Public Health Commons^™

Commercial Sex Workers In Five Ethiopian Cities: A Baseline Survey For Usaid Targeted Hiv Prevention Program For Most-At-Risk Populations, Woldemariam Girma, Annabel Erulkar

HIV and AIDS

This report presents findings from a baseline survey of commercial sex workers (CSWs) that was undertaken in five Ethiopian cities. 2,050 CSWs were interviewed for the survey. CSW were disproportionally young and came from extremely disadvantaged backgrounds. Most respondents also cited negative working standards from another profession, or family responsibilities as reasons leading to sex work. Condom use was very high but use may be inconsistent or over-reported and should be studied further. Findings also propose additional advocacy for positive peer support groups, more HIV testing for at-risk populations, and addressing violence among CSWs and other Ethiopian women.

The Afford Health Marketing Initiative In Uganda: Mid-Term Evaluation, Oleksandr Rohozynsky, Christie Billingsley, Annette Bongiovanni

HIV and AIDS

AFFORD is a five-year (2005–10) social marketing initiative financed by the United States Agency for International Development (USAID)/Uganda. It supports the Uganda Ministry of Health’s strategic plan to promote positive health-care-seeking behavior and reduce the shortage of health products and services related to family planning and reproductive health; child health; malaria prevention and treatment; and HIV prevention, care, and treatment. AFFORD seeks to achieve the sustainable marketing of products and services that prevent transmission of HIV, malaria, and diarrheal diseases; to help couples plan their families; and to help people living with HIV enjoy improved quality of life. Target groups …

Final Evaluation Of The Project For Expanding The Role Of Networks Of People Living With Hiv/Aids, Young-Mi Kim, John Lukwago, Stella Neema

HIV and AIDS

In July 2006, the International HIV/AIDS Alliance launched a three-year project on Expanding the Role of Networks of People Living with HIV/AIDS in Uganda. The project, which is funded by the United States Agency for International Development (USAID)/Uganda, sought to increase the involvement of people living with HIV/AIDS (PHA) in the HIV/AIDS response and to improve access to and utilization of prevention, treatment, care, and support services for PHA households. USAID/Uganda commissioned an evaluation of the project’s design, strategies, and performance in order to improve its implementation and learn from its successes and challenges. The study was a cross-sectional descriptive …

Formative Evaluation: Presidential Initiative On Aids Strategy For Communication To Youth, Netsayi N. Mudege, Chi-Chi Undie

HIV and AIDS

HIV prevention programming is increasingly taking place in school settings, which provide an expansive population of young people and offer immense potential for impact on the lives of this target group. The Presidential Initiative on AIDS Strategy for Communication to Youth (PIASCY) is a school-based program that has sought to address the HIV/AIDS epidemic in Uganda in a holistic manner since 2002, targeting young people, school personnel, parents, and the wider community. A formative evaluation was conducted by the African Population and Health Research Center in February 2009 to provide an understanding of: the extent to which PIASCY is achieving …

The Overlooked Epidemic: Addressing Hiv Prevention And Treatment Among Men Who Have Sex With Men In Sub-Saharan Africa, National Aids Control Council Of Kenya, Population Council

HIV and AIDS

Globally, less than 1 out of 20 men who have sex with men (MSM) has access to HIV prevention and care. UNAIDS has estimated that at least 5 to 10 percent of all HIV infections globally occur through male-to-male sexual activity. In spite of the high risk of HIV infection and evidence of extensive sexual networks, national HIV programs in Africa have been slow to address MSM in prevention and treatment efforts. To address these issues, the Population Council and the National AIDS Control Council of Kenya convened a meeting on May 14–15, 2008. The goals of the meeting were …

Technical Assistance To The Uganda Aids Commission For Operationallisation Of The Performance Monitoring And Management Plan, Frederick Makumbi, Roy Mayega, David Kisitu, Juliet Sekandi, Denis A. Bwesigye, Robert Miller, Sam Kalibala

HIV and AIDS

The Uganda AIDS Commission (UAC) has committed to rolling out and making operational a new National Performance Monitoring and Management Plan (PMMP) to monitor and evaluate the national response to the HIV/AIDS epidemic. The PMMP has at its core the collection and processing of 58 national indicators, 47 district output indicators, and 22 outcome indicators covering prevention, care, treatment, and social support. The rollout is challenging because at least seven organizations must collaborate at the national level, and appropriate staff at the district level need to be in place and trained in new procedures of data collection. In addition, these …

Family Centred Approach For Hiv Services: Pilot Study In South Africa, Meredith Sheehy, Nomtandazo Patricia Mini, Tonicah Maphanga, Scott E. Kellerman

HIV and AIDS

In 2003, UNICEF estimated that nearly 250,000 children were infected with HIV in South Africa. While scale-up of prevention of mother-to-child transmission (PMTCT) programs has improved testing and care for perinatally infected infants, uptake of these services remains low in much of sub-Saharan Africa and few HIV infected children are diagnosed and receive services through PMTCT programs. With support from USAID/PEPFAR, the Horizons Program adapted a family-centered model for children and families in need of broader-reaching HIV diagnostic services in South Africa. The Family Centered Approach (FCA) pilot intervention was designed to expand access to HIV testing for family members …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Cambodia 2005, Population Council

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Cambodia 2005” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

Ensuring Education For All In Bihar: Highlighting The Obstacles, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

The extent to which India will be able to successfully harness its demographic dividend depends significantly on the situation of its youth, notably on the levels of education and market-oriented skills they attain. While many states have made progress on the education front, many other states, including Bihar, have lagged behind. Looking at the current educational situation of youth in Bihar, this policy brief argues that significant investments in terms of appropriate policies and programs are required to enable the state to: achieve the Millennium Development Goals of universal primary education and elimination of gender disparity in primary and secondary …

Adolescent Girls In Urban Ethiopia: Vulnerability And Opportunity, Abebaw Ferede, Annabel Erulkar

Poverty, Gender, and Youth

In 2008, the Population Council undertook a survey of out-of-school, adolescent girls (aged 10 to 19) in slum areas of urban Ethiopia—a population that is highly vulnerable to HIV infection. The survey serves as a baseline for HIV prevention programs designed and implemented jointly by the Ministry of Youth and Sports, Regional Bureaus of Youth and Sports, and the Population Council. This study provided valuable direction for programmers interested in supporting adolescent girls, particularly early adolescent (10 to 14 years old) and out-of-school girls who are highly vulnerable and in need of dedicated attention. Special efforts are needed to support …

Variables In Health Care Policy Making: Resolving A Quandary, George P. Smith Ii

Scholarly Articles

Contemporary debate in health care resource management is tied to a central moral issue: how to achieve the optimum level of reasonable or appropriate treatment based on the medical condition of each patient. Failure to tackle and resolve this issue in a confident and forthright manner ensures that the present approach to health care decision-making will continue in a state of indecisiveness if not, indeed, lethargy. Undergirding this moral issue is the foundational economic dilemma of controlling costs while limiting access to health care resources. Crafting a just solution to an equitable distribution of finite health care resources is, indeed, …

Using Motivational Interviewing In Public Health Practice To Prevent Fetal Alcohol Syndrome, Lisa J. Ficker, Cheryl Lauber, Sandra L. King, Jewell Akins, Dranoel Knox, William Ridella

Michigan Journal of Public Health

Background: Surveys of women in prenatal care at busy clinics in Detroit, Michigan have reported 12.5% continue to drink during pregnancy (Flynn et al, 2003) and women in substance abuse treatment programs in Wayne County, MI have an incidence rate for Fetal Alcohol Syndrome (FAS) of 4 in 1,000 births, double the national prevalence rate of FAS. The goal of the current study was to intervene with women at high risk for an alcohol-exposed pregnancy using techniques of Brief Motivational Interviewing (BMI) in a verbal and written format. Methods: One third (33%) of 1,784 women screened at Detroit Department of …

Analyzing Adherence To Prenatal Supplements: Does Pill Count Measure Up?, Kristie Elizabeth Appelgren

MUSC Theses and Dissertations

Background: Results of a trial of prenatal Vitamin D supplementation are analyzed for associations of pill count data with serum-based measures of adherence. Obiective: It is hypothesized that adherence as measured by pill count will have a significant association with serum-based measures of adherence. Design: The study from which the data for this analysis were derived is a large randomized, controlled, and double-blinded trial of vitamin D supplements in pregnant women. The women have been stratified by race and randomized into three groups, which receive a 400IU (control), 20001U, or 40001U dose of vitamin D[subscript 3] once daily. Women enter …

Childhood Obesity: The Law's Response To The Surgeon General's Call To Action To Prevent And Decrease Overweight And Obesity, Leah Loeb

Journal of Health Care Law and Policy

No abstract provided.

The Responses Of Bamenda Disability Organizations To Hiv And Aids: A Multiple Case Study, Lynn Cockburn

Walden Dissertations and Doctoral Studies

In Cameroon, many disabled people (an estimated 10-20% of the population) have inadequate access to education and health care, and disabled people's organizations (DPOs) are advocating for social change. Yet, there is a scarcity of information regarding how African DPOs address HIV and AIDS. The purpose of this study was to assess how DPOs in Cameroon have responded to AIDS in the disabled population and to identify strategies to enable DPOs to manage AIDS issues. This study was guided by the complex adaptive systems theory as the theoretical framework. The research questions focused on what DPOs have done to develop …

Foodborne Or Pandemic: An Analysis Of The Transmission Of Norovirus-Associated Gastroenteritis And The Role Of Food Handlers, M. S. Dreyfuss

Walden Dissertations and Doctoral Studies

This study examined the strength of association between food workers and food to norovirus in comparison to bacteria associated with foodborne-related gastroenteritis by whether norovirus had a direct (physical evidence), indirect (statistical evidence), or suspect (neither of the two) association with food or food handlers. The Centers for Disease Control and Prevention considers norovirus to cause the largest number of foodborne-related gastroenteritis cases in the United States. The association of norovirus with foodborne outbreaks through its information data collection form focuses on the food worker as the typical source. Yet, many outbreaks are not foodborne in nature. The gap in …

Beliefs And Attitudes Regarding Health -Enhancing Behaviors In African American And Caucasian Women, Cassaundra Murray

Walden Dissertations and Doctoral Studies

A disproportionate number of African American (AA) women are overweight, obese, and more likely to have weight related health concerns compared with Caucasian (C) women. Previous research indicates perception about health-enhancing behaviors influences AA females' health behavior. A gap exists in the current literature regarding AA women's perception of eating and exercise behavior and the impact social support has on AA women's adherence to USDA recommendations. The purpose of this study was twofold: (1) to examine AA women's weight locus of control, perceived susceptibility to weight related diseases, and perceived barriers to healthy eating and exercise relative to C women; …

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 5, Iss. 1, Winter 2009

Public Health Link

This issue includes a spotlight on alumnae—Meghan Gannon, along with recaps of the Oxfam Hunger banquet, SAPHE Students Participate in AIDS Walk Philly, the Annual APHA: Public Health Without Borders conference and program announcements.

Violence Against Women Raises Risk Of Cervical Cancer, Ann L. Coker, Claudia Hopenhayn, Christopher P. Desimone, Heather M. Bush, Leslie Crofford

CRVAW Faculty Journal Articles

Background: An emerging literature suggests that violence against women (VAW), particularly sexual violence, may increase the risk of acquiring a sexually transmitted infection (STI) and, therefore, may be associated with cervical cancer development. The purpose of this cross-sectional analysis was to determine if women who had experienced violence had higher prevalence rates of invasive cervical cancer.

Methods: Women aged 18–88 who joined the Kentucky Women’s Health Registry (2006–2007) and completed a questionnaire were included in the sample. Multivariate logistic regression analyses were used to adjust odds ratio (OR) for confounders (e.g., age, education, current marital status, lifetime illegal drug use, …

Hpv Vaccine Acceptance Among Latina Mothers By Hpv Status, Maureen Sanderson, Ann L. Coker, Katherine S. Eggleston, Maria E. Fernandez, Concepcion D. Arrastia, Mary Kay Fadden

CRVAW Faculty Journal Articles

Objective: We investigated whether Latina mothers who were and were not human papillomavirus (HPV) positive differed in their knowledge and acceptance of the HPV vaccine for their children.

Methods: We conducted a cross–sectional survey among women aged 18–64 years between April 2007 and April 2008. Data collectors conducted in-person interviews in community clinics with 215 HPV-negative women and 190 HPV-positive women (with respective response rates of 64% and 84%). Most (83%) HPV-positive women were recruited at dysplasia clinics. Although no HPV-negative women were recruited at dysplasia clinics, they were recruited at other low-income public and private clinics.

Results: After adjustment …

Breast Cancer Screening In Women Exposed In Utero To Diethylstilbestrol, Elizabeth A. Camp, Ann L. Coker, Stanley J. Robboy, Kenneth L. Noller, Karen J. Goodman, Linda T. Titus-Ernstoff, Elizabeth E. Hatch, Arthur L. Herbst, Rebecca Troisi, Raymond H. Kaufman, Ervin Adam

CRVAW Faculty Journal Articles

Purpose: To determine if women exposed in utero to diethylstilbestrol (DES) are more likely than unexposed women to receive recommended or additional breast cancer screening examinations.

Methods: 1994 Diethylstilbestrol-Adenosis (DESAD) cohort data are used to assess the degree of recommended compliance of breast cancer screenings found in 3140 DES-exposed and 826 unexposed women. Participants were enrolled at four sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data that included reported frequency over the preceding 5 years (1990–1994) of breast-self examinations (BSEs), clinical breast examinations (CBEs), and mammograms.

Results: DES-exposed women exceeded annual …

Ethnic Disparities In Cervical Cancer Survival Among Medicare Eligible Women In A Multiethnic Population, Ann L. Coker, Katherine S. Eggleston, Xianglin L. Du, Lois Ramondetta

CRVAW Faculty Journal Articles

To determine predictors of cervical cancer survival by socioeconomic status (SES), urbanization, race/ethnicity, comorbid conditions, and treatment among elderly Medicare-eligible women whose conditions were diagnosed with cervical cancer in a multiethnic population.

Methods: A total of 538 women with cervical cancer aged 65 years or older were identified from 1999 to 2001 from the Texas Cancer Registry and were linked with the state Medicare data and Texas Vital Records to determine survival times. All women had similar access to care through Medicare fee-for-services insurance. A composite measure of SES was created using census tract-level data as was urbanization. Treatment and …

The Effects Of Aerosolized Brevetoxin Exposure On The Human Respiratory System, Katie M. Spaulding

International Journal of Global Health and Health Disparities

While much information has been collected about the effects of brevetoxin ingestion in contaminated seafood, there has been very little research conducted and little is known about the effects of these toxins when inhaled in aerosols (Backer et al., 2003). The effects of brevetoxins are of great public health concern because not only are harmful algal blooms increasing in frequency and duration of occurrence, they are also expanding their area of distribution (Sellner et al., 2003; Kirkpatrick, 2004). Since a significant proportion of the world's population live within 75 miles of an ocean coast and this density of human coastal …

Mrsa In Animals And The Risk Of Infection In Humans, Shannon Tucker

International Journal of Global Health and Health Disparities

MRSA infection is a major concern in animals and, as in humans, animals can also become carriers. It is suspected that most animals acquire MRSA from humans (reverse zoonosis) (Heot & Hough, 2008). In 1959, Mann was one of the first to culture the nostrils of cats and dogs for Staphylococcus sp. and he "proposed that the common house pet can serve as an important reservoir or carrier of staphylococci infective for man" (Mann, 1959). In the 1970's MRSA strains were isolated in milk samples in Belgium (Devriese, Van Damme, & Fameree, 1972) (Devriese & Hommez, 1975). Humans can be …

Animal Source Foods And Adolescent Nutrition, Abbey J. Canon

International Journal of Global Health and Health Disparities

Due to a variety of production, processing, or preservation limitations, or because of household economic, cultural or religious factors, many children, especially those in developing countries, do not consume an adequate amount of animal source foods (ASF). While little to no animal products are consumed in many developing countries, they are nonetheless essential to a healthy diet, especially for a growing child. The majority of low income households in developing countries base their diets on cereal grains or starchy tubers. These typical diets pose many threats to the nutritional health of children. Grains and starches lack many essential micronutrients, and …

Hospice Africa Uganda: End-Of-Project Evaluation Of Palliative Care Services, Annette Bongiovanni, Mary Alexis Greenan

HIV and AIDS

Hospice Africa Uganda (HAU) is a nongovernmental organization that provides palliative care services to people living with HIV/AIDS (PHA) and cancer. Based in Kampala, HAU aims to scale-up palliative care within and beyond the nation’s borders. From 2005–08, HAU sought to achieve the following objectives: 1) Increase coverage and scope of palliative care services available to PHA and their families; 2) Train health workers and other HIV/AIDS care providers to integrate pain management, symptom control, and end-of-life care into their existing HIV/AIDS support programs; 3) Build the capacity of families, communities, and community-based organizations in palliative care provision; 4) Integrate …

Freedom To Live, Freedom To Die: Health Disparities In El Salvador, Shaina Elizabeth Rose

Senior Honors Theses and Projects

No abstract provided.

Health Belief Model Of Breast Cancer Screening For Female College Students, Kirsten M. Frankenfield

Master's Theses and Doctoral Dissertations

No abstract provided.

Kenya's Fertility Transition: Trends, Determinants And Implications For Policy And Programmes, Ian Askew, Alex C. Ezeh, John Bongaarts, John Townsend

Reproductive Health

In Africa, fertility rates in the 1990s declined less rapidly than had been projected, and in a few cases the fertility transition appears to have stalled. This development has serious implications for future population growth because projected population size is sensitive to minor variations in current fertility trends. The 16 countries with three DHS surveys in sub-Saharan Africa can be divided into three subgroups: stalled transitions, insignificant declines, and significant declines. Half of the 16 countries experienced a stall, and an additional two experienced insignificant declines. The Population Council prepared a series of demographic and policy analyses that drew from …

Kwazulu-Natal Department Of Health Policy And Guidelines For Integrated Ante And Postnatal Care At District Hospital Community Health Centre And Clinic Level, Population Council

Reproductive Health

A 2006 baseline survey conducted by CARE Kenya indicated that sexual and gender-based violence (SGBV) is widespread throughout Kenya’s North Eastern Province. Other findings revealed that high levels of stigma and gender imbalances are associated with sexual violence and female genital mutilation (FGM) and that a coordinated approach to responding to the service needs of survivors is missing. As noted in this report, there is limited awareness of the legal mechanisms available to survivors. The Population Council’s study in Wajir District ascertained the need for and possible components of an integrated and comprehensive services model that could meet the needs …