Open Access. Powered by Scholars. Published by Universities.®

International Public Health Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 1741 - 1770 of 2065

Full-Text Articles in International Public Health

Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health Jan 2001

Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of …


Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health Jan 2001

Kenya Update: Frontiers Adolescent Reproductive Health Project, Frontiers In Reproductive Health

Reproductive Health

The Kenya Adolescent Reproductive Health Project (KARHP) was launched in October 1999 in Busia and Vihiga districts as a three-year operations research study to determine the feasibility, cost, and effectiveness of implementing systematic interventions that address the reproductive health (RH) needs of adolescents aged 10–19 years. This USAID-funded project is part of the Population Council’s Frontiers in Reproductive Health Program’s global operations research. PATH (Program for Appropriate Technology in Health) is implementing the project, in collaboration with the Ministries of Health, Education, and Home Affairs, Heritage, and Sports. The objective of the study is to establish the effectiveness of interventions …


Reproductive Tract Infections: A Guide For Programme Managers, Sarah Hawkes, Anjali Nayyar, Johannes Van Dam, Kevin R. O'Reilly, Bidia Deperthes, Dinesh Agarwal Jan 2001

Reproductive Tract Infections: A Guide For Programme Managers, Sarah Hawkes, Anjali Nayyar, Johannes Van Dam, Kevin R. O'Reilly, Bidia Deperthes, Dinesh Agarwal

Reproductive Health

Reproductive tract infections (RTIs) including sexually transmitted infections represent a silent worldwide pandemic that adversely impacts the reproductive health (RH) of women and men. Various community- and hospital-based studies in India have provided insights into the magnitude of the problem. The International Conference on Population and Development (1994) emphasized integration of RH services to meet the needs of men and women especially with prevention and management of RTIs/STIs. The emergence of HIV and the identification of STIs as a risk factor for the spread of HIV have further lent a sense of urgency for a programmatic response to address this …


South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health Jan 2001

South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health

Reproductive Health

In 2000, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and 7 affiliated peer education programs. The 12 centers, located in urban, peri-urban, and rural areas, offer very different services. The two centers of the KwaZulu-Natal Department of Health focus on providing reproductive health (RH) information and services to adolescents. The six centers of the Youth and Adolescent Reproductive Health Project provide a broader range of youth-friendly RH services, including counseling and life skills education, as well as modest recreational activities. The four centers run by loveLife have large …


Zambia: Peer Educators Can Promote Safer Sex Behaviors, Frontiers In Reproductive Health Jan 2001

Zambia: Peer Educators Can Promote Safer Sex Behaviors, Frontiers In Reproductive Health

Reproductive Health

Zambian adolescents are at high risk of unwanted pregnancy, sexually transmitted infections (STIs), and HIV infection due to early sexual initiation, low use of contraceptives and condoms, and other high-risk sexual behaviors. During 1996–1998, CARE Zambia and the Population Council conducted a study to test community-based approaches to improve adolescent sexual and reproductive health. CARE Zambia talked to adolescents in four communities outside Lusaka. Using participatory learning and action techniques, researchers identified factors leading to high-risk sexual behaviors, including lack of economic, recreational, and educational opportunities for youth. This information helped to design the study. Two interventions—condom distribution by peer …


Extending Operations Research To Social Marketing Programs, Teresa De Vargas Jan 2001

Extending Operations Research To Social Marketing Programs, Teresa De Vargas

Reproductive Health

CEMOPLAF of Quito, Ecuador sells reproductive health products to pharmacies and other outlets to contribute to its sustainability. However, the nonprofit agency lacked basic information regarding the program’s profitability, niche, and quality. Operations research was conducted to provide this information, including a financial analysis of the marketing program and two market research studies. Each study included a capacity-building component so that CEMOPLAF could conduct similar research in the future without technical assistance. A regional conference attended by nongovernmental organizations provided an opportunity to share sustainability tools and lessons learned.


Operations Research In Reproductive Health And Family Planning At The Cairo Demographic Center, Magdi A. Ibrahim, James R. Foreit, M.E. Khan Jan 2001

Operations Research In Reproductive Health And Family Planning At The Cairo Demographic Center, Magdi A. Ibrahim, James R. Foreit, M.E. Khan

Reproductive Health

This report evaluates the effectiveness of a two-year training program at the Cairo Demographic Center to increase the number of researchers using operations research (OR), and to help institutionalize the ability of the Center to offer training in operations research in reproductive health. It also provides feedback for OR curriculum development. The project trained researchers with program and policymaking responsibilities and provided participants with the experience of designing an OR project, and built participants’ skills in communicating research results to managers. Participant evaluations showed that, overall, the course met its objectives. The training that the students received in OR has …


An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed Jan 2001

An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed

Reproductive Health

The Egyptian Ministry of Health and Population and FRONTIERS discussed the need for investigating service delivery aspects of the Egyptian NORPLANT® program. This study emerged from those consultations. The study provides a comprehensive assessment of the program: how services are administered and used through the ongoing Introduction Program as it approaches five years of operation. The report lists major findings with program implications and offers recommendations regarding quality of care; tracking and locating NORPLANT® users; program sustainability; and information, education, and communication strategies.


Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa Jan 2001

Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa

Reproductive Health

The Hospital Roosevelt is Guatemala’s largest hospital, and serves as a referral and training facility for the entire country. Within the Hospital Roosevelt, the Department of Obstetrics and Gynecology established a Reproductive Health Unit (RHU) to offer family planning information and services to obstetrics inpatients and OB/GYN outpatient clients, and to serve as a training site for medical residents completing their OB/GYN rotations. Hospital administrators requested assistance from the Frontiers in Reproductive Health (FRONTIERS) program to help establish a fee schedule for the RHU, with the goal of paying its own personnel costs after one year of operation. The FRONTIERS …


Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar Jan 2001

Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar

Reproductive Health

The Honduran Ministry of Health (MOH) and the Population Council’s INOPAL III Project tested the acceptability of postpartum/postabortion contraception at the Escuela Hospital, the largest in the country. The project showed that more than 30 percent of the women seen for a delivery or a complication due to abortion, were interested in adopting a contraceptive method prior to discharge from the hospital. Given the success of the project, the MOH asked the Population Council’s FRONTIERS program for technical and financial support to extend those services to five additional hospitals in the country. Important improvements were found for the four indicators …


Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon Jan 2001

Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon

Reproductive Health

Using the results of a previous operations research study, the Ministry of Health of Honduras recently changed the National Women’s Health Service Delivery Guidelines to explicitly authorize nurse auxiliaries to insert IUDs, deliver Depo-Provera, and take Pap smears. These services are new to the rural communities served by rural health centers (RHCs). The objective of this project was to test whether the demand for these newly introduced services would increase if a promotional brochure was distributed in the surrounding communities by the RHC’s clients among potentially interested friends in these communities. The study found that the intervention that was tested …


An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu Jan 2001

An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu

Reproductive Health

Within South Africa there is much interest in expanding youth center programs, particularly in the nongovernmental sector, in part because of recognition that the HIV/AIDS crisis is disproportionately affecting young South Africans. This study was designed to give implementing agencies and donors a broad view of how the youth centers function, who they reach, and the quality of information and services. The assessment underscored the importance of monitoring the performance of programs and understanding who is being reached with what interventions. Youth centers that focus on providing recreational facilities attract a large number of clients, often boys who are repeat …


An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz Jan 2001

An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz

Reproductive Health

Since its inception, the Zimbabwe National Family Planning Council’s (ZNFPC) community-based distribution (CBD) program has made significant and well-documented contributions to the demand for and use of family planning in Zimbabwe. Data from several studies have shown, however, a steady decline in this contribution and that the CBD agents spend more time resupplying existing clients than recruiting new acceptors. Moreover, the CBD program urgently needs to be able to address the AIDS crisis in the country. ZNFPC has undertaken this review to guide it in making appropriate decisions about the future direction of the program, allowing CBDs to have a …


An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku Jan 2001

An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku

Reproductive Health

Maendeleo Ya Wanawake (MYWO), with technical assistance from the Program for Appropriate Technology in Health (PATH), has been implementing an Alternative Rite of passage programme as part of its efforts to eradicate the practice of female genital mutilation (FGM) in five districts in Kenya. This study addressed the factors that influence some families and individuals to adopt the Alternative Rite while others, exposed to the same messages discouraging FGM, decide not to. It also evaluated the effect of the training component of the Alternative Rite on the girls who participated.


Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend Jan 2001

Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend

Reproductive Health

The International Conference on Population and Development in 1994 led to an upsurge in interest in implementing reproductive health (RH) programs worldwide. The urgency to act has led to the development of disparate activities in several developing countries including India. While programs have been growing in numbers, their quality is in question. A fundamental problem has been lack of capacity at all levels of the health service system to respond to the paradigm shift articulated by the advocates of the reproductive health and rights agenda. To redesign programs, considerable research must be undertaken to understand the health needs and sociocultural …


Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi Jan 2001

Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi

Reproductive Health

The Special Studies Program was implemented as part of the Pilot Health Project in the West Bank and Gaza to provide small grants to Palestinian researchers, research organizations, and advanced graduate students to conduct research that examines critical reproductive health topics related to maternal and child health care, including family planning. The research implemented under the Special Studies Program covered a range of topics including male involvement in reproductive health, clients' satisfaction with family planning programs, the relationship between early marriage and the delivery of premature infants, factors affecting compliance for iron supplementation, and diabetes mellitus during pregnancy. The research …


Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya Jan 2001

Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya

Reproductive Health

Sexually transmitted infections (STIs), including HIV, currently have high salience on the health care agendas of many countries, including India. Strategies for their control are ideally based on a number of well-recognised principles. These include: assessments of the burden of disease; the availability of interventions at policy and programme levels, to influence behaviour change and technical ‘solutions’; and the calculated cost-effectiveness of these interventions. In the case of India, data to inform these principles are often lacking in the case of STI control. In this paper we have reviewed the evidence base for STI control in the Indian context. The …


Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi Jan 2000

Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi

HIV and AIDS

A growing body of scientific publications suggests that male circumcision is associated with reduced risk of HIV infection in sub-Saharan Africa. Thus, male circumcision is being considered as a potential intervention in the prevention of sexually transmitted HIV infection, even though this procedure has profound cultural implications and carries the risk of complications, and its benefits are realized only many years later. This report presents the findings of a meeting of international researchers, organized by the Horizons Project to explore the programmatic and research implications of the association between male circumcision and HIV prevention. Most studies on male circumcision and …


The Female Condom: Dynamics Of Use In Urban Zimbabwe, Deanna Kerrigan, Steve Mobley, Naomi Rutenberg, Andrew A. Fisher, Ellen Weiss Jan 2000

The Female Condom: Dynamics Of Use In Urban Zimbabwe, Deanna Kerrigan, Steve Mobley, Naomi Rutenberg, Andrew A. Fisher, Ellen Weiss

HIV and AIDS

In July 1997, Population Services International (PSI), at the request of the Zimbabwe National AIDS Coordination Programme, launched a social marketing program for the female condom in Zimbabwe. To avoid stigma associated with condoms and STI prevention, the female condom was marketed as a family planning product or “contraceptive sheath” under the brand name “Care.” It was initially sold through pharmacies and clinics at a heavily subsidized retail price of US $0.24 for two; distribution has since expanded to other urban outlets, including supermarkets and convenience stores. Approximately one year after the start of the social marketing program, the Horizons …


Peer Education And Hiv/Aids: Past Experience, Future Directions, Deanna Kerrigan, Ellen Weiss Jan 2000

Peer Education And Hiv/Aids: Past Experience, Future Directions, Deanna Kerrigan, Ellen Weiss

HIV and AIDS

Peer education typically involves training and supporting members of a given group to effect change among members of the same group. Peer education is often used to effect changes in knowledge, attitudes, beliefs, and behaviors at the individual level. However, peer education may also create change at the group or societal level by modifying norms and stimulating collective action that contributes to changes in policies and programs. Worldwide, peer education is one of the most widely used strategies to address the HIV/AIDS pandemic. This report presents findings from a project designed to identify components and principles that influence HIV/AIDS peer …


Egypt: Family Planning Providers Should Encourage Clients To Discuss Sexual Problems, Frontiers In Reproductive Health Jan 2000

Egypt: Family Planning Providers Should Encourage Clients To Discuss Sexual Problems, Frontiers In Reproductive Health

Reproductive Health

This 1999 study examined the feasibility and impact of introducing the discussion of sexuality during family planning (FP) consultations. Conducted by the Population Council in collaboration with the Egyptian Ministry of Health and Population (MOHP), the study took place in four MOHP clinics and two affiliated private clinics. Nurses and physicians at all six clinics attended a two-day training session on contraceptives with an emphasis on barrier methods. Providers in the three clinics that had been randomly chosen as intervention sites also received three days of training on sexuality, gender, and counseling skills. To assess the acceptability of sexuality counseling …


Men As Supportive Partners In Reproductive Health: Moving From Rhetoric To Reality, Saraswati Raju, Ann Leonard Jan 2000

Men As Supportive Partners In Reproductive Health: Moving From Rhetoric To Reality, Saraswati Raju, Ann Leonard

Reproductive Health

This book builds on presentations of the Workshop on Men as Supportive Partners in Reproductive and Sexual Health held in Kathmandu, Nepal, in 1998. By analyzing the experiences of nongovernmental organizations across India, this publication reviews important concerns that should inform the discourse on male partnership. The previous views of reaching men as contraceptive users and removing them as impediments to women’s efforts to control fertility are too limited. The argument is not whether men and women should use family planning, but rather the extent to which men can become supportive of women’s reproductive and sexual rights and actively take …


Sexual And Reproductive Health And Health Sector Reform In Latin America And The Caribbean: Challenges And Opportunities, Ana Langer, Gustavo Nigenda, Sandra G. Garcia, Rosario Valdez, Emanuel Orozco, Jennifer Catino Jan 2000

Sexual And Reproductive Health And Health Sector Reform In Latin America And The Caribbean: Challenges And Opportunities, Ana Langer, Gustavo Nigenda, Sandra G. Garcia, Rosario Valdez, Emanuel Orozco, Jennifer Catino

Reproductive Health

Most countries in Latin America and the Caribbean (LAC) are at varying stages of a reform process to improve the response capacity of health systems by upgrading the effectiveness and sustainability of programs and services. Changes promoted by the reform focus on priority health needs and underprivileged society groups. Some problems, such as sexual and reproductive health (SRH), can be tackled with cost-effective technologies. Reform projects offer a unique opportunity to reconsider policies, programs, and services aimed at facing the issues encompassed in the term SRH. Nonetheless, the formulation of a strategy and the identification of concrete measures represent a …


Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi Jan 2000

Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi

Reproductive Health

Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also …


A Comparative Analysis Of Anti-Trafficking Intervention Approaches In Nepal, Catrin Evans, Pankaja Bhattarai, Celine Daly, Vaishali Sharma Mahendra, Nick Langton Jan 2000

A Comparative Analysis Of Anti-Trafficking Intervention Approaches In Nepal, Catrin Evans, Pankaja Bhattarai, Celine Daly, Vaishali Sharma Mahendra, Nick Langton

Poverty, Gender, and Youth

This report on current intervention models is part of a larger research study entitled “Intervention Needs for the Prevention of Trafficking and the Care and Support of Trafficked Persons in the Context of an Emerging HIV/AIDS Epidemic in Nepal.” The United States Agency for International Development supported this comprehensive study under the Population Council’s Horizons Program. The Population Council subcontracted the Asia Foundation in Kathmandu to conduct the research. This report documents and analyzes current intervention models for the prevention of trafficking and the care and support of trafficked persons in Nepal. Between August and September 2000, two researchers interviewed …


Women Street Vendors: The Road To Recognition, Monique Cohen Jan 2000

Women Street Vendors: The Road To Recognition, Monique Cohen

Poverty, Gender, and Youth

This issue of SEEDS explores the experience of women working and organizing as urban street vendors at a time when both the volume of demand and the number of vendors are expected to grow. As municipalities seek to change laws that affect how street vendors ply their trade, it is clear that vendors must have a seat at the table. Local-level organizational efforts need to be consolidated at the national level to cement vendors’ hard-earned gains as rights in national laws and policy. A 1995 meeting in Bellagio conceived an international alliance of street vendors—StreetNet—which aims to promote the exchange …


The Potential Role Of Contraception In Reducing Abortion, John Bongaarts, Charles F. Westoff Jan 2000

The Potential Role Of Contraception In Reducing Abortion, John Bongaarts, Charles F. Westoff

Poverty, Gender, and Youth

Since the 1960s the proportion of couples practicing contraception has risen rapidly, particularly in the developing world, and the mix of methods is now dominated by modern methods. Despite these trends, the incidence of unintended pregnancy remains high mainly because the number of children desired has declined. Worldwide there are almost as many unintended as intended pregnancies each year (not counting miscarriages, which are excluded in this analysis) and more than half of these unintended pregnancies end in abortion. This study examines the potential role of further increases in contraceptive prevalence and effectiveness in reducing abortion rates. The model used …


Unmet Need For Family Planning In Developing Countries And Implications For Population Policy, John B. Casterline, Steven W. Sinding Jan 2000

Unmet Need For Family Planning In Developing Countries And Implications For Population Policy, John B. Casterline, Steven W. Sinding

Poverty, Gender, and Youth

Unmet need for family planning has been a core concept in international population discourse for several decades. In this paper we reevaluate its utility. We review the history of unmet need and the development of increasingly refined methods of its empirical measurement. We then turn to the main questions that have been raised about unmet need during the past decade, some of which concern the validity of the concept and others its role in the post-ICPD environment. The discussion draws heavily on empirical research conducted during the 1990s, much of it localized, in-depth studies combining quantitative and qualitative methodologies, that …


Socialization To Gender Roles And Marriage Among Egyptian Adolescents, Barbara Mensch, Barbara L. Ibrahim, Susan M. Lee, Omaima El-Gibaly Jan 2000

Socialization To Gender Roles And Marriage Among Egyptian Adolescents, Barbara Mensch, Barbara L. Ibrahim, Susan M. Lee, Omaima El-Gibaly

Poverty, Gender, and Youth

Using nationally representative survey data, this paper explores gender role socialization and attitudes toward marriage among unmarried Egyptian adolescents aged 16-19 years. We examine the daily activities of adolescent boys and girls, views about age at marriage and desirable qualities in a spouse, and various indicators of gender role attitudes including opinions about whether wives should defer to husbands, about sharing household decisionmaking, and about responsibility for domestic tasks. Our findings reflect strong gender differentiation: girls have much less free time than boys, are much less mobile, are much less likely to participate in paid work, and have heavier domestic …


Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson Jan 2000

Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson

Poverty, Gender, and Youth

The main objectives of this study are to review existing methodologies for projecting future trends in contraception, evaluate the validity of the assumptions underlying these projections, propose methodological improvements, and assess the prospects for new methods of contraception in the coming decade. The prevalence of contraception in the developing world has increased dramatically over the past several decades from near zero to around 60 percent in 2000. Demand for contraception can be expected to continue to rise rapidly for the next few decades as population size continues to grow and fertility declines further to near the replacement level. As a …