| 1. Title: [Contraception: modern trends and controversies] Source: Srpski Arhiv Za Celokupno Lekarstvo. 2009 May-Jun;137(5-6):310-9. Abstract: Ever since ancient civilizations, the possibility of preventing unwanted pregnancies has always been the subject of interest. All available contraception methods have both advantages and disadvantages, and it is up to the doctor and the patient to make a rational choice in each individual case. Many methods for temporary prevention of unwanted pregnancy are used for the purpose of contraception, as well as sterilization, as a permanent method. A large variety of contraceptives offers opting for the most suitable method for each patient, with the highest level of efficiency and safety. With their adequate administration, the rate of unwanted pregnancies should be significantly minimized. Methods used for contraception are constantly improving and simultaneously, new and more efficient ones are being developed. The research in the field of contraceptives is not completed yet and hopefully, in the future, we shall be closer to finding available, efficient, user-friendly medicaments in the prevention of pregnancy and sexually transmitted diseases, with minimum side effects, which is on the verge of perfection. Novelties in the field of contraception must be the theme of continuous medical education of gynaecologists, so that they could provide the right information and give advice to their patients in choosing the most adequate contraceptive. Language: Serbian Keywords: GLOBAL | SUMMARY REPORT | CONTRACEPTION | DECISION MAKING | PREGNANCY, UNWANTED | STERILIZATION, SEXUAL | CONTRACEPTIVE METHODS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE METHOD ACCEPTABILITY | Family Planning | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Agents | Safety | Public Health | Health | Contraceptive Usage Document Number: 342047 |
2.  Title: Constructive men's engagement in reproductive health: a training-of-trainers' manual. Couple communication and shared decisionmaking related to reproductive health. Author: Futures Group International. Health Policy Initiative; Care International. Keneya Ciwara; Mali. Ministere de la Sante. Division de la Sante Reproductive Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 May. 26 p. (USAID Contract No. GPO-I-01-05-00040-00) Abstract: This curriculum was developed as part of a USAID | Health Policy Initiative, Task Order 1 project focused on building an enabling policy and institutional environment for constructive men's engagement (CME) in reproductive health in Mali. The project worked with the Ministry of Health and other partners in facilitating the process of creating national guidelines to integrate CME in family planning and reproductive health (FP / RH) and to improve women's and men's uptake of FP / RH services. The project brought together the assembly of a large, multisectoral group of stakeholders to develop, refine, and validate Mali's national guidelines in support of the national Reproductive Health Strategic Plan. The Minister of Health quickly approved the guidelines and signed them into effect on May 20, 2008. This document contains the manual used in the pilot workshops with relais communautaires. It is designed to enable community health educators to incorporate activities related to constructive men's engagement in reproductive health (CME-RH) in their daily work. This includes promoting dialogue among men and women to increase couple communication and shared decisionmaking related to FP / RH. As such, it can be adapted in other settings, based on local needs. Language: English Keywords: KENYA | MANUAL | TRAINING ACTIVITIES | COUPLES | DECISION MAKING | TRAINING OF TRAINERS | REPRODUCTIVE HEALTH | MEN'S INVOLVEMENT | INTERPERSONAL COMMUNICATION | WORKSHOPS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Training Programs | Education | Family Characteristics | Family and Household | Sociocultural Factors | Behavior | Health | Programs | Organization and Administration | Communication Document Number: 331535 |
| 3. Title: Understanding the effects of personal and school religiosity on the decision to abort a premarital pregnancy. Author: Adamczyk A Source: Journal of Health and Social Behavior. 2009 Jun;50(2):180-95. Abstract: Although much research has examined the relationship between religion and abortion attitudes, few studies have examined whether religion influences abortion behavior. This study looks at whether individual and school religiosity influence reported abortion behavior among women who become pregnant while unmarried. Hierarchical Logistic Models are implemented to analyze two waves of data from the National Longitudinal Study of Adolescent Health. Findings show that personal religiosity is unrelated to reported abortion behavior. However, conservative Protestants appear less likely to obtain abortions than mainline Protestants, Catholics, and women of non-Christian faiths. Regardless of personal religious affiliation, having attended a school with a high proportion of conservative Protestants appears to discourage abortion as women enter their twenties. Conversely, women from private religious high schools appear more likely to report obtaining an abortion than women from public schools. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LONGITUDINAL STUDIES | YOUTH | STUDENTS | SECONDARY SCHOOLS | PREGNANCY | UNMARRIED | RELIGION | ABORTION | CATHOLICISM | CHRISTIANITY | DECISION MAKING | PREMARITAL PREGNANCY | Developed Countries | North America | Americas | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Reproduction | Marital Status | Nuptiality | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Behavior | Reproductive Behavior | Fertility | Population Dynamics Document Number: 342236 Notification |
| 4. Title: Women's empowerment and the intention to continue the practice of female genital cutting in Egypt. Author: Afifi M Source: Archives of Iranian Medicine. 2009 Mar;12(2):154-60. Abstract: BACKGROUND: The study aimed to (dis)prove the association of the level of women's empowerment with their future intention to perpetuate female genital cutting for their daughters. METHODS: In a national representative community-based sample of 14,393 currently-married women in Egypt, the level of empowerment, intention to continue the practice, and other socio- demographic variables were collected in the 2000 Egypt Demographic and Health Survey. Secondary in-depth analysis was conducted on data downloaded from MEASURE Demographic Health Surveys (MEASURE DHS) website.RESULTS: About 14% of the women intended to discontinue the practice. Twenty-six percent of the women were empowered in all household decisions. Levels of women's empowerment adjusted for age, residence, education, interaction between empowerment and education, work status, and female genital cutting status of currently-married women were entered in six logistic regression models in a sequential way.CONCLUSION: In the last model, those of high levels of empowerment and education were 8.06 times more likely not intending to perpetuate female genital cutting for their daughters than low- empowered low-educated women. Language: English Keywords: EGYPT | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | STATISTICAL REGRESSION | CURRENTLY MARRIED | WOMEN | FEMALE GENITAL CUTTING | WOMEN'S EMPOWERMENT | DECISION MAKING | EDUCATIONAL STATUS | OCCUPATIONAL STATUS | ATTITUDES | AGE FACTORS | Developing Countries | Africa, North | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Research Methodology | Marital Status | Nuptiality | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors | Women's Status | Socioeconomic Factors | Economic Factors | Behavior | Socioeconomic Status | Employment Status | Psychological Factors | Population Characteristics Document Number: 342003 |
5.  Peer Reviewed Title: Can a clinical prediction tool guide HIV-testing decisions? Experience at a national hospital in Guatemala. Author: Anderson MR; Samayoa B; O'Sullivan LF; Fletcher J; Arathoon E Source: International Journal of STD and AIDS. 2009 Jan;20(1):30-4. Abstract: The USA and international recommendations no longer emphasize using risk factors to target groups for HIV-testing. Using a Guatemalan database of HIV tests, we developed a clinical prediction rule to guide decisions on HIV-testing. Prior to HIV-testing, data were collected on demographics, risk factors and prior testing. Based on a theoretical construct incorporating demographics, known HIV risk factors and symptoms, we developed a logistic regression model to predict HIV seropositivity. Between 2000 and 2005, 16,471 tests were performed, of which 19.8% were positive. The algorithm successfully predicted 1883 of 2489 HIV-positive tests (sensitivity 76%, likelihood ratio [LR]-positive 2.45) and 6282 of 9086 HIV-negative tests (specificity 69%, LR-negative 0.35). Although the model indices are robust, applying the model in a clinical setting would have little impact on improving selective testing practices. Our findings support current recommendations for universal HIV-testing, not selective testing based on risk factors. Before these recommendations can be adopted widely in Guatemala, treatment access needs to be assured and protections put in place for people diagnosed with HIV infection. Language: English Keywords: GUATEMALA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | MATHEMATICAL MODEL | STATISTICAL REGRESSION | HIV TESTING | HOSPITALS | DECISION MAKING | RISK ASSESSMENT | PROBABILITY | Central America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Theoretical Models | Data Analysis | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Behavior | Evaluation | Statistical Studies Document Number: 330715 |
| 6. Peer Reviewed Title: Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts ("Bareback Sex") among men who have sex with men. Author: Bauermeister JA; Carballo-Dieguez A; Ventuneac A; Dolezal C Source: AIDS Education and Prevention. 2009 Apr;21(2):156-68. Abstract: Although condom use is an effective barrier against HIV transmission, some men who have sex with men (MSM) engage in bareback sex (unprotected anal sex in risky contexts) and increase their risk for HIV (re)infection. Understanding MSM's decision to bareback (vis-a-vis condom use) is essential to develop effective HIV/AIDS prevention programs for this population. An ethnically diverse sample of men who bareback (n = 120) was recruited exclusively on the Internet and stratified to include two thirds who reported both unprotected receptive anal intercourse (URAI) and being HIV uninfected. We used exploratory factor analysis to explore the domains within the Decisional Balance to Bareback (DBB) scale, and test the association between DBB and risky sexual behaviors. HIV-positive MSM (n = 31) reported higher costs/losses associated with condom use than HIV-negative men (n = 89). We found two underlying factors in the DBB scale: a Coping with Social Vulnerabilities subscale (eight items; alpha = .89) and a Pleasure and Emotional Connection subscale (five items; alpha = .92). We found a positive association between DBB (i.e. greater gains associated with bareback sex) and URAI occasions, number of partners, and having one or more sero-discordant partners in the past 3 months. We conclude that because MSM may avoid using condoms in order to cope with psychosocial vulnerabilities and create intimacy with other MSM, this population could benefit from alternatives to condoms such as pre/post exposure prophylaxis and rectal microbicides. Language: English Keywords: NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | FACTOR ANALYSIS | ANAL SEX | CONDOM USE | HIV TRANSMISSION | DECISION MAKING | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | EMOTIONS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Data Analysis | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | Information Networks | Communication | Psychological Factors Document Number: 331286 |
| 7. Peer Reviewed Title: The persistence of induced abortion in Cuba: exploring the notion of an "abortion culture". Author: Belanger D; Flynn A Source: Studies in Family Planning. 2009 Mar;40(1):13-26. Abstract: Cuba's annual induced abortion rate persistently ranks among the highest in the world, and abortion plays a prominent role in Cuban fertility regulation despite widespread contraceptive prevalence and state promotion of modern contraceptives. We explore this phenomenon using the concept of an "abortion culture," typically used in reference to Soviet and post-Soviet countries. We synthesize existing literature to provide a historical account of abortion and contraception in Cuba. We also provide a qualitative analysis of abortion and contraceptive use based on in-depth interviews conducted in 2005 in Havana with 24 women who have had an abortion and 10 men whose partners have had an abortion. Information gained from a focus-group discussion with medical professionals also informed the study. Our four principal findings are: (a) longstanding awareness of abortion, (b) the view of abortion as a personal decision, (c) the influence of economic constraints on the decision to induce an abortion, and (d) general skepticism toward contraceptives. We discuss our results on abortion in Cuba in relation to the notion of social diffusion, an approach commonly used to explain the spread of fertility control throughout a population. Language: English Keywords: CUBA | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | WOMEN IN DEVELOPMENT | MEN | ABORTION RATE | CULTURE | COMMUNISM | PERCEPTION | ATTITUDES | KNOWLEDGE | MICROECONOMIC FACTORS | DECISION MAKING | CONTRACEPTIVE USAGE | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Economic Development | Economic Factors | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Socialism | Political Systems | Political Factors | Psychological Factors | Behavior | Contraception Document Number: 341079 |
| 8. Peer Reviewed Title: Twenty or thirty microgram ethinyloestradiol in an oral contraceptive: Does it make a difference in the mind and the daily practice of gynaecologists and general practitioners? Author: Bitzer J; Frey B; von Schonau M; Sabler N; Tschudin S Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun 5;:1-10. Abstract: Objectives Currently, evidence-based guidelines concerning the use of oral contraceptives (OCs) containing either 20 or 30 mug ethinyloestradiol (EE) and the same progestogen, are lacking. We wanted to identify whether Swiss gynaecologists and general practitioners (GPs) have specific criteria on which they base their prescribing habit. Methods Two questionnaires were submitted to 158 physicians. The first one contained a list of possible criteria relevant for decision making and a description of specific clinical situations. The second one concerned actual patients who received either a 20 mug (Yasminelle(R)) or a 30 mug (Yasmin(R)) OC containing the same progestogen drospirenone. Results The most relevant criteria for decision making (in hierarchical order) were family history of venous thromboembolic disease (VTE), headache, smoking, age beyond 35, stability of the menstrual cycle, breast tenderness, body mass index, irregular bleeding and acne. The 20 mug dosage was preferred for women older than 35, those smoking more than 15 cigarettes per day, those with a family history of VTE, and those complaining of breast tenderness or headache. The 30 mug dosage was preferred for patients with a history of irregular bleeding, a family history of osteoporosis, expected poor compliance and acne. Conclusion Swiss gynaecologists and GPs do not preferentially prescribe the lowest possible dosage of EE. They use indirect markers they consider relevant for differential prescribing. For some markers, there is inconsistency, indicating that preferences for 20 mug and 30 mug preparations may be influenced by other factors. Language: English Keywords: SWITZERLAND | RESEARCH REPORT | PHYSICIANS | WOMEN | CLIENTS | DECISION MAKING | TOBACCO USE | HEADACHE | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | CONTRACEPTIVE AGENTS, SIDE EFFECTS | THROMBOEMBOLISM | AGE FACTORS | ADMINISTRATION AND DOSAGE | Developed Countries | Europe, Central | Europe | Health Personnel | Delivery of Health Care | Health | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Behavior | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Embolism | Vascular Diseases | Population Characteristics | Drugs | Treatment | Medical Procedures | Medicine | Health Services Document Number: 341601 |
| 9. Title: "Everything I know I learned from my mother...Or not": perspectives of African-American and white women on decisions about tubal sterilization. Author: Borrero S; Nikolajski C; Rodriguez KL; Creinin MD; Arnold RM; Ibrahim SA Source: Journal of General Internal Medicine. 2009 Mar;24(3):312-9. Abstract: BACKGROUND: African-American women have had higher rates of female sterilization compared to white women since its emergence as a contraceptive method. The reasons underlying this observed racial difference are unknown. OBJECTIVES: The goals of this study were to (1) explore what factors shape black and white women's decisions about tubal sterilization as a contraceptive method and (2) generate hypotheses about the relationship of race to the decision-making process. DESIGN: We conducted six focus groups stratified by tubal sterilization status and race. During each of the audio-recorded sessions, participants were asked to discuss reasons that women choose sterilization as a contraceptive method. PARTICIPANTS: The participants of the study were 24 African-American women and 14 white women. APPROACH: Transcripts of the sessions were qualitatively analyzed with particular attention to factors that might be unique to each of the two racial groups. RESULTS: Personal factors shaped black and white women's decisions regarding tubal sterilization. Preference for a convenient, highly effective contraceptive method was the main reason to get a tubal sterilization for women of both racial groups. We also identified socio-cultural differences that might explain why black women are more likely than white women to choose tubal sterilization over other contraceptive methods. An unanticipated, but clinically important, finding was that women often reported feeling that their doctors and the health-care system served as barriers to obtaining the desired procedure. CONCLUSION: Socio-cultural differences may help explain why black and white women choose different contraceptive methods. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | QUALITATIVE RESEARCH | BLACKS | WHITES | WOMEN | TUBAL LIGATION | CONTRACEPTIVE METHODS CHOSEN | DECISION MAKING | SOCIOCULTURAL FACTORS | Developed Countries | North America | Americas | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Female Sterilization | Sterilization, Sexual | Family Planning | Contraceptive Usage | Contraception | Behavior Document Number: 341434 |
| 10. Title: Advocacy to improve global health: Strategies and stories from the field. Author: Cokelet E; Wilson R Source: Washington, D.C., Program for Appropriate Technology in Health [PATH], 2009 Mar. 11 p. Abstract: By influencing the priorities and actions of those in power, PATH works to create a policy environment that supports good health. This workbook provides examples of how PATH uses ten key steps for strategic advocacy to achieve lasting policy change. The collection of stories are intended to serve as a resource to help global health implementers and advocates more deliberately develop strategies to achieve policy goals. Language: English Keywords: DEVELOPING COUNTRIES | METHODOLOGICAL STUDIES | RECOMMENDATIONS | EVALUATION RESEARCH | CASE STUDIES | TARGET POPULATION | INFLUENTIALS | WOMEN IN DEVELOPMENT | ADVOCACY | NEEDS ASSESSMENT | HEALTH POLICY | SOCIAL POLICY | POLICY DEVELOPMENT | DECISION MAKING | SOCIAL CHANGE | Studies | Research Methodology | Evaluation Methodology | Evaluation | Program Design | Programs | Organization and Administration | Knowledge Sources | Communication | Economic Development | Economic Factors | Policy | Political Factors | Sociocultural Factors | Planning | Behavior Document Number: 331353 |
| 11. Title: Global health and the Bill & Melinda Gates Foundation [letter] Author: Dabade G; Puliyel J Source: Lancet. 2009 Jun 27;373(9682):2195-6. Abstract: David McCoy and colleagues note that half of all Gates Foundation funding goes towards vaccination. US$1.5 billion provided by the Gates Foundation and some donor countries go to fund the GAVI Alliance's "advance marketing commitments" to purchase vaccines and provide them at subsidised costs in developing countries. The advance marketing commitments for pneumococcal vaccine illustrate the problem with this policy quite lucidly. Madhi and colleagues have calculated that 1000 children have to be vaccinated to prevent approximately four cases of pneumonia. Given that the vaccine costs $250 per child, $250 000 will be spent to prevent these four cases of pneumonia. Treatment of four children with pneumonia with oral cotrimoxazole, in accordance with the WHO protocol, will cost $1 in India. The hope that GAVI's funding of vaccines would push down their prices has been belied. One review found that prices actually went up after GAVI funding, meaning that the higher costs are borne by poor nations when GAVI funding is withdrawn. Entering into advance commitments to market this vaccine in developing countries allows GAVI to divert Gates Foundation money to vaccine manufacturers, without providing commensurate benefits to the children it is supposed to help. We agree with McCoy and colleagues that, given the substantial public subsidies that the foundation receives in the form of tax exemptions, its programmes must be subjected to public scrutiny. (full-text) Language: English Keywords: GLOBAL | CRITIQUE | FUNDS | DECISION MAKING | HEALTH POLICY | DISEASE PREVENTION | VACCINES | PROGRAM ACTIVITIES | RESEARCH AND DEVELOPMENT | INTERNATIONAL COOPERATION | Financial Activities | Economic Factors | Behavior | Policy | Political Factors | Sociocultural Factors | Prevention and Control | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Technology Document Number: 342052 |
| 12. Title: A comparative analysis of select health facility survey methods applied in low and middle income countries. Author: Edward A; Matsubiyashi T; Fapohunda B; Becker S Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2009 Jul. 47 p. (MEASURE Evaluation Working Paper Series WP-09-111USAID Cooperative Agreement No. GHA-A-00-08-00003-00) Abstract: A majority of health systems in developing countries have severe limitations in the technical expertise and research capacity needed to perform independent assessments. Most are heavily reliant on donor support and engage other institutions and academia to undertake these surveys. Hence, it is important to examine the perspectives of the implementers to determine the management utility and plans for future sustainability. A key informant interview guide was developed for interviews with policy planners, implementing agencies, and health providers to examine their perspectives on the management utility of selected approaches. Key informants were interviewed, including policy planners, project directors, systems supervisors / coordinators, and enumerators, and the findings are presented later in this paper. A comparison of the approach to health facility assessment in the specific methods appears next. Based on the results of the review and key informant interviews, this paper discusses the comparative advantage and limitation of HF surveys and their management utility. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | TECHNICAL REPORT | COMPARATIVE STUDIES | SURVEY METHODOLOGY | HEALTH FACILITIES | HEALTH SERVICES EVALUATION | QUALITY OF HEALTH CARE | PROGRAM EFFECTIVENESS | INTERVIEWS | HEALTH SERVICES ADMINISTRATION | DECISION MAKING | Studies | Research Methodology | Surveys | Sampling Studies | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Data Collection | Management | Behavior Document Number: 331840 |
| 13. Peer Reviewed Title: The Relationship Between Rejection Sensitivity and Compliant Condom Use. Author: Edwards GL; Barber BL Source: Archives of Sexual Behavior. 2009 Sep 4; Abstract: Those who are rejection sensitive anxiously expect and readily perceive rejection. Rejection sensitivity is hypothesized to predict behavior; however, this link may be more evident in some contexts than others. The current study examined the link between rejection sensitivity and condom use. Australian young adults in romantic (n = 649, 70% female) and casual (n = 144, 76.2% female) relationship contexts completed measures on rejection sensitivity, condom use preferences, and condom use. Regression analysis showed that rejection sensitivity predicted condom use when participants' condom use preferences were at odds with those they thought their partner held. Specifically, highly rejection-sensitive individuals who preferred more frequent condom use reported using condoms less often, if that was what they thought their partners wanted. The results lend support to the model of rejection sensitivity in that individuals comply more with their perceived partner's preferences if they are more rejection-sensitive. The results also highlight the need to take the situational context into consideration when examining links between personality dispositions and behavior. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | STATISTICAL REGRESSION | YOUTH | CONDOM USE | SEX BEHAVIOR | DECISION MAKING | INTERPERSONAL RELATIONS | PERCEPTION | QUESTIONNAIRES | Oceania | Developed Countries | Data Analysis | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Psychological Factors Document Number: 342840 |
| 14. Peer Reviewed Title: Health-seeking behaviour for childhood malaria: household dynamics in rural Senegal. Author: Franckel A; Lalou R Source: Journal of Biosocial Science. 2009 Jan;41(1):1-19. Abstract: Research on health care behaviour in sub-Saharan Africa usually considers the mother as the reference in the household when a child is sick. The study of health care management within the family is a key issue for understanding therapeutic rationales. This study was conducted in the region of Fatick in Senegal among 902 children with malaria-related fever. The data were taken from a retrospective quantitative survey conducted in all compounds of the DSS (Demographic Surveillance Site) of Niakhar. The results show that child care-taking is fundamentally a collective process: in 70.9% of out-of-home resorts, the treatment decision was collective. The health care process of 68.1% of morbid episodes involved several individuals. The involvement of the mother, the father and other relatives in the collective management of health care followed different logics. Each care-giver had a specific and complementary function depending on gender norms, intergenerational relations and characteristics of the family unit. Family management of illness aims at optimizing financial and human resources given the economic, logistical and social constraints on health care. Nevertheless, collective management also favoured home-based care, prevented good treatment compliance and delayed the resort to health facilities. These results suggest that health education campaigns should focus on an early involvement of fathers in health care-giving and also on the strengthening of the autonomy of mothers. Mothers' empowerment should give women more autonomy in their child's treatment choice. Lastly, there is a need to develop community health facilities and establish shared funding at the community level. Language: English Keywords: SENEGAL | SUMMARY REPORT | RURAL AREAS | HOUSEHOLDS | CHILDREN | MALARIA | UTILIZATION OF HEALTH CARE | BEHAVIOR | HEALTH SERVICES | TREATMENT | HOME CARE | DECISION MAKING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Geographic Factors | Population | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Delivery of Health Care | Health | Medical Procedures | Medicine | Care and Support Document Number: 330567 |
| 15. Peer Reviewed Title: Do women increase their use of reproductive health care when it becomes more available? Evidence from Indonesia. Author: Frankenberg E; Buttenheim A; Sikoki B; Suriastini W Source: Studies in Family Planning. 2009 Mar;40(1):27-38. Abstract: Data from the Indonesia Family Life Survey are used to investigate the impact of a major expansion in access to midwifery services on women's use of antenatal care and delivery assistance. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in poor communities that were distant from health-care centers. We analyze information from pregnancy histories to relate changes in the choices that individual women make across pregnancies to the arrival of a trained midwife in the village. We show that regardless of a woman's educational level, the placement of village midwives in communities is associated with significant increases in women's receipt of iron tablets and in their choices about care during delivery-changes that reflect their moving away from reliance on traditional birth attendants. For women with relatively low levels of education, the presence of village midwives has the additional benefit of increasing use of antenatal care during the first trimester of pregnancy. The results of the study suggest that bringing services closer to women can change their patterns of use. Language: English Keywords: INDONESIA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | COMMUNITY WORKERS | UTILIZATION OF HEALTH CARE | CHILDBIRTH | WOMEN'S HEALTH | PROGRAM ACCESSIBILITY | DECISION MAKING | COMMUNITY HEALTH SERVICES | ANTENATAL CARE | TRADITIONAL BIRTH ATTENDANTS | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Health Services | Pregnancy Outcomes | Pregnancy | Reproduction | Program Evaluation | Programs | Organization and Administration | Behavior | Primary Health Care | Maternal Health Services | Maternal-Child Health Services Document Number: 341081 |
| 16. Peer Reviewed Title: Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics. Author: Ganatra B; Kalyanwala S; Elul B; Coyaji K; Tewari S Source: Global Public Health. 2009 May 8;:1-12. Abstract: We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed. Language: English Keywords: INDIA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | URBAN POPULATION | ABORTION | PERCEPTION | MOTIVATION | FEAR | EMOTIONS | LOGISTICS | NEEDS ASSESSMENT | DECISION MAKING | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Psychological Factors | Behavior | Management | Organization and Administration | Evaluation Document Number: 341474 |
| 17. Title: [Comprehensive sexual and contraceptive education for young people] Educacion integral en sexualidad y anticoncepcion para los/las jovenes. Author: Gonzalez Hernando C; Sanchez-Crespo Bolanos JR; Gonzalez Hernando A Source: Enfermeria Clinica. 2009 Jul 13; Abstract: According to the National Institute of Statistics (INE) the number of unwanted pregnancies in Spain is increasing every year. This is particularly worrying as regards unwanted in young people, particularly those under 15, which increased by 76% from 2001 to 2005. The younger age when people begin sexual relationships, the increasingly liberal attitudes, a higher number of sexual partners and high risk sexual practices, expose them to very important health problems, such as unwanted pregnancies and sexually transmitted diseases (STD). Adolescence is a vital phase in the personal and sexual identity process. Sexual Education is necessary in a society which seems to be well informed but on the other hand has a high proportion of ignorance and errors, which could seriously affect the emotional balance of people. Teaching to know and accept their own body, seek information or ask for help is an education that can help them to maintain healthier and satisfactory relationships. On the other hand, the increase in undesired pregnancies and sexually transmitted diseases, including HIV, makes this kind of education a priority. Our experience in sexual education for young people answers this need. Young people have the right to an effective sexual education. Information and comprehensive sexual education provide them with the knowledge, skills and attitudes necessary to take decisions in the present and future. Language: Spanish Keywords: SPAIN | RESEARCH REPORT | YOUTH | ADOLESCENTS | PREGNANCY, UNWANTED | SEX BEHAVIOR | SEXUAL PARTNERS | SEXUALLY TRANSMITTED DISEASES | SEX EDUCATION | INFORMATION | KNOWLEDGE | DECISION MAKING | PROGRAM EVALUATION | Developed Countries | Europe, Southwestern | Europe | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Reproductive Tract Infections | Infections | Diseases | Education | Sociocultural Factors | Programs | Organization and Administration Document Number: 342124 |
| 18. Title: Individual versus household migration decision rules: gender and marital status differences in intentions to migrate in South Africa. Author: Gubhaju B; De Jong GF Source: International Migration. 2009 Jun;47(1):31-61. Abstract: This research tests the thesis that the neoclassical microeconomic and the new household economic theoretical assumptions on migration decision-making rules are segmented by gender, marital status, and time frame of intention to migrate. Comparative tests of both theories within the same study design are relatively rare. Utilizing data from the Causes of Migration in South Africa national migration survey, we analyse how individually held "own-future" versus alternative "household well-being" migration decision rules effect the intentions to migrate of male and female adults in South Africa. Results from the gender and marital status specific logistic regressions models show consistent support for the different gender-marital status decision rule thesis. Specifically, the "maximizing one's own future" neoclassical microeconomic theory proposition is more applicable for never married men and women, the "maximizing household income" proposition for married men with short-term migration intentions, and the "reduce household risk" proposition for longer time horizon migration intentions of married men and women. Results provide new evidence on the way household strategies and individual goals jointly affect intentions to move or stay. Language: English Keywords: SOUTH AFRICA | THEORETICAL STUDIES | SURVEYS | EVER MARRIED | NEVER MARRIED | MIGRATION | MOTIVATION | GENDER ISSUES | MARITAL STATUS | DECISION MAKING | ECONOMIC FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Sampling Studies | Nuptiality | Demographic Factors | Population | Population Dynamics | Psychological Factors | Behavior | Sociocultural Factors Document Number: 341299 |
| 19. Title: Childbearing and contraceptive decision making amongst Afghan men and women: a qualitative analysis. Author: Haider S; Todd C; Ahmadzai M; Rahimi S; Azfar P; Morris JL; Miller S Source: Health Care For Women International. 2009 Oct;30(10):935-53. Abstract: Afghanistan has one of the highest maternal mortality ratios and lowest contraceptive prevalence rates globally. Limited information is known regarding Afghan men and women's attitudes toward childbearing, child spacing, and contraceptive use, which is essential for delivery of appropriate services. We conducted a qualitative study among postpartum couples enrolled at maternity hospitals in Kabul, Afghanistan. We identified important themes that highlight the complex inter-relationship between acknowledged risks of childbearing, desire for family planning, rationales for limited contraceptive use, and sociocultural barriers to contraceptive use. We offer practical recommendations for application of findings toward family planning and maternal mortality reduction programs. Language: English Keywords: AFGHANISTAN | RESEARCH REPORT | QUALITATIVE RESEARCH | MEN | WOMEN | COUPLES | POSTPARTUM | DECISION MAKING | BIRTH SPACING | REPRODUCTIVE BEHAVIOR | CONTRACEPTIVE USAGE | SOCIOECONOMIC FACTORS | FAMILY PLANNING PROGRAMS | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Behavior | Family Planning | Fertility | Population Dynamics | Contraception | Economic Factors Document Number: 342710 |
| 20. Title: The social context of childcare practices and child malnutrition in Niger's recent food crisis. Author: Hampshire K; Casiday R; Kilpatrick K; Panter-Brick C Source: Disasters. 2009 Mar;33(1):132-51. Abstract: In 2004-05, Niger suffered a food crisis during which global attention focused on high levels of acute malnutrition among children. In response, decentralised emergency nutrition programmes were introduced into much of southern Niger. Child malnutrition, however, is a chronic problem and its links with food production and household food security are complex. This qualitative, anthropological study investigates pathways by which children are rendered vulnerable in the context of a nutritional 'emergency'. It focuses on household-level decisions that determine resource allocation and childcare practices in order to explain why practices apparently detrimental to children's health persist. Risk aversion, the need to maintain self-identity and status, and constrained decision making result in a failure to invest extra necessary resources ingrowth-faltering children. Understanding and responding to the social context of child malnutrition will help humanitarian workers to integrate their efforts more effectively with longer-term development programmes aimed at improving livelihood security. Language: English Keywords: NIGER | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | HOUSEHOLDS | CHILD NUTRITION | MALNUTRITION | FAMINE | DECENTRALIZATION | NUTRITION PROGRAMS | ANTHROPOLOGY, CULTURAL | DECISION MAKING | RESOURCE ALLOCATION | HOME ECONOMICS | CHILD CARE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Nutrition | Health | Nutrition Disorders | Diseases | Food Supply | Natural Resources | Environment | Political Factors | Primary Health Care | Health Services | Delivery of Health Care | Anthropology | Social Sciences | Science | Behavior | Financial Activities | Economic Factors | Microeconomic Factors | Child Rearing Document Number: 331289 |
| 21. Title: Introduction to the supplement on HIV, HAART, and fertility in sub-Saharan Africa [editorial] Author: Kaida A; Bangsberg DR; Gray G; Hogg RS; King R; Miller CL Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S1-S4. Abstract: Recent years have witnessed an unprecedented global effort aimed at providing universal access to highly active antiretroviral therapy (HAART), however, comparatively little attention has been given to how HAART may affect reproductive decision-making, sexual and reproductive practices, and fertility.1 These issues are particularly critical in HIV endemic settings where the majority of new infections occur among women (UNAIDS 2008). The goal of this supplement of AIDS and Behavior is to bring together current, innovative research from sub-Saharan Africa that explores the influence of HAART on reproductive decision-making, reproductive and sexual health, and reproductive outcomes at individual, social, and environmental levels. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | SUMMARY REPORT | ANTIRETROVIRAL THERAPY | PROGRAM ACCESSIBILITY | HIV INFECTIONS | REPRODUCTIVE BEHAVIOR | REPRODUCTIVE HEALTH | DECISION MAKING | FERTILITY | STIGMA | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Africa | Developing Countries | HIV | Viral Diseases | Diseases | Program Evaluation | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Health | Behavior | Social Problems | Sociocultural Factors | Disease Transmission Control | Prevention and Control Document Number: 341888 |
| 22. Peer Reviewed Title: Adjustment to termination of pregnancy for fetal anomaly: a longitudinal study in women at 4, 8, and 16 months. Author: Korenromp MJ; Page-Christiaens GC; van den Bout J; Mulder EJ; Visser GH Source: American Journal of Obstetrics and Gynecology. 2009 Aug;201(2):160.e1-7. Abstract: OBJECTIVE: We studied psychological outcomes and predictors for adverse outcome in 147 women 4, 8, and 16 months after termination of pregnancy for fetal anomaly. STUDY DESIGN: We conducted a longitudinal study with validated self-completed questionnaires. RESULTS: Four months after termination 46% of women showed pathological levels of posttraumatic stress symptoms, decreasing to 20.5% after 16 months. As to depression, these figures were 28% and 13%, respectively. Late onset of problematic adaptation did not occur frequently. Outcome at 4 months was the most important predictor of persistent impaired psychological outcome. Other predictors were low self-efficacy, high level of doubt during decision making, lack of partner support, being religious, and advanced gestational age. Strong feelings of regret for the decision were mentioned by 2.7% of women. CONCLUSION: Termination of pregnancy for fetal anomaly has significant psychological consequences for 20% of women up to > 1 year. Only few women mention feelings of regret. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | LONGITUDINAL STUDIES | WOMEN | POSTABORTION | POSTABORTION CARE | PSYCHOLOGICAL FACTORS | STRESS | DEPRESSION | CONGENITAL ABNORMALITIES | DECISION MAKING | IMPACT | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Health Services | Delivery of Health Care | Health | Behavior | Mental Disorders | Diseases | Neonatal Diseases and Abnormalities | Communication Document Number: 342609 |
| 23. Title: Factors influencing women's decision to have a home birth in rural Turkey. Author: Kukulu K; Oncel S Source: Midwifery. 2009 Feb;25(1):32-8. Abstract: OBJECTIVE: to ascertain the reasons why mothers choose to have a home birth and the factors that influence these reasons. METHODS: this cross-sectional study involved 392 women and was conducted between June and September 2003 in a rural setting in Turkey. The data were collected using a questionnaire developed by the authors. The questionnaire included demographic information, obstetric background, the reasons for deciding to give birth at home as well as questions on who encouraged the decision to give birth at home and who assisted in the home births. FINDINGS: the decision to have a home birth is related to economic difficulties and the desire to benefit from the assistance of neighbours. Women who had experienced both planned and unplanned home births reported that home birth was unsafe. CONCLUSION: preliminary information is provided about women having home births that may inform practitioners' educational efforts and future research. Language: English Keywords: TURKEY | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | SOCIAL NETWORKS | FRIENDS AND RELATIVES | HOME CARE | CHILDBIRTH | DECISION MAKING | HOME ECONOMICS | PERCEPTION | SAFETY | Europe, Southeastern | Europe | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Care and Support | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Behavior | Microeconomic Factors | Economic Factors | Psychological Factors | Public Health Document Number: 331292 |
| 24. Peer Reviewed Title: A Qualitative Assessment of Decisions Affecting Contraceptive Utilization and Fertility Intentions among HIV-Positive Women in Soweto, South Africa. Author: Laher F; Todd CS; Stibich MA; Phofa R; Behane X; Mohapi L; Gray G Source: AIDS and Behavior. 2009 Mar 24;13:S47-S54. Abstract: The HIV epidemic in sub-Saharan Africa disproportionately affects women of reproductive age. The increasing provision of Highly Active Anti-Retroviral Therapy (HAART) with improved prognosis and maternal-fetal outcomes calls for an understanding of fertility planning for HIV-positive women. We describe the effect of HIV and HAART on pregnancy desires and contraceptive use among HIV-positive women in Soweto, South Africa. Focus group discussions and in-depth interviews were conducted with 42 HIV-positive women of reproductive age. Analysis was performed using ATLAS-ti (ATLAS-ti Center, Berlin). Emergent themes were impact of HIV diagnosis on pregnancy intentions; factors affecting contraceptive uptake including real and normative side effects, body image, and perceived vaginal wetness; and the mitigating influence of partnership on both pregnancy intentions and contraceptive use. Routine counseling about pregnancy desires and contraception should be offered to HIV-positive women. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | WOMEN | CONTRACEPTION | REPRODUCTIVE BEHAVIOR | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | FERTILITY | DECISION MAKING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Demographic Factors | Population | Family Planning | Population Dynamics | HIV | Behavior Document Number: 330852 |
| 25. Peer Reviewed Title: Women’s expectations of treatment and care after an antenatal HIV diagnosis in Lilongwe, Malawi. Author: Levy JM Source: Reproductive Health Matters. 2009 May;17(33):152-161. Abstract: Women in sub-Saharan Africa are increasingly learning their HIV status in prevention of mother-to-child transmission of HIV (PMTCT) programmes in the context of antenatal care. This paper examines women's decisions about HIV testing and their experience of PMTCT and HIV-related care in one clinic in Lilongwe, Malawi. It is based on qualitative, ethnographic research conducted in 2004 and 2005, including interviews and focus group discussions with 55 HIV-positive women participating in a PMTCT programme, and 21 interviews with key informants from the programme and the health system. Women's expectations from testing were consistent with the benefits for their own health and their infants' health, as communicated by nurses. However, the PMTCT programme only poorly met their expectations. Reasons for this disjuncture included the construction of women as still healthy even when they needed treatment, a focus only on infant health, health system weaknesses, lack of integrated care and timely referral, and defining HIV exclusively as a medical issue, while ignoring the social determinants of health. Women's own health was particularly marginalised within the PMTCT programme, yet good models exist for comprehensive care for women, infants and their families that should be implemented as testing is scaled up. Spanish Abstract: Las mujeres en África subsahariana están conociendo cada vez más su estado de VIH en programas de prevención de la transmisión materno-infantil (PTMI) del VIH, en el contexto de la atención antenatal. Este artículo examina las decisiones de las mujeres respecto a las pruebas de VIH y su experiencia con la PTMI y el tratamiento del VIH en una clínica de Lilongwe, en Malaui. Se basa en una investigación etnográfica cualitativa, realizada en 2004 y 2005, con entrevistas y discusiones en grupos focales con 55 mujeres VIH-positivas, que participaron en un programa de PTMI, y 21 entrevistas con informantes clave del programa y el sistema de salud. Las expectativas de las mujeres en cuanto a las pruebas concordaron con los beneficios para su propia salud y la salud de sus bebés, según informaron las enfermeras. Sin embargo, el programa de PTMI no logró satisfacer bien sus expectativas por las siguientes razones: ver a las mujeres como saludables aun cuando necesitaban tratamiento, centrarse sólo en la salud de los bebés, las debilidades del sistema de salud, la falta de servicios integrados y referencias oportunas, y definir al VIH exclusivamente como un problema médico sin prestar atención a los determinantes sociales de la salud. Aunque la salud de las mujeres fue particularmente marginada en el programa de PTMI, existen buenos modelos de atención integral para las mujeres, sus bebés y sus familias, que deberían implementarse según se vayan ampliando los programas de pruebas del VIH. French Abstract: En Afrique subsaharienne, de plus en plus de femmes connaissent leur statut sérologique grâce aux programmes de prévention de la transmission mère-enfant du VIH (PTME) dans le contexte des soins prénatals. Cet article examine les décisions des femmes sur le test et leur expérience de la PTME et des soins liés au VIH dans un dispensaire à Lilongwe, Malawi. Il est fondé sur une recherche qualitative ethnographique menée en 2004 et 2005 qui comprenait des entretiens et des discussions de groupe avec 55 femmes séropositives participant à un programme de PTME, et 21 entretiens avec des informateurs clés du programme et du système de santé. Les attentes des femmes quant au dépistage cadraient avec les avantages pour leur santé et celle de leur bébé tels que les infirmières les avaient exposés. Néanmoins, le programme de PTME répondait mal à leurs espérances, notamment du fait que les femmes se voyaient encore en bonne santé alors qu'elles avaient besoin d'un traitement. D'autres raisons étaient l'accent mis uniquement sur la santé du nourrisson, les faiblesses du système de santé, le manque de soins intégrés et de transfert ponctuel des patients, et la définition du VIH exclusivement comme une question médicale, au mépris des déterminants sociaux de la santé. La santé des femmes était particulièrement marginalisée dans le programme de PTME. Pourtant, de bons modèles de soins complets existent pour les femmes, les nourrissons et leur famille. Ils devraient être appliqués alors que le dépistage s'étend. Language: English Keywords: MALAWI | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | ANTENATAL CARE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV TESTING | COUNSELING | INTERVIEWS | DECISION MAKING | MOTIVATION | ANTIRETROVIRAL THERAPY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Clinic Activities | Program Activities | Programs | Organization and Administration | Data Collection | Behavior | Psychological Factors | HIV | HIV Infections | Viral Diseases Document Number: 342024 |
| 26. Title: Kin influence on the decision to start using modern contraception: A longitudinal study from rural Gambia. Author: Mace R; Colleran H Source: American Journal of Human Biology. 2009 May 5; Abstract: In earlier work in rural Gambia, we found that kin influence reproductive success: matrilineal kin, especially mothers, maternal grandmothers and unmarried older sisters all helped to promote the survival and nutrition of young children; in contrast patrilineal kin, especially husband's mother, promoted fertility. These differing influences of maternal and paternal lineage are predicted on the basis of kin selection and sexual conflict theory, because the costs of reproduction fall more heavily on the mother than the father. These studies covered the period 1950-1975, when this population was essentially "natural fertility, natural mortality." It is not possible to tell whether these effects were due to kin influencing active reproductive decision-making, or due to indirect effects such as kin improving nutrition by helping. Since 1976, modern contraception has become available in this community. In an analysis of the behavioral ecology of the decision to start using modern contraception, we found that high parity for your age was a key determinant of the decision, as was village and calendar year. Here, we examine whether the presence or absence of kin and also whether the contraceptive status of kin influenced the decision to start using contraception. We find little evidence that kin directly influence contraceptive uptake, either by their presence/absence or as models for social learning. However, death of a first husband (i.e., widowhood) does accelerate contraceptive uptake. We discuss our results from an evolutionary demography perspective, in particular regarding theories of sexual conflict, biased cultural transmission, and social learning. Am. J. Hum. Biol., 2009. (c) 2009 Wiley-Liss, Inc. Language: English Keywords: GAMBIA | RESEARCH REPORT | LONGITUDINAL STUDIES | RURAL AREAS | KINSHIP NETWORKS | MOTHERS | GRANDPARENTS | MATRIARCHY | FERTILITY | CONTRACEPTION | DECISION MAKING | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Geographic Factors | Population | Family and Household | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Population Dynamics | Demographic Factors | Family Planning | Behavior Document Number: 341044 |
| 27. Peer Reviewed Title: Young unmarried men's understanding of female hormonal contraception. Author: Merkh RD; Whittaker PG; Baker K; Hock-Long L; Armstrong K Source: Contraception. 2009 Mar;79(3):228-35. Abstract: BACKGROUND: A better understanding of men's attitudes, norms and behaviors regarding women's use of hormonal contraception is needed. STUDY DESIGN: We conducted contraceptive life-history interviews with 41 ethnically diverse males ages 18-25 years which detailed up to six heterosexual relationships, focusing on knowledge, attitudes, norms and behaviors regarding hormonal contraception use, decision making and communication. RESULTS: Men's attitudes, norms and behaviors associated with hormonal contraceptive decisions and use varied greatly across participants and their relationships. Findings suggest a mixture of attitudes and practices regarding the importance of communication around contraception influenced by sexual experiences, age and relationship type. Many men demonstrated limited knowledge about contraceptives and identified improving contraceptive knowledge as an essential step in facilitating contraceptive communication. CONCLUSIONS: Increased awareness about young men's understanding of and perceived roles regarding hormonal contraception will help in designing services that address contraceptive adherence, contraceptive communication and incorrect or inadequate contraceptive knowledge. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | EVENT HISTORY ANALYSIS | UNMARRIED | MEN | KNOWLEDGE | CONTRACEPTION | CONTRACEPTIVE AGENTS | HORMONES | ATTITUDES | VALUE ORIENTATION | SEX BEHAVIOR | DECISION MAKING | PARTNER COMMUNICATION | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Analysis | Marital Status | Nuptiality | Demographic Factors | Population | Sociocultural Factors | Family Planning | Endocrine System | Physiology | Biology | Psychological Factors | Behavior | Interpersonal Relations Document Number: 330054 |
| 28. Peer Reviewed Title: Women living with HIV in South Africa and their concerns about fertility. Author: Nduna M; Farlane L Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S62-S65. Abstract: Health and quality of life benefits accrued from the availability of highly active antiretroviral therapy (HAART) are commendable, but the social milieu continues to pose challenges for women's decision making around having children. This paper qualitatively explored women's questions and concerns around living with HIV, being on HAART and pregnancy. Women of reproductive age were recruited from Eastern Cape and Gauteng Provinces, South Africa. Information on women's fertility desires and pregnancy planning was collected through participatory workshop, focus groups, and one-on-one interviews. Three main themes emerged. Women living with HIV require information on the impact of HIV on pregnancy outcomes and vice versa. Women who are young, lost a child, not consistently using contraception or who have not been seriously ill have positive reproductive aspirations. Ambivalent attitudes of health care workers towards pregnancy impacts women's fertility aspirations. Unbiased pre-conceptual communication should form part of HIV treatment and care services, despite expressed pregnancy intentions. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | FOCUS GROUPS | WOMEN | PERSONS LIVING WITH HIV/AIDS | HEALTH PERSONNEL | ANTIRETROVIRAL THERAPY | PREGNANCY | DECISION MAKING | FERTILITY PREFERENCES | ATTITUDES | INTERVIEWS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | HIV | Reproduction | Behavior | Fertility | Population Dynamics | Psychological Factors Document Number: 341902 |
| 29. Peer Reviewed Title: Ethical and social issues facing obstetricians in low-income countries. Author: Ogwuegbu CC; Eze OH Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):237-49. Abstract: A review of publications on ethical and social issues from low-income countries was done with the aim of highlighting the major ethical and social issues facing obstetricians in these countries. Low-income countries were identified using the World Health Organization income group classification of member nations. Obstetricians in low-income countries face a wide range of special social and ethical issues that reflect the peculiarities of their practice environment characterized by poverty, low education, deep attachment to tradition and culture, low social status of women, and high levels of physician's paternalism. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | LITERATURE REVIEW | PHYSICIANS | OBSTETRICS | ETHICS | POVERTY | SOCIOCULTURAL FACTORS | WOMEN'S STATUS | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | DECISION MAKING | INFORMED CONSENT | EDUCATIONAL STATUS | HARMFUL TRADITIONAL PRACTICES | Health Personnel | Delivery of Health Care | Health | Medicine | Health Services | Socioeconomic Factors | Economic Factors | Maternal-Child Health Services | Primary Health Care | Behavior | Socioeconomic Status | Traditional Health Practices | Culture Document Number: 342174 |
| 30. Title: Does access to contraception raise teenage pregnancy rates? Author: Paton D Source: Nursing Times. 2009 Mar 24-30;105(11):11. Abstract: Since the government launched its Teenage Pregnancy Strategy in 1999, millions of pounds have been spent on access to 'confidential sexual health services' for young people. Many nurses are uncomfortable with providing such services to children under 16, especially without parental knowledge. Unfortunately, the latest data shows that pregnancy and abortion rates for under-16s are higher now. Given this, nurses may be questioning whether they have been right to go along with this policy. A 2007 Obstetrics and Gynecology review of the evidence relating to emergency contraception concluded that 'to date, no study has shown that increased access to [emergency contraception] reduces unintended pregnancy or abortion rates' (Raymond et al, 2007). When policy interventions have unexpected impacts that subvert the aim of the policy, economists often refer to the law of unintended consequences. In this case, by lowering the pregnancy risk, easier access to birth control may encourage more young people to engage in sexual activity. If so, pregnancies decrease among those who would have sex anyway, but increase among those who have sex when they otherwise would not have done. Overall, we end up with a similar number of pregnancies but with more sexually active underage youngsters. Many contraceptive methods offer no protection against sexually transmitted infections (STIs). Research published in Sex Education suggests increased access to emergency contraception may be associated with higher teenage STI rates (Paton, 2006). On a positive note, academic evidence is clear that involving parents in the decision-making is crucial. When the Gillick ruling was in effect in England and Wales during most of 1985, contraception could not be provided to underage girls without parental involvement. Take-up at family planning clinics dropped by about 30%, yet underage pregnancy rates decreased slightly relative to older teenagers. The ruling was overturned in late 1985. In addition, research in the Journal of Health Economics and elsewhere reveals that laws requiring parental consent before an abortion is performed on a minor lead to significant decreases in teenage abortions, pregnancies and even STIs (Levine, 2003). It is unclear why it has taken so long for the findings to filter down to nurses. Whatever the reason, nurses might remember that although the Fraser guidelines permit nurses to provide minors with access to abortion and contraception without parental knowledge if they can make informed decisions, they do not require nurses to do so. Furthermore, all health professionals-and taxpayers -should question why PCTs spend resources on measures such as school-based provision of emergency contraception that, at best, are ineffective and, at worst, may contribute to poor sexual health among teenagers. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | ADOLESCENTS | PARENTAL INVOLVEMENT | ADOLESCENT PREGNANCY | CONTRACEPTIVE USAGE | CONTRACEPTION | DECISION MAKING | RISK REDUCTION BEHAVIOR | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Family Planning | Program Evaluation | Programs | Organization and Administration Document Number: 331149 |
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