Women's Health Commons^™

Strategies For Encouraging The Abandonment Of Female Genital Cutting In West Africa: Experiences From Senegal, Burkina Faso, And Mali, Nafissatou J. Diop, Ian Askew

Reproductive Health

This article explores efforts to encourage abandonment of female genital cutting (FGC) in Senegal, Burkina Faso, and Mali. The strategy of encouraging traditional practitioners to stop performing FGC is not effective as community-level support for the practice remains high. Training health staff significantly improved healthcare providers' levels of knowledge about FGC and its complications. Consequently, it was recommended that such training be incorporated into preservice medical training. The use of community-based strategies like the Village Education Program (VEP) showed the most promise, as their multifaceted approach addresses knowledge, attitudes, actions, and communal support in an integrated manner. The way forward …

Analyse De L'Evolution De La Pratique De L'Excision Au Burkina Faso: L'Environment Institutionel, Politique Et Programmatique De La Lutte Contre La Pratique De L'Excision, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini

Reproductive Health

La présente analyse du projet Frontiers du Population Council fait un tour historique des événements majeurs de la lutte contre la pratique de l’excision au Burkina Faso avant d’aborder les conventions internationales auxquelles le pays a adhéré ainsi que les textes nationaux adoptés en ce qui concerne les droits de l’homme, spécifiquement le droit des femmes et des enfants. Elle analyse également l’application de la loi à travers l’évolution des cas de condamnation depuis l’adoption de la loi. Enfin, elle s’intéressera à quelques programmes d’intervention mis en place en identifiant les acquis et les limites. Ce travail fait partie d’une …

Predictors Of Intention To Use Contraception, Given Alcohol Consumption, Among Women In Southeast Alaska, Donna Louise Hebbeler

Loma Linda University Electronic Theses, Dissertations & Projects

Fetal alcohol exposure is a serious public health problem and is 100% preventable. Traditionally, FASD prevention programs and research recommendations have targeted peri-conceptual or pregnant women. Another approach to the prevention of FASD involves preventing pregnancy in women who use alcohol. The purpose of this cross sectional study was to identify factors that predicted women’s intention to use contraception using the theory of planned behavior (TPB), to determine if predictors of the theoretical constructs varied in women depending on alcohol use, and to examine interactions between alcohol use and TPB constructs. Qualitative data was gathered to triangulate with the quantitative …

Clioquinol And Pyrrolidine Dithiocarbamate Complex With Copper To Form Proteasome Inhibitors And Apoptosis Inducers In Human Breast Cancer Cells, Kenyon G. Daniel, Di Chen, Shirley Orlu, Qiuzhi Cui, Fred R. Miller, Q Ping Dou

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

A physiological feature of many tumor tissues and cells is the tendency to accumulate high concentrations of copper. While the precise role of copper in tumors is cryptic, copper, but not other trace metals, is required for angiogenesis. We have recently reported that organic copper-containing compounds, including 8-hydroxyquinoline-copper(II) and 5,7-dichloro-8-hydroxyquinoline-copper(II), comprise a novel class of proteasome inhibitors and tumor cell apoptosis inducers. In the current study, we investigate whether clioquinol (CQ), an analog of 8-hydroxyquinoline and an Alzheimer's disease drug, and pyrrolidine dithiocarbamate (PDTC), a known copper-binding compound and antioxidant, can interact with copper to form cancer-specific proteasome …

The Role Of Aromatase Inhibitors In Ameliorating Deleterious Effects Of Ovarian Stimulation On Outcome Of Infertility Treatment, Mohamed Fm Mitwally, Robert F. Casper, Michael P. Diamond

Wayne State University Associated BioMed Central Scholarship

Abstract

Clinical utilization of ovulation stimulation to facilitate the ability of a couple to conceive has not only provided a valuable therapeutic approach, but has also yielded extensive information on the physiology of ovarian follicular recruitment, endometrial receptivity and early embryo competency. One of the consequences of the use of fertility enhancing agents for ovarian stimulation has been the creation of a hyperestrogenic state, which may influence each of these parameters. Use of aromatase inhibitors reduces hyperestrogenism inevitably attained during ovarian stimulation. In addition, the adjunct use of aromatase inhibitors during ovarian stimulation reduces amount of gonadotropins required for optimum …

Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

African American Breast Cancer Health Disparities, Theresa Lynn Gaul

Honors Program Theses

Health disparities are "the differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States" (National Cancer Institute [NCI], 2002). Racial and ethnic minorities experience serious disparities in health access and outcomes. Disparities in the burden of death and illness experienced by African Americans in particular, as compared with our nation's population as a whole, are particularly striking. There are a variety of factors contributing to these inequalities. The purpose of this report is to examine these factors and the consequential effects on the African American's …

Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Guérir Les Blessures, Faire Naître L’Espoir: Le Partenariat Tanzanien Contre La Fistule Obstétricale, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Human Chorionic Gonadotropin Administration Is Associated With High Pregnancy Rates During Ovarian Stimulation And Timed Intercourse Or Intrauterine Insemination, Mohamed F. Mitwally, Sonya Abdel-Razeq, Robert F. Casper

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.

Methods

Retrospective analysis of 2000 consecutive completed treatment cycles (637 timed-intercourse and …

Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan

Reproductive Health

CARE International, with technical support from the Frontiers in Reproductive Health Program completed a study in Ethiopia and Kenya designed to test the effectiveness of education activities using behavior change communication (BCC) approaches and advocacy activities by religious and other key leaders to abandon female genital cutting (FGC). In Ethiopia, the increased knowledge of harmful FGC effects and human rights issues translated to a positive attitude in support of FGC abandonment and an intention not to cut their daughters in the future. In Kenya, the analysis indicated mixed results in attitude and intended behavior change.

Experience From A Community-Based Education Program In Burkina Faso: The Tostan Program, Djingri Ouoba, Zakari Congo, Nafissatou J. Diop, Molly Melching, Baya Banza, Georges Guiella, Inge Baumgarten

Reproductive Health

This study describes a project that tested the feasibility and effectiveness of replicating the village empowerment program (VEP) developed by the Senegalese NGO, TOSTAN, in Burkina Faso. Although originally developed for empowering women, the program implemented in Burkina Faso also involved men because of their key role in such decisions. Frontiers in Reproductive Health, with funding from USAID and the GTZ Supra Regional Project for the Elimination of FGC, supported the adaptation, implementation, and evaluation of the VEP model in 23 villages in the province of Bazega/Zoundwéogo. In the existing social climate among the Burkinabé, where there is widespread awareness …

Medicalization Of Female Genital Cutting Among The Abagusii In Nyanza Province, Kenya, Carolyne Njue, Ian Askew

Reproductive Health

This study sought to understand the role that health providers play in the medicalization of female genital cutting (FGC) among the Abagusii community in western Kenya, among whom the practice continues to be almost universal. Interviews with service providers and their clients revealed an overwhelming belief that FGC fulfills a traditional cultural obligation among the Abagusii, and that it limits a woman’s sexual desire and confers respect on girls. New approaches are needed within this community to present FGC as violating human rights and national laws, as well as threatening girls’ and women’s health. The study recommends measures such as …

Encuestas De Voluntad De Pago Para Fijar Precios De Productos Y Servicios De Salud Reproductiva: Manual De Usuarios, Karen G. Fleischman Foreit, James R. Foreit

Reproductive Health

Social programs need to balance volume (coverage) and income (sustainability). The law of supply and demand states that we can not obtain coverage and support at the same time, because when prices rise, demand decreases. This manual presents willingness-to-pay (WTP) surveys that allow program managers to simulate changes in demand related to price, without actually changing prices. The Population Council, with The Futures Group International, developed these surveys that can be used for existing and new products and services, collect responses from clients with no formal education with sensitivity to their individual characteristics, and provide conservative estimates that accurately predict …

Female Circumcision In Indonesia. Extent, Implications And Possible Interventions To Uphold Women's Health Rights, Meiwita P. Budiharsana, Lila Amaliah, Budi Utomo

Reproductive Health

In Indonesia, the practice of female circumcision (FC) has long existed, but information concerning where and how it is carried out has been limited. The specific aims of the study conducted by the Population Council Jakarta were to provide research-based information on FC customary practices and their socio-cultural determinants, and if possible, to assess any long-term physical and psychological consequences. Study findings indicate that in general Muslim communities support the continuation of FC practice, because they perceive it as both a societal custom and a religious duty. The report strongly recommends that key donor agencies pressure the Ministry of Health …

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..

Breast Diseases: A Histopathological Analysis Of 3279 Cases At A Tertiary Care Center In Pakistan, M. S. Siddiqui, Naila Kayani, Shahid Pervez, S. A. Aziz, S. Muzaffar, Z. Setna, M. Israr, S. H. Hasan, M. S. Gill

Department of Pathology and Laboratory Medicine

Objective: To know the frequency of breast diseases in Pakistani females.

Methods: A retrospective analysis of 3279 breast specimens received over a period of 4 years (1 993-1996) at the department of pathology, the Aga Khan University Hospital.

Results: Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of …

Clinical, Pathological And Molecular Factors Predicting Axillary Node Involvement In Primary Breast Cancer In Pakistani Women, T. Siddiqui, A. Salam, S. Khan, N. Kayani, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background:

Axillary lymph node involvement in primary breast cancer is one of its most important prognostic features. Thus any factors that may predict axillary lymph node involvement in this setting could be potentially helpful in treatment planning and other interventions.

Objective:

The objective of this study was to evaluate clinical, pathological and immuno-histochemical markers in univariate and multivariate analysis, which may be helpful predictors of axillary lymph node involvement in breast cancer.

Method:

A retrospective analysis of 555 cases. Of these 58% had axillary nodal positivity and 42% were negative.

Conclusion:

Factors of no significance included patient’s age, height, weight, …

Epidermal Growth Factor Receptor (Egfr) As A Prognostic Marker: An Immunohistochemical Study On 315 Consecutive Breast Carcinoma Patients, S. A. Aziz, Shahid Pervez, N. Kayani, M. H. Rahbar, S. Khan

Department of Pathology and Laboratory Medicine

Objective: To assess the independent and interdependent prognostic value of epidermal growth factor receptor (EGFR) in carcinoma of breast in female population. The Type I family of growth factor receptors includes epidermal growth factor receptor (EGFR also known as EGFRI).

Methods: The expression of EGFR protein was analysed immunohistochemically on 315 tumour specimens of infiltrating ductal carcinoma of breast. These patients also had axillary lymph nodes sampling.

Results: Overexpression and/or amplification of EGFR was observed in 70 (22.00%) tumours. Eleven (16%) were grade I, 43 (61%) grade II and 16 (23%) grade Ill tumours. Axillary lymph node metastasis had significant …

Jadelle® Levonorgestrel Rod Implants: A Summary Of Scientific Data And Lessons Learned From Programmatic Experience, Irving Sivin, Harold A. Nash, Sandra N. Waldman

Formulation/Product Development

This scientific monograph provides a comprehensive summary of the clinical characteristics of Jadelle levonorgestrel (LNG) rod implants, as observed during clinical trials conducted by the Population Council. The monograph also reviews lessons learned about how to provide Jadelle, based partly on conclusions gleaned from the extensive experience with Norplant, the earlier implant system, and suggests practical ways in which to introduce Jadelle into family planning programs.

Prevalence And Risk Factors For Vaginal Candida Colonization In Women With Type 1 And Type 2 Diabetes, Ella M. De Leon, Scott J. Jacober, Jack D. Sobel, Betsy Foxman

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Diabetes mellitus increases the rate of vaginal colonization and infection with Candida species

Methods

We surveyed women with diabetes receiving care at either an urban or suburban diabetes clinic to examine the relationship between vaginal Candida colonization, diabetes type and duration, and HbA_1c level. 101 participants completed the self-administered questionnaire and self-collected a vaginal swab for Candida culture. Candida colonization was similar by age and race.

Results

Type 1 diabetics were three times as likely as type 2 diabetics to be colonized with any Candida species (OR = 3.4; 95% CI: 1.03, 11.41; p = 0.04); even …

Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health

Reproductive Health

The Population Council’s Frontiers in Reproductive Health program, with funding from USAID, organized a consultative meeting on the practice of female genital cutting (FGC) in Nairobi, Kenya in April 2002. The meeting brought together a small group of researchers and program managers who are actively undertaking operations research and systematic program evaluations to review the state of the art concerning intervention research design and measurement issues. The deliberations at this workshop should stimulate interest both in undertaking operations research more routinely when programming anti-FGC activities and in furthering the development and application of research methods appropriate for this subject. Several …

Psychosocial Correlates Of Physiologlcal Improvement In Female Cardiac Patients: Improving Effectiveness Of Cardiac Rehabilitation Programs, Linda A. Halvorsen

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to determine the relationship between a set or psychosocial variables and a set of physiological variables for a cohort of female cardiac rehabilitation patients. The independent variable set included initial denial, inlcnwl locus of control, perceived mental health status, and perceived physical health status. Dependent variables included change scores for metabolic equivalents and resting heat rate. The sample consisted of76 women who were enrolled in a Phase II cardiac rehabilitation program. Demographic information including number of completed rehabilitation sessions, age, martial status, and diagnosis was provided. A series of bivariate correlations were conducted to …

An Analysis Of The Changing Forces Behind Health Insurance Coverage Of Homebirth, Christina Anne Gasbarro

Dissertations and Theses

The expansion of managed care, which is premised on containing costs while maintaining market share, represents a radical transformation of the U.S. health care system. A central question for medical sociologists is to determine how the changes brought by managed care influence health insurance and health care options. In evaluating the impacts of managed care, obstetrics is a particularly important site of study. Part of this agenda involves gathering baseline data on a specific transformation in obstetrics practice new to the managed care scene: the emergence of health insurance coverage for the option of home birth. The research project detailed …

Dna Ploidy Analysis Of Borderline Epithelial Ovarian Tumours, Saba Lodhi, Sabeen Najam, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective: Borderline epithelial ovarian tumors not uncommonly pose a great difficulty to surgical pathologists as morphologically they may show very similar features as those of malignant epithelial tumors except invasion. However it is important to separate these from their invasive counterparts because of their superior prognosis. Recently, attention has been focussed on the prognostic value of flow cytometric analysis of DNA ploidy in borderline epithelial ovarian tumors. The purpose of this study is to investigate whether flow cytometric analysis of cellular DNA content acts as a useful adjunct to the histopathological diagnosis of borderline malignancy.

Materials and Methods: Fifteen histologically …

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 …

Informing Research On Hiv Prevention: A Consultation, Sharon Fonn, C. Elizabeth Mcgrory

HIV and AIDS

According to a 1998 UNAIDS/WHO report, HIV infection among women is the fastest-growing segment of the AIDS pandemic, especially in developing countries. Unfortunately, the HIV-prevention strategies put forward by the public health community—monogamy, condom use, and treatment of sexually transmitted infections—are not feasible for many women. Women urgently need a means within their personal control to protect themselves against HIV. Recognizing this need, a number of international and nongovernmental organizations and government agencies have called for the development of microbicides, products that women could use vaginally to prevent infection with sexually transmitted infections, particularly HIV. The Population Council is one …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Rapport Du Seminaire National [Au Mali] Pour La Definition D'Une Strategie D'Eradication De L'Excision, Population Council

Reproductive Health

This is a report on a workshop for the eradication of female genital mutilation (FGM) held in Bamako, Mali. The workshop presented the results of a literature review on FGM and the actions taken to counter the practice in Mali; provided updates on the activities of six national NGOs working on issues surrounding FGM; and developed a Plan of Action for activities aimed at reducing the practice. The workshop brought together 85 participants, including policy- and decisionmakers from the government, NGOs, and religious groups. The workshop led to the finalization of a national Plan of Action to the Year 2000 …