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Manual For Designing Community Based Interventions For Preventing Postpartum Hemorrhage (Pph) Using Misoprostol: Standardized Pilot-Test Training Manual, Saumya Ramarao, Tekle-Ab Mekbib, Sarah Raifman

Reproductive Health

This manual is a comprehensive, standardized, step-by-step guide for Population Council staff to use when designing and implementing community-based pilot interventions for the prevention of postpartum hemorrhage using misoprostol. The introduction and background section provide basic information about maternal mortality, normal and abnormal pregnancy, and postpartum hemorrhage. This section also describes prevailing methods of prevention and treatment for postpartum hemorrhage, active management of the third stage of labor, and use of misoprostol for the prevention and control of postpartum hemorrhage. The second half of the manual focuses on how to develop a protocol for an intervention study on misoprostol. It …

Sexual Violence: Setting The Research Agenda For Kenya, Catherine Maternowska, Jill Keesbury, Nduku Kilonzo

Reproductive Health

This research agenda is the result of a stakeholders’ meeting held in Nairobi on June 11–12, 2008, that identified, developed, and prioritized areas for research on sexual violence in Kenya. The meeting was convened by the Population Council, Liverpool VCT, Care & Treatment, and the International Centre of Reproductive Health, Kenya. Kenya’s research agenda is premised on the need to generate the evidence required to impact policy formulation and services strengthening. Knowledge gaps that form the basis of key research areas identified include the need to: 1) Understand the nature, contexts, and prevalence of sexual violence; 2) Document and evaluate …

Multi-Sectoral Approaches To Preventing Sexual Assault And Domestic Violence: A Collective Force To Stop The Violence, Population Council

Reproductive Health

The Multi-Sectoral Approaches to Preventing Sexual Assault and Domestic Violence Symposium took place May 6–7, 2009, in Gauteng, South Africa. The symposium aimed to: increase awareness of sexual assault and domestic violence and its relationship to HIV and AIDS among decision-makers; promote evidence-based programming for practitioners; advocate for increased preventative measures and service delivery around sexual and gender-based violence (SGBV) in the public and private sectors; facilitate networking, strengthen and develop partnerships, and create opportunities for ongoing collaboration between key stakeholders; and inspire a coordinated plan of action for prevention that supports the government’s 365-day plan. South Africa has some …

Ecp Handbook: Introducing And Mainstreaming The Provision Of Emergency Contraceptive Pills In Developing Countries, Sharif M.I. Hossain, M.E. Khan, Ricardo Vernon, Jill Keesbury, Ian Askew, John Townsend, Victoria Rumbold

Reproductive Health

For many women, emergency contraceptive pills (ECPs) offer an opportunity to prevent unintended pregnancy following contraceptive method failure, rape, or unprotected sex. Access to this safe, effective option remains an essential element of women’s quality reproductive health care. However, ECPs remain inaccessible across much of the world, particularly in developing countries where limited commodity supplies, provider competency, public awareness, and misinformation routinely coalesce to restrict availability. While ECPs have been introduced on a pilot basis in many countries, their effective integration into both the public and private sectors has lagged. Successful interventions are guided by the principle that provision of …

Reference Guides For Health Care Organizations Seeking Accreditation For High-Quality, Gender-Sensitive Reproductive Health Services, Patricia Riveros, Erica Palenque, Ricardo Vernon, Ignacio Carreno, John H. Bratt

Reproductive Health

Bolivia’s Integral Health Coordination Program (PROCOSI), a network of 33 nongovernmental organizations (NGOs) providing reproductive health care, has long promoted gender sensitivity as a necessary component of high-quality health care. PROCOSI encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their reproductive health programs. The Reference Guides in this publication provide guidance to help health-care organizations and NGOs implement high-quality, gender-sensitive standards to achieve certification for their member clinics and administrative centers. The procedures and standards included here are based on the process developed by PROCOSI, but the approach and standards can …

Reference Guides For Health Care Organizations Seeking Accreditation For High-Quality, Gender-Sensitive Reproductive Health Services—Appendixes, Patricia Riveros, Erica Palenque, Ricardo Vernon, Ignacio Carreno, John H. Bratt

Reproductive Health

Bolivia’s Integral Health Coordination Program (PROCOSI), a network of 33 nongovernmental organizations (NGOs) providing reproductive health care, has long promoted gender sensitivity as a necessary component of high-quality health care. PROCOSI encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their reproductive health programs. Included in this document are the Appendixes to “The Reference Guides for Health Care Organizations Seeking Accreditation for High-Quality, Gender-Sensitive Reproductive Health Services,” which provide guidance to help health-care organizations and NGOs implement high-quality, gender-sensitive standards to achieve certification for their member clinics and administrative centers. The procedures …

Improving The Quality Of Family Planning And Reproductive Tract Infection Services For Urban Slum Populations: Demand-Based Reproductive Health Commodity Project, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Mafizur Rahman

Reproductive Health

Quality of care has been a neglected dimension of family planning (FP) services for a long time in Bangladesh. Furthermore, effective programs are yet to be implemented to address the imbalance in contraceptive method mix. As outlined in this report, efforts were made through an operations research project to improve the quality of FP and reproductive tract infection (RTI) services provided by NGO clinics in selected slums in Bangladesh. The capacity of these NGO clinics to offer high-quality services to slum neighborhoods was strengthened by training service providers, strengthening service delivery points, and improving counseling services to ensure client satisfaction. …

Mainstreaming Emergency Contraception In Kenya: Final Project Report, Jill Keesbury, Wilson Liambila, Francis Obare, Paul Kuria

Reproductive Health

For more than a decade, advocates have sought to improve access to emergency contraception (EC) around the world. These efforts have been highly successful in Europe and North America, have generated much debate in Latin America, and are beginning to take hold in Asia. In Africa, however, the success of EC programs remains limited. Even in countries where the regulatory environment is favorable, resource constraints within the public sector limit the ability to provide consistent and quality EC services at low cost. In a growing number of African countries, the private sector has emerged to fill these gaps, increasing access …

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.

The Copperbelt Model Of Integrated Care For Survivors Of Rape And Defilement: Testing The Feasibility Of Police Provision Of Emergency Contraceptive Pills, Jill Keesbury, Mary Zama, Sudha Shreeniwas

Reproductive Health

The Zambian Ministry of Home Affairs (Police Service), Ministry of Health (MOH) and the Population Council collaborated on an operations research study designed to improve services for survivors of gender-based violence (GBV). Specifically, the study tested the feasibility of police provision of emergency contraception (EC). It also hypothesized that the intervention could strengthen GBV services at both police and health facilities through an increased emphasis on multisectoral collaboration. Based on the study’s findings, national scale-up of this program has been widely endorsed. The following recommendations are offered to guide such scale-up: ensure that a dedicated EC pill is available through …

The Refentse Model For Post-Rape Care: Strengthening Sexual Assault Care And Hiv Post-Exposure Prophylaxis In A District Hospital In Rural South Africa, Julia C. Kim, Ian Askew, Lufuno Muvhango, Ntabozuko Dwane, Tanya Abramsky, Stephen Jan, Ennica Ntlemo, Jane Chege, Charlotte Watts

Reproductive Health

The Refentse study aimed to develop a nurse-driven, post-rape care model that could be integrated into existing reproductive health/HIV services within a rural South African hospital, and to evaluate the impact of this model on the quality of care delivered. Following the intervention, there were significant improvements in the quality of clinical history and examination, and the provision of pregnancy testing, emergency contraception, STI treatment, HIV counseling and testing, post-exposure prophylaxis (PEP), trauma counseling, and referrals. The report concludes that it is possible to improve sexual assault services including PEP within a rural South African hospital at modest cost, using …

Translating Medical Evidence Into Practice: Working With Communities And Providers To Promote Active Management Of The Third Stage Of Labour, B. Subha Sri

Reproductive Health

Although postpartum hemorrhage is a leading cause of death in India, and despite the fact that active management of the third stage of labor (AMTSL) has been established as a best practice, efforts to promote it have been limited. This paper documents the experiences of a project that aimed to enable the translation of available evidence regarding AMTSL into practice through two strategies, at community and provider levels respectively. Community-level activities included efforts to build awareness regarding safe delivery practices, sensitize individuals regarding the rights perspective and their entitlement to safe services, and facilitate the translation of this awareness into …

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, …

Medical Response To Male Same-Sex Sexuality In Western India: An Exploration Of 'Conversion Treatments' For Homosexuality, Ketki Ranade

Reproductive Health

This report aims to explore the use of conversion therapy by healthcare providers in Western India to treat homosexuals, the criteria used for selecting clients for conversion therapy, the types of therapies employed, and perceived outcomes of such therapies. In contrast to most international guidelines for treatment of homosexuality, conversion therapy still seems to be practiced by many healthcare providers in India. Findings suggest that providers’ attitudes, understanding, and assumptions regarding normative and non-normative sexuality, homosexuality, marriage, procreation, and change or cure of homosexual sexual orientation makes up a complex belief system that has not incorporated some of the latest …

Exploring The Lives Of Youth In The Bpo Sector: Findings From A Study In Gurgaon, Monisha Vaid

Reproductive Health

This report seeks to fill gaps in information on the lives of unmarried youth in the business process outsourcing (BPO) sector in India. Specifically, it documents young people’s self-efficacy and their connections with their family and peers, as well as their sexual experiences and substance use practices. The findings presented in this report reiterate the fact that BPO employment not only provides young adults with a profitable and challenging work environment, but also has other positive outcomes: many young BPO employees associated their increased independence and self-efficacy to their employment in this sector, many reported close peer networks, and many …

An Assessment Of Sexual And Gender Based Violence In Wajir District, North Eastern Kenya, Gladys K. Mwangi, Guyo W. Jaldesa

Reproductive Health

A 2006 baseline survey conducted by CARE Kenya indicated that sexual and gender-based violence (SGBV) is widespread throughout Kenya’s North Eastern Province. Other findings revealed that high levels of stigma and gender imbalances are associated with sexual violence and female genital mutilation (FGM) and that a coordinated approach to responding to the service needs of survivors is missing. As noted in this report, there is limited awareness of the legal mechanisms available to survivors. The Population Council’s study in Wajir District ascertained the need for and possible components of an integrated and comprehensive services model that could meet the needs …

“Riding Bareback”: Factors Involved In The Development Of A Bareback Identity, Scott Charles Musgrove

Antioch University Dissertations & Theses

Researchers in the area of HIV prevention have long been aware of the rising incidence of unprotected sex among men who have sex with men (MSM). In recent years researchers have witnessed the emergence of the behaviors, attitudes and practices that discriminate between those of the MSM community who strictly and consistently adhere to safer sex practices, those who inconsistently practice safer sex, and those who eschew protected sex altogether. Understanding the factors that motivate the development and adoption of a "barebacker identity" in spite of serious potential for HIV infection may well help support the efforts of public agencies …

Test Of A Multidisciplinary Health Behavior Model Of Medicare Elders' Antihypertensive Acquisitions, Ann Marie Kopitzke

Health Services Research Dissertations

This study examined the relative utility of the enhanced Health Belief Model as compared to the proposed Pharmaceutical Acquisition Model for Medicare Elders (PAMME) in describing antihypertensive acquisition with usage intentions for Medicare elders (65 years or older) in Southeastern Virginia. Data collection included record reviews to identify hypertensive Medicare elders. Consenting Medicare elders were randomly selected for invitation, with consenting Medicare elders contacted by telephone or in-person interviews. The survey instrument utilized open and closed ended questions. The target population for this study is Southeastern Virginia Medicare elders enrolled in a Part D plan and prescribed at least one …

The Influence Of Familism On Descriptive And Injunctive Norms In Predicting The Intention To Eat A Vegetarian Diet Among Chinese Seventh-Day Adventists, See Wei Toh

Loma Linda University Electronic Theses, Dissertations & Projects

According to the theory of planned behavior (TpB), one determinant of intention to engage in a behavior is the subjective norm. Various studies have found that subjective norm is often the weaker predictor of intention compared to perceived behavioral control and attitude. This study examined whether familism (emphasis on the family rather than the individual) would contribute positively to the predictive power of the TpB model through interactions with the family portion of descriptive and injunctive norms. Descriptive and injunctive norms are component variables of the subjective norm. A sample of 284 adult Chinese Seventh-day Adventists 18 years and older …

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Gerontology Institute Publications

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

"Sitting In Different Chairs:" Roles Of The Community Health Workers In The Poder Es Salud/Power For Health Project, Stephanie Farquhar, Noelle Wiggins, Yvonne L. Michael, G. Luhr, Jennifer Jordon, A. Lopez

Community Health Faculty Publications and Presentations

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Methods: Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs …

Breast Cancer Screening Disparities In Japanese-American Women, Theodora Stratis

Loma Linda University Electronic Theses, Dissertations & Projects

Cancer screening disparities in ethnic minority women have received much research attention in the last several years due to a marked increase in ethnic minority cancer incidence and poor survival rates (Miller, Kollnel, Bernstein, Young Swanson, West et ah, 1996). Breast cancer is the leading cause of death for Asian American women (Asian American Network for Cancer Awareness, Research & Training, 2002) and, although their incidence and mortality rates are lower than Caucasian women, these rates continue to increase every year. This increasing mortality rate is likely due to the underutilization of breast cancer screening by Asian American women. Asian …

Cultural Beliefs About Health Professionals, Attributions For Mistreatment, And Continuity Of Cancer-Related Care, Jennifer Anne Tucker

Loma Linda University Electronic Theses, Dissertations & Projects

This research examined attributions for health care mistreatment, related emotions, and the role of cultural beliefs about health care professionals as determinants of cancer-related continuity of care among Anglo and Latino women in Southern California. This research was guided by Betancourt’s model of culture adapted for the study of health behavior (Betancourt & Flynn, 2008) and Weiner’s (1996) attribution theory of motivation and emotion. As predicted, higher levels of negative cultural beliefs about health professionals resulted in lower intentions for continuity of care indirectly through mediating psychological perceptions of intentionality for mistreatment, controllability of its causes, and anger toward the …

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Native American Forum on Nuclear Issues

Special Bonnie Raitt Benefit Tickets

Socioeconomic Determinants Of Hiv Status In Kenya, Kimberly Fletcher

Masters Theses & Specialist Projects

The spread of Human Immunodeficiency Virus (HIV) is one of the greatest threats to stability and development in Kenya. The country's infection rate is estimated between seven and eight percent, making it one of the highest in the world. Several studies have been done that examine subpopulations such as truck drivers, sex workers, and migrants. However, to date there is little research that examines who, across the country, is contracting HIV. Kenya's 2003 Demographic and Health Survey includes data that make it possible to determine which groups have the highest odds of being infected. The question of who is contracting …

Tribes And Yucca Mountain: Native American Forum On Nuclear Issues, Fred Dilger

Native American Forum on Nuclear Issues

Abstract:

-Yucca Mountain: Extensive history of social-cultural studies

-No interaction on transportation

-Unsuccessful effort began in 1993 and ended in 1995

-DOE tribal policy was a very good start

-Restarted again in 2004-DOE invites tribes to TEC meeting

-Shape future interaction between DOE and other Tribes

-Tribes identify themselves as affected by DOE differently than DOE defines affected tribes

Infant Feeding Decisions Among Pregnant Black Wic Participants And The Role Of Peer Support, Astrid D. Mickens

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal …

To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie

Management Faculty Research

Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …

Assessment Of Risk Factors For Hiv Infection Among Men Who Have Sex With Men In The Metropolitan Area Of Campinas City, Brazil, Using Respondent-Driven Sampling, Maeve De Mello, Adriana De Araujo Pinho, Magda Chinaglia, Waimar Tun, Aristides Barbosa Junior, Maria Cristina, F.J. Ilario, Paulo Reis, Regina C.S. Salles, Suzanne Westman, Juan Diaz

HIV and AIDS

The Population Council, in collaboration with the Brazil Ministry of Health, the Municipal Program of STD/AIDS of Campinas, and the US Centers for Disease Control and Prevention/Global AIDS Program/Brazil, conducted a study to characterize the sociodemographic, behavioral, and environmental factors associated with subgroups of MSM who are most at risk for HIV infection. This research is the first Brazilian study to provide population-based estimates for HIV, syphilis, and HIV-related risk behaviors using an innovative sampling technique to reach members of the target population. Our data suggest the importance for HIV prevention programs to address not only sexual risk reduction, but …

Is It Feasible To Integrate Alcohol-Related Risk Reduction Counseling Into Vct Services? Findings From Kenya, Caroline Mackenzie, Karusa Kiragu, George Odingo, Rukia Yassin, Peter Shikuku, Patrick Angala, Nduku Kilonzo, William Sinkele, Melania Akinyi

HIV and AIDS

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the …