Medicine and Health Commons^™

Beacon Of Hope: Evaluation Of The Kenya Girl Guides Association Hiv/Aids Program For School Children, Karusa Kiragu, George Odingo, Milka Juma, Jane Mbugua, Magdalen Waweru, Wamuyu Mahinda, Beatrice Mwaniki, Charity Muturi, Simon Ochieng, Tobey C. Nelson, Ann P. Mccauley

HIV and AIDS

This Horizons report presents findings from an evaluation of the Kenya Girl Guides Participatory Peer Education Program for HIV and AIDS Prevention. The objective of the program was to train Girl Guide patrol leaders as peer educators, who in turn would communicate key information and concepts about such topics as HIV prevention, relationships, and self-esteem to other Girl Guides, and ultimately to their school peers. The results demonstrate that peer education conducted by Girl Guides is a feasible strategy for imparting HIV and AIDS education to school-going youth; however, such a program would need to be branded, strengthened, and appropriately …

Transcending Boundaries To Improve The Food Security Of Hiv-Affected Households In Rural Uganda: A Case Study, Katharine Coon, Jessica Ogden, John Odolon, Anthony Obudi-Owor, Charles Otim, James Byakigga, Peter Spebanja

HIV and AIDS

A case study conducted in Tororo, Uganda found that a partnership between TASO, an AIDS service NGO and agricultural extension, was successful in helping HIV-affected communities improve food security. This Horizons study reports that four participatory training workshops developed through the alliance resulted in improved management capacity and more collaborative organizational structures among the district partners. This in turn created the conditions for the AIDS community workers and other field partners to work more effectively together with farmers’ groups at the local level to identify and address constraints to food security.

Reaching Truckers In Brazil With Non-Stigmatizing And Effective Hiv/Sti Services, Magda Chinaglia, Sheri A. Lippman, Julie Pulerwitz, Maeve De Mello, Rick Homan, Juan Diaz

HIV and AIDS

Research with mobile populations has demonstrated that men in the mobile workforce tend to be exposed to greater HIV risk, and have higher sexually transmitted infection (STI) and HIV prevalence, than those in less mobile or non-mobile professions. At the request of the Brazilian Ministry of Health and with support from USAID/Brazil, the Population Council conducted an assessment in Brazilian border areas to determine which populations were most in need of HIV prevention activities. The research revealed the presence of an extremely mobile, international truck driver community with little to no access to HIV prevention, testing, and treatment services. The …

Continuum Of Care For Hiv-Positive Women Accessing Programs To Prevent Parent-To-Child Transmission: Findings From India, Vaishali Sharma Mahendra, Rupa Mudoi, Archana Oinam, Venkat Pakkela, Avina Sarna, Sucheta Panda, Ashok Rau, L. Birendrajit Singh, Naomi Rutenberg

HIV and AIDS

This study examined the efforts of PPTCT programs in different cities in India to offer women a continuum of care, and shows that the programs have both strengths and shortcomings. The government launched a national treatment program that offers antiretroviral therapy (ART) to HIV-positive women, children below 15 years of age, and men. However, since the start-up of the ART program there have been concerns about limited access to and utilization of these services by women and children. To address these shortcomings, the PPTCT programs studied should strengthen their referral systems to public and private treatment and family planning services, …

The Health Crisis In Russia, Christine Danton

Human Rights & Human Welfare

A health crisis has emerged in Russia due to declining health and inadequate health care. The crisis is so severe that the term “disappearing population” has been applied to Russia due to a high death rate, low birth rate, and low life expectancy among its people. These factors continue to worsen due to inefficiency and a lack of resources throughout the health care system. The government has been slow to respond to the current crisis, often ignoring calls to reform the system and sometimes passing inappropriate measures. Non-governmental organizations (NGOs) and medical professionals report there is an urgent need to …

Disparities In Health And Well-Being Among Latinos In Washington Heights/Inwood, 2000–2005, Ana Motta-Moss

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report analyzes how well the residents of Washington Heights/Inwood (WH/IN) have fared on selected health indicators set forth by the NYC Department of Health and Mental Hygene between 2000 and 2005.

Methods: Data on Latinos and other racial/ethnic groups were obtained from the U.S. Census Bureau American Community Survey, reorganized for public use by the Minnesota Population Center, University of Minnesota, IPUMSusa. Cases in the dataset were weighted and analyzed to produce population estimates.

Results: Immigrant families in particular face a multitude of health concerns, as well as specific barriers to accessing health care services. The socioeconomic and …

Key Findings From An Evaluation Of The Mothers2mothers Program In Kwazulu-Natal, South Africa, Carolyn Baek, Vuyiswa Mathambo, Sibongile Mkhize, Irwin Friedman, Louis Apicella, Naomi Rutenberg

HIV and AIDS

The Horizons program of Population Council, in collaboration with Health Systems Trust, completed the first evaluation of mothers2mothers (m2m) as part of its introduction in KwaZulu-Natal Province, South Africa. It is the first external evaluation that provides quantitative evidence about the role of the well-known m2m program in complementing services to prevent mother-to-child transmission of HIV (PMTCT). m2m is a peer support program that aims to provide education and psychosocial support to HIV-positive pregnant women and new mothers, help women access existing health care, and follow up with mothers and babies to ensure they receive appropriate medical care after delivery. …

Ethnic Differentials In Parental Health Seeking For Childhood Illness In Vietnam, Bussarawan Teerawichitchainan, James F. Phillips

Poverty, Gender, and Youth

The recent introduction of user fees for Vietnam’s primary healthcare services has generated concern that economic policies may adversely affect health-seeking behavior and health outcomes of the poor, particularly among impoverished families who are members of socially marginalized minority groups. This Population Council working paper examines this debate by analyzing parental recall of illness and care-seeking for sick children under age 5 recorded by the 2001–02 Vietnam National Health Survey. Ethnic differentials are evident in all geographic and income levels, although adverse effects of minority status are most pronounced among poor households in remote areas. Results suggest that social equity …

Book Review: Social Justice: The Moral Foundations Of Public Health And Health Policy, Robin West

Georgetown Law Faculty Publications and Other Works

This essay is a review of Social Justice: The Moral Foundations of Public Health and Health Policy by Madison Powers & Ruth Faden (2006).

In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate? In a world filled with inequalities in health and well-being, which inequalities matter most and are the most morally urgent to address? In order to answer these questions, Powers and Faden develop a unique theory of social justice that, while developed for the specific contexts of public health and health …

Las Vegas: A Sustainable Urban Environment For Health?, Nancy Menzel

Nevada Journal of Public Health

The rapid growth of Las Vegas has resulted in negative consequences for the health of its residents to a level that threatens the area’s sustainability. This article reviews key indicators of population health in Las Vegas through the framework of the US Centers for Disease Control and Prevention’s Healthy People in Healthy Places and concludes that public health professionals, citizens, businesses, and political leaders must act now to protect and improve population health.

Indigenous Healing Practices Among Rural Elderly African Americans, Debra A. Harley

Aboriginal Policy Research Consortium International (APRCi)

Elderly African Americans residing in rural areas have practiced and continue to practice indige- nous healing practices for various reasons. In addition to the belief in the value of such practices, many of these individuals practice indigenous healing because it is cost effective. In this article information is presented on the history of research on indigenous healing practices, theories and models of indigenous healing in the United States, cultural influence, and views of health care providers regarding such practices. This article concludes with a discussion of the relevance of indigenous healing practices across disciplines and approaches, and recommendations of using …

Reducing Aids-Related Stigma And Discrimination In Indian Hospitals, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly

HIV and AIDS

People living with HIV/AIDS in India, as elsewhere, face stigma and discrimination in a variety of contexts. Research in India has shown that stigma and discrimination against HIV-positive people and those perceived to be infected are common in hospitals and act as barriers to seeking and receiving critical treatment and care services. Recognizing the need to move beyond documentation of the problem, three New Delhi hospitals; SHARAN, an Indian NGO; and the Horizons program, with support from the National AIDS Control Organisation (NACO), carried out an operations research project to develop and test responses to hospital-based stigma and discrimination against …

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 …

Examining Adherence And Sexual Behavior Among Patients On Antiretroviral Therapy In India, Avina Sarna, Indrani Gupta, Sanjay Pujari, A.K. Sengar, Rajiv Garg, Ellen Weiss

HIV and AIDS

With increased availability of ART, HIV-positive individuals are living healthier lives and continuing or resuming sexual activity. However, optimism related to ART’s success in slowing disease progression, reducing viral load, and improving health status may lead to more risky sexual practices and a possible increase in transmission of infections. To determining the sexual behavior of HIV-positive persons on ART, the Horizons program, in collaboration with research partners in Delhi and Pune, conducted a study to assess current levels of adherence to ART among a sample of people living with HIV/AIDS, identify the factors that influence their adherence to treatment, and …

Orphans And Vulnerable Youth In Bulawayo, Zimbabwe: An Exploratory Study Of Psychosocial Well-Being And Psychosocial Support, Laelia Gilborn, Louis Apicella, Jonathan Brakarsh, Linda Dube, Kyle Jemison, Mark Kluckow, Tricia Smith, Leslie M. Snider

HIV and AIDS

This Population Council Horizons report presents findings from an exploratory study by the Regional Psychosocial Support Initiative and Catholic Relief Services’ Support to Replicable, Innovative Village/Community-level Efforts Program of vulnerable youth living in and around Bulawayo, Zimbabwe. It describes their demographic characteristics, exposure to stress and trauma, and psychosocial well-being. The report also highlights the relationships between psychosocial well-being outcomes and exposure to stress and trauma, and the differences in psychosocial well-being between males and females, orphaned and nonorphaned youth, and younger and older adolescents. The report concludes with program and research implications.

Exploring Current Practices In Pediatric Arv Rollout And Integration With Early Childhood Programs In South Africa: A Rapid Situation Analysis, Desiree Michaels, Brian Eley, Lewis Ndhlovu, Naomi Rutenberg

HIV and AIDS

This Horizons program report describes the status of pediatric HIV treatment in selected sites in South Africa, identifies gaps in service delivery, and proposes recommendations for strengthening services and expanding children’s access to treatment. The study provides much needed information on critical issues of pediatric HIV care, especially regarding health service and contextual issues surrounding the expansion of access to treatment for HIV-infected children, and key factors that facilitate sustainability of treatment by young children. The aims of the study were to identify successful program strategies in pediatric HIV treatment in South Africa and to determine priority knowledge gaps to …

Qalys And Policy Evaluation: A New Perspective, Matthew D. Adler

Faculty Scholarship

No abstract provided.

Akinbola E. Akinwumi On Sickness And Wealth: The Corporate Assault On Global Health By Meredith Fort, Mary Anne Mercer And Oscar Gish (Eds). Cambridge: South End Press, 2004. 237pp., Akinbola E. Akinwumi

Human Rights & Human Welfare

A review of:

Sickness and Wealth: The Corporate Assault on Global Health by Meredith Fort, Mary Anne Mercer and Oscar Gish (eds). Cambridge: South End Press, 2004. 237pp.

The Impact Of Program Changes On Enrollment, Access, And Utilization In The Oregon Health Plan Standard Population, Matthew J. Carlson, Bill J. Wright

Sociology Faculty Publications and Presentations

In February 2003, in an effort to expand Medicaid coverage within tight fiscal constraints, the Oregon Health Plan (OHP) underwent a significant redesign of benefits, cost-sharing and premium structure. The OHP2 redesign resulted in two tiers of coverage, OHP Plus and OHP Standard, and a premium subsidy program. The OHP Plus benefit package and cost sharing structure is similar to the original OHP and serves the federally-mandated Medicaid populations: children and pregnant women, low-income elderly and individuals meeting the SSI definition of disability. OHP Standard, designed for Oregon’s expansion population,1 includes a reduced benefit package, expanded co-pays and increased premiums. …

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 …

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, …

Involving Young People In The Care And Support Of People Living With Hiv/Aids In Zambia, Eka Esu-Williams, Katie D. Schenk, Joseph Motsepe, Scott Geibel, Anderson Zulu

HIV and AIDS

The Population Council, in collaboration with CARE International and Family Health Trust, conducted a study in Zambia to determine which care and support needs of people living with HIV and AIDS and their families could be met by trained youth, and to establish whether youth engaged in formalized care and support activities would increase their adoption of protective behaviors or reduce the stigma faced by members of AIDS-affected households. Discussions with caregivers and clients demonstrated that trained youth are able to meet a range of the needs of clients and orphans and vulnerable children, and that their efforts may be …