Public Health Commons^™

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 …

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, …

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 …

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, …

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, …

The Benefits Of Breastfeeding: An Introduction For Health Educators, Sheila G. J. Clark, Timothy J. Bungum

Environmental & Global Health Faculty Research

Currently 16% of Americans breastfeed their children for at least 12 months as recommended by the AAP, which is well below the HP 2010 goal of 25%. Breastfed infants receive benefits that can improve their health throughout their lives. The benefits of breastfeeding for children include increased resistance to infectious diseases, such as gastroenteritis, respiratory tract infections, and ear infections. Breastfed children also display lower rates of chronic diseases including diabetes, obesity, asthma, and leukemia. The choice to breastfeed results in economic benefits from lower health care costs and from reduced spending on infant formula. The Healthy People 2010 targets …

All The News That’S Fat To Print: The American "Obesity Epidemic" And The Media, Natalie Boero

Faculty Publications, Sociology

Increasingly the term epidemic is being used to describe the current prevalence of fatness in the United States. Skyrocketing rates of obesity among all groups of Americans, particularly children, the poor, and minorities, have become a major public health concern. Indeed, it is difficult to open a newspaper or magazine without encountering a discussion of the expanding American waistline and the health problems associated therewith. In this paper I use 751 New York Times articles on obesity to examine the media construction of the obesity epidemic. I show that there is not one dominant discourse (i.e. medicine) constructing this epidemic, …

Predictors That Affect The Caregiver's Health Status And The Role Of Social Support On The Caregiver's Health Status, Hong Wang

All-Inclusive List of Electronic Theses and Dissertations

This study examines whether the caregiver's self-rated health status is affected by the caregiver's demographic characteristics (age, education level, and income), caregiver's stressor (the number of ADL and IADL), mediating variables of the caregiver's appraisal (willingness to help non-family members, level satisfaction with life, and financial burden), of and mediating variable of social support (information and/or advice from other family members or friends). Data were drawn from Chronic Illness and Caregiving, a national telephone survey conducted by Harris Interactive Inc. on behalf of The Robert Wood Johnson Foundation, Johns Hopkins University, and Partnership for Solutions. The sample size of caregivers …

Next-Of-Kin Perceptions Of Physician Responsiveness To Symptoms Of Hospitalized Patients Near Death, Joel C. Cantor, Jan Blustein, Matthew J. Carlson, David A. Gould

Sociology Faculty Publications and Presentations

Many different medical providers visit critically ill patients during a hospitalization, and patients and family members may not feel any physician is truly in charge of care. This study explores whether perceiving that a physician was clearly in charge is associated with reports by surviving next of kin about the responsiveness of physicians to symptoms in hospitalized patients near the end of life. We conducted telephone interviews with surviving next of kin of adult patients (n = 1107) who died in one of five New York City teaching hospitals between April 1998 and June 1999 after a minimum 3-day inpatient …

Sibling Death In Childhood: An Evaluation Of The Literature Regarding Inclusion Of Minority Cultures, 1990–2002, Joyce Kay L. Cherry

Community & Environmental Health Theses & Dissertations

This evaluation seeks to determine the extent to which the professional literature concerning bereaved children in the United States includes African American, Hispanic American, and Asian American children whose siblings have died in childhood.

A literature search identifies 58 articles, published between 1990 and 2002, concerning children under age 19 living in the United States whose siblings have died. Articles are sorted by time frame and classified by type. There are 31 descriptive articles consisting of five literature reviews, five commentaries, five case studies, and 16 narratives; there are 27 research articles. Analysis determines the extent to which race, culture, …

Long-Term Care: Informed By Research, Francis G. Caro

Gerontology Institute Publications

Health services research has contributed to health policy and service developments that have led to major improvements in the quality of long-term care in the United States. This policy brief highlights a few areas in which publicly and privately funded research has informed the long-term care field.

United Power For Action And Justice: Breaking The Cycle Of Homelessness Reports - Policy Brief, Center For Urban Research And Learning, Christine George, Chiara Sabina, Aparna Sharma

Center for Urban Research and Learning: Publications and Other Works

This is a story of two groups of determined people with intersecting interests. Group one: a dozen leaders within United Power for Action and Justice who set out to prove their conviction, that homelessness is one symptom of a complex of issues that destabilizes individuals and communities. Group two: persons who are homeless and struggle daily to “fit in” to a landscape that is, more and more, structured to shut them out. In 2000, a cluster of leaders within United Power organized member institutions in the north and northwest suburbs of Chicago, and initiated a relationship with Congressman John Porter …

Population Mobility High-Risk Environments And The Diffusion Of Hiv/Stds: A Community Based Study In Southwest China, Hongyun Fu

Sociology & Criminal Justice Theses & Dissertations

Globally, population migration has been associated with the spread ofHIV/STDs in many countries. A similar trend has been observed in China from the very beginning of the HIV epidemic, but empirical research is very limited. Furthermore, the previous studies mainly focused on the micro impact of migration on individual migrant's risky behaviors. The impact of population mobility on the general population, especially on non-migrant residents, has been ignored. Using data collected from a specially designed community level survey, which was conducted in a province in the Southwest of China, this study examines the macro-level association between temporary migration and the …

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Sociology & Criminology Faculty Publications

OBJECTIVE:

To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).

METHODS:

Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

RESULTS:

Hand hygiene practices, knowledge, and opinions did not change after …

Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess

Theses, Dissertations and Capstones

Medicaid-funded long-term care services are traditionally delivered in nursing homes. States may apply for waivers which allow them to provide home and community based services with Medicaid funds. Because these services are by definition an alternative to nursing home care, waiver services are generally based upon a medical model which emphasizes medical deficits and tends to restrict consumers’ movements to inside the home. Recent developments such as the Olmstead Decision and federal New Freedom Initiatives have caused states to recognize that consumers desire and have a legal right to be part of a community rather than institutionalized or homebound. These …

Nsucommuniversity Link - January 2003, Nova Southeastern University

NSU Digital: Communiversity

No abstract provided.

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Empowering Communities To Respond To Hiv/Aids: Ndola Demonstration Project On Maternal And Child Health: Operations Research Final Report, Hope Humana, Linkages, National Food And Nutrition Commission, Ndola District Health Management Team, Horizons Program, Zambia Integrated Health Project

HIV and AIDS

A pre–post intervention study conducted in Zambia by Horizons and local NGOs and governmental organizations demonstrated that HIV voluntary counseling and testing (VCT) and infant feeding counseling (IFC) to mothers attending maternal and child health (MCH) clinics are vital components of any mother-to-child transmission (MTCT) reduction strategy, whether or not antiretrovirals (ARVs) are available. These interventions enable mothers to make informed and healthy decisions. Data from the Ndola Demonstration Project yielded encouraging results from efforts to improve the capacity of mothers to make informed decisions about their own health and the health of their infant. The interventions succeeded in raising …

Improving Postpartum Care Among Low Parity Mothers In Palestine, Center For Development In Primary Health Care (Cdphc)

Reproductive Health

In an effort to improve the health status of Palestinian women and their children in the West Bank and Gaza, USAID, in collaboration with the Palestinian Ministry of Health and a number of NGOs, designed and funded a 28-month pilot activity, the Pilot Health Project (PHP), that was expected to have a positive impact on the health of women and children. This report describes the results of the intervention designed to measure the effectiveness of a second home visit on low-parity women in 1) improving their knowledge and practices regarding their own health as well as the health of their …

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Carolyn Barnes, Erica Keogh, Nontokozo Nemarundwe, Loveness Nyikahadzoi, Ellen Weiss

HIV and AIDS

This study, conducted in Zimbabwe, sought to better understand the relationship between a microfinance program, Zambuko Trust, and how microentrepreneurs’ households cope with the impact of HIV/AIDS. The study examined how HIV/AIDS is affecting Zambuko’s operations and what microfinance institutions (MFIs) can do to lessen the impact of HIV/AIDS on their clients and operations. The findings indicate several small yet important ways that MFI programs help microentrepreneurs and their families respond to these impacts through access to credit and business management training. Participation in a microfinance program led to income smoothing and better financial management, which can help households mitigate …

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Gerontology Institute Publications

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

Evidence-Based Development Of Health And Family Planning Programs In Bangladesh And Ghana, James F. Phillips, Tanya C. Jones, Frank K. Nyonator, Shruti Ravikumar

Poverty, Gender, and Youth

This paper describes two initiatives that have used experimental studies to guide the development of community-based health and family planning programs. In Bangladesh and Ghana, factorial experiments were implemented in stages. An exploratory phase developed a service system for community-based health care; an experimental phase assessed the demographic impact of the system; a replication phase examined the transferability of the experimental program to a non-research setting; and a scaling-up phase facilitated the extension of the new system to the national health care program. All stages were guided by research, with questions, mechanisms, and outcomes shifting as the process developed. Large-scale …

Determinants Of Old-Age Mortality In Taiwan, Zachary Zimmer, Linda G. Martin, Hui-Sheng Lin

Poverty, Gender, and Youth

Relationships among socio-demographic characteristics, general assessments of health, and old-age mortality are well established in developed countries. There is also an increasing focus on the connection between early-life experiences and latelife health. This paper tests these and other associations using representative survey data from Taiwan on the population aged 60 and older in 1989, 1993, and 1996 that have been linked to data on deaths between 1989 and 1999 from a national death registry. The study also explores the possible influence of Taiwan’s Universal Health Insurance Program, instituted in 1995, and whether or not the survival of some groups of …

Estimating Mean Lifetime, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

The life expectancy implied by current age-specific mortality rates is calculated with life table methods that are among the oldest and most fundamental tools of demography. We demonstrate that these conventional estimates of period life expectancy are affected by an undesirable “tempo effect.” The tempo effect is positive when the mean age at death is rising and negative when the mean age is declining. Estimates of the effect for females in three countries with high and rising life expectancy range from 1.6 years in the United States and Sweden to 2.4 years in France for the period 1980-95.

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

Poverty, Gender, and Youth

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

The Ghana Community-Based Health Planning And Services Initiative: Fostering Evidence-Based Organizational Change And Development In A Resource-Constrained Setting, Frank K. Nyonator, John Koku Awoonor-Williams, James F. Phillips, Tanya C. Jones, Robert A. Miller

Poverty, Gender, and Youth

Research projects demonstrating ways to improve health services often fail to have an impact on what national health programs actually do. An approach to evidence-based policy development has been launched in Ghana that bridges the gap between research and program implementation. The Community-based Health Planning and Services (CHPS) initiative employs strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteers, resources, and cultural institutions to support community-based primary health care. Over the 1999 to 2002 period, 100 out of the 110 districts in Ghana adopted a CHPS initiative. This paper reviews features of the initiative …

Primary Schooling In Sub-Saharan Africa: Recent Trends And Current Challenges, Cynthia B. Lloyd, Paul C. Hewett

Poverty, Gender, and Youth

At the dawn of the twenty-first century we estimate that more than 37 million young adolescents aged 10-14 in sub-Saharan Africa will not complete primary school. Our estimates are based on data from nationally representative Demographic and Health Surveys from 26 countries, collectively representing 83 percent of the sub-Saharan youth population. This number is nearly twice the entire population of children aged 10-14 in the United States, virtually all of whom will complete primary school. Reducing the number of uneducated African youth is a primary objective of the United Nations as laid out in the Millennium Development Goal for education, …