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Full-Text Articles in International Public Health

Testing Balanced Counseling To Improve Provider-Client Interaction In Guatemala's Moh Clinics, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Julio Garcia Colindres, Benedicto Vasquez, Carlos Morales Jan 2003

Testing Balanced Counseling To Improve Provider-Client Interaction In Guatemala's Moh Clinics, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Julio Garcia Colindres, Benedicto Vasquez, Carlos Morales

Reproductive Health

The job aids–assisted Balanced Counseling Strategy adopted by Guatemala’s Ministry of Health required specific instructions for use by nonprofessional providers and an intervention that assured provider compliance with the behavioral requirements of the new paradigm. Results show that the trained providers outperformed the controls in quality of care at each level of session length, but used nine extra minutes per session on average. Nonprofessional providers can take advantage of the job aids–assisted Balanced Counseling Algorithm and substantially improve their quality of care. Extra time invested in counseling new family planning clients will be easily absorbed insofar as they continue to …


Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena Jan 2003

Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena

Reproductive Health

The purpose of this study was to identify the reasons for the low use of the IUD in Guatemala and to explore the reasons why other reversible methods are selected more frequently than IUDs. The study aimed to determine the availability and acceptability of IUDs as a contraceptive option within the Ministry of Health, the Guatemalan Social Security Institute, and APROFAM. Results indicated that service providers do not take into consideration women’s reproductive needs or intentions when they provide family planning counseling. There are several demand-side factors that affect the use of the IUD, including lack of knowledge about the …


One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo Jan 2003

One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo

Reproductive Health

This report presents a one-year assessment of quality-of-care improvements in Peru, following provider training on the job aids–assisted Balanced Counseling Strategy. Results showed significant enhancement of quality of care, an increase in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) …


Policy And Program Implications Of The Matching Grants Program In The Philippines, Marilou Palabrica-Costello, Nimfa Ogena, Alejandro N. Herrin Jan 2003

Policy And Program Implications Of The Matching Grants Program In The Philippines, Marilou Palabrica-Costello, Nimfa Ogena, Alejandro N. Herrin

Reproductive Health

In 1999, the Philippines Department of Health, with support from USAID and technical assistance from Management Sciences for Health (MSH), implemented the matching grants program (MGP) as a component of the local government performance program. The MGP aims to improve the capability of municipalities and component cities to expand service delivery, and to achieve significant increases in rates of fully immunized children, vitamin A supplementation, tetanus toxoid immunization for women, as well as in the use of family planning methods, especially modern methods. Upon the request of the USAID Mission, the Frontiers in Reproductive Health program worked closely with MSH …


Postabortion Family Planning Operations Research Study In Perm, Russia, Irina Savelieva, John M. Pile, Inna Sacci, Ratha Loganathan Jan 2003

Postabortion Family Planning Operations Research Study In Perm, Russia, Irina Savelieva, John M. Pile, Inna Sacci, Ratha Loganathan

Reproductive Health

EngenderHealth, the Population Council’s FRONTIERS program, and the Research Center of Obstetrics, Gynecology, and Perinatology of the Russian Academy of Medical Sciences, with support from the Perm Health Departments, undertook an operations research study to test models for increasing contraceptive use and reducing the repeat abortion rate among abortion clients in Perm, Russia. The study also assessed the direct and indirect costs of abortion and contraceptive use incurred by women in the year following their index abortion (the abortion which took place the day of entry into the study). The findings of the study were significant for the training interventions …


Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth Jan 2003

Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth

Reproductive Health

EngenderHealth, in collaboration with the Ministry of Health, conducted an operations research project to examine the feasibility of introducing an integrated three-element model of postabortion care (PAC) services in secondary- and primary-level sites in two predominantly rural regions in Senegal. The intervention provided health personnel with: 1) training to improve clinical competence, counseling, infection prevention, and general care; 2) technical assistance, materials, and support to aid in overcoming challenges; and 3) ongoing monitoring and supervision. The project findings attest to the benefits of expanding existing PAC programs in rural settings and suggest that the advantages of such an expansion outweigh …


Improving Quality Of Care For Family Planning Services In Uganda, Joel Okullo, Quinto Okello, Harriet Birungi, Ian Askew, Barbara Janowitz, Carmen Cuthbertson, Florence Ebanyat Jan 2003

Improving Quality Of Care For Family Planning Services In Uganda, Joel Okullo, Quinto Okello, Harriet Birungi, Ian Askew, Barbara Janowitz, Carmen Cuthbertson, Florence Ebanyat

Reproductive Health

The Regional Centre for Quality of Health Care at Makerere University, Uganda in collaboration with the Delivery of Improved Services for Health II Project, the Ministry of Health (MOH), and the Population Council’s FRONTIERS Program, conducted an operations research project to help the MOH improve the quality of family planning services with the aim of helping couples better attain their reproductive goals. The study developed a package of interventions (the Yellow Star Programme—YSP) that sought to increase the readiness of clinics to offer basic family planning services, to improve provider motivation, and to empower clients to request quality services. The …


Creation Of A Unified Management Information System For Three Ngos In The West Bank And Gaza, Health, Development, Information And Policy Institute Jan 2003

Creation Of A Unified Management Information System For Three Ngos In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

The goal of the Pilot Health Project (PHP) has been to improve the health status of Palestinian women and children. To further this goal, the Health, Development, Information and Policy Institute (HDIP) was given the responsibility to develop a management information system (MIS) for the collection, storage, processing, and dissemination of information for PHP clinics. In cooperation with the Palestinian Ministry of Health (MOH) and various healthcare providers and MIS professionals, HDIP worked through a carefully organized and highly participatory process to design and develop the MIS for the PHP. This report reviews that process and presents the features of …


Assessment Of Pilot Health Project Outcome Indicators: West Bank/Gaza, Laila Nawar, Dale Huntington, Ibrahim Kharboush, Nancy Ali, Mahmoud Shaheen Jan 2003

Assessment Of Pilot Health Project Outcome Indicators: West Bank/Gaza, Laila Nawar, Dale Huntington, Ibrahim Kharboush, Nancy Ali, Mahmoud Shaheen

Reproductive Health

The Pilot Health Project (PHP) was designed to address Palestinian women’s most pressing reproductive health needs. This report presents results from a single cross-sectional study that was conducted by the Health, Development, Information and Policy Institute (HDIP) between May and August 2000 in order to determine the baseline measures for the PHP’s key outcome indicators among healthcare providers and clients in the PHP clinics. Based on the findings reflected by the study, a number of recommendations were made that need to be followed up and implemented by the Improved Village and Community Health Services Project. These include the need for …


Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health Jan 2003

Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health

Reproductive Health

Many public, NGO, and private-sector service-delivery systems are suitably matched to the requirements of providing injectable contraceptives in India, including the ability to ensure choice and service delivery quality. This operations research study was designed to demonstrate the feasibility of providing injectable contraceptives in private medical practices and to contribute to the body of scientific literature on the acceptability of this method in India. DKT India and EngenderHealth formed a partnership with the Population Council’s Frontiers in Reproductive Health program to conduct this study in Gujarat. The ability to generate recommendations is limited, however, by the special characteristics of the …


Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching Jan 2003

Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …


Replication Of The Tostan Programme In Burkina Faso: How 23 Villages Participated In A Human Rights-Based Education Programme And Abandoned The Practice Of Female Genital Cutting In Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching Jan 2003

Replication Of The Tostan Programme In Burkina Faso: How 23 Villages Participated In A Human Rights-Based Education Programme And Abandoned The Practice Of Female Genital Cutting In Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …


Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert Jan 2003

Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert

Reproductive Health

This paper presents the results of an extensive review of the literature pertaining to the relationship between vaginal lubrication and the acceptability of microbicides, spermicides, and male and female condoms. The review highlights the need for research that better elucidates norms, preferences, and practices regarding lubrication during sex within and across countries. The second part of the report presents the results of the first phase of a qualitative study on lubrication during sex showing that diverse personal and cultural factors shape preferences and practices and may ultimately affect the acceptability of microbicides. The immediate challenge is to provide women with …


Non-Consensual Sexual Experiences Of Young People: A Review Of The Evidence From Developing Countries, Shireen J. Jejeebhoy, Sarah Bott Jan 2003

Non-Consensual Sexual Experiences Of Young People: A Review Of The Evidence From Developing Countries, Shireen J. Jejeebhoy, Sarah Bott

Reproductive Health

Although there is increasing evidence of risky consensual sex among young people in developing countries, non-consensual sexual experiences among them have rarely been studied and few interventions have been designed to protect them from the risks of such experiences. However, what is available suggests that coercion and unwantedness may play a considerable role in the sexual relations of young people—girls and young women but also boys and young men. The implications of non-consensual sexual experiences for young people’s rights, their health and development and the risks they pose in the transition to adulthood are enormous. This review collates what is …


Changing Family Planning Scenario In India: An Overview Of Recent Evidence, K.G. Santhya Jan 2003

Changing Family Planning Scenario In India: An Overview Of Recent Evidence, K.G. Santhya

Reproductive Health

Over the decades, there has been a substantial increase in contraceptive use in India. The direction, emphasis and strategies of the Family Welfare Programme have changed over time. However, meeting the contraceptive needs of considerable proportions of women and men and improving the quality of family planning services continue to be a challenge. The 1990s witnessed a growing recognition of this, and several innovative policy and programme initiatives have been launched to address these issues. This paper reviews and synthesises evidence from surveys and studies conducted in the 1990s and thereafter on contraceptive use dynamics and the unmet need for …


Actions That Protect: Promoting Sexual And Reproductive Health And Choice Among Young People In India, Shireen J. Jejeebhoy, Mary Philip Sebastian Jan 2003

Actions That Protect: Promoting Sexual And Reproductive Health And Choice Among Young People In India, Shireen J. Jejeebhoy, Mary Philip Sebastian

Reproductive Health

This paper synthesises the evidence on the sexual and reproductive health situation of young people in India, and explores what we know about underlying factors that place them at risk of or protect them from unsafe and unwanted sexual and reproductive health experiences. The picture that emerges suggests that substantial proportions of young people experience risky or unwanted sexual activity, do not receive prompt or appropriate care, and experience adverse reproductive health outcomes. Contextual factors such as poverty, gender imbalances and lack of education or livelihood opportunities clearly increase the vulnerability of youth. Other factors at the family, community and …


Trends. Fantasies, Death, And Violence, Ibpp Editor Oct 2002

Trends. Fantasies, Death, And Violence, Ibpp Editor

International Bulletin of Political Psychology

This Trends article examines violence and death in the context of the goals of international health organizations.


Integrating Hiv Prevention And Care Into Maternal And Child Health Care Settings: Lessons Learned From Horizons Studies, Naomi Rutenberg, Sam Kalibala, Charles Mwai, James Rosen Jan 2002

Integrating Hiv Prevention And Care Into Maternal And Child Health Care Settings: Lessons Learned From Horizons Studies, Naomi Rutenberg, Sam Kalibala, Charles Mwai, James Rosen

HIV and AIDS

Many women in the developing world still lack access to high-quality HIV/AIDS prevention and care services. To address this problem, Horizons has undertaken a range of operations research efforts that examine the integration of HIV-related care in the maternal-child health setting. At a workshop held in Kenya in July 2001, participants discussed the experience to date and formulated practical strategies for improving the integration. This consultation report summarizes that discussion according to the following seven key program components: Training and Motivation to Improve the Performance of Health Workers; Supervision of HIV Services and Quality Assurance of HIV Testing; Caring for …


Hiv/Aids-Related Stigma And Discrimination: A Conceptual Framework And An Agenda For Action, Richard Parker, Peter Aggleton, Kathy Attawell, Julie Pulerwitz, Lisanne Brown Jan 2002

Hiv/Aids-Related Stigma And Discrimination: A Conceptual Framework And An Agenda For Action, Richard Parker, Peter Aggleton, Kathy Attawell, Julie Pulerwitz, Lisanne Brown

HIV and AIDS

In 1987, Jonathan Mann, then director of the WHO Global Programme on AIDS, identified three phases of the HIV/AIDS epidemic: the epidemic of HIV, the epidemic of AIDS, and the epidemic of stigma, discrimination, and denial. Despite international efforts to tackle HIV/AIDS since then, stigma and discrimination (S&D) remain among the most poorly understood aspects of the epidemic. This poor understanding is due in part to the complexity and diversity of S&D, but also to limitations in current thinking within the field and the inadequacy of available theoretical and methodological tools. This paper proposes a new conceptual framework to help …


Responding To Cairo: Case Studies Of Changing Practice In Reproductive Health And Family Planning, Nicole Haberland, Diana Measham Jan 2002

Responding To Cairo: Case Studies Of Changing Practice In Reproductive Health And Family Planning, Nicole Haberland, Diana Measham

Poverty, Gender, and Youth

The 1994 International Conference on Population and Development in Cairo codified views long advocated by women’s health activists the world over. The conference marked a turning point in the history of the population field—one that brought reproductive health and women’s rights to the forefront of the international population agenda. The 22 case studies in this book document changes in practice in reproductive health and family planning programs within 18 countries. The case studies demonstrate the important strides that were made in the years following the conference and point to many challenges that remain. The abolition or modification of population policies …


Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle Jan 2002

Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle

HIV and AIDS

A study conducted in Dakar, Senegal by researchers from the National AIDS Council, Cheikh Anta Diop University, and the Horizons program obtained information on the needs, behaviors, knowledge, and attitudes of men who have sex with men (MSM). This study offers important insights into the sexuality of MSM, their vulnerability to STI/HIV, and the role of violence and stigma in their lives. The results also highlight the lack of sexual health services and information available to cover the specific needs of MSM. The results of this study were summarized during a meeting held in April 2001 in Dakar and raised …


Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta Jan 2002

Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta

HIV and AIDS

While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …


The Female Condom: Dynamics Of Use In Urban Zimbabwe, Horizons Program Jan 2002

The Female Condom: Dynamics Of Use In Urban Zimbabwe, Horizons Program

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. The campaign's intended audience was women in long-term relationships. To avoid the stigma associated with condoms and the prevention of sexually transmitted infections, PSI marketed the female condom as a family planning product under the brand name Care™. Approximately one year after the start of the female condom social marketing campaign, the Horizons Program and PSI conducted a descriptive, cross-sectional study of female condom users, male condom users, and nonusers of either …


Estimating The Cost And Effectiveness Of Different Sti Management Strategies For Sex Workers In Madagascar, Horizons Program Jan 2002

Estimating The Cost And Effectiveness Of Different Sti Management Strategies For Sex Workers In Madagascar, Horizons Program

HIV and AIDS

In Madagascar, the prevalence of sexually transmitted infections (STIs) is a serious public health problem, particularly among sex workers. A Horizons study conducted in 2000 found approximately two-thirds of female sex workers had an STI, although few were infected with HIV. Since the link between STIs and transmission of HIV has been well established, affordable strategies to manage STIs among sex workers need to be developed. Study investigators also assessed STI management practices in health facilities in two urban areas of Madagascar. Health practitioners were using a syndromic approach, which may be appropriate for managing certain STIs in the general …


Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Horizons Program Jan 2002

Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Horizons Program

HIV and AIDS

Research conducted in many countries has highlighted the vulnerability of men who have sex with men (MSM) to HIV and other STIs. Yet in Africa, they receive little attention in HIV/AIDS programming and service delivery because of widespread denial and stigmatization of homosexual behavior. In Senegal, a study conducted by researchers from the National AIDS Control Program, Cheikh Anta Diop University, and the Horizons Program has provided valuable information about the needs, behaviors, knowledge, and attitudes of MSM that has important implications for program managers and policymakers working to stem the spread of HIV/AIDS. The researchers used ethnographic and survey …


Satisfaire Les Besoins De Santé Des Hommes Qui Ont Des Rapports Sexuels Avec D'Autres Hommes Au Sénégal, Horizons Program Jan 2002

Satisfaire Les Besoins De Santé Des Hommes Qui Ont Des Rapports Sexuels Avec D'Autres Hommes Au Sénégal, Horizons Program

HIV and AIDS

No abstract provided.


Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Horizons Program Jan 2002

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Horizons Program

HIV and AIDS

The widespread prevalence of HIV/AIDS in sub-Saharan Africa adversely affects millions of households. In recent years, microfinance has been proposed as a strategy to help the households of microentrepreneurs respond to the negative economic impacts of HIV/AIDS. This attention to the potential role of microfinance builds upon earlier research that shows that microfinance institutions (MFIs) that charge commercial rates of interest and use sound business practices can become operationally self-sustainable and help improve the lives of the poor and vulnerable nonpoor. This type of MFI generally offers small loans, often combined with savings services. An MFI may also offer business …


Designing Hiv/Aids Intervention Studies: An Operations Research Handbook, Andrew A. Fisher, James R. Foreit, John E. Laing, John E. Stoeckel, John Townsend Jan 2002

Designing Hiv/Aids Intervention Studies: An Operations Research Handbook, Andrew A. Fisher, James R. Foreit, John E. Laing, John E. Stoeckel, John Townsend

HIV and AIDS

This handbook has several objectives and uses. First, it is designed to help HIV/AIDS researchers develop and write a detailed operations research proposal. An appropriate use of the handbook is as a resource in workshops or courses on research design and proposal development. Thus, the organization of the handbook follows that of a research proposal, starting with identifying, defining, and justifying a research problem, and ending with how to prepare a budget. Although the handbook is not an academic textbook on research methods, it does provide a review of many key concepts and important methods essential for conducting HIV/AIDS field …


Greater Involvement Of Plha In Ngo Service Delivery: Findings From A Four-Country Study, Horizons Program Jan 2002

Greater Involvement Of Plha In Ngo Service Delivery: Findings From A Four-Country Study, Horizons Program

HIV and AIDS

At the conclusion of the Paris AIDS Summit in 1994, 42 governments issued a declaration supporting the greater involvement of people living with HIV/AIDS (PLHA) in policy formulation and service delivery. Despite growing recognition of its importance, there has been little research that examines PLHA involvement in the delivery of prevention, care, and support services in developing countries and its effects on PLHA, others affected by HIV/AIDS, and nongovernmental organizations (NGOs). To address this gap, the Horizons Program and the International HIV/AIDS Alliance conducted a study of PLHA involvement in NGOs in Burkina Faso, Ecuador, Maharashtra State, India, and Zambia …


Cost Of Care And Support Services For Plha: Implications For The Financial Sustainability Of Nongovernmental Organizations, Horizons Program Jan 2002

Cost Of Care And Support Services For Plha: Implications For The Financial Sustainability Of Nongovernmental Organizations, Horizons Program

HIV and AIDS

As HIV/AIDS prevalence increases, providers of care and support services will face greater demand for their services. The ability of nongovernmental organizations (NGOs) to help meet this increased demand will be influenced in part by their ability to control the cost of their services while generating sufficient revenue to meet expenses. The Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE) in Chennai, India, was one of the earliest providers of integrated care and support services in South India and currently serves clients from the four South Indian states. This brief highlights the key findings of a study that …