Medicine and Health Commons^™

Our Stories: Women Speak Out Against Hiv And Aids—An Interactive Communication Package For Rural Low-Literate Women, Vijaya Nidadavolu, Moumita Saha, Vijaya Usha Rani

HIV and AIDS

The National AIDS Control Organisation (NACO) estimates that there are over 5.1 million people living with HIV and AIDS in India. Among new infections reported in 2006, 88 percent were reported in the reproductive age group (15–49 years). The virus is spreading rapidly among women, including married and monogamous women, and adolescent girls. Existing literature shows that women's vulnerability is compounded due to their gendered disadvantage in information access, literacy, and decision-making. This disadvantage is particularly acute in the case of married women in rural India. NACO has indicated the need to develop audience-appropriate strategies for communicating HIV-related information. To …

Reducing The Social Exclusion Of Girls, Kelly Hallman, Eva Roca

Poverty, Gender, and Youth

Across the globe, girls are systematically excluded from participation in social, economic, and political life. The absence of girls in these arenas has implications not only for the young women themselves but also for society as a whole, exacerbating poverty and perpetuating disparities in health, education, and economic achievement. Internationally, this marginalization makes it difficult or impossible for some countries to achieve society-wide goals, such as the Millennium Development Goals identified by the United Nations as benchmarks to reduce poverty. For a number of years, the Population Council has been studying the causes and effects of girls’ social exclusion in …

Evaluation Of Berhane Hewan: A Pilot Program To Promote Education And Delay Marriage In Rural Ethiopia, Annabel Erulkar, Eunice N. Muthengi

Poverty, Gender, and Youth

The Berhane Hewan Program pilot-tested in rural Ethiopia from 2004–06 was developed to sensitize community members to the dangers of child marriage, prevent early marriage among unmarried adolescents, and provide support for girls who are already married. The program included social mobilization of girls aged 10–19 into groups led by female mentors; support to stay in school or convening of groups outside of school including nonformal education and livelihoods skills; and community-wide conversations on early marriage and reproductive health issues affecting girls. Economic incentives were provided to families who did not marry off their daughters during the project period. Population-based …

The Experience Of Married Adolescent Girls In Northern Nigeria, Annabel Erulkar, Mairo Bello

Poverty, Gender, and Youth

Programs for young people in sub-Saharan Africa have been directed largely toward unmarried adolescents, neglecting the fact that a large proportion of adolescents—especially girls—are married in some settings. Early marriage is a common feature of girls’ adolescence in Northern Nigeria, yet few programs are in place to support this sizable and vulnerable group. To suggest directions for future programming, Adolescent Health and Information Projects (AHIP) and the Population Council examined the lives of married and unmarried girls in two geopolitical regions of Nigeria, North West and North East. The study, as described in this report, consisted of secondary analysis of …

Changing Transitions To Adulthood In Vietnam's Remote Northern Uplands: A Focus On Ethnic Minority Youth And Their Families [Vietnamese], Bussarawan Teerawichitchainan, Hac Van Vinh, Nguyen Thi Phuong Lan

Poverty, Gender, and Youth

Ethnic minorities, who tend to live in remote mountainous areas, account for 15 percent of Vietnam’s 84 million total population and, according to a recent estimate, 61 percent of them are poor. Evidence suggests that despite recent efforts by the Government of Vietnam to promote poverty reduction in remote areas, a majority of ethnic minorities have not yet experienced positive change, contrary to their Kinh (ethnic Vietnamese) neighbors who have enjoyed substantial improvement in living standards. To identify program interventions that promote healthy human development and, in turn, positively affect Vietnam’s economic growth, it is crucial to have a comprehensive …

Obtaining More Accurate And Reliable Information From Adolescents Regarding Sti/Hiv Risk Behaviors, Barbara Mensch, Paul C. Hewett

Poverty, Gender, and Youth

To investigate the quality of self-reported data on sexual behavior, Population Council researchers conducted a study in a rural district of Malawi. They implemented a randomized experiment to assess whether audio computer-assisted self-interviewing (ACASI) produces more valid data on sexual behavior than face-to-face interviews. The Malawi study builds on an experiment conducted as part of a household-based survey of Kenyan adolescents. In Kenya and Malawi, there is clear evidence that mode of interviewing and probing of various sexual partnerships affect the reporting of sexual activity. According to Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 25, ACASI is …

Changing Transitions To Adulthood In Vietnam's Remote Northern Uplands: A Focus On Ethnic Minority Youth And Their Families, Bussarawan Teerawichitchainan, Hac Van Vinh, Nguyen Thi Phuong Lan

Poverty, Gender, and Youth

Ethnic minorities, who tend to live in remote mountainous areas, account for 15 percent of Vietnam’s 84 million total population and, according to a recent estimate, 61 percent of them are poor. Evidence suggests that despite recent efforts by the Government of Vietnam to promote poverty reduction in remote areas, a majority of ethnic minorities have not yet experienced positive change, contrary to their Kinh (ethnic Vietnamese) neighbors who have enjoyed substantial improvement in living standards. To identify program interventions that promote healthy human development and, in turn, positively affect Vietnam’s economic growth, it is crucial to have a comprehensive …

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

Poverty, Gender, and Youth

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

Leave No Woman Behind, Ethiopia: Baseline Report, Annabel Erulkar, Tekle-Ab Mekbib, Helen Amdemikael, Garry Conille

Poverty, Gender, and Youth

“Leave No Woman Behind, Ethiopia” is an experimental project being implemented in rural areas of Ethiopia’s Amhara region. The project uses the mobilization of women into groups and adult literacy as an entry point for reproductive health education and referrals. Measurement of the program’s impact is being undertaken using a quasi-experimental research design including baseline and endline surveys in six Kebele Associations in rural Amhara. This report presents findings from the baseline survey conducted among more than 3,000 girls and women aged 10–45 in rural Amhara region. The results cover a broad range of topics including education, work, livelihoods, social …

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

Poverty, Gender, and Youth

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

Reducir La Exclusión Social Des Las Niñas, Kelly Hallman, Eva Roca

Poverty, Gender, and Youth

En todo el mundo, las niñas son sistemáticamente excluidas de la participación en la vida social, económica y política. La ausencia de niñas en estos terrenos tiene consecuencias, no solo para las mismas jóvenes sino también para la sociedad en su totalidad, ya que se exacerba la pobreza y se perpetúan las disparidades de salud, educación y éxito económico. A nivel internacional, esta marginación dificulta o hace imposible que algunos países logren objetivos en toda la sociedad, como los Objetivos de Desarrollo del Milenio, considerados por las Naciones Unidas como parámetros para reducir la pobreza. Desde hace algunos años, el …

Promoting More Gender-Equitable Norms And Behaviors Among Young Men As An Hiv/Aids Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento

HIV and AIDS

The Population Council and the Promundo Institute studied the effectiveness of interventions in Brazil designed to change the attitudes of young men in relation to gender norms and reducing the risk of contracting HIV/STIs. One conclusion of the study was the recognition of the importance of engaging young people (men and women) in the issue of gender relations and the risks of HIV contamination. The results of the study indicate that addressing inequitable gender norms, particularly those that define masculinity, can be an important element of HIV prevention strategies. These findings suggest that group education interventions can successfully influence young …

Abc Messages For Hiv Prevention In Kenya: Clarity And Confusion, Barriers And Facilitators, Julie Pulerwitz, Tiffany Lillie, Louis Apicella, Ann P. Mccauley, Tobey C. Nelson, Simon Ochieng, Peter Mwarogo, Karusa Kiragu, Edward Kunyanga

HIV and AIDS

The Horizons Program and FHI/IMPACT developed a collaborative research study to explore how adults and youth in Kenya define and perceive the ABC (abstinence/being faithful/consistent condom use) terms and behaviors. Additional objectives of the study were to identify attitudes and norms around the ABC behaviors that influence perceptions of them, and the role of important actors in transmitting messages about them. Findings highlight potential challenges in promoting each of the ABC behaviors, as well as some positive elements that can be built upon when developing programs. HIV prevention programs that incorporate ABC messages—both in Kenya and elsewhere—should consider a number …

Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz

Reproductive Health

Female genital mutilation (FGM) is a traditional practice that affects women and girls in several African countries. It is practiced in a variety of ways, classified by WHO into four broad types all found in Kenya. In some communities it is associated with passage into maturity; in others, it is considered a symbol of ethnic identity, a religious obligation, or a necessary prerequisite for marriage, either through symbolizing attainment of womanhood or as a means of preserving and demonstrating virginity. FGM is considered a harmful traditional practice because it may be associated with a variety of short- and long-term health …

Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller

Reproductive Health

Maternal mortality in Pakistan is believed to be quite high, at about 350–500 maternal deaths per 100,000 live births. Reducing maternal mortality is one of the major objectives of the Government of Pakistan. Interventions required to address maternal mortality include safe motherhood, which means a woman’s ability to have a safe and healthy pregnancy and delivery. The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal and neonatal mortality in a predominantly rural district of Pakistan. The vast majority of maternal deaths are attributed to delays in …

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

Reproductive Health

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

Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project, an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan, was a three-year project (2003 to 2006) funded by the European Union. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas to accomplish its goals: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role …

Safe Motherhood Applied Research And Training (Smart) Report 3: Changes In Knowledge And Behavior Of Women And Families, Muhammad Shafique Arif, Peter C. Miller, Nayyer Munir, Irfan Masood

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was conceived as an operations research project designed to test the effectiveness of two different strategies for improving maternal and neonatal health in Pakistan. To evaluate the results of this test, several types of evaluative research were conducted, including qualitative studies of various types, health systems assessments, evaluations of specific components, and household surveys. The household surveys are the subject of this report, which is Report 3 (Changes in knowledge and behavior of women and families) in a series of six. The surveys are two types: a large-scale, before-after household survey …

Safe Motherhood Applied Research And Training (Smart) Report 4: Knowledge And Behaviour Of Service Providers, Zakir Hussain Shah, Saima Pervaiz

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role in decision-making and seeking care for their families in matters relating to maternal and newborn …

Workplace Organization, Labor Process Control And Occupational Health. Ph. D. Dissertation, Linda Treiber

Faculty Articles

The purpose of this research is to understand the complex relationships between working conditions and occupational health. The research draws from labor process theory that generally views worker control over the labor process as essential to non-alienated labor and from epidemiologic models of host, agent/exposure, and environment. Using General Social Survey 2002 cross sectional data, I investigate the effects of standard epidemiologic factors and worker labor process control factors in multivariate models to predict the dependent variables of workplace injury, persistent pain, exhaustion, and general health status. I suggest that labor process autonomy, social cohesion and skill utilization generally have …

Reducing The Transmission Of Hiv And Sexually Transmitted Infections In A Mining Community: Findings From The Carletonville Mothusimpilo Intervention Project: 1998 To 2001, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam, Yodwa Mzaidume, Bareng Rasego, Solly Moema

HIV and AIDS

The Horizons program, in collaboration with the Center for Scientific and Industrial Research, the South African Institute for Medical Research, and the London School of Economics, conducted an intervention study in the mining town of Carletonville, South Africa to examine the social determinants of the HIV epidemic, and to assess the impact of a targeted program of HIV and STI prevention and service delivery. The project did not reduce STI prevalence or HIV prevalence, as changing sexual behavior is far more complex than educating individuals about HIV. The report recommends interventions to support behavioral change education, STI treatment, the role …

Understanding The Hiv/Sti Risks And Prevention Needs Of Men Who Have Sex With Men In Nairobi, Kenya, Washington Onyango-Ouma, Harriet Birungi, Scott Geibel

HIV and AIDS

Despite increasing awareness of the role men who have sex with men (MSM) can play in the dynamics of HIV transmission in Africa, research on MSM in Kenya has been limited. In response to this gap, researchers from the Institute of African Studies at the University of Nairobi and the Horizons and FRONTIERS programs of the Population Council undertook a study of MSM in Nairobi. The overall goals of the study were to understand the extent to which MSM are at risk of HIV and other STIs, identify the factors associated with risk behaviors, and identify MSM sexual health needs …

'The Aids Is Coming And There Is Nowhere To Run...': Culture, Gender, And The Politics Of Kisongo Maasai Women And Girls' Vulnerability To Hiv/Aids (Immune Deficiency, Tanzania), V. Corey Wright

Theses and Dissertations (Comprehensive)

This thesis outlines the research findings and implications for practice generated from the, “A Gender Issue: Reducing the Vulnerability of Kisongo Maasai Girls to HIV/AIDS” project, which was a participatory action research (PAR) study in collaboration with the Kisongo Maasai in Northern Tanzania. The objectives of the study were to explore the factors that may contribute to girls’ vulnerability to HIV/AIDS, and develop a culturally-specific framework that may contribute to effective design and administration of program and policy-level interventions. The findings of this study illustrate the ‘politics of health’ that determine girls’ vulnerability to HIV/AIDS. It presents a cultural analysis …

Chronic Pain: The Extra Burden On Canadian Women, Marta Meana, Robert Cho, Marie Desmeules

Psychology Faculty Research

Health Issue

Chronic pain is a major health problem associated with significant costs to both afflicted individuals and society as a whole. These costs seem to be disproportionately borne by women, who generally have higher prevalence rates for chronic pain than do men.

Key findings

Data obtained from 125,574 respondents to the Canadian Community Health Survey (2000–2001) indicated that 18% of Canadian women suffered from chronic pain, compared to 14% of men. This gender discrepancy, however, seemed to be linked primarily to differences in age, income, and education between adult men and women in this large sample. Age, income, depression …

Combining Community Approaches And Government Policy To Prevent Hiv Infection In The Dominican Republic, Deanna Kerrigan, Luis Moreno, Santo Rosario, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

A recent Horizons study conducted jointly with two Dominican NGOs assessed the impact of two environmental-structural models in reducing HIV-related risk among female sex workers in the Dominican Republic and compared their cost-effectiveness. In the two cities studied, there were improvements from pre- to post-intervention in the key outcome variables, however the type and level of these changes varied by intervention approach. Based on our findings, program planners and policymakers involved in the study in the Dominican Republic agree that the integrated solidarity and policy model in conjunction with ongoing peer education and community mobilization activities is an appropriate, cost-effective, …

Strengthening Sti Treatment And Hiv/Aids Prevention Services In Carletonville, South Africa, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam

HIV and AIDS

Although knowledge about HIV/AIDS is widespread in South Africa, adult HIV prevalence is high, indicating high levels of risky sexual behavior. Understanding the gap between knowledge and behavior requires an examination of the social context in which the epidemic occurs. The Horizons Program conducted an intervention study in the Carletonville area to study the social determinants of the HIV epidemic and to assess the impact of a targeted program of HIV and STI prevention and service delivery. In 1998, the Mothusimpilo (“Working together for health”) Intervention Project (MIP) was launched to reduce community prevalence of HIV and other STIs and …

Combinando Estrategias Comunitarias Y Política Gubernamental Para Prevenir La Infección Del Vih En La República Dominicana, Deanna Kerrigan, Luis Moreno, Santo Rosario, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

Programas efectivos para evitar nuevas infecciones del VIH entre trabajadoras sexuales y sus parejas, y por lo tanto la población en general, son componentes críticos de estrategias nacionales de prevención del VIH. Un estudio recientemente realizado por Horizons, en conjunto con dos organizaciones no-gubernamentales dominicanas y el Programa Nacional del Control de ITS y SIDA evaluó el impacto de dos modelos ambientales-estructurales en disminuir el riesgo de VIH en trabajadoras sexuales en la República Dominicana y comparó el costo-efectividad de los dos modelos. Los modelos, construidos sobre la base de años de experiencia adquirida a través de programas de educación …

Community Approaches And Government Policy Reduce Hiv Risk In The Dominican Republic, Deanna Kerrigan, Luis Moreno, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

Effective programs that avert new HIV infections among sex workers and their partners, and hence the general population, are critical components of national HIV-prevention strategies. Prevention efforts have frequently relied on interventions that reach members of these vulnerable groups as individuals, such as condom promotion and STI management. Now, many researchers and program implementers are increasingly turning to “environmental-structural” interventions that address the physical, social, and political contexts in which individual behavior takes place. A recent Horizons study conducted jointly with two Dominican NGOs—Centro de Orientación e Investigación Integral and Centro de Promoción e Solidaridad Humana—and the National Program for …

Intervenciones Comunitarias Y Política Gubernamental Reducen El Riesgo Del Vih En La República Dominicana, Deanna Kerrigan, Luis Moreno, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

Programas efectivos para evitar nuevas infecciones del VIH entre trabajadoras sexuales y sus parejas, y por lo tanto la población en general, son componentes críticos de estrategias nacionales de prevención del VIH. Generalmente los esfuerzos de prevención se han concentrado en intervenciones que alcanzan a los miembros de estos grupos vulnerables al nivel individual, tal como promoción de condones y manejo de ITS. Actualmente, muchos investigadores y gerentes de programas se encuentran dirigiéndose a intervenciones “ambientales-estructurales” que toman en cuenta los contextos físicos, sociales y políticos en que el comportamiento individual ocurre. Un estudio reciente realizado por Horizons, en conjunto …

The Role Of Incentives In Promoting Workplace Hiv/Aids Policies And Programs, Simon Baker, Srisuman Sartsara, Patchara Rumakom, Philip Guest, Katie D. Schenk, Anthony Pramualratana, Suparat Suksakulwat, Surachai Panakitsuwan, Sikarat Moonmeung

HIV and AIDS

This brief examines the role of incentives in encouraging companies in Thailand to adopt workplace policies and programs that address AIDS-related stigma and discrimination and respond to the needs of workers for information and services. The research was a collaboration between the Horizons Program, American International Assurance (AIA), the Thailand Business Coalition on AIDS (TBCA), and AusAID. After the initiative was launched (known as the AIDS-response Standard Organization), TBCA staff built relationships with company managers to explain and promote the advantages of joining. Companies agreeing to implement at least three HIV/AIDS workplace policies would receive a reduction of 5–10 percent …