Public Health Commons^™

Too Young To Be A Mother: A Description Of The Lives Of Married Adolescent Girls In Egypt, Omaima El-Gibaly, Susan M. Lee

Poverty, Gender, and Youth

Improving the status and health of women is high on the agenda of the Ministry of Health and Population in Egypt. Investing in the lives of women who marry in their teens has long-term benefits for these girls and their children. Valid information is needed, however, to address these girls’ special needs. Adolescent health is currently one of the major concerns of the Ministry of Health and Population, as is delaying early marriage and addressing the reproductive and other health needs of married girls. The Ministry was a fieldwork partner with the Population Council, providing data collection from primary health …

Socioeconomic Disadvantage And Unsafe Sexual Behaviors Among Young Women And Men In South Africa, Kelly Hallman

Poverty, Gender, and Youth

This study investigates how relative socioeconomic status influences the sexual behaviors of young women and men aged 14–24 years in KwaZulu-Natal Province, South Africa—an environment characterized by high HIV prevalence and high rates of poverty and inequality. Relative economic disadvantage is found to significantly increase the likelihood of a variety of unsafe sexual behaviors and experiences. Poorer young people, especially females, also have significantly lower access to media sources for family planning information. Without sufficient attention in the design and placement of HIV prevention programs to the economic and social conditions in which individuals live, the potential effectiveness of the …

Growing Up In Pakistan: The Separate Experiences Of Males And Females, Cynthia B. Lloyd, Monica J. Grant

Poverty, Gender, and Youth

This Population Council working paper examines gender differences in transitions to adulthood in Pakistan. The survey covers key aspects of adolescents’ lives, including the timing of several adult transitions and a detailed accounting of time use over the previous 24 hours. The results of the analysis confirm the fundamental importance of schooling to transitions to adulthood. Those without any schooling, which still includes 15 percent of young men and 46 percent of young women, assume the work burdens of adults prematurely and are deprived of the opportunity for learning in an institutional setting outside the family. Those who do attend …

Bridging The Gap Between Evidence-Based Innovation And National Health-Sector Reform In Ghana, John Koku Awoonor-Williams, Ellie S. Feinglass, Rachel Tobey, Maya Vaughan-Smith, Frank K. Nyonator, Tanya C. Jones, James F. Phillips

Poverty, Gender, and Youth

Although experimental trials often identify optimal strategies for improving community health, transferring operational innovation from well-funded research programs to resource-constrained settings often languishes. Because research initiatives are based in institutions equipped with unique resources and staff capabilities, results are often dismissed by decisionmakers as irrelevant to large-scale operations and national health policy. This article describes an initiative undertaken in Nkwanta District, Ghana, focusing on this problem. The Nkwanta District initiative is a critical link between the experimental study conducted in Navrongo, Ghana, and a national effort to scale up the innovations developed in that study. A 2002 Nkwanta district-level survey …

Urban Poverty And Health In Developing Countries: Household And Neighborhood Effects [Arabic], Mark R. Montgomery, Paul C. Hewett

Poverty, Gender, and Youth

In the United States and other high-income countries, where most people live in cities, there is intense scholarly and program interest in the effects of household and neighborhood living standards on health. Yet very few studies of developing-country cities have examined these issues. This paper investigates whether in these cities the health of women and young children is influenced by both household and neighborhood standards of living. Using data from the urban samples of 85 Demographic and Health Surveys, and modeling living standards using factor-analytic MIMIC methods, we find, first, that the neighborhoods of poor households are more heterogeneous than …

The Experience Of Adolescence In Rural Amhara Region, Ethiopia, Annabel Erulkar, Tekle-Ab Mekbib, Negussie Simie, Tsehai Gulema

Poverty, Gender, and Youth

This study aims to broaden the understanding of young lives in rural Ethiopia, specifically, Amhara Region. It finds that over half of the adolescents in the sample had never been to school. The most common reason for boys and girls not attending school was poverty, followed by early marriage for girls, and too many work responsibilities for boys. It finds that over half of the adolescents interviewed were illiterate. The study offers suggestions to address the programmatic needs of rural youth as well as neglected subgroups of adolescents.

Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Guérir Les Blessures, Faire Naître L’Espoir: Le Partenariat Tanzanien Contre La Fistule Obstétricale, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Linking Reproductive Health To Social Power: Community Health Workers In Belize And Pakistan, Susana Galdos, Lucella Campbell, Patricia Mohammed, Debbie Rogow, Saumya Ramarao, Ali M. Mir, Nicole Haberland

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité focuses on two traditional family planning programs that undertook projects to help women enlarge their zone of influence in both the private and public spheres. The first case study focuses on the Belize Family Life Association (BFLA), a nongovernmental organization in a small Caribbean country. The second case study recounts the experience of the Pakistani government, which has an enormous, but entrenched, target-oriented family planning program. Both programs began by recognizing that women’s lack of social power is a major obstacle to their being able to protect their own health. Both trained village workers to regard …

Adolescent Life In Low Income And Slum Areas Of Addis Ababa, Ethiopia, Annabel Erulkar, Tekle-Ab Mekbib, Negussie Simie, Tsehai Gulema

Poverty, Gender, and Youth

The Ethiopian Ministry of Youth, Sports and Culture has long considered attention to the lives of Ethiopian adolescents as a priority intervention area for research and programs in the country. This study conducted with the Population Council gives critical insight into the lives of adolescent girls and boys in the low income and slum areas of Addis Ababa. Research and programs for young people tend to homogenize the adolescent population into one genderless mass, with little regard to age or social context. Greater segmentation of the adolescent population is needed in the design and content of programs, as well as …

Popular Perceptions Of Emerging Influences On Mortality And Longevity In Bangladesh And West Bengal, Sajeda Amin, Alaka Malwade Basu

Poverty, Gender, and Youth

Although new environmental and pathological threats to human survival and longevity have been documented, relatively little is known about how these threats are perceived in the popular imagination. During fieldwork in rural Bangladesh and West Bengal, India, researching the changing costs of and motivations for reproduction, the authors included survey questions on respondents’ perceptions of changing mortality. Child-mortality levels were perceived to have fallen drastically in recent times, but for the middle-aged and the elderly, the past was seen as a better time in terms of health and survival. The decline in adult health is attributed to environmental deterioration and …

Gender Differences In Time Use Among Adolescents In Developing Countries: Implications Of Rising School Enrollment Rates, Amanda Ritchie, Cynthia B. Lloyd, Monica J. Grant

Poverty, Gender, and Youth

Researchers at the Population Council have been involved in the collection of data on time use from adolescents in India, Kenya, Pakistan, and South Africa. Three questions are addressed in this working paper: (1) How does time use change during the transition to adulthood? (2) Does gender role differentiation intensify during the transition? (3) Does school attendance attenuate gender differences? The data document differences in time use patterns between students and nonstudents. Although female adolescent students still work longer hours than male adolescent students, the gender division of labor that typically develops during adolescence is greatly attenuated among students when …

Long-Range Trends In Adult Mortality: Models And Projection Methods, John Bongaarts

Poverty, Gender, and Youth

This Population Council working paper has two objectives: (1) to test a new version of the logistic model for the pattern of change over time in age-specific adult mortality rates, and (2) to develop a new method for projecting future trends in adult mortality. A test of the goodness-of-fit of the logistic model for the force of mortality indicates that its slope parameter is nearly constant over time. This finding suggests a variant of the model that is called the shifting logistic model. A new projection method based on the shifting mortality model is proposed and compared with the widely …

The Effect Of A Livelihoods Intervention In An Urban Slum In India: Do Vocational Counseling And Training Alter The Attitudes And Behavior Of Adolescent Girls?, Barbara Mensch, Monica J. Grant, Mary Philip Sebastian, Paul C. Hewett, Dale Huntington

Poverty, Gender, and Youth

This Population Council working paper examines whether an experimental intervention for girls aged 14–19 that provided reproductive health information, vocational counseling and training, and assistance with opening savings accounts in slum areas of Allahabad in Uttar Pradesh, India had an effect on their attitudes and behaviors. Although the livelihoods program was acceptable to parents and feasible to implement, the project had only a minimal impact on the behavior and attitudes of adolescent girls in the experimental slums. The greatest changes between the baseline and the endline surveys were found in those outcomes that most closely reflected the content of the …

Patterns Of Variations In Escherichia Coli Strains That Produce Cytolethal Distending Toxin, Carol L. Pickett, Robert B. Lee, Aysegul Eyigor, Ben Elitzur, Emily M. Fox, Nancy A. Strockbine

United States Public Health Resources

A collection of 20 Escherichia coli strains that produce cytolethal distending toxin (CDT) were analyzed for their virulence-associated genes. All of these strains were serotyped, and multiplex PCR analysis was used to ascertain the presence of genes encoding other virulence factors, including Shiga toxin, intimin, enterohemolysin, cytotoxic necrotizing factor type 1 (CNF1) and CNF2, heat-stable toxin, and heat-labile toxin. These CDT-producing strains possessed various combinations of known virulence genes, some of which have not been noted before. Partial cdtB sequences were obtained from 10 of these strains, and their predicted CdtB sequences were compared to known E. coli CdtB sequences; …

Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford

Gerontology Institute Publications

The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …

Human Chorionic Gonadotropin Administration Is Associated With High Pregnancy Rates During Ovarian Stimulation And Timed Intercourse Or Intrauterine Insemination, Mohamed F. Mitwally, Sonya Abdel-Razeq, Robert F. Casper

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.

Methods

Retrospective analysis of 2000 consecutive completed treatment cycles (637 timed-intercourse and …

Do Recent Data From The Seychelles Islands Alter The Conclusions Of The Nrc Report On The Toxicological Effects Of Methylmercury?, Alan H. Stern, Joseph L. Jacobson, Louise Ryan, Thomas A. Burke

Wayne State University Associated BioMed Central Scholarship

Abstract

In 2000, the National Research Council (NRC), an arm of the National Academy of Sciences, released a report entitled, "Toxicological Effects of Methylmercury." The overall conclusion of that report was that, at levels of exposure in some fish- and marine mammal-consuming communities (including those in the Faroe Islands and New Zealand), subtle but significant adverse effects on neuropsychological development were occurring as a result of in utero exposure. Since the release of that report, there has been continuing discussion of the public health relevance of current levels of exposure to Methylmercury. Much of this discussion has been linked to …

Cardiovascular Disease Risk Factor Profile Of African American College Freshmen, Theodosha S. Gilliard

MUSC Theses and Dissertations

Background: Rates of CVD are higher among African Americans compared to whites and natives of South Carolina and the Southeast compared to non-natives. Obesity, a CVD risk factor, is also known to be more prevalent in African Americans compared to whites. Ethnic differences in body image are thought to play a role in the higher rates of obesity among African Americans compared to whites. This study investigated the prevalence of CVD risk factors and body image in an at risk population, African American adolescents primarily from the state of South Carolina. Research Design and Methods: Students were given a Health …

The Roles, Responsibilities, And Realities Of Married Adolescent Males And Adolescent Fathers: A Brief Literature Review, Gary Barker, Jorge Lyra, Benedito Medrado

Poverty, Gender, and Youth

From the perspective of developing countries, we know relatively little about married adolescent males and adolescent fathers, and much of what we know is inferred from research with young women or comes from a few specific regions in the world. However, there has been a growing interest in the issue on the part of researchers, policy-makers, and program staff. This interest has coincided with increasing attention in general to men, with gender studies, and with sexual and reproductive health initiatives. Early marriage and early childbearing are much more prevalent among young women than young men, and the negative consequences are …

Ishraq: Safe Spaces To Learn, Play And Grow: Expansion Of Recreational Sports Program For Adolescent Rural Girls In Egypt, Nadia Zibani

Poverty, Gender, and Youth

Over the past three years, the Ishraq program in the villages of northern El-Minya, Egypt, grew from a novel idea into a vibrant reality. In the process, approximately 300 rural girls have participated in a life-transforming chance to learn, play, and grow into productive members of their local communities. Currently other villages—and soon other governorates—are joining the Ishraq network. Ishraq is a mixture of literacy, life-skills training, and—for girls who have been sheltered in domestic situations of poverty and isolation—a chance to play sports and games with other girls their age and develop a sense of self-worth and mastery; the …

Mary T'S: A Restaurant Providing Healthy Food Options, Mary T. Savner

Seton Hall University Dissertations and Theses (ETDs)

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Does Dowry Improve Life For Brides? A Test Of The Bequest Theory Of Dowry In Rural Bangladesh, Luciana Suran, Sajeda Amin, Lopita Huq, Kobita Chowdury

Poverty, Gender, and Youth

In recent years, dowry levels in Bangladesh have risen to previously unforeseen levels—sometimes three or four times a family’s total assets. Some recent economic writings suggest that dowry functions as a bequest or pre-mortem inheritance, implying it persists because it is “good for the bride.” Using panel data from an adolescent study in rural Bangladesh, this Population Council working paper explores the association between dowry and the prevalence of domestic abuse to test the bequest theory of dowry. Contrary to the prediction of the bequest theory, married females who paid dowry at marriage have a higher likelihood of reporting domestic …

Les Implications Du Mariage Précoce Pour Les Politiques De Vih/Sida, Judith Bruce, Shelley Clark

Poverty, Gender, and Youth

Ce dossier est basé sur un document contextuel préparé pour la Consultation Technique OMS/ FNUAP/Population Council sur les Adolescentes Mariées, tenue à Genève en Suisse du 09 au 12 Décembre 2003 (le document final intitulé "Inclure les adolescentes mariées dans les politiques de santé reproductive des adolescents et de VIH/SIDA"). La Consultation a réuni des experts provenant des Nations Unies, des bailleurs de fonds et des agences non gouvernementales pour examiner les faits concernant la santé reproductive des adolescentes mariées, leur vulnérabilité face à l’infection du VIH, leurs inégalités sociales et économiques ainsi que leurs droits. Les rapports avec des …

Forced Sexual Relations Among Married Young Women In Developing Countries, Deepika Ganju, William Finger, Shireen J. Jejeebhoy, Vijaya Nidadavolu, K.G. Santhya, Iqbal Shah, Shyam Thapa, Ina Warriner

Poverty, Gender, and Youth

Recent research in developing countries suggests that a considerable number of young women may experience forced sex within marriage, but most women may be inhibited from reporting these experiences due to shame, fear of reprisal, or deep-rooted unequal gender norms. In September 2003, a global consultative meeting on nonconsensual sex among young people in developing countries was held in New Delhi, India. The meeting was organized by the Population Council in collaboration with World Health Organization/Department of Reproductive Health and Research, and Family Health International/YouthNet. Participants included researchers, legal analysts, representatives from community-based NGOs, policy-makers, and young people themselves. Papers …

The Adverse Health And Social Outcomes Of Sexual Coercion: Experiences Of Young Women In Developing Countries, Deepika Ganju, William Finger, Shireen J. Jejeebhoy, Vijaya Nidadavolu, K.G. Santhya, Iqbal Shah, Shyam Thapa, Ina Warriner

Poverty, Gender, and Youth

Although evidence from developing countries is limited, what is available suggests that significant numbers of young women have experienced coercive sex. Studies in diverse settings in Africa, Asia, and Latin America reveal that forced sexual initiation and experiences are not uncommon in all of these settings. Many young victims of abuse fear disclosure as they feel they may be blamed for provoking the incident or stigmatized for having experienced it, and suffer such incidents in silence. Presentations at a meeting held in New Delhi in September 2003 highlighted findings from recent studies that suggest an association between early experiences of …

Population Aging And The Rising Cost Of Public Pensions, John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …

Moyens De Subsistance Des Adolescentes. Questions Primordiales Et Outils Essentiels : Rapport D'Un Atelier, Carey Meyers

Poverty, Gender, and Youth

This report, co-published by the Population Council and the International Center for Research on Women, describes a workshop convened in Cairo in 1999 to learn more about the nature of both younger and older adolescents' work experience, differentiate the particular needs and potentials of adolescent girls, and identify programs and policies that might have promise for supporting them.

Trends And Transitions In Children's Coresidence With Older Adults In Beijing Municipality, Zachary Zimmer, Xianghua Fang, Toshiko Kaneda, Zhe Tang, Julia Kwong

Poverty, Gender, and Youth

The reduction in family size in China and concurrent social and economic change are raising concerns that traditional sources of support may be eroding. This Population Council working paper paper examines a) whether rates of coresidence between older adults and their adult children in the Beijing municipality of China have been declining, and b) the determinants of coresidence and coresidence transitions. Results suggest that family support structures for the elderly, when they are facilitated through coresidence, remain basically intact, particularly for those who require the greatest amount of support. Further assessment is required to elucidate the effects of availability, need, …

Population Aging And The Rising Cost Of Public Pensions [Arabic], John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …