Public Health Commons^™

Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia

Reproductive Health

As in many developing countries, young people in Kenya and Senegal (aged 10–20) account for about 25 percent of the population. To ensure their future contribution to their countries, it is of vital strategic importance to safeguard their welfare. Rapid social change in both countries exposes youth to sexual and reproductive health (RH) risks, including unintended pregnancy, sexually transmitted infections including HIV, and sexual violence. Beginning in 1999, the Population Council’s FRONTIERS program conducted operations research studies that tested the feasibility, acceptability, and cost of a public-sector, multisectoral intervention to enhance young people’s RH knowledge and behavior. Study findings showed …

India: Quality Assurance Procedure Monitors And Improves Quality Of Services, Population Council

Reproductive Health

A quality assurance (QA) procedure was pilot-tested and subsequently scaled up throughout the state of Gujarat, India, after demonstrating that a 65-item checklist is an efficient tool for identifying and remedying gaps in service delivery. From 2004–06, FRONTIERS developed and tested a standardized QA procedure. The State Ministry of Health and Family Welfare (MOHFW) used the procedure to assess health-care services in rural clinics in two pilot districts each in the states of Gujarat and Maharashtra. Based on positive results, the State MOHFW expanded the QA procedure in a phased manner throughout all 25 districts of Gujarat. The model is …

Kenya And Ethiopia: Community And Religious Leaders Are Effective Advocates For Hiv Testing For Young Couples, Population Council

Reproductive Health

Early marriage is common for girls in much of sub-Saharan Africa. A common belief is that marriage protects them from HIV, but studies show that married girls are at much higher risk from HIV and from maternal morbidity and mortality. FRONTIERS conducted operations research in Ethiopia and Kenya to assess the acceptability and feasibility of community-based interventions to raise awareness of the HIV risks of early marriage and promote the use of HIV counseling and testing (C&T) services by couples. The studies were an initial phase in a planned four-year intervention; this brief reports on the feasibility of the approach. …

South Africa: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council

Reproductive Health

The South African government wishes to expand availability and use of counseling and testing (C&T) for HIV. One option is to integrate C&T into well-attended services, such as family planning (FP). In 2004, the Population Council began a three-year study with the Department of Health in North West Province. The study tested the feasibility, acceptability, and cost of two models for integrating HIV prevention services within established FP programs, and evaluated their quality against standard practice. In the testing-model clinics, providers provided C&T services at the same consultation; in the referral-model clinics, providers offered HIV counseling and referred clients to …

Increasing Women's Use Of The Iud For Family Planning, Ricardo Vernon

Reproductive Health

The intrauterine device (IUD) is highly effective, easy to use, and has few side effects. The device costs the provider about US$2 and offers a duration of protection that makes it the most cost-effective of the temporary methods if used for two years or more. The IUD's many advantages also make it a good alternative for reducing unmet need for long-term contraception around the world. Between 5 and 17 percent of all married women of reproductive age in 53 less developed countries do not want to have more children but are not using a contraceptive method. Because the IUD can …

Assessing Integration Methodology (Aim): A Handbook For Measuring And Assessing The Integration Of Family Planning And Other Reproductive Health Services, M. Estela Rivero-Fuentes, Saumya Ramarao, Ricardo Estrada, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Harriet Birungi, John Townsend, Susana Medina

Reproductive Health

Several international statements over the past two decades have endorsed the integration of family planning (FP) services with other reproductive health (RH) services as a means of expanding availability and access for potential users. Many rationales underlie the move toward integrating FP with other services. First is that it provides benefits to the client and the program. Moreover, there is the expectation that the costs to the health system of configuring two or more services will cost less than providing them independently. However, there is still little empirical evidence available about integration of services. Over time, a number of methodologies …

Financial Capacity Building For Ngo Sustainability, John H. Bratt, Rick Homan, Barbara Janowitz, James R. Foreit

Reproductive Health

While demand for family planning and reproductive health services is increasing worldwide, a number of recent trends threaten the financial sustainability of donor-supported NGOs that provide these services. First, the U.S. Agency for International Development has seen its funding for population assistance decline since 1995. A second reason is the growth of government-funded programs that provide these services for low-income clients, which reduced the need for NGOs to focus programs entirely on the poor. Health-sector reform has created opportunities for NGOs via public–private partnerships in some countries, but sustained public-sector support is unlikely given limited economic growth in domestic economies …

Family Planning And Comprehensive Abortion Care Handbook For Medical Students And House Officers, Population Council

Reproductive Health

The persistently high maternal mortality and morbidity in Ghana is partly due to high rates of unwanted fertility, unsafe abortion, and relatively low use of modern contraception. In 2006, a consortium of agencies, including the Population Council, initiated the Reducing Maternal Mortality and Morbidity program. The program provides financial and technical resources that will enable the government to significantly expand women's access to modern family planning, contraception, and comprehensive abortion care (CAC) to reduce maternal mortality in Ghana. This handbook on FP and CAC was developed as part of the program. It updates a previous document produced more than ten …

Dissocier Les Mutilations Génitales Féminines De L'Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi

Reproductive Health

Les mutilations ou excisions génitales féminines (MGF/E) sont pratiquées dans au moins 28 pays d'Afrique subsaharienne, quelques pays du Moyen-Orient et d'Asie, et parmi les populations immigrées de ces pays en Europe, en Amérique du Nord et en Australie. Dans le monde, on estime que 100 à 140 millions de filles et de femmes ont subi cette pratique, et au moins trois millions de filles sont à risque chaque année. La communauté ethnique somalienne au Kenya ainsi qu'en Somalie, à Djibouti et en Éthiopie pratique l'excision depuis des siècles et la pratique semble être restée largement inchangée. Le programme FRONTIERS …

Africa Regional Sexual And Gender-Based Violence Network Consultation: Technical Exchange And Planning Meeting, Population Council

Reproductive Health

In March 2008, the Population Council brought together members of the Africa Regional Sexual and Gender Based Violence (SGBV) Network for a South-South technical exchange meeting. The objectives were to identify best practices from existing programs, provide an evidence base for new programming, and develop mechanisms for South-South technical assistance. As detailed in this report, discussions covered the medical, legal, and psychosocial issues associated with SGBV prevention and response activities. Participants identified the following: Protocols and guidance documents are essential for ensuring comprehensive, quality response at all levels. Enabling access and utilization of the full range of medical services remains …

Study Of Sexually Transmitted Infections Among Urban Men In Pakistan: Identifying The Bridging Population, Ali M. Mir, Laura Reichenbach, Abdul Wajid, Mumraiz Khan

Reproductive Health

Pakistan currently has low levels of HIV infection, however the country is considered at high potential risk for an HIV epidemic. In major cities there are large concentrations of individuals whose behaviors make them extremely vulnerable to the rapid spread of HIV and of classical sexually transmitted infections (STIs), including male and female sex workers, men who have sex with men, and injecting drug users. HIV can spread to the general population through individuals who have contact with both high-risk groups and the general heterosexual population (the “bridging population”). Identifying the bridging population and bridging behaviors among urban men and …

Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The World Health Organization estimates that 585,000 women die from pregnancy-related conditions each year. Pregnancy-related conditions, including dysfunctional labor, hemorrhage, infection, toxemia, and unsafe abortion, are the leading cause of death among women of reproductive age in many developing countries. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan, through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to …

Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to the hospital. PAIMAN is compiling data from three data sources and making efforts to improve the functioning of these Health Information Systems (HISs) for efficient management of health services at the district level through generation of quality data and their …

Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council

Reproductive Health

The Kenyan government’s reproductive health policy highlights service integration and quality of care. While integrating counseling and testing (C&T) for HIV into family planning (FP) can potentially increase the range of services to clients at risk from sexually transmitted infections (STIs) including HIV, few studies have documented the feasibility, effects, or costs of such integration. From 2005–07, the Population Council worked with the Kenyan Ministry of Health to test the feasibility of two models for integrating C&T into existing FP services. Both models featured client education on HIV prevention during FP visits. Providers were trained to routinely use the Balanced …

Profile Of Abortion Seekers In Ghana And Their Decision-Making Processes, Philomena Nyarko, Cletus Adohinzin, Saumya Ramarao, Placide Tapsoba, Ayorinde Ajayi

Reproductive Health

In 2006, a consortium of agencies, including the Population Council, came together to provide technical and financial support to the Government of Ghana in the rollout of comprehensive abortion care (CAC) services. The consortium collaborated with the government in expanding women’s access to modern family planning and CAC. The consortium’s program, Reducing Maternal Mortality and Morbidity (R3M), aims to reduce unwanted pregnancy and severe complications and deaths caused by unsafe abortion. The formative research in this report was undertaken to provide a profile of beneficiaries, their needs for information and services, their decision-making process in seeking care, and the quality …

Delinking Female Genital Mutilation/Cutting From Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi

Reproductive Health

Female genital mutilation or cutting (FGM/C) is practiced in at least 28 countries in sub-Saharan Africa, a few countries in the Middle East and Asia, and among immigrant populations from these countries in Europe, North America, and Australia. Worldwide, an estimated 100 to 140 million girls and women have undergone the practice, and at least three million girls are at risk each year. The Somali ethnic community in Kenya as well in Somalia, Djibouti, and Ethiopia, has practiced female genital cutting for centuries and the practice appears to have remained largely unchanged. The Population Council’s FRONTIERS program carried out two …

Improving Reproductive Health And Hiv Prevention Among Married Adolescents In Amhara, Ethiopia, Annabel Erulkar, Tekle-Ab Mekbib

Reproductive Health

The objective of this project is to improve reproductive health (RH), prevent new HIV infections, and promote mutual faithfulness through addressing the HIV and reproductive risk among married adolescents, who are a large, vulnerable, and neglected category of Ethiopian youth. The Population Council partnered with Ethiopia Ministry of Education, the Ethiopian Orthodox Church, and the Ethiopian Muslim Development Agency to implement the project in Amhara region. The program used religious structures to spread messages about early marriage, HIV, and reproductive health. Local women leaders were trained as mentors of married adolescent girls, convening clubs through which HIV/RH information was conveyed, …

Introduction Of Quality Of Care And A Gender Perspective In Reproductive Health Service Organizations In Latin America And The Caribbean, Patricia Riveros, Antonieta Martin, Ricardo Vernon

Reproductive Health

In 2005 and with the technical assistance of the Frontiers in Reproductive Health (FRONTIERS) Program, the Integrated Health Coordination Program (PROCOSI), a Bolivian network of 33 nongovernmental organizations, designed and tested a set of four guidelines to help organizations deliver high-quality reproductive health services with a gender perspective. The guidelines were: 1) to present a strategy to certify organizations as “gender sensitive” healthcare providers; 2) to present the knowledge staff members should know to be certified; 3) to describe procedures to collect and analyze the data to evaluate implementation of the strategy; and 4) to describe how to assess strategy …

Crude Birth Rates And Contraceptive Use By Racial/Ethnic Group In The U.S., 1990-2000, Victoria Stone

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report analyzes crude birth rates and contraceptive use among women in the three primary racial/ethnic groups, White, Black, and Latina, and further examines birth rates by age-specific groups in the United States between 1990 and 2000.

Methods: The data examined here was derived from the NYC Vital Statistics 2002 Report and the Census 2000 SF4 table on Sex by Age by race and Latino nationality. The birth rates were calculated by dividing live birth numbers (Vital Statistics report) by total population count by age and racial/ethnic group (Census 2000 data) and multiplying this number by 1000.

Results: In …

Familialism, Social Support, And Stress: Positive Implications For Pregnant Latinas, Belinda Campos, Christine Dunkel Schetter, Cleopatra M. Abdou, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

This study examined the association of familialism, a cultural value that emphasizes close family relationships, with social Support, stress, pregnancy anxiety, and infant birth weight. Foreign-born Latina (n = 31), U.S.-born Latina (n = 68), and European American (n = 166) women living in the United States participated in a prospective study of pregnancy in which they completed measures of familialism, social support, stress, and pregnancy anxiety during their second trimester. As expected, Latinas scored higher on familialism than European Americans. Familialism was positively correlated with social support and negatively correlated with stress and pregnancy anxiety in the overall sample. …

Ua12/2/1 College Heights Herald, Vol. 83, No. 19, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news

Loop Analysis Of Causal Feedback In Epidemiology: An Illustration Relating To Urban Neighborhoods And Resident Depressive Experiences, Alexis Dinno

Community Health Faculty Publications and Presentations

The causal feedback implied by urban neighborhood conditions that shape human health experiences, that in turn shape neighborhood conditions through a complex causal web, raises a challenge for traditional epidemiological causal analyses. This article introduces the loop analysis method, and builds off of a core loop model linking neighborhood property vacancy rate, resident depressive symptoms, rate of neighborhood death, and rate of neighborhood exit in a feedback network. I justify and apply loop analysis to the specific example of depressive symptoms and abandoned urban residential property to show how inquiries into the behavior of causal systems can answer different kinds …

Ua12/2/1 College Heights Herald, Vol. 83, No. 8, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news.

Lead-Contaminated Candies In Southern Nevada, Shawn Gerstenberger, Glenn Savage, Clayton Sellers, Keith Zupnik, Emmanuel C. Gorospe

Environmental & Global Health Faculty Research

Lead-contaminated candies from Latin America are beginning to gain attention in the public media1,2 and in the medical literature.3–5 These candies come from a number of sources and are manufactured outside Food and Drug Administration regulatory control. In 2005, we sampled 50 imported Latin American candies sold in Southern Nevada. A total of 20 (40%) tested positive with an average lead content of 1.46  0.27 mg/kg in the candies’ wrappers and straws, based on standard Graphite Furnace Atomic Absorption Spectrophotometry methodology. Given these results, the Southern Nevada Health District issued a cease-and-desist order on February 13, 2006, to local …

Predictors Of Female Sexual Dysfunction, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual dysfunction. They suggested that unique factors need to be examined to understand sexual dysfunction in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors described as aspects of women’s lives that can be the source of sexual dysfunction. The current study examined indicators of the above factors-body shame, relationship satisfaction, sexual self-schema, positive and negative affect, and overall health-as predictors of female sexual dysfunction. The hypotheses were: Body shame and negative affect will be negatively associated with sexual function; and relationship …

The Depiction Of Alcohol Tobacco And Other Substances In Children's G & Pg-Rated Animated Films Post 2000, Lindsay F. Graham

Sociology & Criminal Justice Theses & Dissertations

This study will analyze the depiction of alcohol, tobacco, and other substances in G and PG-rated animated films from November 1, 2000 to December 31, 2005. These films will include those released in theaters and video in English, at least 60 minutes in length, and of the animated genre during this five-year window. There is evidence that due to recent societal pressures facing the Motion Picture Association of America and their rating guidelines, the presence of alcohol and tobacco in children's animated Grated films has lessened. These incidents of exposure have since moved up the rating totem pole to receive …

Psychometric Evaluation Of An Instrument For Assessing Policy Outcomes For Families With Children Who Have Severe Developmental Disabilities: The Beach Center Family Quality Of Life Scale, Joni Taylor Mcfelea

Health Services Research Dissertations

The purpose of the study was to evaluate the psychometric properties of the Beach Center Family Quality of Life Scale (BCFQLS) in a sample of families with children who have severe developmental disabilities. The study sought to determine whether or not the scale could be used to measure the quality of life of such families and to differentiate between the quality of life of two family groups—those whose child lives in the family home and those whose child lives outside the family home.

The study used an observational, cross-sectional design and both qualitative and quantitative methods. Self-identified primary caregivers of …

The Health Implications Of Violence Against Women: Untangling The Complexities Of Actual And Chronic Effects: Part Two, Carol E. Jordan

Office for Policy Studies on Violence Against Women Publications

No abstract provided.

A Trade-Off Proposal For Funding Long-Term Care, Yung-Ping Chen

Gerontology Institute Publications

Long-term care can be a depressing subject. Most of us tend not to think about it. However, we cannot long avoid it as the 76 million baby boomers begin reaching older ages in a few short years. According to projections, in 40 years, those aged 65 to 84 (numbering 31.6 million in 2005) will more than double, and those 85 plus (about 5.1 million in 2005), who are more at risk of dependency, will more than triple (U.S. Census Bureau, 2004 and 2006). Heavy reliance on Medicaid, already the second largest budget item in most states, would not appear viable. …

Building Community Research Capacity: Process Evaluation Of Community Training And Education In A Community-Based Participatory Research Program Serving A Predominately Puerto Rican Community, Laurene M. Tumiel-Berhalter, Victoria Mclaughlin-Diaz, John Vena, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: Education and training build community research capacity and have impact on improvements of health outcomes.

Objectives: This manuscript describes the training and educational approaches to building research capacity that were utilized in a community-based participatory research program serving a Puerto Rican population and identifies barriers and strategies for overcoming them.

Methods: A process evaluation identified a multitiered approach to training and education that was critical to reaching the broad community.

Results: This approach included four major categories providing a continuum of education and training opportunities: networking, methods training, on-the-job experience, and community education. Participation in these opportunities supported the …