International Public Health Commons^™

Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru

Reproductive Health

This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …

Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai

Reproductive Health

The objectives of this Population Council study were twofold: first to collect information on prevailing practices of abortion and post‐abortion care in Pakistan and, second, to gauge changes in the magnitude and quality of abortion‐related complications and care during the last decade (since the 2002 national study of “Unwanted Pregnancy and Post‐abortion Complications in Pakistan”). The study found that the level of post‐abortion family planning (FP) counseling in both public and private health facilities offering PAC services was inadequate. There has been no improvement over the decade in the level of counseling reported, and, even more disappointingly, only half of …

Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew

Reproductive Health

No abstract provided.

Hivcore Operations Research Workshop Summary Report, Nrupa Jani

HIV and AIDS

Over the past decade, unprecedented progress has been made in the scale-up of HIV treatment, care, and support, yet substantial coverage gaps remain. Targeted operations research and program evaluation can play a significant role in ensuring efficient and effective service delivery, scaling up to reach more clients and on a broader geographical scope, enhancing quality of care, and improving the health status and health systems in developing country settings. With funding from USAID, the Population Council and partners are responding to these critical service delivery issues through HIVCore. HIVCore improves the efficiency, effectiveness, scale, and quality of HIV and AIDS …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi

Poverty, Gender, and Youth

The decision to engage in the development of girl-friendly savings accounts was made as part of the Population Council’s work with adolescent girls in Kenya. In June 2008 the Council and MicroSave Consulting started the Safe and Smart Savings Products for Vulnerable Adolescent Girls. Based on the market research and prior experience with developing programs for adolescent girls, a product concept for a group-based savings account was developed, in which the group model was used to address the legal constraints of minors not being able to hold individual accounts. In Kenya and Uganda, two financial institutions were identified, and the …

Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on …

Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt, Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi

Poverty, Gender, and Youth

This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the …

The Contracting World Of Girls At Puberty: Violence And Gender-Divergent Access To The Public Sphere Among Adolescents In South Africa, Kelly Hallman, Nora Kenworthy, Judith A. Diers, Nick Swan, Bashi Devnarain

Poverty, Gender, and Youth

This Population Council working paper describes a participatory mapping project undertaken with single-sex groups of grade 5 and grade 8–9 children in urban and rural KwaZulu-Natal, South Africa. At grade 5, female self-defined community areas were equal to or larger in size than those of males in both sites. However, wide gender divergence in access to the public sphere was found among grade 8–9 children. Although curtailed spatial access, especially in urban areas, is intended to protect post-pubescent girls, grade 8–9 girls reported most spaces in their small navigable areas unsafe. Reducing girls’ access to the public sphere does not …

The Ishraq Program For Out-Of-School Girls: From Pilot To Scale-Up [Arabic], Mona Selim, Nahla G. Abdel-Tawab, Khaled El Sayed, Asmaa Elbadawy, Heba El Kalaawy

Poverty, Gender, and Youth

In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities …

Capturing The Demographic Dividend In Pakistan, Zeba Sathar, Rabbi Royan, John Bongaarts

Poverty, Gender, and Youth

Pakistan’s demographic profile is changing: fertility is slowly decreasing, and people are living longer. If Pakistan succeeds in strengthening education and bringing the full panoply of reproductive rights and reproductive health services to women, it will have taken two important steps in transforming demographic change into poverty reduction and better lives for the great majority of Pakistanis. If it also takes other policy actions that can spur productive employment and investment, positive outcomes are all the more likely. This book brings together many ideas that have been discussed for some time in Pakistan and around the world, including extensive development …

Policy Brief: Adolescent Girls And Migration In The Developing World, Population Council

Poverty, Gender, and Youth

When a migrant girl is successful, she creates a ripple effect through generations: families and future children will be better off because of her ability to finish school, get a job, and stay healthy. Despite the positive potential of migration for adolescent girls, migrant girls are largely ignored in policy and programs designed to reach migrants and adolescents. Because of their age and gender, migrant girls are especially vulnerable to risks such as exploitative employment. If these girls arrive at their destination and settle in safely, their diligence can enable them to capitalize on new opportunities and become productive, contributing …

Designing, Implementing, And Evaluating A Targeted, Evidence-Based Intervention For A Vulnerable Subgroup Of Girls: A Case Study Of The Filles Éveillées ("Girls Awakened") Pilot Program For Migrant Adolescent Girls In Domestic Service In Urban Burkina Faso, Sarah Engebretsen

Poverty, Gender, and Youth

Investing in adolescent girls is crucial in the developing world where a large and growing proportion of the population is under the age of 24. Research has demonstrated that adolescent girls face serious challenges around the time of puberty including withdrawal from (and lack of safety in) public spaces, loss of peers, leaving school, pressure for marriage or liaisons as livelihood strategies, and internalization of harmful gender norms. Investments need to be made at critical moments in early adolescence. While policymakers and development professionals have acknowledged the need to make investments in the poorest girls in the poorest communities early …

Follow-Up Study Of Migrant Adolescent Girls In Domestic Service Who Participated In The First Cohort Of The Filles Éveillées ("Girls Awakened") Program, Sarah Engebretsen

Poverty, Gender, and Youth

Circular migration (from rural to urban areas and back) among adolescents is common throughout West Africa, with the principle motivation being the search for economic opportunities, including domestic work. The evidence base on adolescent migration and domestic work is fairly thin. Evidence on programmatic effectiveness generally ends at program completion and does not follow adolescents over time. The current study follows a subsample of migrant adolescent girls in domestic service in urban Burkina Faso who participated in the first cohort of the Filles Éveillées (Girls Awakened) pilot program. Filles Éveillées was designed to provide migrant girls in domestic service with …

The Adolescent Girls Empowerment Program: Lessons Learned From The Pilot Test Program, Karen Austrian, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Adolescent girls in Zambia face a range of risks and vulnerabilities that compromise their healthy development into young women, and lack the social, health, and economic assets to mitigate these risks. The issues that girls are confronted with include high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, and lack of agency and participation. The Adolescent Girls Empowerment Program (AGEP) has three major components: safe spaces groups in which girls meet once a week over the course of two years for training …

Comprendre La Vie Des Adolescentes Avant Et Après La Migration: Enquête Réalisée Sur Les Sites D'Origine Auprès D'Anciennes Filles Migrantes Employées Comme Aide-Ménagères, Gisele Kaboré

Poverty, Gender, and Youth

Le Population Council met en œuvre un projet en direction des adolescentes migrantes travaillant comme employées de maison dans les zones urbaines au Burkina Faso (Ouagadougou et Bobo-Dioulasso). Ce programme, dénommé «Filles Éveillées», a pour objectif d’élargir les réseaux sociaux des filles et de développer leurs compétences en capacités financières, en santé et hygiène, santé de la reproduction et en compétences de la vie courante. Il offre également aux bénéficiaires l’opportunité d’accéder à l’alphabétisation. Dans un effort d’améliorer ce programme en ville, il s’est avéré opportun de mieux comprendre les circonstances de la vie des adolescentes dans le village avant …

Évaluation De Filles Éveillées : Programme Pilote Pour Adolescentes Migrantes Employées De Maison, Sarah Engebretsen

Poverty, Gender, and Youth

Le programme «Filles Éveillées» a été conçu dans le but d’accroître les réseaux sociaux et de développer les compétences des adolescentes migrantes employées de maison au Burkina Faso urbain. Il a fait l’objet de deux cycles pilotes: en 2011-2012 à Bobo-Dioulasso, puis en 2012-2013 à Ouagadougou et Bobo-Dioulasso. Une évaluation de processus a été effectuée entre les deux cycles avant d’évaluer l’efficacité du programme et d’y proposer les améliorations de structure, mise en œuvre et contenu jugées utiles avant le lancement de la seconde cohorte. Cette évaluation a donné lieu aux changements suivants: simplification du contenu programmatique sur la santé …

Subjective Health Status And Health-Related Quality Of Life Among Women With Recurrent Vulvovaginal Candidosis (Rvvc) In Europe And The Usa, Samuel Aballéa, Florent Guelfucci, Julian Wagner, Amine Khemiri, Jean-Paul Dietz, Jack Sobel, Mondher Toumi

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.

Methods

A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing …

Is The Reporting Timeliness Gap For Avian Flu And H1n1 Outbreaks In Global Health Surveillance Systems Associated With Country Transparency?, Feng-Jen Tsai, Eva Tseng, Chang-Chuan Chan, Hiko Tamashiro, Sandrine Motamed, André C Rougemont

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: This study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the WHO and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap.

METHODS: We recorded the initial release dates of each report related to avian flu or H1N1 listed on the WHO Disease Outbreak News site and the matching outbreak report from ProMED-mail, a non-governmental program for monitoring emerging …

Prevalence And Correlates Of Being Bullied Among In-School Adolescents In Malawi: Results From The 2009 Global School-Based Health Survey, H.W. Kubwalo, A.S. Muula, S. Siziya, S. Pasupulati, E. Rudatsikira

Community & Environmental Health Faculty Publications

Background

Physical and emotional violence against adolescents is a neglected, but growing problem globally. Violence against adolescents negatively affects the victim in terms of physical health, school attendance and performance and social adjustment. The literature on the prevalence and associated factors of bullying against adolescents is sparse in southern Africa outside South Africa. Such data are even sparser for Malawi. The current study was conducted to estimate the prevalence of self-reported bullying and its personal and social correlates.

Methods

A secondary analysis of the Malawi School-Based Student Health Survey (2009) was done. Descriptive analyses were done to describe the sample …