Public Health Commons^™

Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias

Reproductive Health

As the world grapples with the HIV pandemic, the implementation of the agenda determined by the International Conference on Population and Development (1994) at Cairo, and the matter of providing health services of adequate quality in an ethical, gender-sensitive manner, new questions are arising about how to attend to reproductive tract infections, including sexually transmitted infections (STIs), among women. This paper reviews the results of validation studies of syndromic algorithms, other nonlaboratory clinically based tools, and risk scoring for finding women infected with chlamydia and gonorrhea, particularly among those attending family planning and antenatal clinics in developing countries. The results …

The Female Condom In Zimbabwe: The Interplay Of Research, Advocacy, And Government Action, Population Council

HIV and AIDS

During the past decade, a significant increase in reported cases of HIV/AIDS in Zimbabwe prompted the government, local organizations, and international donors to intensify prevention efforts. As part of this response, in November 1996 Zimbabwe’s National AIDS Coordinating Programme invited Population Services International to launch a social marketing program to promote the female condom, making this protective device widely available for the first time in Africa. After an acceptability study showed that Zimbabwean men and women liked using the female condom, leaders of these organizations encouraged public discussion and media attention, which helped pave the way to approval and introduction …

Improving The Management Of Stis Among Mch/Fp Clients At The Nakuru Municipal Council Health Clinics, Julie Solo, Baker Ndugga Maggwa, James Kariba Wabaru, Bedan Kiare Kariuki, Gregory Maitha

Reproductive Health

In an effort to address the global crisis of HIV/AIDS and to reduce the spread of other sexually transmitted infections (STIs), maternal and child health/family planning (MCH/FP) programs have attempted to integrate the management of STIs into their services. This integration was endorsed at the 1994 International Conference on Population and Development in Cairo. However, as noted in this report, programs have encountered a number of difficulties as they try to effectively manage STIs in an MCH/FP setting. In particular, the effective detection and treatment of STIs has proven difficult among MCH/FP populations. This current study was developed to help …

Participation And The Focus Of Nutrition Education In A Rural Child Growth Monitoring Program In Kenya, Elizabeth N. Kuria

Theses: Doctorates and Masters

Nutrition education is one of the strategies that addresses high levels of malnutrition in the world. Since independence in 1963. Kenya has instituted socio-economic, food security, nutrition and health policies to improve the nutrition and quality of life of it's people. In spite of these policies, one third of the Kenyan population is undernourished. This study was planned to establish how nutrition education is conducted in the Ministry of Health Thika District through a rural child growth monitoring program and to generate and reflect on women's participation in decision making in the program. Open-ended interviews were conducted with 21 women …

Centred Voices : A Study Of The Lived Experience Of Women's Health Centre Coordinators, Jodie L. Moyle

Theses: Doctorates and Masters

The purpose of this phenomenological study is to explore and describe the lived experience of women's health centre coordinators. In addition to the intrinsic value of telling these women's stories, this research provides data which can he used to strengthen the economic, political, organisational and social position of women’s health centres and the women who work in them. Four women managers from regional urban women's health centres in Australia were interviewed about their subjective experiences with respect to their current working roles. Interviews were audio taped, transcribed and coded to produce themes and to preserve anonymity. Data was analysed using …

Native Outreach: A Report To American Indian, Alaska Native And Native Hawaiian Communities, C.S. Glover, F.S. Hodge

Native Health Database Full Text

The National Cancer Institute (NCI) is presenting a monograph written specifically for community leaders, health professionals and lay health workers serving Native American communities. Native Americans have higher mortality rates than the general U.S. population for several major cancer sites. This publication focuses on the need to reduce those rates through effective interventions at the grassroots level.

American Indians And Crime, Bureau Of Justice Statistics, U.S. Department Of Justice, L.A. Greenfeld, S. Smith

Native Health Database Full Text

This report represents a compilation and new analysis of data on the effects and consequences of violent crime among American Indians. The report uses data from a wide variety of sources, including statistical series maintained by the Bureau of Justice Statistics (BJS), the FBI, and the Bureau of the Census. Data are reported from American Indian crime victims on how they were affected by the victimization and about who victimized them. The report also includes the first BJS estimates of the total number of American Indians under the custody or supervision of the justice system.

Alaska Native Cancer Survival Report, A.P. Lanier, P. Holck, J. Kelly, B. Smith, T. Mcevoy

Native Health Database Full Text

This report presents Alaska Native cancer survival rates and stage of disease at diagnosis. Data on survival and stage at diagnosis are given for all cancers combined, and for select primary cancer sites (the organ in which the cancer first began). Survival rates are given for only those cancers for which there were enough patients to calculate reliable estimates. The focus is on five-year relative survival rates because these rates are most commonly used in the cancer literature and most appropriate for comparisons between populations.

Editorial: Mental Health Needs Assessments Performed By Four Urban American Indian Organizations, D.K. Novins

Native Health Database Full Text

In 1991, the Indian Health Service funded a nationwide initiative with the goal of determining the need for culturally appropriate mental health services among American Indian people residing in urban areas. In the author's opinion, the assessment method used in this initiative is a valuable, fresh approach that is a significant change from flawed attempts to make these assessments in the past.

Farm Tractor Safety In Kentucky, 1995, Steven R. Browning, Susan C. Westneat, Helena Truszczynska, Deborah Reed, Robert Mcknight

Preventive Medicine and Environmental Health Faculty Publications

Objective: Tractor rollovers are a major cause of farm injuries and fatalities. The authors used data from a statewide surveillance study to estimate the prevalence of safety features such as rollover protective structures, seat belts, and power take-off shields on farm tractors in Kentucky.

Methods: Using data from the Farm Family Health and Hazard Surveillance Project, the authors report on the prevalence of farm tractor safety features by size of farm, by region of the state, by number of tractors per farm, and by tractor age and estimate the prevalence of tractors equipped with rollover protection by region and for …

Classification Of Participants Into Two Health Resource Utilization Groups By The Health Enrollment Assessment Review (Hear) Survey, Jody W. Donehoo

Health Services Research Dissertations

The study examined the ability of the Health Enrollment Assessment Review (HEAR) survey instrument to classify participants into one of two groups according to utilization of health resources anticipated in the following year. Developed by the U.S. Air Force, the HEAR survey is used worldwide by the Department of Defense for enrollees in TRICARE Prime, the military's adaptation of the HMO model of managed care. Individual HEAR reports are prepared for survey participants and their primary care providers in TRICARE Prime. Although it is currently administered worldwide to a majority of the 8.4 million health care beneficiaries of the Department …

Benchmarking Financial Operations Using The Premier Operations Outlook Database, Margaret M. Thompson

Community & Environmental Health Theses & Dissertations

Acute-care hospitals have come under increased pressure to reduce costs while increasing the quality of providing care. Historically, increasing costs of providing care has had the greatest impact on the reduction of operating margins necessary to expand capital and for repayment of debt. Facilities can benchmark internal historical data to identify areas where costs have increased and are able to explain the factors that contribute to the increases. One of the challenges facing hospitals in their efforts to reduce operating costs is how, what, and where, do they obtain comparative data to benchmark the cost of operating medical facility to …

Effectiveness Of The "Baby Think It Over" Program On Adolescents' Contraceptive And Child-Rearing Attitudes, Stephanie Ann Johnson

Masters Theses

An increasing number of high schools in the United States have begun to use the "Baby Think It Over" doll as part of their curriculum in certain classes. This study examined the effectiveness of this doll on influencing 46 male and female adolescents' attitudes and behaviors regarding pregnancy, sexual activity, and contraceptives. Five specific subscales were developed to measure the teens' contraceptive attitudes and behaviors before and after using the doll regarding their feelings about becoming pregnant, understanding/comprehension of the responsibilities of child-rearing, appreciation of the impact of child-bearing on their lives/future, and attitudes toward premarital sex. Also, a qualitative …

Resurgence Of Sleeping Sickness In Tambura County, Sudan, Anne Moore, Michaleen Richer, Mario Enrile, Edward Losio, Jacquelin Roberts, Deborah A. Levy

Journal Articles: Epidemiology

Endemic foci of human African trypanosomiasis are present in southern Sudan. In 1996 and 1997, trypanosomiasis increased sharply in Tambura County. To define the magnitude and geographic distribution of the outbreak, we conducted a prevalence survey using population-based cluster sampling in 16 villages: 1,358 participants answered questions about routine activities and tsetse fly contact and received serologic testing. Seroprevalence in the surveyed area was 19.4% (95% confidence interval = 16.9%, 21.8%). We confirmed infection in 66% of seropositive persons who received one parasitologic examination and in 95% of those who had serial examinations of lymph node fluid and blood. Activities …

Concepções De Doença Por Familiares De Pacientes Com Diagnóstico De Esquizofrenia: Illness Conceptions Among Relatives Of Patients Diagnosed With Schizophrenia, Cecilia C. Villares, Cristina Redko, E Jair J. Mari

Population and Public Health Sciences Faculty Publications

Family conceptions of the nature of their relative's illness are part of the coping process and reveal the cultural construction of the illness experience. As part of a larger qualitative study conducted at the Schizophrenia Program of the Department of Psychiatry, Escola Paulista de Medicina - Unifesp, 14 relatives of 8 out-patients diagnosed with schizophrenia were interviewed and invited to talk freely about their ideas and feelings concerning their relative's problem. Qualitative analysis was conducted to elicit categories of illness representations. Three main categories are presented for discussion, Problema de Nervoso, Problema na Cabeça and Problema Espiritual (Nerves, Head and …

International Law And Global Public Health, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao

Poverty, Gender, and Youth

Despite ongoing declines in fertility in many countries, the population of the world is experiencing a period of rapid expansion, and its size is expected to exceed 10 billion by the end of the demographic transition. Three causes of this growth are identified and quantified: 1) fertility above the replacement level of two surviving children per woman, 2) continuing declines in mortality, and 3) population momentum resulting from a young age structure. A set of simple analytic expressions is proposed for estimating these factors from standard demographic indicators. Population momentum is shown to be the main cause of future growth …

The Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts

Poverty, Gender, and Youth

This study examines the role of tempo effects in the fertility declines of developing countries. These effects temporarily inflate the total fertility rate (relative to the actual fertility of cohorts of women) during periods when the age at childbearing declines and they deflate it when childbearing is postponed. An analysis of data from the World Fertility Surveys and the Demographic and Health Surveys demonstrates that fertility trends observed in many developing countries are likely to be distorted by changes in the timing of childbearing. In most countries women are delaying childbearing, which implies that observed fertility is lower than it …

Population Weights In The International Order, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Population relativities play little part in the international system. A nation’s economic and military power is influenced by population size, but as one factor among many. Formal relations among states exclude population from consideration by the principle of sovereign equality. Three sources of possible change in this situation are explored, in which states would be “population-weighted” to a greater degree than before. Convergence of productivity levels around the world, expected by many, would bring the economic and population rankings of states more into line. Such convergence is occurring, but selectively and for the most part quite slowly. Anticipation of its …

Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar

Poverty, Gender, and Youth

Although an overall decline has occurred in adolescent fertility in Kenya, the proportion of births to teenagers that takes place prior to marriage is rising. At the same time that premarital sex and childbearing have increased, educational participation has expanded considerably, especially for girls. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 33 primary schools that the adolescents attended, this paper explores whether certain aspects of the school environment affect the likelihood of early and unprotected sex among adolescent girls and boys in three districts of Kenya. Because of the concern with “schoolgirl pregnancy” …

Mortality Decline And The Demographic Response: Toward A New Agenda, Mark R. Montgomery

Poverty, Gender, and Youth

A central proposition of demographic transition theory is that declines in infant and child mortality can encourage subsequent declines in fertility. Even the earliest formulations of the theory recognized that fertility decline would occur only with a lag, but neither theory nor empirical work has explored the length of such lags. This paper urges that individual perceptions and beliefs about mortality risks, conspicuously absent from the demographic research agenda, be studied directly. It proceeds to link mortality perceptions to health care decisionmaking and investments in children. The paper concludes by calling for a new agenda on mortality decline. This agenda …

The Decline Of Female Circumcision In Egypt: Evidence And Interpretation, Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than …

Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline

Poverty, Gender, and Youth

Fertility has declined substantially in developing countries in the period since 1960, primarily as the result of increases in contraceptive prevalence. Little dispute is found on this point, but considerable debate has arisen about the causes of the increase in contraceptive prevalence. One unresolved issue is the causal contribution of changes in fertility desires. The sources of increase in contraceptive prevalence are analyzed in 22 countries in Latin America, Asia, and Africa in the period from the 1970s to the 1990s, using World Fertility Surveys and Demographic and Health Surveys data. Through regression decomposition, change in prevalence is attributed to …

Urban Growth In Developing Countries: A Review Of Projections And Predictions, Martin Brockerhoff

Poverty, Gender, and Youth

Comparison of the United Nations’ earliest and most recent projections to the year 2000 suggests that urban and city growth in developing regions has occurred much more slowly than was anticipated as recently as 1980. A modified “urban population explosion” in developing countries since the 1970s conforms to explanatory models of urban growth developed by economists around 1980. Trends in productivity and terms of trade, in particular, have been highly favorable to agriculture as compared to manufacturing, presumably slowing migration to urban centers. Increases in national population growth rates have produced less than commensurate in rates of city growth, further …

Measuring Living Standards With Proxy Variables, Mark R. Montgomery, Michele Gragnolati, Kathleen A. Burke, Edmundo Paredes

Poverty, Gender, and Youth

Very few demographic surveys in developing countries gather information on household income or consumption expenditure, despite the theoretical importance of these measures. Consequently, researchers have been forced to rely on ad hoc collections of proxy measures for living standards, and the properties of these proxies have not been systematically analyzed. In this research, we ask what hypotheses can be tested using proxy variables, and evaluate the performance of proxy measures in relation to consumption expenditures per adult, our preferred measure of living standards. We find that the proxy variables commonly employed in demographic research are very weak predictors of consumption …

The Decline Of Female Circumcision In Egypt: Evidence And Interpretation [Arabic], Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than …

Emotional Dysregulation In Children With Aids-Diagnosed Mothers: A Comparative Study, Kathleen O'Brien-Sheber

Seton Hall University Dissertations and Theses (ETDs)

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Is Old Bridge High School Meeting The Needs Of All Students' Knowledge With Respect To The Hiv/Aids Curriculum?, Dawn Forgerson

Seton Hall University Dissertations and Theses (ETDs)

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Zimbabwe: Los Métodos De Detección De Itr En Mujeres No Son Cost-Efectivos, Population Council

Reproductive Health

Las infecciones del tracto reproductivo (ITR) son frecuentes en Zimbabwe. Muchas de estas infecciones aumentan el riesgo de contraer el virus de inmunodeficiencia humana (VIH). En 1998, el Consejo Nacional de Planificación Familiar de Zimbabwe (en inglés, ZNFPC) realizó un estudio de IO para evaluar la viabilidad de integrar el diagnóstico y tratamiento de ITR en su oferta de servicios. La población estudiada estaba constituida por 1,634 clientas de tres clínicas de ZNFPC. Se preguntó a las usuarias si presentaban dolor en la región abdominal inferior, flujo vaginal y otros síntomas de ITR; asimismo, se les examinó para detectar la …

Lessons From Community-Based Distribution Of Family Planning In Africa, James F. Phillips, Wendy L. Greene, Elizabeth F. Jackson

Poverty, Gender, and Youth

This paper reviews findings and experiences from efforts to implement community-based family planning services in sub-Saharan Africa. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt or is considerably less than was observed in similar projects in Asia in the 1970s and 1980s. Reasons for the constrained impact of community-based family planning in Africa are reviewed and assumptions about the efficacy and mechanism of community-based distribution (CBD) are discussed. Whereas several contrasting approaches to CBD have been tried, little is known about the relative merits of alternative CBD approaches.