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Articles 331 - 360 of 562
Full-Text Articles in International Public Health
Involving Young People In The Care And Support Of People Living With Hiv In Zambia: An Evaluation Of Program Sustainability, Eka Esu-Williams, Catherine Searle, Anderson Zulu
Involving Young People In The Care And Support Of People Living With Hiv In Zambia: An Evaluation Of Program Sustainability, Eka Esu-Williams, Catherine Searle, Anderson Zulu
HIV and AIDS
In 2005, approximately 17 percent of the population of reproductive age in Zambia was infected with HIV and nearly 710,000 under the age of 18 were orphans. As the needs of people living with HIV (PLHIV) and orphans and vulnerable children (OVC) escalate, communities are seeking new ways of helping those affected by the disease. A Horizons intervention study conducted in northern Zambia from 2000–02 found that youth could be trained to help meet the care and support needs of PLHIV and their families, including OVC. Study participants belonged to anti-AIDS clubs that taught about HIV and how to prevent …
Idhini Fahamishi Katika Majaribio Ya Kikliniki Ya Ukingaji Wa Virusi Vya Ukimwi, Population Council
Idhini Fahamishi Katika Majaribio Ya Kikliniki Ya Ukingaji Wa Virusi Vya Ukimwi, Population Council
HIV and AIDS
Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.
Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon
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
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
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 …
Marriage Considerations In Sending Girls To School In Bangladesh: Some Qualitative Evidence, Sajeda Amin, Lopita Huq
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
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 …
How Early Marriage Compromises Girls' Lives, Maharashtra, International Institute For Population Sciences (Iips)
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)
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)
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
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
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)
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
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
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)
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)
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
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 …
Evaluation Of The Long-Term Impact Of The Tostan Programme On The Abandonment Of Fgm/C And Early Marriage: Results From A Qualitative Study In Senegal, Nafissatou J. Diop, Amadou Moreau, Helene Benga
Evaluation Of The Long-Term Impact Of The Tostan Programme On The Abandonment Of Fgm/C And Early Marriage: Results From A Qualitative Study In Senegal, Nafissatou J. Diop, Amadou Moreau, Helene Benga
Reproductive Health
In 1998–99, a village empowerment program was implemented in the Thiès/Fatick and Kolda regions of Senegal by the nongovernmental organization Tostan, to mobilize communities to hold public declarations in support of abandoning harmful traditional practices, including female genital mutilation/cutting (FGM/C) and child marriage. The information presented in this report indicates that many did end the practices following a public declaration, however, the lack of follow-up in the field and the absence of support mechanisms pose a large obstacle. Nevertheless, the program achieved significant results: knowledge of life skills resulting in positive changes and a shift in the perception of FGM/C …
Analysis Of The Evolution Of The Practice Of Female Genital Mutilation/Cutting In Burkina Faso, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini
Analysis Of The Evolution Of The Practice Of Female Genital Mutilation/Cutting In Burkina Faso, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini
Reproductive Health
This study was undertaken as a collaboration between the Population Council’s Frontiers in Reproductive Health program and the Comité National de Lutte contre la Pratique de l’Excision (CNLPE) within the Ministry of Social Action and National Solidarity in Burkina Faso. The creation of a favorable environment for the campaign against excision in Burkina Faso has facilitated various anti-cutting activities over the past two decades and enabled the achievement of gains, both in terms of awareness and behavior change. However some of the strategies need further readjustment: among the reasons why excision still continues in Burkina Faso is a certain view …
South Africa: Integrated Approach Improves Quality Of Post-Rape Care, Population Council
South Africa: Integrated Approach Improves Quality Of Post-Rape Care, Population Council
Reproductive Health
In South Africa, an integrated model for post-rape care by nurses in a rural district hospital, which included a designated room for medical management and guidelines for providing reproductive health and HIV services, improved the quality of care provided. However, nurses remained reluctant to collect forensic evidence that could be used for prosecuting perpetrators. South Africa has developed a strong policy framework outlining medical management of rape survivors, which includes provision of HIV testing and post-exposure prophylaxis and emergency contraception, ideally within 72 hours. However, implementation has been hampered by numerous obstacles, both in health care infrastructure and policy, and …
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Reproductive Health
A program to operationalize and institutionalize a gender perspective in reproductive health services in Bolivia resulted in a significant reduction in unmet need for contraception, increased client satisfaction, and improved communication between partners. Bolivia’s Integral Health Coordination Program (PROCOSI) encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their RH programs. In 2005, FRONTIERS collaborated with PROCOSI to test the feasibility and costs of a system for certifying that its member organizations provided gender-sensitive RH services. The two-year project followed a 2000 intervention to incorporate gender perspectives in PROCOSI clinics that led …
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Reproductive Health
In 2006, FRONTIERS collaborated with the National Committee Against the Practice of FGM/C on an analysis of recent trends in female genital mutilation/circumcision (FGM/C) in rural and urban Burkina Faso. The study, conducted to help develop policies and programs for FGM/C abandonment in Burkina Faso and more widely in Africa, had three components: a description of the institutional, political, and programmatic environment in Burkina; a secondary analysis of data from existing studies; and an assessment of the community’s perceptions and behavior regarding FGM/C, as well as the factors that contribute to abandonment or continuation of the practice. For the policy …
Dominican Republic, Haiti, Nicaragua: Women Living With Hiv Have Unmet Family Planning Needs, Population Council
Dominican Republic, Haiti, Nicaragua: Women Living With Hiv Have Unmet Family Planning Needs, Population Council
Reproductive Health
Women living with HIV in the Dominican Republic, Haiti, and Nicaragua are marginalized in many ways, including their access to family planning (FP) services. Making FP services accessible to persons living with HIV (PLWH) is one of four key strategies that WHO promotes in its comprehensive approach to prevent HIV infections in infants and young children. This strategy also increases the coverage and quality of FP services among a population commonly underserved and at high risk of unplanned pregnancy. Expanded access to antiretroviral therapy in many developing countries has improved the life expectancies and health of many PLWH who are …
Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council
Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council
Reproductive Health
In 2004, FRONTIERS collaborated with UNICEF on a study of female genital mutilation/cutting (FGM/C) in Kenya’s Somali community and on ways of managing maternal care for cut women. The study showed that the health-care system in North Eastern Province, where many Somalis live, is ill prepared to deal with women who have been cut, particularly infibulated women who are pregnant or delivering. The study recommended improving providers’ ability to counsel and treat pregnant cut women as part of an overall improvement of maternal care, and strengthening providers’ role as behavior change agents within communities. In 2005, FRONTIERS launched an intervention …
Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council
Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council
Reproductive Health
Kenya and Malawi have developed national policies to prevent malaria in pregnancy. Measures to prevent malaria among antenatal clients were shown to be sustainable several years after pilot interventions ended. In Malawi, the approach has been expanded nationwide. In most malaria-endemic areas of Africa, women in their first and second pregnancies have the highest risk of acquiring malaria and, consequently, of malaria-associated anemia and low birth-weight. Two USAID-funded interventions aimed at strengthening the prevention and management of malaria in pregnancy were pilot-tested at the district level in Kenya (1998–2002) and Malawi (1998–2004). As noted in this brief, the goal was …
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Reproductive Health
In 1998, the nongovernmental organization Tostan implemented a village empowerment program in southern and western Senegal to help communities, especially women, improve living and health conditions in their villages, and to mobilize villages to hold public declarations supporting abandonment of harmful practices, particularly female genital mutilation/cutting (FGM/C) and child marriage. The program included modules on hygiene, literacy and numeracy, human rights, and children’s and women’s health. The Tostan approach has since been implemented more broadly in Senegal and in Burkina Faso, Guinea, and Sudan. In 2005–06, FRONTIERS evaluated the long-term impact of the program, focusing on the abandonment of FGM/C …
Kenya: Islamic Scholars Find No Religious Justification For Fgm/C, Population Council
Kenya: Islamic Scholars Find No Religious Justification For Fgm/C, Population Council
Reproductive Health
In 2004, FRONTIERS undertook a study on the cultural basis of female genital mutilation and cutting (FGM/C) in Kenya’s Somali community. The study showed universal support for FGM/C, and indicated that one of the major justifications is the perception that Islam requires female as well as male genital cutting. Interviews with informants showed that belief in the religious justification overrides arguments about the health and human rights aspects and the knowledge that it is illegal in Kenya. In 2005, FRONTIERS launched an intervention to engage the community in discussions about FGM/C to clarify the religious position. FRONTIERS arranged symposia involving …
Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi
Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi
Reproductive Health
In 2001, the World Health Organization issued guidance on a new model of antenatal care (ANC) called goal-oriented or focused antenatal care (FANC), for implementation in developing countries. The new model reduces the number of required antenatal visits to four, and provides focused services shown to improve maternal outcomes. FANC emphasizes helping women maintain normal pregnancies by identifying existing health conditions, detecting emerging complications, promoting health, preparing for a healthy birth, and educating clients on postpartum care including nutrition, breastfeeding, and family planning. Trials conducted in Argentina, Cuba, Saudi Arabia, and Thailand proved that FANC was safe and was a …
Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia
Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia
Reproductive Health
As in many developing countries, young people in Kenya and Senegal (aged 10–20) account for about 25 percent of the population. To ensure their future contribution to their countries, it is of vital strategic importance to safeguard their welfare. Rapid social change in both countries exposes youth to sexual and reproductive health (RH) risks, including unintended pregnancy, sexually transmitted infections including HIV, and sexual violence. Beginning in 1999, the Population Council’s FRONTIERS program conducted operations research studies that tested the feasibility, acceptability, and cost of a public-sector, multisectoral intervention to enhance young people’s RH knowledge and behavior. Study findings showed …