International Public Health Commons^™

Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. At a workshop held in Burundi, 3–5 June 2014, the Population Council, Alliance Burundaise contre le SIDA, and local partners in Burundi identified successful activities, highlighted important challenges and best practices, and found innovative ways to improve Link Up programming. This document contains a selection of the most …

Sexual And Reproductive Health Among Young Female Sex Workers In Bangladesh Brothels—Baseline Findings From Link Up, Population Council

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. Consortium members PIACT Bangladesh and Marie Stopes Bangladesh implemented a brothel-based program for female sex workers to address sexual and reproductive health and rights. Working in eight brothels in seven districts, trained female sex worker peer educators provided face-to-face education, including referrals to on-site and off-site health care …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Belize 2011, Population Council, Unicef Belize

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Belize 2011” 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 …

Annotated Bibliography Of Peer-Reviewed Literature Related To The Sexual And Reproductive Health Of Young People In Nigeria (2000-2014), Population Council

HIV and AIDS

The 1994 International Conference on Population and Development’s Programme of Action identified eight components (safe motherhood, gender equity, family planning information and services, prevention and treatment of infertility and sexual dysfunction in both men and women, prevention and management of the complications of abortion, prevention and treatment of reproductive tract infections and sexually transmitted infections including HIV, elimination of harmful customary practices, and screening for reproductive tract cancers—prostate, breast, and cervix) of sexual and reproductive health (SRH) for all persons including young people aged 10–24. This annotated bibliography is organized with the eight components as its guiding framework with several …

Experiences With Pregnancy Among Female Sex Workers In Ethiopia: A Link Up Exploratory Study, Population Council, Miz-Hasab Research Center, Organization For Social Services For Aids

HIV and AIDS

In Ethiopia, it is illegal to operate a brothel or procure sex workers as a commercial activity, but the sale of sex by women is not prohibited by law. Research suggests that the number of Ethiopian female sex workers is growing, with younger women and girls increasingly entering the sex trade. Public health programs and policies typically have emphasized HIV prevention in this vulnerable population. A 2014 study of 3,882 Ethiopian female sex workers found that HIV prevalence in the 10 study sites ranged from 15–33 percent, compared to national prevalence of 1.9 percent among women. Furthermore, since most female …

The Impact Of Population, Health, And Environment Projects: A Synthesis Of Evidence, Rachel Winnik Yavinsky, Carolyn Lamere, Kristen P. Patterson, Jason Bremner

Reproductive Health

This working paper synthesizes the existing research and results from projects that integrate family planning with environment, livelihoods, natural-resource management, and other non-health development sectors. The report synthesizes the published and gray literature on current and past integrated projects and the experiences of implementers to generate a summary of the state of knowledge on integrated family planning and environment projects. Specifically, this synthesis documents what is being measured by integrated projects, the proven benefits of integration, and gaps in the evidence base. Based on this analysis, the synthesis highlights and discusses successes and challenges for documenting the impact of integrating …

Low Use And High Discontinuation Of Modern Contraceptives In Pakistan: Reasons And Policy Recommendations, Population Council

Reproductive Health

According to the latest Pakistan Demographic and Health Survey, 20 percent of married women of reproductive age have unmet need for contraception. Moreover, the country’s contraceptive prevalence rate (CPR), for modern and traditional methods combined, is only 35 percent—one of the lowest CPRs in the region. In addition to the problem of nonuse, the country is finding it difficult to keep current contraceptive users onboard: compared to other developing countries, Pakistan has the highest rate of discontinuation of contraceptive use. Thus, while there has been an overall increase in the use of contraceptives—modern and traditional—there is a large difference between …

The Effect Of Integrating Hiv Services On Quality Of Postnatal Care, Integra Initiative

Reproductive Health

Addressing the postnatal needs of new mothers is a neglected area of care throughout sub-Saharan Africa. Unintended pregnancies during the first 12 months following delivery, and vertical transmission of HIV during labor and delivery, are some of the challenges faced by women during the extended postpartum period. Many women want to delay or avoid another pregnancy, but are not using a modern contraceptive method. Few developing countries ensure that mothers and newborns are assessed early and monitored during the initial six-week period as recommended by WHO, which contributes to discontinuity of services received during pregnancy and delivery and limits linkages …

Expanding Young People's Access To Integrated Services In Malawi, Integra Initiative

Reproductive Health

In sub-Saharan Africa, uptake of sexual and reproductive health (SRH) services among young people remains low, placing millions of young people at risk of poor reproductive health outcomes and sexually transmitted infections, including HIV. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London School of Hygiene & Tropical Medicine and the Population Council. Issue 7 of the series focuses on expanding young people’s access to integrated services in Malawi. Conclusions include: improving the quality …

Reducing Maternal And Child Mortality In Punjab: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Punjab’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 45 percent of maternal deaths, 26 percent of infant deaths, and 76 percent of young child deaths. FP’s wider health …

Diagnosing An International Health Crisis: A Structural Exploration Of Ebola 2014, Maddison Zayn Jansen

Honors Program Theses

The Ebola crisis of 2014, though concentrated most heavily in three small countries in western Africa, awoke the international community to its lack of effective health crisis infrastructure. As the disease rocked the globe, multinational groups scrambled to help those directly affected and protect the overwhelming majority of people not directly affected. Most preventative measures failed, and pre-existing initiatives to stem the flow of the disease only served to open the floodgates more. After careful examination of the literature surrounding medical, cultural, financial, national, and global circumstances enabling Ebola to flourish, as well as applying individual analysis and examination, it …

Microbiological Contamination Of Mobile Phones Of Clinicians In Intensive Care Units And Neonatal Care Units In Public Hospitals In Kuwait, Mohammed Heyba, Mohammad Ismaiel, Abdulrahman Alotaibi, Mohamed Mahmoud, Hussain Baqer, Ali Safar, Noura Al-Sweih, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

Background: The objective of this study was to explore the prevalence of microbiological contamination of mobile phones that belong to clinicians in intensive care units (ICUs), pediatric intensive care units (PICUs), and neonatal care units (NCUs) in all public secondary care hospitals in Kuwait. The study also aimed to describe mobile phones disinfection practices as well as factors associated with mobile phone contamination.

Methods: This is a cross-sectional study that included all clinicians with mobile phones in ICUs, PICUs, and NCUs in all secondary care hospitals in Kuwait. Samples for culture were collected from mobile phones and transported for microbiological …

Learning From Women About Hiv Risk, Hiv Testing Behaviors, And Prevention Practices In Mpumalanga, South Africa: A Descriptive Study To Inform Microbicides Introduction, Martha Brady, Saiqa Mullick, Barbara Friedland, Marlena Gehret Plagianos, Linda Du Plessis, Thabiso Mango

HIV and AIDS

The provision of any new prevention product in clinical trial settings is often vastly different from implementation in “real life” public sector settings. In addition, use of antiretrovirals (ARV), such as tenofovir gel, for pre-exposure prophylaxis requires regular HIV testing to ensure users are uninfected before initiating and continuing product use. Therefore, before any ARV-based prevention product can be introduced to women, information is needed on HIV testing practices, how best to integrate products into existing primary health care systems, and women’s risk perception and health-seeking behaviors. The Population Council, in partnership with Solutions IPPT, conducted a study to learn …

Law’S Power To Safeguard Global Health: A Lancet–O’Neill Institute, Georgetown University Commission On Global Health And The Law, Lawrence O. Gostin, John T. Monahan, Mary C. Debartolo, Richard Horton

Georgetown Law Faculty Publications and Other Works

The law-–global, national, and subnational–-plays a vital, yet often underappreciated, role in safeguarding and promoting the public’s health. In this article, we launch the Lancet-O’Neill Institute, Georgetown University Commission on Global Health and the Law. Commissioners from around the world will explore the critical opportunities and challenges of using law as a tool, while evaluating the evidence base for legal interventions. The Commission aims to define and systematically describe the current landscape of law that affects global health and safety.

Commissioners were chosen from disciplines that range from health, policy, and law to economics and governance. The Commission aims …

Assessment Of Longitudinal Efficacy Of Community Based Intervention For Schistosomiasis In Mara District, Lake Victoria Region Of Tanzania, Lauren Ogawa, Guy Bennallack, Aaron Heffner, Jason Duong, Robin Rosenblatt, Yasmin Nibbe, Eiman Mahmoud

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Program/Project Purpose: An estimated 200 million people are infected with schistosomiasis, making the disease one of the top neglected tropical diseases and a major global health concern. In Tanzania, with a population just over 42 million, about 33 million are in need of treatment or preventative chemotherapy. The disease is of particular concern in the Lake Victoria region, due to daily use of lake water. In conjunction with the Shirati district hospital, Touro University-CA has led control programs carried out in mobile clinics at local villages by providing screening, treatment, and education. Recently there has been a push for …

Evidence Of Son Preference And Resulting Demographic And Health Outcomes In Pakistan, Zeba Sathar, Gul Rashida, Sabahat Hussain, Anushe Hassan

Poverty, Gender, and Youth

Pakistan has a highly patriarchal society. Consequently, the desire for sons is a dominant and widely prevalent cultural value that is reinforced by feudal kinship systems that permeate many parts of the country. While reliance on sons is stronger in rural areas because of agricultural work and the tying of land ownership with male inheritance, even in other areas boys are seen to be important in carrying on the family name and taking care of parents in old age. On the other hand, daughters are seen as an expense and an economic burden in both rural and urban areas. A …

Delivering Contraceptive Vaginal Rings—Task Sharing In The Delivery Of Family Planning Programs: Experiences From Senegal, Babacar Mane, Nafissatou Diop, Saumya Ramarao

Reproductive Health

The Population Council is conducting activities to facilitate the introduction of vaginal rings in sub-Saharan Africa. This report notes that the first ring to be introduced will be the Council’s Progesterone Contraceptive Vaginal Ring (PCVR), which is relevant in contexts where women practice prolonged lactation. The PCVR will also address the high unmet need for family planning (FP), especially for postpartum women. The Council aims to expand the availability and affordability of vaginal rings in Kenya, Nigeria, and Senegal. One of the challenges is the lack of skilled providers. To design plans for involving mid- and lower-level health workers in …

Health Facility Guidelines And Management Benchmarks: Improving Workplace Health Services And Health Management In Factories, Farms And Other Workplaces In Low- And Middle-Income Countries, David Wofford, Marat Yu, Lauren Shields, Maria Pontes

Reproductive Health

This document contains a set of voluntary health and management guidelines for corporations and their supply chains to promote continual improvement and application of good practices, better access to men’s and women’s health services, and more effective use of health resources at workplaces in the developing world. It is focused on both quality of health services provided at the workplace and adequacy of company policies and management systems to ensure that workers have access to health services. The main goals of the guidelines are to: 1) help enterprises—multinational companies and their supplier or subsidiary companies in developing countries—improve the management …

Family Planning Vouchers To Improve Delivery And Uptake Of Contraception In Low And Middle Income Countries: A Systematic Review, Benjamin Bellows, Ashish Bajracharya, Carol Bulaya, Sophie Inambwae

Reproductive Health

Family planning vouchers have provided accessible and quality reproductive health services to the poor and have been critical to countries in making progress in achieving Millennium Development Goal 5. Increased utilization of contraception allows for birth spacing, decreases unintended pregnancy, and results in healthier mothers and families. Strategies to improve utilization through targeted subsidies in low- and middle income countries (LMICs) have not been fully documented in a systematic review of the literature. This study report summarizes the effect of voucher systems for contraceptive services on socioeconomic and demographic indicators in LMICs. A systematic review of unpublished reports and published …

Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend

Reproductive Health

Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …

Expanding Access To Education For Teenage Mothers In Homa Bay County: What ‘Might’ Work, Chi-Chi Undie

Reproductive Health

No abstract provided.

Curriculum On Adolescent-Friendly Health Services And Health Voucher Mechanisms: Facilitator's Training Manual, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) in rural and urban Zambia aims to build social, health, and economic assets of adolescent girls. A safe spaces component is at the core of AGEP. Girls groups, under the guidance of a female mentor from the same community, provide a safe and supportive learning environment. The meetings are critical in building social assets for vulnerable girls—including friendships, self-esteem, trusting relationships with adults, and social support. The training content over the course of the year varies from sexual and reproductive health and life skills to financial education and nutrition training. Girls in AGEP receive …

Understanding Factors Influencing Adverse Sex Ratios At Birth In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Irfan Hossain, Forhana Rahman Noor

Poverty, Gender, and Youth

Nationally, the sex ratio at birth has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. However, at the regional level, Bangladesh is characterized by an east-west divide in sex ratios at birth. While the western region shows normal sex ratios at birth, the eastern region displays distorted sex ratios. To understand the factors that contribute to regional variations, a household survey was conducted among married women aged 18–49 years who had at least two living children. Views of health-care providers on gender-biased sex selection and of program implementers on …

Education, Numeracy, And Literacy: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10–19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. The program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers, and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and are being followed over four years—including the two years of the program and two years after. This brief describes the characteristics of these girls at baseline. Of the girls who are currently in school, …

Addressing Gender-Biased Sex Selection In Haryana, India: Promising Approaches, Shireen J. Jejeebhoy, Rajib Acharya, Sharmistha Basu, A.J. Francis Zavier

Poverty, Gender, and Youth

Persistently adverse sex ratios remain a challenge in India despite the enforcement of the PCPNDT (Pre-Conception and Pre-Natal Diagnostic Techniques) Act in 1994. Nevertheless, over the decade 2001–2011, positive shifts from very adverse to less adverse levels have occurred in a few states. Two districts in Haryana state—Kurukshetra and Sonipat—whose sex ratios displayed some and no improvement, respectively, are compared in an attempt to find promising programme directions to counter gender-biased sex selection. Comparisons are drawn from the attitudes and experiences of surveyed women and interviews with service providers and programme implementers, about sex-selection technology. Also addressed are differences in …

Sexual Behaviors And Biomarkers: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10–19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. More than 10,000 girls participated in weekly girls’ group meetings, received health vouchers, and opened savings accounts. More than 5,000 girls, unmarried at baseline, were enrolled in a randomized, controlled trial and followed over four years—two years in the program and two years after the program ended. This brief describes the characteristics of enrolled girls at baseline.

Use Of Health Services: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10-19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. The program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers, and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and are being followed over four years—including the two years of the program and two years after. This brief describes the use of health services by these girls at baseline.

Adolescent Girls Initiative-Kenya: Program Overview, Population Council

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education, health, and general well-being—including early marriage; teenage pregnancy; early, unprotected, and/or unwanted sexual activity; violence; social isolation; and HIV/STIs. For the most part, very young adolescent girls who live in risk-prone environments have not yet experienced these negative outcomes. It is critical, therefore, to intervene early and increase girls’ capacity to overcome these risks before the challenges result in outcomes that may be irreversible. Research has shown that single-sector interventions are not adequate to obtain the range of outcomes needed to help girls enter into adulthood …

Sexual And Gender-Based Violence: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10-19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. Sexual and gender-based violence (SGBV) is a pervasive global health problem. Women and girls are most at risk, and consequences include physical injury, psychological trauma, unwanted pregnancy, and sexually transmitted infections, including HIV. The AGEP program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and …