Demography, Population, and Ecology Commons^™

Popular Perceptions Of Emerging Influences On Mortality And Longevity In Bangladesh And West Bengal, Sajeda Amin, Alaka Malwade Basu

Poverty, Gender, and Youth

Although new environmental and pathological threats to human survival and longevity have been documented, relatively little is known about how these threats are perceived in the popular imagination. During fieldwork in rural Bangladesh and West Bengal, India, researching the changing costs of and motivations for reproduction, the authors included survey questions on respondents’ perceptions of changing mortality. Child-mortality levels were perceived to have fallen drastically in recent times, but for the middle-aged and the elderly, the past was seen as a better time in terms of health and survival. The decline in adult health is attributed to environmental deterioration and …

Gender Differences In Time Use Among Adolescents In Developing Countries: Implications Of Rising School Enrollment Rates, Amanda Ritchie, Cynthia B. Lloyd, Monica J. Grant

Poverty, Gender, and Youth

Researchers at the Population Council have been involved in the collection of data on time use from adolescents in India, Kenya, Pakistan, and South Africa. Three questions are addressed in this working paper: (1) How does time use change during the transition to adulthood? (2) Does gender role differentiation intensify during the transition? (3) Does school attendance attenuate gender differences? The data document differences in time use patterns between students and nonstudents. Although female adolescent students still work longer hours than male adolescent students, the gender division of labor that typically develops during adolescence is greatly attenuated among students when …

Long-Range Trends In Adult Mortality: Models And Projection Methods, John Bongaarts

Poverty, Gender, and Youth

This Population Council working paper has two objectives: (1) to test a new version of the logistic model for the pattern of change over time in age-specific adult mortality rates, and (2) to develop a new method for projecting future trends in adult mortality. A test of the goodness-of-fit of the logistic model for the force of mortality indicates that its slope parameter is nearly constant over time. This finding suggests a variant of the model that is called the shifting logistic model. A new projection method based on the shifting mortality model is proposed and compared with the widely …

Les Implications Du Mariage Précoce Pour Les Politiques De Vih/Sida, Judith Bruce, Shelley Clark

Poverty, Gender, and Youth

Ce dossier est basé sur un document contextuel préparé pour la Consultation Technique OMS/ FNUAP/Population Council sur les Adolescentes Mariées, tenue à Genève en Suisse du 09 au 12 Décembre 2003 (le document final intitulé "Inclure les adolescentes mariées dans les politiques de santé reproductive des adolescents et de VIH/SIDA"). La Consultation a réuni des experts provenant des Nations Unies, des bailleurs de fonds et des agences non gouvernementales pour examiner les faits concernant la santé reproductive des adolescentes mariées, leur vulnérabilité face à l’infection du VIH, leurs inégalités sociales et économiques ainsi que leurs droits. Les rapports avec des …

Population Aging And The Rising Cost Of Public Pensions, John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …

Moyens De Subsistance Des Adolescentes. Questions Primordiales Et Outils Essentiels : Rapport D'Un Atelier, Carey Meyers

Poverty, Gender, and Youth

This report, co-published by the Population Council and the International Center for Research on Women, describes a workshop convened in Cairo in 1999 to learn more about the nature of both younger and older adolescents' work experience, differentiate the particular needs and potentials of adolescent girls, and identify programs and policies that might have promise for supporting them.

Trends And Transitions In Children's Coresidence With Older Adults In Beijing Municipality, Zachary Zimmer, Xianghua Fang, Toshiko Kaneda, Zhe Tang, Julia Kwong

Poverty, Gender, and Youth

The reduction in family size in China and concurrent social and economic change are raising concerns that traditional sources of support may be eroding. This Population Council working paper paper examines a) whether rates of coresidence between older adults and their adult children in the Beijing municipality of China have been declining, and b) the determinants of coresidence and coresidence transitions. Results suggest that family support structures for the elderly, when they are facilitated through coresidence, remain basically intact, particularly for those who require the greatest amount of support. Further assessment is required to elucidate the effects of availability, need, …

Population Aging And The Rising Cost Of Public Pensions [Arabic], John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …

Urban Poverty And Health In Developing Countries: Household And Neighborhood Effects, Mark R. Montgomery, Paul C. Hewett

Poverty, Gender, and Youth

In the United States and other high-income countries, where most people live in cities, there is intense scholarly and program interest in the effects of household and neighborhood living standards on health. This paper investigates whether in these cities the health of women and young children is influenced by both household and neighborhood standards of living. To judge from our results, it appears that as a rule, poor urban households do not tend to live in uniformly poor communities; indeed, about one in ten of a poor household’s neighbors is relatively affluent, belonging to the upper quartile of the urban …

Introduction Of Emergency Contraception In Bangladesh: Using Operations Research For Policy Decisions, M.E. Khan, Sharif M.I. Hossain, Md. Moshiur Rahman

Reproductive Health

The Directorate of Family Planning, Bangladesh, the Population Council, Pathfinder International, and John Snow Incorporated collaborated to conduct this operations research study to assess the acceptability and feasibility of providing emergency contraception pills (ECP) as a backup support to existing family planning methods. The study demonstrated that all categories of health providers, including NGO outreach workers, could be effectively trained to provide ECP services. The study also demonstrated high acceptability of ECP and revealed that if used correctly, the success rate in avoiding unwanted pregnancy was extremely high. The positive findings of the study have helped the Ministry of Health …

Improving Adolescent Reproductive Health In Bangladesh, Ismat Bhuiya, Ubaidur Rob, Asiful Haider Chowdhury, Laila Rahman, Nazmul Haque, Susan E. Adamchak, Rick Homan, M.E. Khan

Reproductive Health

An operations research project was launched in northwestern Bangladesh with the objective of preventing adverse outcomes and promoting healthy lifestyles among adolescents by providing reproductive health education and services. The Population Council, in collaboration with the Urban Family Health Partnership and its three nongovernmental service delivery partners, worked in three urban areas of the country. On the basis of its findings, the study first recommends implementation of a combination of reproductive health interventions at the school, community, and health-facility levels, accompanied by community sensitization, to effectively respond to adolescent reproductive health needs. Second, information providers such as teachers and facilitators …

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 …

Impact Of Improved Client-Provider Interaction On Women's Achievement Of Fertility Goals In Egypt, Laila Nawar, Ibrahim Kharboush, Magdi A. Ibrahim, Hesham Makhlouf, Susan E. Adamchak

Reproductive Health

A two-phase operations research study was launched in Egypt in early 2000 with the goal of demonstrating how improving the quality of client–provider interaction (CPI) could be achieved in large healthcare systems, specifically in relation to family planning. The study was designed to explore how CPI improvements could enhance family planning knowledge, method continuation rates, client satisfaction, and achievement of fertility goals. Client outcome variables were expected to improve as a result of improving client–provider interaction. The study recommends continued development and testing of innovative, attractive, and well-designed IEC messages that influence woman's fertility preferences; continuous training of health providers; …

Informing The Medical Community In Guatemala About Emergency Contraception, Edgar Kestler, Lilian Ramirez

Reproductive Health

The general purpose of this project was to increase the awareness of and access to emergency contraception (EC) among the medical community in Guatemala. Specific project objectives included: 1) training three physicians as trainers in all aspects of EC; 2) adapting and disseminating scientific literature and informational materials about the method and about EC programs in Latin America and worldwide; and 3) training at least 250 participants about the characteristics of emergency contraception, its mechanisms of action, and counseling techniques. The project concluded with several lessons for improving dissemination and policy, including: the dissemination workshops had a positive effect on …

Scaling Up A Successful Counseling Model In Guatemala, Guatemalan Association Of Female Physicians (Agmm)

Reproductive Health

This project aimed to improve clients’ ability to make an informed choice of contraceptive methods by scaling up the use of the balanced counseling strategy in public service delivery institutions in Guatemala. To reach this end, the project provided technical assistance to Calidad en Salud (Quality in Health), the leading reproductive health project in Guatemala, to train service providers in public institutions about the counseling methodology. The project successfully introduced the balanced counseling strategy in Guatemala and, as a result, has improved the informed choice of contraceptives in the country.

Effects Of Igss' Job Aids-Assisted Balanced Counseling Algorithms On Quality Of Care And Client Outcomes, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Gustavo Gutierrez, Veronica Davila, Carlo Boniato, Alex Rios

Reproductive Health

This study identified a need to improve the quality of care at the main maternity hospital of the Social Security Institute (IGSS) in Guatemala. Problems included very short counseling sessions, counseling not focused on clients’ needs, redundancy in the role of physicians and social workers as providers, skewed method mix, and low client return rate for method resupply. The intervention, using Balanced Counseling Algorithms, changed the counseling behavior of physicians and social workers and enhanced the quality of family planning care. The report includes recommendations for continuing these improvements: monitoring provider implementation of the job aids–assisted Balanced Counseling Algorithms, monitoring …

Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Dale Huntington, Mary Philip Sebastian, Barbara Mensch, Wesley H. Clark, Aditya Narain Singh, Sohini Roychowdhury, M.E. Khan, Nirmala Selvam, Bella C. Patel, Sandhya Barge, Y.P. Gupta, Lovleen Johri, Gita Biswas, Manohar Shenoy

Reproductive Health

The Population Council’s Frontiers in Reproductive Health (FRONTIERS) program and Policy Research Division, in collaboration with CARE India, conducted an operations research study in Allahabad, Uttar Pradesh to examine the feasibility and impact of adding livelihood counseling and training, savings formation activities, and follow-up support to an ongoing reproductive health program for adolescents. The short-term objective of the study was to foster development of alternative socialization processes for adolescent girls that encourage positive sexual and reproductive health behaviors. The study also aimed to produce a replicable model for CARE and other agencies to use in adding livelihood activities to adolescent …

Promotion Of Lactation Amenorrhea Method Intervention Trial, Kazakhstan, Shamil Tazhibayev, Toregeldy Sharmanov, Ayan Ergalieva, Oksana Dolmatova, Orynkul Mukasheva, Aina Seidakhmetova, Raikhan Kushenova

Reproductive Health

In order to expand the benefits of breastfeeding as a birth spacing option for women in the Republic of Kazakhstan, the Kazakh Academy of Nutrition at the Academy of Preventive Medicine in Almaty conducted an operations research study to test the effectiveness of lactational amenorrhea method (LAM) promotion among women in Kazakhstan, as part of the Population Council’s Frontiers in Reproductive Health Small Grants Program. Results show that the intervention programs implemented in experimental baby-friendly hospitals (BFHs) and ordinary hospitals (OHs) improved women’s knowledge, skills, and desire to breastfeed The report concludes that training activities should be strengthened and all …

Developing A Supervision Instrument For Postabortion Care In Guatemala, Bolivia And Mexico, Carlos Brambila

Reproductive Health

The main objective of this project was to develop and test a supervision instrument and corresponding guidelines to collect information about postabortion care (PAC) services and to provide constructive feedback to service providers and program managers. The instrument and guidelines were designed to be used by technical supervisors to monitor performance and engage providers in continuous quality improvement of PAC services. As part of the project activities, existing postabortion care supervision practices were reviewed and analyzed, and, during a one-week workshop in December 2002, an international technical committee produced a first version of the instrument and guidelines. These materials were …

Youth Behavioral Risks And Psychosocial Resources In Peru's Alternative-Development Zones, Federico R. Leon, Mary L. Claux

Reproductive Health

Alternative-development programs are being offered to the population of seven regions of central-eastern Peru involved in coca cropping. The youth of these regions are above the national average in risk of pregnancy and sexually transmitted infections, use of alcohol and drugs, and violence against women. This study sought to identify and describe protective factors expected to function as counterforces to such risks; develop reliable indicators and provide a baseline concerning the risk behaviors and protective factors; compare youth by gender, developmental stage, urbanization, and geography to determine whether segmented interventions are required; and recommend specific intervention strategies. The results 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 …

Improving Health Care Providers' Knowledge, Attitudes, And Practices In Reproductive Health In Rural Romania, Elaine Claire Himelfarb

Reproductive Health

To support new health reform initiatives undertaken by the Romanian Ministry of Health and Family, and in support of the USAID Romania strategy for improving women’s reproductive health, Project Concern International/Romania (PCI/R) was awarded a two-year grant to implement a reproductive healthcare project, Healthy Parents-Healthy Children (HP-HC). This project trained family physicians and nurses in rural dispensaries in techniques to improve pre- and postnatal care, including training on modern contraception, cervical and breast cancer screening, treating menopause and its symptoms, and the encouragement of healthy lifestyles. The goal of this OR project was to test the efficacy of interventions to …

Involving Men In Maternity Care: South Africa, Busi Kunene, Mags Beksinska, Simphiwe Zondi, Nobuhle Mthembu, Saiqa Mullick, Emma Ottolenghi, Immo Kleinschmidt, Susan E. Adamchak, Barbara Janowitz, Carmen Cuthbertson

Reproductive Health

The Reproductive Health Research Unit University of the Witwatersrand, South Africa, in partnership with the FRONTIERS Program of the Population Council, and the KwaZulu-Natal Department of Health conducted a three-year operations research study titled “Men in Maternity” in the Ethekwini district. The intervention was clinic-based and included two broad strategies: improving antenatal care services by strengthening the existing antenatal package and service monitoring and supervision; and introducing couple counseling by providing training to health providers, inviting partners of antenatal women to attend counseling twice during pregnancy and once post delivery, and providing information to couples with a new antenatal booklet. …

Tulane University Final Report, M. Celeste Marin, Anastasia J. Gage, Suhaila Khan

Reproductive Health

The Frontiers in Reproductive Health (FRONTIERS) program is a 10-year cooperative agreement between the United States Agency for International Development (USAID) and the Population Council in partnership with Family Health International and Tulane University School of Public Health and Tropical Medicine. This report summarizes the main activities undertaken by Tulane University under its subagreement with the Population Council on the FRONTIERS project from 1998–2004. As a partner, Tulane furthered progress toward all three of the program’s intermediate results: contributing innovative interventions tested to improve reproductive health through the small grants program; helping research staff take a more proactive approach to …

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 …

The Tostan Program: Evaluation Of A Community Based Education Program In Senegal, Nafissatou J. Diop, Modou Mbacke Faye, Amadou Moreau, Jacqueline Cabral, Helene Benga, Fatou Cisse, Babacar Mane, Inge Baumgarten, Molly Melching

Reproductive Health

This operations research project evaluated the effect and impact of a basic education program, developed by TOSTAN, a nongovernmental organization based at Thiès, Senegal. The basic education program consisted of four modules: hygiene, problem-solving, women’s health, and human rights. Through these four themes, emphasis was placed on enabling the participants, who were mostly women, to analyze their own situation more effectively and thus find the best solutions for themselves. The GTZ Supra Regional Project for the Elimination of Female Genital Cutting funded implementation of the program in 90 villages in Kolda Region, and the Population Council’s Frontiers in Reproductive Health …

Safe Motherhood Demonstration Project, Western Province: Final Report, Charlotte E. Warren, Wilson Liambila

Reproductive Health

Since March 2000, the Population Council and the University of Nairobi have been assisting the Kenya Ministry of Health to implement Safe Motherhood activities in Western Kenya. The purpose of this project was to increase utilization of quality maternal services in the selected districts and, in an effort to improve pregnancy outcomes, focused on improving quality of antenatal care, essential obstetric care, clean and safe delivery, postpartum care, postabortion care, and management issues at all levels. In addition, the project focused on strengthening referral practices and addressing factors responsible for delays by pregnant women in making decisions on when, where, …

Socio-Economic And Demographic Factors Associated With Injecting Drug Use Among Drug Users In Karachi, Pakistan, A. Agha, S. Parviz, M. Younus, Zafar Fatmi

Community Health Sciences

Objective: To identify the socio-economic and demographic factors associated with injecting drug users (IDUs) in Karachi.

Methods: We recruited 242 IDUs (taking drugs through sub-dermal routes) and 231 non-IDUs (taking drugs other than sub-dermal routes) from February through June 1996. IDUs were interviewed regarding sociodemographic factors, economic condition, and social network (marital status, living with spouse). In addition, information regarding location of drug users within the city (districts of Karachi) and current history of sexually transmitted diseases (STDs) were gathered. Moreover, blood samples were also obtained for HIV testing

.Results: Multivariate analysis showed that the income generation via illegal …

Identifying Compliance Issues In The Community Health Care Clinic Environment, Faye K. Beery

Graduate Theses

This study explored the high number of failed appointments and follow-up appointments at a community health care children’s clinic. A thirty-seven item questionnaire was randomly given to 112 participants seeking health care at the clinic on a random basis. Based on literature reviews, five hypothesis were generated to examine reasons for failing to keep appointments for children: 1. Communication difficulties between healthcare personnel and parents regarding patient comprehension of instructions and bottle directions were anticipated. 2. Patient/physician/clinic relationships were expected to influence patient compliance. The need for more reminder calls for appointments was anticipated to be a factor in patient …

United Power For Action And Justice: Breaking The Cycle Of Homelessness Reports - Policy Brief, Center For Urban Research And Learning, Christine George, Chiara Sabina, Aparna Sharma

Center for Urban Research and Learning: Publications and Other Works

This is a story of two groups of determined people with intersecting interests. Group one: a dozen leaders within United Power for Action and Justice who set out to prove their conviction, that homelessness is one symptom of a complex of issues that destabilizes individuals and communities. Group two: persons who are homeless and struggle daily to “fit in” to a landscape that is, more and more, structured to shut them out. In 2000, a cluster of leaders within United Power organized member institutions in the north and northwest suburbs of Chicago, and initiated a relationship with Congressman John Porter …