International Public Health Commons^™

Improving The Health Care Response To Gender-Based Violence: Phase Ii, Meiwita P. Budiharsana, Mai Quoc Tung

Reproductive Health

In 2009, the Population Council/Vietnam in collaboration with the Hanoi Health Service carried out an evaluation survey among Duc Giang Hospital staff to assess the extent to which awareness and perceptions of gender-based violence (GBV) had changed since the project commenced in 2005. The survey also assessed the extent to which the response of the hospital and Women’s Center for Counseling and Health had been strengthened, and made recommendations on changes to improve the situation. Overall, this project has been effective in raising awareness and willingness to integrate GBV screening into health services. The project conducted its training program at …

Being (Becoming Empowered In Nursing Growth): Training Guide For Nursing Students On Sexuality And Gender, Maryann Washington

Reproductive Health

This training guide was produced as part of a Health and Population Innovation Fellowship administered by the Population Council, India, and aims to help the faculty of nursing students to deliver comprehensive sexuality education effectively and efficiently, to help trainee nurses see the whole picture of sexuality in its matrix of safety, pleasure, reproduction, illness, and health. The package is called ‘BEING’ (acronym for Becoming Empowered in Nursing Growth) as it is assumed that, if delivered well, it could empower nurses’ growth to address these issues.

Premarital Sexual Behaviour Among Unmarried College Students Of Gujarat, India, Rachna Sujay

Reproductive Health

The aim of this report is to explore experiences of sexual relations and factors (including, for example, those at the individual, parental, peer, and college levels) associated with premarital sex, safe and otherwise, among college-going male and female students in Gujarat, India. Findings suggest that awareness of sexual and reproductive matters was relatively limited, attitudes to premarital sex typically gendered, and fewer than half of all students had been exposed to sexuality education in school or college. Romantic partnerships and physical intimacy were reported by considerable proportions of male and female students; premarital sex among notable minorities; and unsafe sex, …

Empowering Married Young Women And Improving Their Sexual And Reproductive Health: Effects Of The First-Time Parents Project, K.G. Santhya, Nicole Haberland, Arup Das, F. Ram, R.K. Sinha, Usha Ram, S.K. Mohanty

Poverty, Gender, and Youth

The Population Council, in partnership with Child In Need Institute in Kolkata, Deepak Charitable Trust in Vadodara, and International Institute for Population Sciences, Mumbai, initiated the First-time Parents Project in India to develop and test an integrated package of health and social interventions to improve married young women’s reproductive and sexual health knowledge and practices, enhance their ability to act in their own interest, and expand their social support networks. The project was formulated on the hypothesis that the periods immediately following marriage and surrounding the first pregnancy and birth offer a unique and powerful entry point for improving the …

Romance And Sex Before Marriage Among Young Women And Men In Maharashtra, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

Premarital partnerships among youth are widely discouraged in India. Indeed, there is a widespread perception that youth do not find opportunities to mix and form romantic relationships, and that premarital sex is negligible. These kinds of perceptions are often cited to argue against the provision of sexuality or family life education and sexual and reproductive health services to unmarried young people. While several small studies have noted that sizable proportions of young people, particularly young men, are sexually active before marriage, the lack of rigorous evidence on the levels and patterns of intimate partnerships among youth continues to hamper the …

Guía Operativa Para Programas De Educación Sexual Y Servicios De Salud Reproductiva Para Jóvenes, Ofelia Aguilar, Lorena Santos, Marisa Diaz Infante, Rocio Mejia, Ricardo Vernon, Antonieta Martin

Reproductive Health

El presente libro tiene como fin poner al alcance de personas y organizaciones interesadas en establecer políticas y programas de servicios y educación sexual para los jóvenes, una guía basada en el Programa Gente Joven que implementa la Fundación Mexicana para la Planeación Familiar, A.C. (MEXFAM). Consideramos que los componentes y las actividades de este programa pueden ser adaptados en otras latitudes y así enriquecer proyectos orientados al trabajo con jóvenes.

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The purpose of this book is to make available, to people and organizations interested in establishing policies and programs on sexual education and services for young people, a …

Improving Communication Between Parents And Adolescents On Reproductive Health And Hiv/Aids, Nafissatou J. Diop, Alioune Diagne

Reproductive Health

Cette recherche opérationnelle avait pour but d’évaluer la fonctionnalité et l’efficacité d’un modèle d’intervention destiné à prendre en charge les besoins d’informations des adolescent(e)s en matière de santé de la reproduction et cela à travers le renforcement et l’amélioration de la communication entre les parents et les enfants/adolescent(e)s. Les résultats ont montré la faisabilité de mettre en place un programme qui est spécifiquement destiné à améliorer le niveau et la qualité de la communication entre les parents/tuteurs et les adolescent(e)s sur les questions de SR/VIH/SIDA et cela malgré le caractère encore sensible de cette question dans le contexte socioculturel sénégalais. …

Enhancing Utilization Of The Findings From The Youth Reproductive Health Project In Senegal, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

This operations research (OR) study focused on providing information appropriate to the cultural context of Senegalese adolescents on a variety of reproductive health issues including: knowledge of the human body; puberty; sexuality; gender roles; different cultural, familial, and peer values regarding sexual and reproductive behavior; contraception; responsible parenthood; STIs and AIDS; and sources of help and services. The study was undertaken in three urban communities in northern Senegal and had an overall positive result on young people's reproductive health knowledge, enhanced community understanding of youth reproductive health needs, and showed that a multisectoral approach is vital to supporting young people’s …

Identifying Areas For Linkages Between Hiv And Srh For Vulnerable Populations: An Exploratory Study To Assess Female Sex Workers' Sexual And Reproductive Health Needs, Vaishali Sharma Mahendra, Sushma Mehrotra, B. Srikanthi, Sucheta Panda, Avina Sarna, A.K. Jayasree, Rajendra Prasad, Naomi Rutenberg

HIV and AIDS

Sexual and reproductive ill-health and HIV/AIDS share root causes, including poverty, gender inequality, and social marginalization of the most vulnerable populations. This has prompted the international community to call for policy and program approaches to strengthen the linkages between SRH and HIV/AIDS programs. However, most integration efforts have given priority to family planning, maternal and child health, and STI treatment and to addressing the needs of married women from the general population. Female sex workers have been targeted for HIV prevention efforts but little attention has been given to SRH-related care. To bring sex workers into the focus for SRH-HIV …

Addressing Gupt Rog: Narrative Prevention Counselling For Sti/Hiv Prevention—A Guide To Ayush And Allopathic Practitioners, Bonnie K. Nastasi, Niranjan Saggurti, Stephen L. Schensul, Ravi K. Verma, Meena Gandhi

HIV and AIDS

Although India has over 600,000 registered AYUSH practitioners who are engaged in homeopathic, Ayurvedic, and Unani systems of medicine, they have not been integrated into the country’s national health system. While practitioners of these systems of medicine treat all illnesses, they have a special niche in providing services to address men’s sexual health concerns (Gupt Rog). A project on Research and Intervention in Sexual Health: Theory to Action was undertaken by the International Institute for Population Sciences/Mumbai, the Population Council/New Delhi, and partners, in three slum communities in Mumbai, from 2001–07. The objective was to control the spread of sexually …

The Role Of Schools In Promoting Sexual And Reproductive Health Among Adolescents In Developing Countries, Cynthia B. Lloyd

Poverty, Gender, and Youth

This Population Council working paper reviews the state of knowledge about relationships between schooling and adolescent reproductive health. With the spread of mass schooling and the growing share of adolescents who attend school, the opportunities for synergies between health and education policies and programs are growing. Data on cross-country variations in health conditions on the one hand, and variations in attendance and attainment patterns and school systems on the other hand, provide a framework for assessing alternative approaches to the promotion of adolescent sexual and reproductive health in different contexts. Disappointing findings from recent school-based reproductive health interventions in poor …

Le Contexte De L’Initiation Sexuelle En Évolution Dans La Région Subsaharienne De L’Afrique, Barbara Mensch

Poverty, Gender, and Youth

L'ampleur de l'épidémie du SIDA en Afrique subsaharienne expose particulièrement les jeunes femmes au risque de l'infection par le VIH et requiert une meilleure compréhension des comportements reproductifs, y compris l'initiation sexuelle et les relations sexuelles pré-maritales. La croissance des relations sexuelles pré-maritales est une conséquence inévitable des mariages tardifs dans les pays en développement, en particulier à cause du fait que la période pendant laquelle les filles sont sexuellement mûres et non mariées est prolongée quand le mariage est retardé. Un récent projet du Population Council a fait des recherches sur les liens entre le changement d'âge au mariage …

Addressing The Sexual And Reproductive Health Needs Of Young People: Perspectives And Experiences Of Stakeholders From The Health And Non-Health Sectors, K.G. Santhya, Shireen J. Jejeebhoy, Saswata Ghosh, Nicole Haberland

Poverty, Gender, and Youth

In India, recent policies have underscored the right of adolescents and youth to sexual and reproductive health (SRH) counseling and services. Despite recent policies and programs, little information is available on the extent to which policy recommendations and program strategies have been implemented, and the extent to which services serve the disparate needs of married and unmarried young women and men. Also, there is limited evidence about the extent to which health-care providers at different levels of service delivery and stakeholders from other sectors are involved in providing SRH and HIV/AIDS-related information and services to young people, or their perceptions …

The Changing Context Of Sexual Initiation In Sub-Saharan Africa, Barbara Mensch

Poverty, Gender, and Youth

The magnitude of the AIDS epidemic in sub-Saharan Africa puts young women at particularly high risk for HIV infection and calls for a better understanding of reproductive behavior, including sexual initiation and premarital sex. An increase in premarital sex is an inevitable consequence of later marriage in the developing world, if for no other reason than that the period during which girls are sexually mature and unmarried is prolonged when marriage is postponed. A recent Population Council project investigated the links between changing age at marriage and premarital sexual behavior in 27 sub-Saharan African countries. After documenting the decline in …

Fewer And Better-Educated Children: Expanded Choices In Schooling And Fertility In Rural Pakistan, Zeba Sathar, Cynthia B. Lloyd, Minhaj Ul Haque, Mumraiz Khan, Monica J. Grant

Poverty, Gender, and Youth

This report presents the results of a longitudinal study of changing educational opportunities in rural Punjab and N.W.F.P. from 1997 to 2004. The purpose of the study was to answer two major research questions: what were the effects of changes in schooling opportunities in the community over the past six years on enrollment and attainment, and what were the effects on family planning and fertility behavior? This study builds on an earlier study undertaken in 1997. As noted in this report, the study is innovative in several ways: (1) it is longitudinal; (2) it combines consideration of three dimensions of …

Formation Of Partnerships Among Young Women And Men In Pune District, Maharashtra, Mallika Alexander, Laila Garda, Savita Kanade, Shireen J. Jejeebhoy, Bela Ganatra

Poverty, Gender, and Youth

Young people in India face traditional age- and sex-stratified norms that espouse gender double standards. Premarital partnerships are taboo and anecdotal evidence suggests that in many settings in India, the hint of a romantic relationship or even social interaction between young girls and boys is sufficient to damage a family's reputation and/or result in accelerated arranged marriage, particularly for the girl. While there is a prevailing perception at the community level that in these circumstances, premarital partnerships are rare, there is a small body of literature that suggests that such partnerships are indeed formed and sexual relations experienced, among, typically, …

Integrating Adolescent Livelihood Activities Within A Reproductive Health Programme For Urban Slum Dwellers In India, Population Council

Poverty, Gender, and Youth

Although a wide variety of livelihood programs for adult women exist in India, they rarely include adolescent girls. Of those that do, few employ rigorous scientific methods to evaluate program impact. This brief describes a project conducted in slum areas of Allahabad, in Uttar Pradesh. The Population Council, in collaboration with CARE-India, tested the feasibility and impact of adding four livelihoods and life-skill components to a reproductive health program for adolescent girls (both school-going and out-of-school) aged 14–19. Using a quasi-experimental pre- and post-test design that contrasted the experimental group with a comparison group of adolescents, the project investigated whether …

Formation Of Partnerships Among Young Women And Men In Pune District, Maharashtra, Population Council

Poverty, Gender, and Youth

Aside from their educational attainment, economic activity levels, and age at marriage, little is known about the lives of young people in India, especially the extent to which and the contexts in which they form romantic, marital, and other partnerships or the nature of these partnerships. At a time when India's youth policy and reproductive and child health programs have acknowledged the need to focus on youth, it is central that these gaps in understanding are filled. The KEM Hospital Research Centre and the Population Council conducted a study in Maharashtra in 2003–05 to obtain information on romantic and sexual …

Tuko Pamoja: Adolescent Reproductive Health And Life Skills Curriculum, Path, Population Council

Reproductive Health

As they move through adolescence, young people begin to have different kinds of relationships with their peers, family members, and adults; good communication and other skills can help ensure that these relationships are satisfying and mutually respectful. Young people need to learn to manage new feelings about sexuality to make responsible decisions about their health, reproduction, and parenthood. This manual, the second edition of the Kenya Adolescent Reproductive Health Curriculum, is for teachers; community, religious, and youth group leaders; health care professionals; and anyone working with young people. The curriculum is designed to delay sexual debut and promote sexual and …

Scaling Up A Reproductive Health Curriculum In Youth Training Courses, Laila Rahman, M. Mazharul Islam, Ubaidur Rob, Ismat Bhuiya, M.E. Khan

Reproductive Health

The Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Bangladesh Ministry of Health and Family Welfare, the Urban Family Health Partnership, and two nongovernmental service delivery partners, carried out the Global Youth project in northwestern Bangladesh from 1999–2003. The important lesson learned from that project was that reproductive health education could increase reproductive health knowledge in adolescents, particularly in areas related to reproductive biology, family planning, pregnancy, sexually transmitted infections, HIV, and AIDS. The population-based surveys further showed that contrary to common belief, reproductive health education does not increase sexual activity; instead it increases the use …

Effects And Cost Of Implementing A Gender-Sensitive Reproductive Health Program In Bolivia, Erica Palenque, Lizzy Montano, Ricardo Vernon, Fernando Gonzales Salguero, Patricia Riveros, John H. Bratt

Reproductive Health

The Integral Health Coordination Program (Programa de Coordinación en Salud Integral or PROCOSI), a network of 24 Bolivian NGOs, and the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program evaluated the effects of interventions on clinic clients and their partners, and estimated the costs of incorporating a gender perspective into service delivery. Results show that sexual and reproductive health service organizations can implement action plans to change organizational policies and service delivery practices and to improve their infrastructure and equipment to make them more convenient for clients. The results further show that the intervention made modest but important changes in …

Improving The Reproductive Health Of Youth In Mexico, Ricardo Vernon, Maricela Dura

Reproductive Health

This project assessed the impact of the Mexican Foundation for Family Planning’s Young People Program (YPP) on: a) the attitudes of community stakeholders toward informing youth about reproductive health issues and making reproductive health services available for sexually-active youth; b) the sexual and reproductive health knowledge, attitudes, and behaviors of adolescents; and c) the way that providers offer reproductive health services to adolescents. In addition, the project determined whether adding a school-based sex education component increased the impact of community interventions on the knowledge, attitudes, and behaviors of adolescents. Survey results showed that the reproductive health knowledge and attitudes of …

Improving The Reproductive Health Of Adolescents In Senegal, Nafissatou J. Diop, Heli Bathidja, Isseu Diop Toure, Thierno Dieng, Babacar Mane, Saumya Ramarao, Susan E. Adamchak, Emelita Wong, Adama Ndoye, Aboubacry Sy, Babacar Fall

Reproductive Health

In October 1999, the Frontiers in Reproductive Health (FRONTIERS) program began a three-year collaboration with the World Health Organization, the Senegal Ministries of Health, Education, and Youth, the Center for Research and Training in Health and Population, and the Population Training Group to test interventions to improve the reproductive health of youth aged 10–19. The community-based intervention included sensitization on adolescent reproductive health for community and religious leaders, reaching parents through women’s groups, and education sessions led by peer educators using a life-skills curriculum. As part of the clinic-based intervention, providers and peer educators were trained to offer youth-friendly services. …

A Multi-Sectoral Approach To Providing Reproductive Health Information And Services To Young People In Western Kenya: The Kenya Adolescent Reproductive Health Project, Ian Askew, Jane Chege, Carolyne Njue, Samson Radeny

Reproductive Health

Informing adolescents about appropriate and acceptable behaviors, and ways to protect themselves against unwanted and unprotected sex, has proved problematic in Kenya. Education programs for in- and out-of-school adolescents are lacking, there is controversy about providing services to sexually active adolescents, and a pervasive concern that sexuality education and contraceptive services leads to promiscuity. Unbiased and accurate information and services are needed if adolescents are to delay becoming sexually active, to resist pressures to engage in nonconsensual sex, and to protect themselves against unwanted pregnancies and infections if they do have sex. Moreover, strategies for providing such information and services …

Determining An Effective And Replicable Communication-Based Mechanisms For Improving Young Couples' Access To And Use Of Reproductive Health Information And Services In Nepal—An Operations Research Study, Center For Research On Environment Health And Population Activities (Crehpa)

Reproductive Health

This operations research study sought to determine an effective communication-based model for increasing the involvement of community-based groups in improving access to and use of reproductive health services and information by young married couples. The study employed a quasi-experimental design with two experimental and two nonequivalent control groups in the Udaypur district of Nepal. As stated in this report, this OR study clearly demonstrates the effectiveness of communication-based models such as the formation and reactivation of Youth Communication Action Groups and Mother’s groups, basic and refresher training, group interaction and mobilization, and social events in creating an enabling environment for …

Promoting Young People's Sexual And Reproductive Health: Stigma, Discrimination And Human Rights, Kate Wood, Peter Aggleton

Reproductive Health

Sponsored jointly by the DFID-supported Safe Passages to Adulthood program, John Snow International, YouthNet/Family Health International, and the Population Council, the international knowledge synthesis meeting on Promoting Young People’s Sexual and Reproductive Health: Stigma, Discrimination and Human Rights took place in Brighton, England, June 5–7, 2003. Participants from a wide variety of countries were invited to describe their experiences of working to challenge stigma and discrimination and promote human rights as they relate to young people’s sexual and reproductive health. The meeting brought together program leaders from a variety of countries to discuss stigma, discrimination, and human rights in relation …

Evaluation Of Community Education Interventions In Sexual And Reproductive Health Services In Urban-Marginal Areas Of La Paz, Bolivia, Maria Dolores Castro Mantilla, Mariel Loayza Antezana

Reproductive Health

The purpose of this study was to strengthen community strategies to improve quality-of-care services first implemented as part of a Bolivian Ministry of Health and Prevention and World Health Organization (WHO) project in 1997–98. To reach groups that do not regularly attend health facilities and improve community demand for services, the Centro de Información y Desarrollo de la Mujer (Center for Information and Development of Women) implemented a community education intervention focusing on sexual and reproductive health and rights targeting adolescents, men, and women with older or no children. Results showed that the interventions improved access to and utilization of …

Culturally Appropriate Information, Education And Communication Strategies For Improving Adolescent Reproductive Health In Cusco, Peru, Marco Florez-Arestegui Cornejo, Rosalinda Barreto Silva

Reproductive Health

The project Culturally Appropriate Information, Education and Communication Strategies for Improving Adolescent Reproductive Health in Cusco, Peru was designed in response to the evident lack of information and education on adolescent reproductive health in the country and, in particular, in the rural areas of the department of Cusco. Research revealed that a great need for sexual and reproductive health information still exists among indigenous adolescents in the rural areas of the region and that sexual education programs have to be sustainable. This report recommends that the Ministry of Education train more teachers in sexual and reproductive health topics, taking into …

My Father Didn't Think This Way': Nigerian Boys Contemplate Gender Equality, Françoise Girard

Poverty, Gender, and Youth

One of the lessons emerging from adolescent programs around the world is the need to create settings where young men can question things that are often seen as unquestionable, such as what it means to be a man. This issue explores the Conscientizing Male Adolescents (CMA) program in Nigeria which, unlike many programs targeting adolescent boys that emphasize short-term activities aimed at preventing disease and unwanted pregnancy, is a long-term program focusing on sexism and critical-thinking skills. An initial evaluation indicates that such programs affirm that we do know how to engage young men, and that historically reinforced gender attitudes …

« Mon Père Pensait Autrement » : Des Garçons Nigérians Réfléchissent À L'Égalité Entre Les Sexes, Françoise Girard

Poverty, Gender, and Youth

L’une des leçons émergeant des programmes pour adolescents dans le monde entier concerne la nécessité de créer des cadres où les jeunes hommes peuvent remettre en question ce qui est souvent considéré comme incontestable, par exemple ce que signifie « être un homme ». Ce numéro décrit le programme nigérian « Conscientiser les adolescents de sexe masculin » (CMA, Conscientizing Male Adolescents). Contrairement à beaucoup de programmes visant les adolescents de sexe masculin, qui mettent l’accent sur des activités à court terme destinées à prévenir la maladie et les grossesses non désirées, le modèle proposé par CMA est un programme …