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Articles 31 - 60 of 132
Full-Text Articles in International Public Health
Panel Survey Of Young People In Egypt (Sype) 2014: Generating Evidence For Policy, Programs, And Research—Appendix, Rania Roushdy, Maia Sieverding
Panel Survey Of Young People In Egypt (Sype) 2014: Generating Evidence For Policy, Programs, And Research—Appendix, Rania Roushdy, Maia Sieverding
Poverty, Gender, and Youth
This document contains the Appendix to the Panel Survey of Young People in Egypt (SYPE) 2014: Generating Evidence for Policy, Programs, and Research, consisting of 39 Indicator Tables. SYPE, which was first conducted in 2009 among Egyptian youth aged 10–29, focuses on education, employment, health, family formation, migration, reproductive health, social issues, and civic/political participation. The second round, SYPE 2014, was conducted in the wake of two youth-led revolutions (2011 and 2013). SYPE 2014 attempts to understand changes that occurred among Egyptian youth over the period between the two rounds through targeting the same group of respondents of the 2009 …
Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Africa's Youth: Insights From A Multi-Country Study, Babatunde A.O. Ahonsi, Nahla G. Abdel-Tawab, Scott Geibel, Sam Kalibala, Jerry Okal, Babacar Mane, Nathi Sohaba, Julialynne Walker, Eric P. Green
Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Africa's Youth: Insights From A Multi-Country Study, Babatunde A.O. Ahonsi, Nahla G. Abdel-Tawab, Scott Geibel, Sam Kalibala, Jerry Okal, Babacar Mane, Nathi Sohaba, Julialynne Walker, Eric P. Green
HIV and AIDS
This report contains information from a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and …
Enhancing Livelihood Opportunities For Young Women In Rural Upper Egypt: The Neqdar Nesharek Program, Nada Ramadan, Nahla G. Abdel-Tawab, Khaled El Sayed, Rania Roushdy
Enhancing Livelihood Opportunities For Young Women In Rural Upper Egypt: The Neqdar Nesharek Program, Nada Ramadan, Nahla G. Abdel-Tawab, Khaled El Sayed, Rania Roushdy
Poverty, Gender, and Youth
During the 30+ years that the Population Council has been operating in Egypt, Council researchers have examined many facets of young people’s lives, including conducting nationally representative surveys in 1997, 2009, and 2014. This research has documented the marginalization of Egyptian women in the public sphere, including the labor market, as well as gender inequities in mobility and access to schooling. Neqdar Nesharek is a social and economic empowerment program that evolved in response to this research and from the Council’s experience over the last few years working closely with out-of-school girls in Upper Egypt via the Ishraq program. The …
Sexual And Reproductive Health Of Women Living With Hiv In Egypt: Unmet Needs And Unfulfilled Dreams, Doaa Oraby, Nahla G. Abdel-Tawab
Sexual And Reproductive Health Of Women Living With Hiv In Egypt: Unmet Needs And Unfulfilled Dreams, Doaa Oraby, Nahla G. Abdel-Tawab
Reproductive Health
The gender profile of the HIV/AIDS epidemic has changed since it emerged 30 years ago when infections were concentrated in key populations of men such as injecting drug users and men who have sex with men. In 2012, women accounted for nearly 50 percent of the estimated 35.3 million people living with HIV/AIDS globally. In the Middle East and North Africa, 44 percent of infected adults are women. The past 30 years have also witnessed remarkable improvements in access to high-quality information and medical services, including services for prevention of mother-to-child transmission of the virus. With care and treatment for …
Justification Of Intimate Partner Violence In Egypt, Amira A. Roess, Esther L. Aranda
Justification Of Intimate Partner Violence In Egypt, Amira A. Roess, Esther L. Aranda
GW Research Days 2013
Background: Intimate Partner Violence (IPV) is an important problem in developing countries and associated with poor reproductive health outcomes.
Objectives: To describe trends and justification of IPV in Egypt.
Methods: We used the 2008 Egypt Demographic Health Surveys (EDHS). Information on IPV was drawn from 16,527 women in 2008. We performed bivariate analyses to examine trends in and risk factors for justification of IPV.
Results: 39.5% of respondents reported that IPV is justifiable. Logistic regression suggests that age, education, wealth and female autonomy are associated with respondents not justifying IPV. In contrast respondents who supported the continuation of female circumcision …
Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt, Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi
Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt, Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi
Poverty, Gender, and Youth
This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the …
The Ishraq Program For Out-Of-School Girls: From Pilot To Scale-Up [Arabic], Mona Selim, Nahla G. Abdel-Tawab, Khaled El Sayed, Asmaa Elbadawy, Heba El Kalaawy
The Ishraq Program For Out-Of-School Girls: From Pilot To Scale-Up [Arabic], Mona Selim, Nahla G. Abdel-Tawab, Khaled El Sayed, Asmaa Elbadawy, Heba El Kalaawy
Poverty, Gender, and Youth
In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities …
The Ishraq Program For Out-Of-School Girls: From Pilot To Scale-Up, Mona Selim, Nahla G. Abdel-Tawab, Khaled El Sayed, Asmaa Elbadawy, Heba El Kalaawy
The Ishraq Program For Out-Of-School Girls: From Pilot To Scale-Up, Mona Selim, Nahla G. Abdel-Tawab, Khaled El Sayed, Asmaa Elbadawy, Heba El Kalaawy
Poverty, Gender, and Youth
In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities …
Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt [Arabic], Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi
Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt [Arabic], Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi
Poverty, Gender, and Youth
This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the …
Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab
Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab
Reproductive Health
These slides present results from a Population Council study conducted in Egypt aimed at identifying factors that prevent Egyptian couples from attainment of their reproductive goals using a rights-based, gender-sensitive analysis of family planning service demand and supply. The analysis focused on six aspects of clients’ rights: clinic/provider readiness, accessibility and affordability, privacy and confidentiality, choice and autonomy, informed decisionmaking, and the right to complain. The presentation concludes with recommendations for closing gaps that exist with regard to protection of clients’ rights to autonomy, choice, informed decisionmaking, privacy, and confidentiality.
Youth Perspectives On Entrepreneurship In Egypt: Barriers To Entrepreneurship As A Means To Combat Youth Unemployment, Maia Sieverding
Youth Perspectives On Entrepreneurship In Egypt: Barriers To Entrepreneurship As A Means To Combat Youth Unemployment, Maia Sieverding
Poverty, Gender, and Youth
This brief examines a range of factors that Egyptian youth perceive to be barriers to starting their own business, including high risk, limited access to finance, complexity of micro-credit schemes, lack of business and marketing training, and the need for connections in order to succeed. According to results from the Survey of Young People in Egypt, these factors combine to create the view among many youth that entrepreneurship is not a viable means of labor-market entry. Rather, youth see entrepreneurship as either a supplemental income-generating activity while also having a “regular” job, or as a later-life employment option once they …
Who Is Covered And Who Under-Reports: An Empirical Analysis Of Access To Social Insurance On The Egyptian Labor Market, Rania Roushdy, Irene Selwaness
Who Is Covered And Who Under-Reports: An Empirical Analysis Of Access To Social Insurance On The Egyptian Labor Market, Rania Roushdy, Irene Selwaness
Poverty, Gender, and Youth
This working paper investigates the dynamics and determinants of having access to social insurance coverage on the Egyptian labor market among wage and non-wage workers. The results show that men, older, married, better educated, and white collar highly skilled workers are more likely to have social insurance coverage. Access to social insurance is more likely to exist in the public sector and in large private enterprises. Furthermore, acquiring social insurance coverage in the private wage work sector does not often come at first entry; but it takes some time to gain such access. In contrast, experience is not important for …
The Reproductive Health Of Young People In Egypt, Nahla G. Abdel-Tawab, Noha Roushdy, Maia Sieverding
The Reproductive Health Of Young People In Egypt, Nahla G. Abdel-Tawab, Noha Roushdy, Maia Sieverding
Poverty, Gender, and Youth
This Population Council brief presents results from the Survey of Young People in Egypt (SYPE) on reproductive health (RH). The SYPE results underscore the need for: the assessment of state and civil society initiatives to transmit RH information; a national, comprehensive, age-appropriate reproductive health module to be integrated into the educational program; a national campaign on HIV/AIDS and other sexually transmitted infections that targets young people of reproductive age; the integration of female circumcision into a broader approach to youth reproductive health and bodily rights; specialized reproductive health services for married adolescent girls; and further research on sexuality and reproductive …
Challenges Facing The Egyptian Education System: Access, Quality, And Inequality [Arabic], Caroline Krafft
Challenges Facing The Egyptian Education System: Access, Quality, And Inequality [Arabic], Caroline Krafft
Poverty, Gender, and Youth
This brief analyzes and summarizes young people's responses to the 2009 Survey of Young People in Egypt (SYPE) to identify the greatest challenges facing the Egyptian educational system, focusing specifically on primary through secondary schooling. Results show that access to school has improved, but some youth, especially females in rural Upper Egypt, remain outside the school system and are increasingly marginalized. The Egyptian school system is delivering low-quality education that is irrelevant to the labor market and has problems with repetition, absenteeism, and drop out which reduce the efficiency of the education system. Unequal distribution of resources in the education …
A Life Course Perspective On Social Protection Among The Working Poor Of Egypt, Maia Sieverding
A Life Course Perspective On Social Protection Among The Working Poor Of Egypt, Maia Sieverding
Poverty, Gender, and Youth
This paper employs a generational comparison to examine how increasing labor market informality has affected how poor households in Egypt gain access to and rely on social protection schemes. The results indicate that among the generation of Egyptians approaching retirement, the expansion of public employment and a policy allowing easy access to survivors’ benefits among female dependents served as important means of increasing social insurance coverage. However, many young households do not have even one member enrolled in the public pension system. Labor market instability and informality have also lowered the perceived value of social protection among this generation. The …
Social Protection In Egypt: A Policy Overview, Maia Sieverding, Irene Selwaness
Social Protection In Egypt: A Policy Overview, Maia Sieverding, Irene Selwaness
Poverty, Gender, and Youth
The need to address the shortcomings of Egypt’s current social protection system as part of a broader process of developing a new social contract between the Egyptian government and its citizens has been noted for a number of years. With a new government recently put in place, Egypt is now at a potential turning point in terms of implementing unfinished reforms to the system or proposing alternative ones. The aim of this paper is therefore to provide an overview and assessment of current public social protection mechanisms and suggest directions for new policy measures. The social and health insurance systems …
The Cost Of Reaching The Most Disadvantaged Girls: Programmatic Evidence From Egypt, Ethiopia, Guatemala, Kenya, South Africa, And Uganda, Jessica Sewall-Menon, Judith Bruce, Karen Austrian, Raven Brown, Jennifer Catino, Alejandra Colom, Angel Del Valle, Habtamu Demele, Annabel Erulkar, Kelly Hallman, Eva Roca, Nadia Zibani
The Cost Of Reaching The Most Disadvantaged Girls: Programmatic Evidence From Egypt, Ethiopia, Guatemala, Kenya, South Africa, And Uganda, Jessica Sewall-Menon, Judith Bruce, Karen Austrian, Raven Brown, Jennifer Catino, Alejandra Colom, Angel Del Valle, Habtamu Demele, Annabel Erulkar, Kelly Hallman, Eva Roca, Nadia Zibani
Poverty, Gender, and Youth
The most disadvantaged adolescent girls are the poorest girls from the poorest communities. They suffer from human rights abuses, lack education and economic opportunity, are affected by HIV/AIDS, and have poor reproductive and maternal health outcomes. To effectively reach these girls so that they can receive critical services such as gathering spaces, life skills, financial literacy, savings accounts, and reproductive health knowledge, they must be targeted as a distinct segment. It is important to invest in building the capacities of local partners and governments to deliver and scale-up low-cost, well-targeted programs. This technical report is intended to assist programmatic officers, …
Is Early Childhood Care And Education A Good Investment For Egypt? Estimates Of Educational Impacts, Costs, And Benefits, Caroline Krafft
Is Early Childhood Care And Education A Good Investment For Egypt? Estimates Of Educational Impacts, Costs, And Benefits, Caroline Krafft
Poverty, Gender, and Youth
This brief examines Early Childhood Care and Education (ECCE) in Egypt. Findings suggest that expansion of ECCE is a good investment. Providing kindergarten to all Egyptian children, and particularly those from disadvantaged backgrounds, could be an important step toward greater equality, efficiency, and attainment in the education system.
Female Disadvantage In The Egyptian Labor Market: A Youth Perspective, Maia Sieverding
Female Disadvantage In The Egyptian Labor Market: A Youth Perspective, Maia Sieverding
Poverty, Gender, and Youth
In this brief, three aspects of female youth’s disadvantage in the labor market are analyzed: low labor force participation, high unemployment, and concentration in the public sector. These issues are closely interrelated and can be addressed through a set of policies that promote family-friendly employment conditions and the formalization of the private sector. The establishment of job search services for female youth is also critical to addressing the gender gap in unemployment.
The Impact Of Water Supply And Sanitation On Child Health: Evidence From Egypt, Rania Roushdy, Maia Sieverding, Hanan Radwan
The Impact Of Water Supply And Sanitation On Child Health: Evidence From Egypt, Rania Roushdy, Maia Sieverding, Hanan Radwan
Poverty, Gender, and Youth
Using a combination of qualitative and quantitative data, this working paper investigates whether access to improved sources of water and sanitation is an effective “treatment” for the incidence of diarrhea among children under five years of age in Egypt. Both components of the study indicate that widespread access to improved sources of drinking water and toilet facilities exists across Egypt; however, service quality remains a significant problem in many areas. In particular, cuts in water supply—and the resulting practice of storing water—are quite common; a sizable percentage of flush toilet facilities are not connected to the public sewer system; and …
Is Early Childhood Care And Education A Good Investment For Egypt? Estimates Of Educational Impacts, Costs, And Benefits [Arabic], Caroline Krafft
Is Early Childhood Care And Education A Good Investment For Egypt? Estimates Of Educational Impacts, Costs, And Benefits [Arabic], Caroline Krafft
Poverty, Gender, and Youth
This summary details the impact of early childhood education in Egypt. The results show that early childhood care and education has an impact on educational attainment that is both statistically significant and sizeable. Such interventions increase overall educational attainment by approximately one year, primarily due to decreased primary and preparatory drop out. The impact on educational attainment is reflected in improved school performance, such as higher test scores, decreased grade repetition, and improvements in school tracking, during the early years. Investments in early childhood education can be a powerful approach to improving educational outcomes, and the research suggests that increases …
Challenges Facing The Egyptian Education System: Access, Quality, And Inequality, Caroline Krafft
Challenges Facing The Egyptian Education System: Access, Quality, And Inequality, Caroline Krafft
Poverty, Gender, and Youth
This brief analyzes and summarizes young people's responses to the 2009 Survey of Young People in Egypt (SYPE) to identify the greatest challenges facing the Egyptian educational system, focusing specifically on primary through secondary schooling. Results show that access to school has improved, but some youth, especially females in rural Upper Egypt, remain outside the school system and are increasingly marginalized. The Egyptian school system is delivering low-quality education that is irrelevant to the labor market and has problems with repetition, absenteeism, and drop out which reduce the efficiency of the education system. Unequal distribution of resources in the education …
Female Wages In The Egyptian Textiles And Clothing Industry: Low Pay Or Discrimination?, Amirah El-Haddad
Female Wages In The Egyptian Textiles And Clothing Industry: Low Pay Or Discrimination?, Amirah El-Haddad
Poverty, Gender, and Youth
This Population Council working paper analyzes data collected from a survey of firms and workers in the textiles and clothing sector in Egypt. These data allow for the explanation of the sector’s gender wage gap by poorer endowments, and relegation of women to low-paying firms and occupations; and by within-firm and within-occupation differential in returns. There is a pay gap in this sector, with men receiving an hourly wage 29 percent higher than that of women, partly because women are concentrated in the lower paid occupations, with a clear glass ceiling in effect, and outright discrimination occurs. The largest of …
On Trade Policies And Wage Disparity In Egypt: Evidence From Microeconomic Data, Chahir Zaki
On Trade Policies And Wage Disparity In Egypt: Evidence From Microeconomic Data, Chahir Zaki
Poverty, Gender, and Youth
This working paper assesses the extent to which trade barriers, including traditional tariff barriers, non-tariff measures, and red tape, affect wage disparity and employment in Egypt. Using a microeconomic dataset, the author assesses to what extent different trade barriers affected wage disparity and employment in Egypt. This disparity is studied in three dimensions: on gender (males vs. females), qualification (blue vs. white collar workers), and regional (urban vs. rural workers). Findings show that both non-tariff measures and red tape barriers have a higher impact than traditional tariffs on wage disparity and that women, urban workers, and blue collar workers are …
Rethinking The Time Allocation Of Egyptian Females: A Matching Analysis, Rana Hardy
Rethinking The Time Allocation Of Egyptian Females: A Matching Analysis, Rana Hardy
Poverty, Gender, and Youth
This study explores the extremely biased division of labor within Egyptian households. The effects of marriage on women’s market and domestic labor supplies are important aspects of this study conducted by the Population Council for its working paper series on gender and work in the Mideast-North Africa region. New explanations for married women’s low participation rates are proposed. A matching model is estimated to determine how selection into marriage alters the time allocation of women. The empirical results show that marriage significantly affects both types of work with married women spending about eight hours less on market work weekly relative …
Women's Economic Resources And Bargaining In Marriage: Does Egyptian Women's Status Depend On Earnings Or Marriage Payments?, Rania Salem
Poverty, Gender, and Youth
This working paper reports on a study using Egyptian survey data to determine whether the effect of women's work on their status is mediated by the material transactions that accompany marriage. This perspective posits that marriage payments made to the bride, as well as assets she herself brings to the marriage, enhance her bargaining position. Analysis of the 2006 Egypt Labor Market Panel Survey panel data is used to explore the associations between women’s labor market activity, earnings, absolute and proportional marriage payments, and a measure of women’s status within marriage, namely their decisionmaking power. Consistent with the existing literature, …
Scaling Up Asset-Building Programs For Marginalized Adolescent Girls In Socially Conservative Settings: The Ishraq Program In Rural Upper Egypt, Nadia Zibani, Martha Brady
Scaling Up Asset-Building Programs For Marginalized Adolescent Girls In Socially Conservative Settings: The Ishraq Program In Rural Upper Egypt, Nadia Zibani, Martha Brady
Poverty, Gender, and Youth
In 2001, the Population Council and partners designed and implement an intervention program to address the needs of out-of-school adolescent girls in rural Upper Egypt. As noted in Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 12, the pilot, referred to as Ishraq (“Sunrise”), was launched in four rural villages of el-Minya governorate in Upper Egypt, the country’s least developed and most disadvantaged region. Targeting girls aged 13–15, this program was designed to promote literacy, impart life skills, build social networks, and foster leadership and self-confidence through sports. By establishing girl-friendly spaces in which participants could meet, learn, …
Survey Of Young People In Egypt (Sype) 2009—Final Report [Arabic], Population Council
Survey Of Young People In Egypt (Sype) 2009—Final Report [Arabic], Population Council
Poverty, Gender, and Youth
Responding to a dearth of data on youth in Egypt, the Population Council conducted a comprehensive situation analysis of Egyptian adolescents and young people: the Survey of Young People in Egypt (SYPE) 2009, which covered a nationally representative sample of 15,029 young people aged 10–29. SYPE collected data on the five key life transitions of education, work, family formation; health; and civic and political participation. SYPE follows up an earlier survey conducted by the Population Council in 1997, The Adolescence and Social Change in Egypt (ASCE) survey. SYPE updates the results provided by the earlier survey and expands their scope. …
Le Travail Des Femmes Dans Le Secteur Agricole: Entre Précarité Et Empowerment—Cas De Trois Régions En Egypte, Au Maroc Et En Tunisie, Zhour Bouzidi, Saker El Nour, Wided Moumen
Le Travail Des Femmes Dans Le Secteur Agricole: Entre Précarité Et Empowerment—Cas De Trois Régions En Egypte, Au Maroc Et En Tunisie, Zhour Bouzidi, Saker El Nour, Wided Moumen
Poverty, Gender, and Youth
Despite a remarkable decline in the agricultural labor force in general, the number of women employed in the agricultural sector is growing substantially, particularly as a result of the intensification of agricultural activity. This Population Council working paper focuses on the working conditions of women in the agricultural sector based on the analysis of three case studies in three countries: the West of Delta in Egypt, the coastal zone of Gharb in Morocco, and the Nadhour region in Tunisia. The report analyzes to what extent agricultural work could be a means of precariousness or empowerment for women workers. Results show …
National Efforts Toward Fgm-Free Villages In Egypt: The Evidence Of Impact, Ghada Barsoum, Nadia Rifaat, Omaima El-Gibaly, Nihal Elwan, Natalie Forcier
National Efforts Toward Fgm-Free Villages In Egypt: The Evidence Of Impact, Ghada Barsoum, Nadia Rifaat, Omaima El-Gibaly, Nihal Elwan, Natalie Forcier
Poverty, Gender, and Youth
This report is a midterm evaluation and documentation of the process and approach of the FGM-Free Village Model implemented in Egypt by the National Council of Childhood and Motherhood with assistance from the Population Council. In a comparison of responses from women and men in intervention groups to those in nonintervention (control) villages, data analysis shows that the program has been successful in changing views and attitudes toward female genital mutilation (FGM). FGM is an entrenched generational practice, and eradicating it in a community requires concerted effort over an extended period of time. This evaluation strongly recommends that efforts be …