International Public Health Commons^™

The Prevention And Management Of Hiv And Sexual And Gender-Based Violence: Responding To The Needs Of Survivors And Those-At-Risk, Sarah Raifman, Ian Askew, Sajeda Amin, Jill Keesbury, Saiqa Mullick, Judith A. Diers, Meiwita P. Budiharsana, Chi-Chi Undie, Mary Zama, Mantshi Menziwa, Sherry Hutchinson, Naomi Rutenberg

Reproductive Health

The Population Council seeks to understand the social, economic, political, and physical context of risks for sexual and gender-based violence and HIV. Among the top priorities of Council research are supporting and evaluating efforts to prevent violence and HIV, including creating safe spaces for adolescent girls, and working with men and boys to change gender norms within the community; and comprehensively responding to the needs of survivors (including those who are HIV-infected) by strengthening health systems and integrating services. The purpose of this guide is to provide practical guidance on the steps necessary to establish and strengthen sexual violence (SV) …

Community Health Workers And The Media Can Be Effective In Providing Health Information To Married Adolescent Girls In The Community, Population Council

Reproductive Health

Past research has found that married adolescent girls in Nyanza Province, Kenya, face higher risks of HIV infection than unmarried but sexually active girls their age in the province and other parts of the country. To address this challenge, the Population Council’s APHIA II Operations Research Project, in collaboration with Well Told Story and the Ministry of Public Health and Sanitation, developed a study to assess the effectiveness of an intervention designed to increase married adolescent girls’ access to comprehensive reproductive health and HIV information and services in Homa Bay and Rachuonyo districts. The study found that using interactive communication …

Community Health Workers Can Effectively Provide Information And Referrals To People Living With Hiv In Their Communities, Population Council

Reproductive Health

A number of studies reported high levels of sexually transmitted infections among people living with HIV (PLHIV). Unfortunately, prevention interventions targeting PLHIV in the community are not common in Kenya, and most PLHIV who are not on ART have limited access to prevention information and risk-reduction counseling. The Population Council’s APHIA II Operations Research Project conducted a research project to address these gaps. This study was conducted in 2010 in collaboration with the International Center for Reproductive Health and the National AIDS and STI Control Programme. The findings show that the intervention had a number of positive outcomes and concludes …

A Pay-For-Performance Innovation Integrating The Quantity And Quality Of Care In Maternal, Newborn And Child Health Services In Bangladesh, Laila Rahman, Ubaidur Rob, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Md. Noorunnabi Talukder, Md. Hafizur Rahman

Reproductive Health

The Population Council explored the possibilities of introducing a Pay-for-Performance (P4P) scheme in Bangladesh to improve maternal, newborn and child healthcare (MNCH) services. Based on the consultation and with guidance from the Government of Bangladesh, the Population Council and UNICEF provided technical assistance to the Directorate General of Health Services (DGHS) to test two P4P strategies for MNCH service providers to improve service volume and quality of care, and for poor clients to receive services subsidized through vouchers or coupons. The first strategy is a combination of pay-for-performance for providers and subsidized coupons for poor pregnant women, newborns, and under-five …

Focus On Male Youths In Addressing Alcohol And Drug Abuse Risk In The Context Of Hiv Prevention Among Young People, Population Council

Reproductive Health

Research evidence shows that people who abuse alcohol are more likely to engage in behavior that puts them at risk of HIV infection, including having unprotected sex. In 2010, the Population Council’s APHIA II Operations Research Project collaborated with the Support for Addictions Prevention and Treatment in Africa Centre in Kenya on research to identify factors associated with alcohol and drug use among out-of-school youth in Kibera, to identify specific factors contributing to HIV risk, and to assess the impact of an intervention to link youths with an alcohol and drug abuse problem to counseling and rehabilitation services. A key …

Levels, Trends And Determinants Of Contraceptive Use Among Adolescent Girls In Kenya, Francis Obare, Harriet Birungi, Chi-Chi Undie, Monica Wanjiru, Wilson Liambila, Ian Askew

Reproductive Health

In Kenya, recent trends in contraceptive use among currently married women aged 15–49 years show that after experiencing a stall between 1998 and 2003, the contraceptive prevalence rate (CPR) increased between 2003 and 2008–2009. Although the increase in CPR after 2003 is encouraging, there is limited understanding of how these changes affected adolescents, especially girls, given the unique sexual and reproductive health challenges that they face. This report is based on a secondary analysis of the Kenya Demographic and Health Surveys (KDHS) data to understand the trends, differentials, and determinants of contraceptive use among adolescent girls aged 15–19 years in …

Integrating Tuberculosis Case Finding And Treatment Into Postnatal Care, Charity Ndwiga, Harriet Birungi, Chi-Chi Undie, Shiphrah Kuria, Joseph Sitienei, Sam Ochola

Reproductive Health

Under the USAID funded FRONTIERS program, the Population Council conducted a study in six health facilities in Western Kenya that demonstrated that screening for TB within an antenatal care (ANC) setting is feasible and acceptable among the service providers. However, a major challenge remains: although TB detection is encouraged among ANC clients within the maternal and child health clinics in the country, providers in these settings fail to appreciate the need for a continuum of care from pregnancy through to the postnatal period. In order to address this gap, the APHIA II Operations Research Project developed and tested an intervention …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council

Reproductive Health

The Population Council’s APHIA II Operations Research Project in Kenya collaborated with Kendu Adventist Hospital and the Christian Health Association to launch a study to examine the effect of improved services and awareness-creation on the uptake of HIV testing and treatment services for children and infants exposed to HIV. The study showed that community education and improvements in individual case tracking can increase the proportion of infants exposed to HIV who are tested for HIV and put on appropriate treatment. The policy brief recommends that health facilities streamline services to ensure that as many exposed infants as possible are identified …

Sexual And Reproductive Health Needs Of Adolescents Living With Hiv In Kenya, Harriet Birungi, Francis Obare, Jane Harriet Namwebya, Ibrahim Mohammed, Margaret Gitau, Margaret Makumi

Reproductive Health

The objective of this study was to assess the sexual and reproductive health needs of adolescents living with HIV in Kenya with a view to identifying and developing interventions that integrate these needs within the existing HIV/AIDS treatment, care, and support programs in the country. The study was a result of collaboration between Population Council, APHIA II Rift Valley and Coast (Family Health International), the National AIDS and STI Control Programme, and APHIA II Nairobi and Central (Pathfinder International). Major findings indicate that many of the adolescents living with HIV are vulnerable, and that programmatic gaps exist in addressing the …

Ten Years Of The Kenya Adolescent Reproductive Health Project: What Has Happened?, Humphres Evelia, Monica Wanjiru, Francis Obare, Harriet Birungi

Reproductive Health

This evaluation by the Population Council’s APHIA II Operations Research Project sought to find out whether the adolescent sexual and reproductive health (ASRH) and HIV/AIDS activities in Kenya had been sustained over a 10-year period when the project was replicated and scaled up to cover seven provinces in the country. The evaluation had three main objectives: 1) to determine the extent to which activities of the Kenya Adolescent Reproductive Health Program (KARHP) have continued at national, provincial, and district levels; 2) to determine whether desired sexual and reproductive health outcomes (knowledge, behavior, and practices) have been sustained among in- and …

Increasing Access To Family Planning (Fp) And Reproductive Health (Rh) Services Through Task-Sharing Between Community Health Workers (Chws) And Community Mid-Level Professionals In Large-Scale Public-Sector Programs: A Literature Review To Help Guide Case Studies, James R. Foreit, Sarah Raifman

Reproductive Health

This literature review covers case studies related to community-based distribution of family planning programs, and community health worker (CHW) programs that included family planning and other reproductive health services. It offers essential processes and implications for additional operations research which look at constraints and factors critical to introducing new program procedures or strengthening existing ones.

Integrating Alcohol Risk Reduction Into Htc Services, Population Council

Reproductive Health

This brief describes how screening for alcohol abuse and hosting long-term support groups through HIV testing and counseling centers (HTC) is one way to decrease high-risk sexual and alcohol behaviors among people who have tested for HIV. Findings from program activities funded by Population Council, Liverpool VCT and Support for Addiction Prevention and Treatment in Africa Center (SAPTA) found that screening HTC clients for alcohol abuse and referral to active support and counseling services is feasible. Follow up using SMS is also recommended. However, the lack of a control group in this study may hinder drawing direct causality between the …

Informe Años Dos Movil.Com: Evaluación De La Línea Final Resumen De Hallazgos Principales, Annik Sorhaindo, Xipatl Contreras, Kate S. Wilson, Sandra G. Garcia

Reproductive Health

This report highlights the findings of the endline evaluation of a two-year leadership project aimed at indigenous youth in Oaxaca, Mexico: Movil.com. Movil.com is a community project headed by peers and built on elements of other models. It is similar to a cascaded peer education and training model, in which nuclear leaders are trained who, in turn, train facilitators of larger groups. The Population Council office in Mexico evaluated the project at the request of the social organization that implements it, the Rosales Castellanos Women's Study Group, an NGO that has worked for more than 30 years with indigenous communities …

Linking Hiv-Positive Family Planning Clients To Treatment And Care Services In Kenya, Wilson Liambila, Francis Obare, Harriet Birungi, Ruth Wayua Muia, Joyce Wanderi Maina, Mary N. Maina, Christine Awuor, Ibrahim Mohammed

Reproductive Health

A project from the Population Council’s USAID-funded FRONTIERS program found that integrating HIV counseling and testing into family planning (FP) services was feasible and acceptable to clients and providers, and led to significant improvement in the quality of care provided. However, a major limitation was that FP clients who tested HIV-positive were not actively linked to care and treatment services, including antiretroviral treatment, and screening and management of sexually transmitted infections. A new initiative aimed to design and test a referral framework for linking HIV-positive FP clients to treatment and care in selected health facilities; assess the acceptability of the …

Using Youth-Friendly Communication Approaches To Communicate Hiv/Aids With Young People Is Feasible And Acceptable, Population Council

Reproductive Health

HIV remains a major concern in Kenya among all segments of the population, including adolescents. New ways of delivering HIV information and services are therefore needed, especially to reach young people and encourage them to take up counselling and testing to know their sero-status. The APHIA II Operations Research Project collaborated with the Ministry of Education, Well Told Story, and the National AIDS and STD Control Programme to implement a project to enhance communication in schools about HIV and create demand for early counseling and testing. The project also sought to create a supportive environment in schools for young people …

Identifying Opportunities And Challenges To Strengthen Union Level Facility For Providing Normal Delivery And Newborn Care Services: Findings From Policy Advocacy Activities, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan

Reproductive Health

The Population Council/Bangladesh, with assistance from the UK Department for International Development (DFID), organized a series of advocacy meetings and workshops that were carried out as part of a policy and systems research study titled “Strengthening Union Level Facility for Providing Normal Delivery and Newborn Care Services.” The Council held one consultative meeting, one stakeholders’ meeting, two experience-sharing workshops in Jamalpur and Thakurgaon, two local-level advocacy workshops in Kurigram and Habiganj, and two roundtable dialogues with journalists from Bengali and English newspapers. This document includes five reports: Strengthening HFWCs (Health and Family Welfare Centers) for Normal Delivery and Newborn Care …

Prevalence And Socio-Demographic Correlates For Serious Injury Among Adolescents Participating In The Djibouti 2007 Global School-Based Health Survey, Adamson S. Muula, Seter Siziya, Emmanuel Rudatsikira

Community & Environmental Health Faculty Publications

Background

Mental health and injury are neglected public health issues especially in low-income nations. The objective of the study was to determine the prevalence and socio-demographic correlates for serious injury in the last 12 months.

Findings

The study used data of the 2007 Djibouti Global School-based Health Survey. Logistic regression analysis was used to establish associations. Of the 1, 777 respondents, 61.1% (63.2% males and 57.8% females) reported having sustained serious injury (SSI). Compared to participants who were not bullied, those who reported being bullied 3-9 days per month were more likely to have sustained serious injury in the last …

The Ingredients Of Change: A Political Ecology Approach To Diabetes In The Somali Community Of Minnesota, Mina Tehrani

Geography Capstone Projects

In the early 1990’s, due to political circumstances at home, Somali immigrants and refugees began arriving in the state of Minnesota in large numbers. Over the past two decades, Somali immigrants have come to comprise one of the most populous ethnic groups in the Twin Cities, and are the largest Somali population in the world outside of Eastern Africa. Although quantitative data is unavailable, qualitative evidence and testimonies of healthcare professionals support the conclusion that Somali immigrants in Minnesota suffer from higher rates of diabetes than non-immigrant groups and than they likely did before migration. Why might this be the …

Agenda: 2010 World Energy Justice Conference: Emerging Solutions For The Energy Poor: Technological, Entrepreneurial And Institutional Challenges, University Of Colorado Boulder. Center For Energy & Environmental Security, Colorado Journal Of International Environmental Law And Policy

2010 World Energy Justice Conference (November 5)

This conference is a sequel to the 2009 World Energy Justice Conference (WEJC 2009) which began examining ways of mainstreaming safe, clean, and efficient energy for the world's Energy Poor (EP). The EP number two and a half billion people living on less than $1-2 a day who have no access to modern energy services. WEJC 2010 more fully develops these themes. WEJC 2010 will explore how the next round of global warming meetings in Cancun could design new flexibility mechanisms that give credits, for example, for the reduction of black carbon by the adoption of cookstoves, and embrace small …

Belize As A Classroom, Jordan Norris, Molly Calico

Impact Belize

During the week of January 7-14, 2010, Molly Calico and Jordan Norris participated in the Impact Belize program through the College of Health and Human Services. This program took place in Gales Point, a rural, underserved community in Belize. Impact students provided medical, dental and public health services to the community in an interdisciplinary service-learning format. As Master of Public Health students, Molly and Jordan directed health education initiatives and served on the Leadership Team for the program. Having participated in January of 2009 as well, Molly and Jordan were well prepared to conduct public health research and to assume …

Impact Belize 2010 Executive Report, Ritchie D. Taylor, Jordan Norris, Molly Calico, Bernie Strenecky, Daniel Carter, Dawn Garrett Wright, Eve Main, Bonny Petty, Molly Kerby, Jill Norris

Impact Belize

No abstract provided.

Looking Back, Moving Forward: Understanding The Hiv Risk And Sexual Health Needs Of Men Who Have Sex With Men, Horizons Studies 2001 To 2008, Scott Geibel, Waimar Tun, Placide Tapsoba, Scott E. Kellerman

HIV and AIDS

In 1997, the Population Council initiated the Horizons Program—a decade-long USAID-funded collaboration with the International Center for Research on Women, the International HIV/AIDS Alliance, PATH, Tulane University, Family Health International, and Johns Hopkins University—designing, implementing, evaluating, and expanding innovative strategies for HIV prevention and care. Horizons developed and tested ways to optimize HIV prevention, care, and treatment programs; worked to reduce stigma and improve gender-biased behaviors; and greatly expanded knowledge about the best ways to support, protect, and treat children affected by HIV and AIDS. In all its projects, Horizons strengthened the capacity of local institutions by providing support and …

Prevention With Positives: How Do We Reach Them In The Community?, Avina Sarna, Jerry Okal, Stanley Luchters, Nzioki King'ola, Scott Geibel

HIV and AIDS

In the past, HIV prevention efforts have focused primarily on developing risk-reduction interventions for those presumed to be HIV-negative and therefore at risk of becoming infected with HIV. In recognition of the need for prevention among people living with HIV (PLHIV), programs have been initiated in Africa, but primarily in clinical settings for those who are on antiretroviral therapy (ART). There is little knowledge about how to reach those PLHIV not on ART, and therefore not in regular contact with the health system or with effective prevention messages. This diagnostic study aimed to address the gap in information on how …

Protecting Hope: Situation Analysis Of Vulnerable Children In Uganda 2009, Sam Kalibala, Lynne Elson

HIV and AIDS

The Government of Uganda has focused attention on the problem of orphaned and other vulnerable children through a number of policies, regulations, and initiatives. In 2004, the Ministry of Gender Labor and Social Development developed the National OVC Policy, aimed at improving the quality of life for poor and vulnerable children, such as children who have been orphaned, children who are living on the streets, children who are at risk of abuse, and children exposed to situations of armed conflict. However, despite the many efforts to improve the circumstances of vulnerable children in Uganda, policymakers, donors, and program managers still …

Rapids Evaluation Final Report 2005-2009 Key Findings, Louis Apicella, Katie D. Schenk, Hena Khan

HIV and AIDS

RAPIDS (Reaching HIV/AIDS Affected People with Integrated Development and Support) is an intervention funded by the United States Agency for International Development (USAID), and is designed to mitigate the impact of HIV/AIDS in Zambia. The overall goal of RAPIDS is to improve the quality of life of Zambians affected by HIV and AIDS by expanding successful community-based models of home-based care and support to orphans and vulnerable children and people who are chronically ill, as well as through interventions targeting youth with livelihood opportunities and life-skills training, focusing on initiatives supporting abstinence and being faithful.

Pepfar Special Initiative On Sexual And Gender-Based Violence: Baseline Report, Lynne Elson, Jill Keesbury

HIV and AIDS

The PEPFAR Special Initiative on Sexual and Gender-Based Violence aims to strengthen services for survivors of sexual violence (SV) though the implementation of a comprehensive model of care in participating PEPFAR partner facilities. This baseline report examines project sites in Uganda and Rwanda and suggests strengthening health services involving training, community and provider awareness and attitudes.

Looking Back, Moving Forward: Reducing Hiv-Related Stigma, Horizons Studies 2000 To 2007, Julie Pulerwitz, Annie P. Michaelis, Ellen Weiss, Lisanne Brown, Vaishali Sharma Mahendra

HIV and AIDS

In 1997, the Population Council initiated the Horizons Program—a decade-long USAID-funded collaboration with the International Center for Research on Women, the International HIV/AIDS Alliance, PATH, Tulane University, Family Health International, and Johns Hopkins University—designing, implementing, evaluating, and expanding innovative strategies for HIV prevention and care. Horizons developed and tested ways to optimize HIV prevention, care, and treatment programs; worked to reduce stigma and improve gender-biased behaviors; and greatly expanded knowledge about the best ways to support, protect, and treat children affected by HIV and AIDS. In all its projects, Horizons strengthened the capacity of local institutions by providing support and …

Looking Back, Moving Forward: Access To Antiretroviral Therapy For Hiv Infected Adults And Children In Developing Countries: Horizons Studies, 2002 To 2008, Avina Sarna, Scott E. Kellerman

HIV and AIDS

In 1997, the Population Council initiated the Horizons Program—a decade-long USAID-funded collaboration with the International Center for Research on Women, the International HIV/AIDS Alliance, PATH, Tulane University, Family Health International, and Johns Hopkins University—designing, implementing, evaluating, and expanding innovative strategies for HIV prevention and care. Horizons developed and tested ways to optimize HIV prevention, care, and treatment programs; worked to reduce stigma and improve gender-biased behaviors; and greatly expanded knowledge about the best ways to support, protect, and treat children affected by HIV and AIDS. In all its projects, Horizons strengthened the capacity of local institutions by providing support and …