International Public Health Commons^™

Patterns Of Migration/Mobility And Hiv Risk Among Female Sex Workers: Tamil Nadu 2007-08, Niranjan Saggurti, Ravi K. Verma, Suvakanta N. Swain, Hanimi Reddy Modugu, Ajay Kumar Singh, Saumya Ramarao, Anrudh K. Jain

HIV and AIDS

In past years, considerable research has been undertaken on the role of female sex workers (FSWs) in the transmission of HIV infection. FSWs have been seen as a major “source” of infection, and consequently, have been extensively targeted to prevent its spread. There is, however, a gap in our understanding of the dynamics of sex work, sex workers' patterns of mobility, and the relationship of such mobility with risk of HIV infection and gender-based violence. The Population Council collaborated with its local partner, TNS, to carry out a study in Tamil Nadu to examine the patterns of mobility of FSWs …

Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon

Reproductive Health

The first days, weeks, and months after a delivery represent a period of substantial information and service needs for both mother and child, including treatment of hemorrhage and infections, breastfeeding information and support, nutritional complements and micronutrients, immunizations for children and mothers, counseling for managing intimate partner violence and depression, and, most importantly, contraception. In areas of high HIV prevalence, contraceptives and antiretroviral therapy are especially critical elements of postpartum care. Yet despite its strategic importance, few organizations have made it a priority to address women's reproductive health and fertility needs during the year following delivery. The situation is compounded …

Manual For Building Capacity Of Trainers And Program Managers In Emergency Contraception, Sharif M.I. Hossain, M.E. Khan, Mary Philip Sebastian, Sohini Roychowdhury

Reproductive Health

This manual equips trainers with appropriate knowledge on emergency contraceptive pills (ECPs). Emergency contraception (EC) refers to any method of contraception that can be used by a woman to prevent an unwanted pregnancy within three days of unprotected intercourse or a contraceptive accident such as condom leakage. This manual discusses ECPs and the provision of related services. After a day’s training, trainers have the knowledge and skills necessary to train service providers and workers on ECPs. The manual is divided into four sessions. The first provides an overview of the demographic and reproductive health (RH) situation in South and South …

Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council

Reproductive Health

The World Health Organization recommends that women receive information on family planning (FP) during antenatal care (ANC), immediately after birth, and during postpartum and well-baby care. However, few studies have assessed the effect of information during each of these stages on women’s use of contraceptive methods. Data collected by FRONTIERS in the Dominican Republic, Haiti, and Nicaragua have been analyzed to answer this question. Use of maternal care services, exposure to FP information, and use of postpartum contraception varies among countries. All women interviewed in the Dominican Republic attended ANC services and delivered in a facility; ANC use and institutional …

Sharing Experiences With Comprehensive Responses To Adolescent Reproductive Health Needs In Africa, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

In 1999, the Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) project, began a three-year collaboration in Senegal on an adolescent reproductive health (ARH) pilot project that showed that a multisectoral, multidisciplinary approach can increase knowledge, enhance attitudes, and foster positive behaviors for reproductive health. Following requests from several neighboring countries, and given the long collaboration with WHO, FRONTIERS initiated efforts in 2007 to enable utilization of these findings in other African countries. The purpose of this report is to promote the utilization of multisectoral approaches for improving ARH programming by governments, donors, and national and international agencies in francophone …

Sexual And Gender Based Violence In Africa: Key Issues For Programming, Population Council

Reproductive Health

The Population Council is supporting a multisectoral and multicountry network of partners dedicated to strengthening sexual and gender-based violence (SGBV) services. Initiated in 2006, the network aims to promote a comprehensive approach to preventing and managing SGBV throughout the region. The implementing partners aim to develop feasible, effective, and efficient models for a comprehensive response to the needs of SGBV survivors; strengthen services that address the health, psychological, and criminal justice consequences of violence; and reduce the determinants of violent behavior within communities. This brochure summarizes the key points of a literature review by the Population Council on SGBV designed …

Factsheet: Youth In India: Situation And Needs Study—Key Indicators, 2006-2007: Bihar, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

This factsheet provides selected key indicators for the state of Bihar, drawn from the Youth in India: Situation and Needs Study (Youth Study) 2006–07. The main goal of the Youth Study was to provide information on the situation of youth in India and the life choices available to them on a broad range of sexual and reproductive health issues, including both behaviors and their antecedents, through a population-based study. Findings are expected to inform evidence-based programming to address the health and other needs of young people. The subnational Youth Study was undertaken in six states: Andhra Pradesh, Bihar, Jharkhand, Maharashtra, …

Factsheet: Youth In India: Situation And Needs—Key Indicators, 2006-2007: Andhra Pradesh, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

This factsheet provides selected key indicators for the state of Andhra Pradesh, drawn from the Youth in India: Situation and Needs Study (Youth Study) 2006–07. The main goal of the Youth Study was to provide information on the situation of youth in India and the life choices available to them on a broad range of sexual and reproductive health issues, including both behaviors and their antecedents, through a population-based study. Findings are expected to inform evidence-based programming to address the health and other needs of young people. The subnational Youth Study was undertaken in six states: Andhra Pradesh, Bihar, Jharkhand, …

Youth In India: Situation And Needs 2006-2007, Maharashtra, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

The Youth in India: Situation and Needs Study (Youth Study) is the first-ever subnationally representative study conducted to identify key transitions experienced by married and unmarried youth in India. While today’s youth are healthier, more urbanized, and better educated than earlier generations, social and economic vulnerabilities persist. In the course of the transition to adulthood, young people face significant risks related to sexual and reproductive health, and many lack the knowledge and power to make informed sexual and reproductive choices. Several national policies and programs formulated since 2000 have underscored a commitment to addressing the multiple needs of this group …

Factsheet: Youth In India: Situation And Needs—Key Indicators, 2006-2007: Rajasthan, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

This factsheet provides selected key indicators for the state of Rajasthan, drawn from the Youth in India: Situation and Needs Study (Youth Study) 2006–07. The main goal of the Youth Study was to provide information on the situation of youth in India and the life choices available to them on a broad range of sexual and reproductive health issues, including both behaviors and their antecedents, through a population-based study. Findings are expected to inform evidence-based programming to address the health and other needs of young people. The subnational Youth Study was undertaken in six states: Andhra Pradesh, Bihar, Jharkhand, Maharashtra, …

Marriage Considerations In Sending Girls To School In Bangladesh: Some Qualitative Evidence, Sajeda Amin, Lopita Huq

Poverty, Gender, and Youth

This working paper analyzes parents’ decisions about girls’ schooling in the context of marriage through in-depth exploration of case studies in two rural areas of northern Bangladesh. The villages are sites of a long-term community study from 1991 and 2002, a time when significant changes were underway, partly as a result of new school incentive programs introduced in 1994. The data show that the rise of dowry demands, a relatively recent practice that is barely a generation old among Muslims in these areas, asserts an important and independent influence on marriage decisions and indirectly influences decisions about schooling. The influence …

Has The Hiv Epidemic Peaked?, John Bongaarts, Thomas Buettner, Gerhard Heilig, Francois Pelletier

Poverty, Gender, and Youth

This working paper reviews the highly diverse regional and country patterns of HIV epidemics and discusses possible causes of the geographic variation in epidemic sizes. The main finding of this analysis is that the HIV epidemic reached a major turning point over the past decade. The peak years of HIV incidence rates are past for all regions, and the peaks of prevalence rates are mostly in the past except in Eastern Europe, where it is expected to peak in 2008. But owing in part to the life-prolonging effect of antiretroviral therapy and to sustained population growth, the absolute number of …

Fertility Transitions In Developing Countries: Progress Or Stagnation?, John Bongaarts

Poverty, Gender, and Youth

Over the past quarter century fertility has declined rapidly in many developing countries. Projections typically assume that this trend will continue until the replacement level is reached. However, recent evidence suggests that ongoing fertility declines may have slowed or stalled in a number of countries in transition. This Population Council study examines the pace of fertility change in developing countries that have multiple DHS surveys to determine whether ongoing transitions are decelerating or stalling. The main findings are that in sub-Saharan African countries, the average pace of decline in fertility is lower around 2000 than in the mid-1990s, and more …

Empowering Married Young Women And Improving Their Sexual And Reproductive Health: Effects Of The First-Time Parents Project, K.G. Santhya, Nicole Haberland, Arup Das, F. Ram, R.K. Sinha, Usha Ram, S.K. Mohanty

Poverty, Gender, and Youth

The Population Council, in partnership with Child In Need Institute in Kolkata, Deepak Charitable Trust in Vadodara, and International Institute for Population Sciences, Mumbai, initiated the First-time Parents Project in India to develop and test an integrated package of health and social interventions to improve married young women’s reproductive and sexual health knowledge and practices, enhance their ability to act in their own interest, and expand their social support networks. The project was formulated on the hypothesis that the periods immediately following marriage and surrounding the first pregnancy and birth offer a unique and powerful entry point for improving the …

How Early Marriage Compromises Girls' Lives, Maharashtra, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

The policy and program discourse around early marriage has increased significantly over the last decade in India. For example, several national-level policies formulated since 2000, including the Prohibition of Child Marriage Act 2006, have advocated special program attention to delay age at marriage and to enforce existing laws against child marriage. Also, programmatically several initiatives have been launched to prevent early marriage. Despite these commitments, substantial proportions of girls continue to marry in adolescence. As recently as 2005–06, 47 percent of women aged 20–24 were married by 18 years nationally. While the situation of married young women in India has …

Romance And Sex Before Marriage Among Young Women And Men In Maharashtra, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

Premarital partnerships among youth are widely discouraged in India. Indeed, there is a widespread perception that youth do not find opportunities to mix and form romantic relationships, and that premarital sex is negligible. These kinds of perceptions are often cited to argue against the provision of sexuality or family life education and sexual and reproductive health services to unmarried young people. While several small studies have noted that sizable proportions of young people, particularly young men, are sexually active before marriage, the lack of rigorous evidence on the levels and patterns of intimate partnerships among youth continues to hamper the …

Parents Matter: How Supportive Parenting Influences The Behaviours Of Youth, Maharashtra, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

In India, policies and programs have increasingly recognized the need to actively engage parents in enabling adolescents to make safe and healthy transitions to adulthood. The design of appropriate strategies to engage parents is, however, hampered by the paucity of evidence available. Little is known about the socialization of daughters and sons, the extent to which socialization practices differ for daughters and sons, and the extent to and ways in which parents communicate sensitive matters to their adolescent children. Similarly, research is limited that sheds light on the role of socialization patterns and parental interaction in influencing young people’s schooling …

Identifying Sources Of Adolescent Exclusion Due To Violence: Participatory Mapping In South Africa, Nora Kenworthy, Kelly Hallman, Judith A. Diers

Poverty, Gender, and Youth

Adolescents in post-apartheid South Africa lead lives that are filled with new opportunities yet overshadowed by rampant violence and crime. The presence of multiple and simultaneous forms of violence and the systemic lack of safety are experienced most acutely by adolescents—in particular, adolescent girls. High levels of violence and crime within the community are coupled with violence within the home and schools. The Population Council’s Transitions to Adulthood Program examines the particular factors that shape adolescents’ life chances and choices. In South Africa, Council researchers have studied how economic literacy and life skills education affect young men and women who …

Reforming Marriage Practices In Bangladesh, Sajeda Amin

Poverty, Gender, and Youth

Marriage customs in Bangladesh vary by region complicating national-level efforts to eliminate some of the more harmful practices, such as early marriage and dowry demands, that undermine the status of women. Efforts to reform marriage must consider economic concerns, social traditions, and social activism. Early marriage—often involving girls as young as 10—has been widely recognized in Bangladesh and elsewhere as a human rights offense. The current legal age at marriage is 18 for women and 21 for men, yet age restrictions are difficult to enforce because Bangladesh lacks an official birth registration system that can verify age. By studying the …

Sexuality Education For Youth In Maharashtra: Yes Or No?, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

Serious reservations have been expressed in Maharashtra about the sexuality component of programs intended to build awareness of safe and healthy behaviors for school-going youth. This policy brief answers: Is there a need for sexuality education in school and out-of-school in Maharashtra? Are the concerns expressed supported by evidence? Evidence was obtained from the Youth in India: Situation and Needs study conducted in Maharashtra, which explored young people’s awareness of sexual and reproductive matters, sexual experiences of youth, parent–child communication on sexual and reproductive matters, and experience and acceptability of sexuality education programs. Parents were asked whether they had discussed …

Female-Initiated Prevention Methods (Fipm) In Kenya: Focus On The Female Condom, Martha Brady

Poverty, Gender, and Youth

As noted in this brief, the female condom (FC) is the only female-initiated prevention product that provides simultaneous protection against pregnancy and sexually transmitted infections, including HIV. Although available for more than a decade, the FC remains limited in supply, not readily available, and underutilized. Obstacles to widespread availability and use are often generalized (e.g., high costs, resistance of partners, or unavailability). With the upcoming second generation of FCs—and ultimately microbicides—being added to female-initiated prevention methods, the need to overcome these impediments with concrete solutions is critical. Government and donor commitment to long-term, sustained supply and program support is essential. …

The Female Condom In Ghana: Exploring The Current State Of Affairs And Gauging Potential For Enhanced Promotion, Reshma Naik, Martha Brady

Poverty, Gender, and Youth

The female condom (FC) is the only safe and effective female-initiated method that provides simultaneous protection against unintended pregnancy as well as sexually transmitted infections, including HIV. An exploratory exercise was conducted by the Population Council to gain an understanding of the current and historical landscape of FC procurement, distribution, and programming in Ghana and to explore the viability of enhancing national FC promotion. The exercise revealed that a large-scale launch of the FC occurred in Ghana in 2000 and was largely successful in raising product awareness; however, uptake remained low. Momentum has waned since the initial launch and financial …

Education And Transition To Work Among Youth In Maharashtra, International Institute For Population Sciences (Iips)

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. In many states, youth have made progress on these fronts. Youth in Maharashtra have made considerable strides in terms of educational attainment, yet it is not clear that they are prepared for the challenges they will face in a globalized world. Looking at the current educational and employment situation of youth in Maharashtra, this policy brief argues that significant investments in terms of appropriate policies and programs …

Young People's Participation In Civil Society And Political Life In Maharashtra, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

Youth participation in civil society and political life is increasingly recognized as an important development objective. The opportunities for participation that young people experience in their communities may influence their development and the types of transitions they make to adulthood. Moreover, behaviors and attitudes relating to community participation that individuals adopt as young people predict lifelong civic affiliations and perspectives. In India, the National Youth Policy 2003 has underscored the role of India’s youth in political decision-making, and has argued for greater representation of youth in appropriate bodies as well as more extensive youth participation in program design and implementation. …

Terms Of Marriage And Time-Use Patterns Of Young Wives: Evidence From Rural Bangladesh, Sajeda Amin, Luciana Suran

Poverty, Gender, and Youth

This working paper explores the relationship between marriage arrangements and daily activities of young married women, using detailed time-use data from an adolescent study in rural Bangladesh. Measures of marriage arrangement are payment of dowry and the relative wealth status of natal and marital families. Using multivariate regression analysis, the results show that women’s time spent in domestic work, socializing, and self-care is significantly associated with marriage arrangement variables. Those who paid dowry spent more time in domestic work and less time in self-care and socializing relative to those who did not pay dowry. These patterns of association are similar …

Multiple Dimensions Of Urban Well-Being: Evidence From India, S. Chandrasekhar, Abhiroop Mukhopadhyay

Poverty, Gender, and Youth

This working paper addresses differences in outcomes across households residing in slums and non-slum urban areas of India. We first established that if utility is defined as access to public goods such as water and sanitation, then residents in non-slum urban areas are unambiguously better off than slum dwellers. On the other hand, we found that the distribution of private goods (monthly per capita expenditure and per capita living area) in non-slum areas does not dominate the distribution of these goods in the slums, implying that non-slum residents are not unequivocally better off than slum residents. Since slums are on …

Early Marriage And Sexual And Reproductive Health Risks: Experiences Of Young Women And Men In Andhra Pradesh And Madhya Pradesh, India, K.G. Santhya, Shireen J. Jejeebhoy, Saswata Ghosh

Poverty, Gender, and Youth

The Population Council undertook a large-scale study of married young women and men in two rural settings in India to assess their situation and vulnerability to HIV and other adverse sexual and reproductive health outcomes. Findings of the study clearly underscore the vulnerability of married youth to STI/HIV as a result of risky sexual experiences before, within, and after marriage. Furthermore, there is a need to sensitize healthcare providers to the special needs and vulnerability of married young people and orient them to the need for developing appropriate strategies to reach diverse groups of young people, including married young women …

Youth In India: Situation And Needs 2006-2007, Executive Summary, Maharashtra, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

This executive summary presents, in brief, findings on the situation of youth in Maharashtra, part of a subnational study undertaken by the International Institute for Population Sciences, Mumbai, and the Population Council, New Delhi, as part of a project to collect information on key transitions experienced by youth in India. Transitions include those related to education, workforce participation, sexual activity, marriage, health and civic participation, the magnitude and patterns of young people’s sexual and reproductive practices before, within, and outside of marriage, as well as related knowledge, decision-making, and attitudes. The project was implemented in six states of India, namely, …

Taller Regional De Utilización De Resultados De Investigación Operativa Para Incrementar El Acceso, La Calidad E Integración De Los Servicios Anticonceptivos En América Latina Y El Caribe, M. Estela Rivero-Fuentes, Antonieta Martin

Reproductive Health

En octubre de 2007, el programa Fronteras de la Salud Reproductiva (FRONTERAS) realizó un taller regional de tres días en La Antigua, Guatemala, para difundir los resultados de sus proyectos de investigación operativa. Durante el taller, los participantes escucharon los avances en la metodología anticonceptiva y escucharon las estrategias efectivas que probó FRONTERAS para incrementar el acceso al DIU y la vasectomía; la integración de la planificación familiar con los servicios posparto, postaborto y PTMI. Los investigadores habloaron sobre los resultados de los estudios, los gerentes de los programas explicaron cómo se usaban los instrumentos y se habló de la …

Guía Operativa Para Programas De Educación Sexual Y Servicios De Salud Reproductiva Para Jóvenes, Ofelia Aguilar, Lorena Santos, Marisa Diaz Infante, Rocio Mejia, Ricardo Vernon, Antonieta Martin

Reproductive Health

El presente libro tiene como fin poner al alcance de personas y organizaciones interesadas en establecer políticas y programas de servicios y educación sexual para los jóvenes, una guía basada en el Programa Gente Joven que implementa la Fundación Mexicana para la Planeación Familiar, A.C. (MEXFAM). Consideramos que los componentes y las actividades de este programa pueden ser adaptados en otras latitudes y así enriquecer proyectos orientados al trabajo con jóvenes.

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The purpose of this book is to make available, to people and organizations interested in establishing policies and programs on sexual education and services for young people, a …