover, blood samples were also obtained for HIV testing

.Results: Multivariate analysis showed that the income generation via illegal …

Ua61/6 Newsletter, Issue 2, Wku Institute For Rural Health Development & Research

WKU Administration Documents

Newsletter created by and about the Institute for Rural Health Development & Research. This issue contains:

• College of Health & Human Services Has New Dean – John Bonaguro
• Simpson, Staci. Institute Aims to Improve Oral Health of Children
• Whitfield, Beth. WKU Mobile Unit KICS Off Dental Event with Webster County – Kentucky Interdisciplinary Community Screening
• Stone, Glynda. TEACH KY: Teachers Exploring & Advocating Careers in Health in Kentucky
• Institute Sponsors Hispanic Health Fair
• HIV Prevention Counseling & Testing Training Program Initiated at WKU
• New Web-based Course Offered Through Communications Disorders Department at WKU
• Lashley, Donita. Child Passenger Safety Training
• Handy, …