Public Health Commons^™

Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health

Reproductive Health

Many public, NGO, and private-sector service-delivery systems are suitably matched to the requirements of providing injectable contraceptives in India, including the ability to ensure choice and service delivery quality. This operations research study was designed to demonstrate the feasibility of providing injectable contraceptives in private medical practices and to contribute to the body of scientific literature on the acceptability of this method in India. DKT India and EngenderHealth formed a partnership with the Population Council’s Frontiers in Reproductive Health program to conduct this study in Gujarat. The ability to generate recommendations is limited, however, by the special characteristics of the …

Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

Replication Of The Tostan Programme In Burkina Faso: How 23 Villages Participated In A Human Rights-Based Education Programme And Abandoned The Practice Of Female Genital Cutting In Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert

Reproductive Health

This paper presents the results of an extensive review of the literature pertaining to the relationship between vaginal lubrication and the acceptability of microbicides, spermicides, and male and female condoms. The review highlights the need for research that better elucidates norms, preferences, and practices regarding lubrication during sex within and across countries. The second part of the report presents the results of the first phase of a qualitative study on lubrication during sex showing that diverse personal and cultural factors shape preferences and practices and may ultimately affect the acceptability of microbicides. The immediate challenge is to provide women with …

Non-Consensual Sexual Experiences Of Young People: A Review Of The Evidence From Developing Countries, Shireen J. Jejeebhoy, Sarah Bott

Reproductive Health

Although there is increasing evidence of risky consensual sex among young people in developing countries, non-consensual sexual experiences among them have rarely been studied and few interventions have been designed to protect them from the risks of such experiences. However, what is available suggests that coercion and unwantedness may play a considerable role in the sexual relations of young people—girls and young women but also boys and young men. The implications of non-consensual sexual experiences for young people’s rights, their health and development and the risks they pose in the transition to adulthood are enormous. This review collates what is …

Changing Family Planning Scenario In India: An Overview Of Recent Evidence, K.G. Santhya

Reproductive Health

Over the decades, there has been a substantial increase in contraceptive use in India. The direction, emphasis and strategies of the Family Welfare Programme have changed over time. However, meeting the contraceptive needs of considerable proportions of women and men and improving the quality of family planning services continue to be a challenge. The 1990s witnessed a growing recognition of this, and several innovative policy and programme initiatives have been launched to address these issues. This paper reviews and synthesises evidence from surveys and studies conducted in the 1990s and thereafter on contraceptive use dynamics and the unmet need for …

Actions That Protect: Promoting Sexual And Reproductive Health And Choice Among Young People In India, Shireen J. Jejeebhoy, Mary Philip Sebastian

Reproductive Health

This paper synthesises the evidence on the sexual and reproductive health situation of young people in India, and explores what we know about underlying factors that place them at risk of or protect them from unsafe and unwanted sexual and reproductive health experiences. The picture that emerges suggests that substantial proportions of young people experience risky or unwanted sexual activity, do not receive prompt or appropriate care, and experience adverse reproductive health outcomes. Contextual factors such as poverty, gender imbalances and lack of education or livelihood opportunities clearly increase the vulnerability of youth. Other factors at the family, community and …

Assault-Related Admissions To Hospital In Central Australia, Ged F. Williams, Wendy P. Chaboyer, Philip J. Schluter

Aboriginal Policy Research Consortium International (APRCi)

Objective: To determine the number of assault-related admissions to hospital in the Central Australia region of the Northern Territory over a six-year period. Design and setting: Retrospective analysis of all patients admitted to Alice Springs Hospital (ASH) and Tennant Creek Hospital (TCH) from July 1995 to June 2001, where the primary cause of injury was “assault”. Main outcome measures: Frequency of assault-related admission to hospital; demographic characteristics of the victims. Results: In the six years, there were 2449 assault-related admissions to ASH and 545 to TCH. Adults aged 25–34 years were most frequently hospitalised for assault, in a proportion greater …

Transportation: A Crucial Issue For Adult Day Care In Vermont, Francis G. Caro, Regula H. Robnett, Jennifer Higgins

Gerontology Institute Publications

Transportation arrangements are an integral but fragile element in the effectiveness of adult day care services in Vermont and nationwide. Almost by definition, adult day center participants generally cannot drive due to cognitive and/or physical limitations. Since adult day care services are congregate in nature and serve community-residing elders, this long-term care option is feasible only when there are arrangements to transport elders to and from service centers. Transportation is therefore a major issue for adult day care services.

The aim of this report is to call attention to transportation issues in adult day care services in Vermont. The report …

Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle

HIV and AIDS

A study conducted in Dakar, Senegal by researchers from the National AIDS Council, Cheikh Anta Diop University, and the Horizons program obtained information on the needs, behaviors, knowledge, and attitudes of men who have sex with men (MSM). This study offers important insights into the sexuality of MSM, their vulnerability to STI/HIV, and the role of violence and stigma in their lives. The results also highlight the lack of sexual health services and information available to cover the specific needs of MSM. The results of this study were summarized during a meeting held in April 2001 in Dakar and raised …

Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta

HIV and AIDS

While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …

Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Horizons Program

HIV and AIDS

Research conducted in many countries has highlighted the vulnerability of men who have sex with men (MSM) to HIV and other STIs. Yet in Africa, they receive little attention in HIV/AIDS programming and service delivery because of widespread denial and stigmatization of homosexual behavior. In Senegal, a study conducted by researchers from the National AIDS Control Program, Cheikh Anta Diop University, and the Horizons Program has provided valuable information about the needs, behaviors, knowledge, and attitudes of MSM that has important implications for program managers and policymakers working to stem the spread of HIV/AIDS. The researchers used ethnographic and survey …

Satisfaire Les Besoins De Santé Des Hommes Qui Ont Des Rapports Sexuels Avec D'Autres Hommes Au Sénégal, Horizons Program

HIV and AIDS

No abstract provided.

Satisfaire Aux Besoins De Santé Des Hommes Qui Ont Des Rapports Sexuels Avec D’Autres Hommes Au Sénégal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle

HIV and AIDS

A study conducted in Dakar, Senegal by researchers from the National AIDS Council, Cheikh Anta Diop University, and the Horizons program obtained information on the needs, behaviors, knowledge, and attitudes of men who have sex with men (MSM). This study offers important insights into the sexuality of MSM, their vulnerability to STI/HIV, and the role of violence and stigma in their lives. The results also highlight the lack of sexual health services and information available to cover the specific needs of MSM. The results of this study were summarized during a meeting held in April 2001 in Dakar and raised …

Ndola Demonstration Project: A Midterm Analysis Of Lessons Learned, Horizons Program

HIV and AIDS

This report summarizes baseline and midterm findings of an intervention pilot study conducted by Horizons, LINKAGES, National Food and Nutrition Commission, District Health Management Team, Hope Humana, and the Zambia Integrated Health Program in Ndola District, Zambia. The aim of the research is to investigate how integrating services for the prevention of mother-to-child transmission (PMCT) of HIV into low-resource maternal and child health (MCH) and antenatal care (ANC) settings influences women’s ability to make and implement informed decisions about HIV. The intervention strengthened routine services and introduced HIV voluntary counseling and testing and PMCT counseling and services into the MCH/ANC …

Frontiers Capacity Building: An Overview, James R. Foreit

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program is a cooperative agreement with USAID to improve family planning and reproductive health service delivery through operations research (OR). Frontiers builds on more than 20 years of research to improve family planning service delivery programs. A major goal of Frontiers is to transfer skills in OR so that public and private agencies in developing countries can conduct OR and apply research findings to reproductive health programs and policies. OR addresses problems in operational effectiveness, access, quality, and efficiency by investigating facets of programs that managers can control and change. As concluded in …

Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim

Poverty, Gender, and Youth

Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …

Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya

Reproductive Health

The goal of this study was to determine the sustainability of the postabortion care (PAC) training and service delivery intervention introduced in the Hospital Nacional Daniel Alcides Carrión in Lima, Peru, and the extent to which the outcomes of the intervention have continued. The objectives of the study were to assess changes over time in the following outcomes: the use of manual vacuum aspiration for incomplete abortion, provision of family planning information to postabortion patients, acceptance of contraception by postabortion patients prior to discharge, provision of medical care information to patients, length of hospital stay, and resources used by the …

Capacitación Y Apoyo De Científicos En Población De Países En Desarrollo: Un Informe De Panel—Resumen Y Recomendaciones, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd

Poverty, Gender, and Youth

Desde su inicio, el Population Council ha reconocido la importancia y el valor que tiene la capacitación del científico en población de países en desarrollo. A partir de 1952, el programa de becas en ciencias sociales del Council ha logrado mantener sus objetivos habiéndo otorgado aproximadamente 1500 becas hacia la capacitación pre- y pos-doctoral en estudios de población. Aunque la demanda de científicos en población continúa firme, el campo ha cambiado considerablemente desde aquellos primeros años, de modo que una reevaluación del programa se tornó necesaria. La Fundación Mellon en el año 2000 otorgó fondos para un proyecto de evaluación …

Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang

Poverty, Gender, and Youth

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …

How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May

Poverty, Gender, and Youth

Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …

The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth

Poverty, Gender, and Youth

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …

Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim

Poverty, Gender, and Youth

In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …

Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh

Poverty, Gender, and Youth

To the extent that research on Vietnamese adolescents has been conducted, it has been concerned with unprotected and unsanctioned sexual activity and its health consequences, namely abortion and sexually transmitted diseases, especially HIV. The question we pose is whether this concern is warranted. Is the population community justified in focusing its attention on early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young people’s lives that should give us greater pause? The paper reviews the literature on adolescent sexual behavior in Vietnam and analyzes data …

The Effect Of Gender Differences In Primary School Access, Type, And Quality On The Decision To Enroll In Rural Pakistan, Cynthia B. Lloyd, Cem Mete, Zeba Sathar

Poverty, Gender, and Youth

The paper explores the effect of primary school access, type, and quality on the decision to enroll in rural Pakistan using a 1997 survey especially designed for this purpose. A unique contribution of the paper is the construction of gender-specific dimensions of school accessibility and school quality according to school type (i.e., public vs. private). Within the same village, girls and boys often face starkly different options for schooling in terms of distance, type, and quality. Public primary schools are segregated by sex; private schools, whose numbers have grown rapidly in recent years in response to rising demand and the …

'Bus Fare, Please': The Economics Of Sex And Gifts Among Adolescents In Urban South Africa, Carol E. Kaufman, Stavros E. Stavrou

Poverty, Gender, and Youth

Force or coercion are often a part of sexual relationships in South Africa, especially among adolescents. This coercion is also often pinioned by an economic exchange: gifts or favours for sex. Studies have pointed out the negative consequences of the exchanges which are often characterised by large age differences (‘sugar daddies’) or power imbalances. Perhaps more pervasive but largely ignored, gift-giving in same-age relationships also may be associated with sexual leverage, an exchange which somehow entitles one partner physical and sexual rights to the other’s body. The circumstances surrounding gifts and favours may shape young women’s and men’s sexual experiences, …

Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline

Poverty, Gender, and Youth

The objective of this research is to examine the association between social organization and reproductive behavior in one setting in sub-Saharan Africa. The particular focus is on the effects of social organization on the diffusion of innovative reproductive ideas and behaviors. Social diffusion is assumed to be strongly affected by patterns of informal social interaction, and these in turn are assumed to be determined in part by the social organization of local communities (gender relations, employment activity, voluntary organizations). The research draws on data collected in six communities in southern Ghana. The analysis reveals a weaker than expected association between …

Universal Sexuality Education In Mongolia: Educating Today To Protect Tomorrow, Delia Barcelona, Laura Laski, Caitlin Gerdts

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité demonstrates how Mongolia developed a national plan to a provide a comprehensive sexual and reproductive health curriculum and media for adolescents. Among the lessons learned from the Mongolian experience were the following: 1) questions about unwanted sexual relations and sexual roles were the most pressing among adolescents, especially girls; 2) printed media are efficient and inexpensive; and 3) parental opposition was almost nonexistent in certain settings—often they expressed gratitude for this education.

Are We Not Peasants Too? Land Rights And Women's Claims In India, Bina Agarwal

Poverty, Gender, and Youth

This edition of SEEDS explores the critical elements in securing effective and independent land rights for women in South Asia. The author presents a range of cooperative strategies for enabling women to retain and cultivate the land and shows how micro-credit and other programs can be redirected to increase the amount and productivity of land women control. Recognizing that new policies and political will are required to foster and sustain such experiments, the author ends with a summary of how women are organizing to place women’s access to land at the center of national and global agendas.

Grandparent Care In The United States: Comparisons By Race And Ethnicity, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to compare information on grandparent caregivers in the United States among members of five different racial and ethnic groups. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household.2 Data from the 2000 Census 5% Public Use Microdata Sample are used in our calculations. The …