Medicine and Health Commons^™

Poverty, Wealth Inequality, And Health Among Older Adults In Rural Cambodia, Zachary Zimmer

Poverty, Gender, and Youth

This working paper examines the distribution of household wealth and tests whether associations exist between wealth inequality and health outcomes among older adults living in one of the world’s poorest regions, rural Cambodia. Results confirm difficult economic conditions among most elderly in rural Cambodia. This study suggests there is some validity to generalizing the relationship between wealth inequality and health to extremely poor populations and that a very small difference in wealth makes a relatively large difference in regard to the association with health among those living in impoverished surroundings.

Egypt: Are Egyptian Couples Willing To Stop At Two Children? Results Of The Slow Fertility Transition Survey [Arabic], Population Council

Reproductive Health

No abstract provided.

Building Capacity To Utilize Operations Research: Strategies And Lessons Learned, James R. Foreit

Reproductive Health

The effectiveness of development assistance depends on good decision-making. Many donors and international health agencies such as USAID, DFID, and WHO are placing more emphasis on the utilization of research results for policy and program development. Yet, while there is a long tradition of training researchers to produce research, there are few lessons on how to teach managers to request and use research results for making program decisions. Addressing this gap has been a major strategy of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS). Since its inception in 1998, FRONTIERS has complemented its support for operations research (OR) …

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 …

Systematic Screening: A Strategy For Determining And Meeting Clients' Reproductive Health Needs, James R. Foreit

Reproductive Health

Systematic screening is a strategy to integrate reproductive health services at the provider level. Integration is the proactive provision of multiple reproductive health services in the same facility at the same time. Systematic screening is a simple intervention to increase the number of services received at a single client visit. In this strategy, providers use a checklist or questionnaire to identify each client’s needs and desires for reproductive health services. They then provide these services during the same visit, through an appointment at the same clinic, or through referral to another facility. The Population Council’s Frontiers in Reproductive Health Program …

Cómo Identificar Y Satisfacer La Necesidad De Servicios Adicionales: Manual Para Gerentes, Ricardo Vernon, James R. Foreit, Emma Ottolenghi

Reproductive Health

Este manual está diseñado para ayudar a los encargados de tomar decisiones, los administradores, los supervisores y los proveedores de programas a introducir la detección sistemática en sus servicios de salud. La detección sistemática puede mejorar la salud de la mujer al abordar múltiples necesidades no satisfechas de servicios de salud reproductiva y otros. Este manual proporciona: actividades necesarias para implementar una detección sistemática; cómo seleccionar las instalaciones, los servicios que se examinarán y quién lo hará; desarrollo, adaptación y pruebas preliminares de listas de verificación de detección sistemática; asesoramiento para capacitar a los evaluadores/proveedores y supervisores; y un esquema …

Make Better Use Of Provider Time In Public Health Clinics, Barbara Janowitz

Reproductive Health

Funding for reproductive health services is stagnant or declining globally, yet population projections, particularly in Africa, indicate that demand for services will increase in the near term. Between 2002 and 2025, for example, the population of women of childbearing age (15–49) is expected to increase by 2 percent annually in sub-Saharan Africa. With this growth will come increased demand for contraception, and other reproductive health services such as antenatal care, safe birthing services, and postpartum care for mothers and children. Concern about increasing demand for services has led program managers to examine the productivity and costs of existing programs. While …

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 …

Role Identity Formation Of Occupational Therapy Students, Denise A. Rotert

Electronic Theses and Dissertations

This study is an examination of the professional socialization process of occupational therapy students from a role identity theoretical perspective. First-year students, second-year students, fieldwork students, and faculty at an occupational therapy educational program at a Midwestern institution volunteered to participate in the study. Data were collected through focus group interviews and surveys. The focus of the study was to determine factors associated with occupational therapy students’ identity salience, commitment, and role-person merger. Interviews and surveys were used to determine what factors, over and above didactic education, influence the socialization of students into the profession of occupational therapy and what …

Suicide Trends And Prevention In Nevada, Matt Wray

Social Health of Nevada Reports

Suicide has been around for as long as human society and it continues to challenge our collective wisdom. Consider this data provided by the National Institute of Medicine:

• Each year about one million people commit suicide worldwide.
• Every year some 30,000 Americans end their lives by suicide, and approximately 650,000 people receive emergency treatment after attempting suicide.
• Every 41 seconds someone in the U.S. attempts suicide; every 16.7 minutes, someone completes suicide; and every day over 85 people die by suicide.
• Suicide is the eighth leading cause of death in the U.S. and the third leading cause of death among …

Problem Gambling And Treatment In Nevada, Bo Bernhard

Social Health of Nevada Reports

For many years, it was moral experts, rather than medical and academic ones, who told us who gambled “too much.” Speaking from pulpits rather than podiums, church leaders informed us that gambling was uniquely subversive of the American way of life, for its something-for-nothing promise threatened to undermine the popular ethic of honest toil and gradual accumulation of goods. Samuel Hopkins, in an 1835 sermon on “The Evils of Gambling,” captured this sensibility: “Let the gambler know that he is watched, and marked; and that . . . he is loathed. Let the man who dares to furnish a resort …

Diseases Prevalence And Behavioral Choices In Nevada, Mary Guinan, Chad L. Cross, Lawrence Sands

Social Health of Nevada Reports

Determining the health of a state population is a complex task. It involves knowing at least the prevalence of various diseases and conditions as well as the leading causes of death and disability compared to a national mean or median. The World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Since health is affected by numerous social, economic, environmental, and cultural factors, these factors must also be considered when examining the health status of a population. All attempts to rank states in health are limited …

Health Care Access And Insurance Availability In Nevada, Charles B. Moseley, Michelle Sotero

Social Health of Nevada Reports

According to the Institute of Medicine (IOM),

• Approximately 18,000 Americans die prematurely every year, solely because they lack health insurance coverage (Institute of Medicine, 2004).
• The IOM estimates that the aggregate cost of increased morbidity and mortality due to un-insurance in the U.S. is between $65 billion and $130 billion per year.
• Costs to the health care system can be measured conservatively in terms of the value of uncompensated care provided to the uninsured, estimated at almost $35 billion in 2001, of which $24 billion was provided by hospitals.

Access to medical care is not a constitutional right in the …

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 …

Hiv/Aids And Condom Usage: Factors That Contribute To African American Women's Vulnerability To Hiv Infection, Monica P. Washington

Sociology & Criminal Justice Theses & Dissertations

HIV/AIDS poses an enormous health threat to African Americans, specifically African American women. According to the Center for Disease Control "1 in 160 African American women are believed to be infected with HIV (Center for Disease Control 1999:1). In 2000, although African American women only represented 12% of the female population, they accounted for 64% of HIV cases reported among women (The White House 2000; National Institute of Allergy and Infectious Diseases 2004).

This study examined HIV/AIDS and African American women and attempted to answer the question: Why are African American women not consistently using condoms to protect themselves against …

Ethical Approaches To Gathering Information From Children And Adolescents In International Settings: Guidelines And Resources, Katie D. Schenk, Jan Williamson

HIV and AIDS

This publication provides practical guidance to help program managers and researchers understand and uphold ethical standards when planning and implementing information-gathering activities among children and adolescents, and promotes discussion of ethical issues among people of different backgrounds and training who gather information for different purposes. The publication, which is divided into three parts, is intended to be helpful to anyone who plans, manages, implements, analyzes, or funds any program or research activity that requires gathering information from children and adolescents, including monitoring and evaluation. Part 1 presents key issues that must be considered from the earliest stages of planning and …

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 …

Programming For Hiv Prevention In South African Schools: A Report On Program Implementation, Priscilla Reddy, Shegs James, Ann P. Mccauley

HIV and AIDS

An evaluation study conducted in KwaZulu Natal, South Africa, provides important insights into whether learners who participated in a fact-based, interactive course had more knowledge about HIV risks, prevention, and care practices; more positive attitudes toward prevention practices and people living with HIV and AIDS; and a higher prevalence of reported safe behaviors than comparable learners who did not participate in the course. Results show that the Life Skills Grade 9 Curriculum had a positive impact of students’ knowledge of HIV/AIDS, attitudes about abstinence, and intention to use condoms. There was, however, no evidence of increased adoption of such protective …

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 …

How Many Years Of Life Could Be Saved If Malaria Were Eliminated From A Hyperendemic Area Of Northern Ghana?, Ayaga A. Bawah, Fred N. Binka

Poverty, Gender, and Youth

For some time, Chinese government policies have treated rural and urban areas very differently, and a by-product of China’s rapid development seems to be an even greater differentiation between urban and rural social and economic life. Over the next several decades, in part because of rapid fertility declines and in part as a result of mortality declines at older ages, China and other developing countries will experience enormous increases in the proportion of older adults and the proportion of the “oldest-old.” It is reasonable to expect that these age structure changes will alter the provision of health care, making an …

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 …

Review Of Field Experiences: Integration Of Family Planning And Pmtct Services, Naomi Rutenberg, Carolyn Baek

HIV and AIDS

The Population Council and its research partners have been addressing several key questions about prevention of mother-to-child HIV transmission (PMTCT) services and how well they function in field settings. The World Health Organization asked the Population Council to provide a review of field experiences regarding the integration of family planning and PMTCT services. This report provides conclusions and recommendations as input into a WHO/UNFPA-sponsored consultative meeting on "The linkages between reproductive health and HIV/AIDS: Family planning and prevention of mother-to-child transmission."

Maximizing Resources To Meet Client Needs: Evaluation Of A Comprehensive Hiv/Aids Care And Support Model In India, Yrg Care, Horizons Program, International Hiv/Aids Alliance

HIV and AIDS

To examine the benefits and feasibility of service delivery, the Horizons program and the International HIV/AIDS Alliance undertook a multifaceted operations research study of YRG CARE, a nongovernmental organization which offers services to PLHA in southern India. Data from this study suggest that comprehensive care and support services have had a positive impact on perceived quality of life, serostatus disclosure, number of illness episodes, and household expenditures for those patients who participated in the study. The results of this component of the study support the value of scaling-up the YRG CARE service model to other NGOs in India to expand …

Expanding The Care Continuum For Hiv/Aids: Bringing Carers Into Focus, Jessica Ogden, Simel Esim, Caren Grown

HIV and AIDS

This review by the International Center for Research on Women explores the specific issues that cluster around the provision of care in the context of the global HIV/AIDS pandemic. With the support of the Population Council’s Horizons program, this review applies the care economy lens to two key sectors, health and social protection, and finds that while important strides are being made, much more needs to be known and done to enable individuals, families, and households to survive in a world shaken by AIDS. The report documents the challenges faced by family care providers, who are primarily women and unlinked …

Expanding Care And Support In South India: Scaling Up Yrg Care's Patient-Centered Approach, Yrg Care, Horizons Program, International Hiv/Aids Alliance

HIV and AIDS

This study examines the experiences of YRG CARE, a Chennai-based NGO, which provides an integrated continuum of prevention, care, and support services for PLHA in South India. In this Horizons report, the authors examine the process of scaling up YRG CARE’s patient-centered approach and how this led to the enhanced provision of care and support services at four selected sites. Networking and collaboration among providers at all sites were essential parts of the strategy. At the end of project workshop, scale-up participants and YRG CARE affirmed their intention to continue collaboration in order to build on the successes of the …

Succession Planning In Uganda: Early Outreach For Aids-Affected Children And Their Families, Horizons Program, Makerere University Department Of Sociology, Plan Uganda

HIV and AIDS

This publication reports on an intervention study that evaluated the effectiveness of a succession planning (SP) program in Uganda. Unlike most other programs for AIDS-affected children, succession planning reaches children and their families while their HIV-positive parents are still living and in a position to plan for their children’s long-term well-being. Research carried out by the Department of Sociology at Makerere University (Kampala) and the Population Council Horizons program suggests that succession planning is a promising approach: despite AIDS-related stigma and cultural resistance to acknowledging illness and death, qualitative research indicates that the approach met with a high degree of …

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, …