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Title: Maternal and perinatal outcome in teenage pregnancies in Sudan.
Author: Adam GK; Elhassan EM; Ahmed AM; Adam I
Source: International Journal of Gynaecology and Obstetrics. 2009 May;105(2):170-1.
Abstract: Pregnancy and childbirth in teenage women pose special risks for both mother and baby. As well as significant medical, nutritional, social, and economic risks, teenage pregnancy is associated with increased risks for adverse pregnancy outcomes, such as preterm birth, low birth weight, and death in the neonatal or postnatal periods. There is a paucity of literature regarding the maternal and perinatal outcome of teenage pregnancies in Sudan, Africa. The aim of the present study was to assess the risk of anemia, operative delivery, and perinatal complications (mainly low birth weight) among primiparous teenagers with a singleton delivery compared with a similar group of women aged 20-24 years. (excerpt)
Language: English

Keywords:
SUDAN | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | ADOLESCENT PREGNANCY | PREGNANCY OUTCOMES | ANEMIA | LOW BIRTH WEIGHT | MATERNAL AGE | EDUCATIONAL STATUS | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Pregnancy | Reproduction | Diseases | Birth Weight | Body Weight | Physiology | Biology | Parental Age | Age Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 341382  

2.
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  

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Title: The role of education level in the intergenerational pattern of adolescent pregnancy in Brazil.
Author: Almeida MC; Aquino EM
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):139-146.
Abstract: Adolescent pregnancy has been associated with the early childbearing experience of the mothers of adolescents, and young people's education level is believed to be an important factor in this phenomenon. In 2002, a representative household survey collected data from 3,050 young men and women ages 20–24 in three Brazilian cities. The main measures were mother's age at first birth, daughter's age at first pregnancy, and son's age when he first impregnated a partner. Ages were dichotomized as younger than 20 and 20 or older. The distribution of respondents, by both their own and their mothers' reproductive experience, was analyzed in relation to various characteristics, and logistic regressions assessed possible associations between these variables and pregnancy experience. Thirty percent of women reported getting pregnant before age 20, and 21% of men said they were younger than 20 when they first impregnated a partner. Of these groups, 34% of women and 31% of men reported that their mothers had first given birth at the same age. Both women and men were more likely to have had an early pregnancy experience if their mother had had a child before age 20. Among women, this positive association disappeared in the final model after adjusting for their education level, whereas among men the association remained after similar adjustment.
Spanish Abstract: Contexto: El embarazo durante la adolescencia se ha asociado con la experiencia de la maternidad temprana de las madres de los y las adolescentes; y se considera el nivel educativo de la gente joven como un factor importante en este fenómeno. Métodos: En 2002, una encuesta representativa de hogares recolectó datos de 3,050 hombres y mujeres jóvenes de 20-24 años en tres ciudades brasileñas. Las principales medidas fueron la edad de la madre de los encuestados en el momento de su primer parto, la edad de la joven en el primer embarazo y la edad del joven al embarazar por primera vez a una pareja; los grupos de edad se dividieron en menores de 20 y de 20 años o mayores. La distribución de las personas encuestadas (tanto por su propia experiencia reproductiva como la de su madre), se analizó en relación con varias características, y se valoró mediante regresiones logísticas las posibles asociaciones entre estas variables y la experiencia del embarazo. Resultados: Treinta por ciento de las jóvenes reportaron haberse embarazado antes de los 20 años; y 21% de los hombres dijeron que eran menores de 20 años cuando su pareja se embarazó. De estos grupos, 34% de las mujeres y 31% de los hombres reportaron que sus madres habían dado a luz por primera vez a la misma edad. Tanto las mujeres como los hombres tuvieron mayor probabilidad de experimentar un embarazo temprano si su madre había tenido un hijo antes de los 20 años (razones de momios, 2.0 y 2.3, respectivamente). En las mujeres, esta asociación positiva desapareció en el modelo final, después de ajustar por nivel de educación, mientras que entre los hombres la asociación permaneció después de un ajuste similar (1.8). Conclusiones: El nivel de educación de las hijas e hijos parece ser un factor importante en la repetición de la fecundidad adolescente a través de las generaciones. Se necesita esfuerzos para aumentar el acceso a la educación y para alentar a la gente joven a que permanezca en la escuela.
French Abstract: Contexte: Les grossesses d'adolescentes ont été associées à l'expérience de la maternité précoce des mères des adolescents concernés et le niveau d'instruction des jeunes semble jouer un rôle important. Méthodes: En 2002, une enquête de ménages représentative a recueilli des données auprès de 3.050 jeunes hommes et femmes de 20 à 24 ans dans trois villes du Brésil. Les principales mesures ont porté sur l'âge de la mère à la première naissance, l'âge de la fille à la première grossesse et l'âge du fils au moment de la fécondation d'une partenaire. Les âges ont été dichotomisés entre moins de 20 ans et 20 ans ou plus. La distribution des répondants en fonction de leur propre expérience génésique et de celle de leur mère a été analysée selon différentes caractéristiques, tandis que les associations possibles entre ces variables et l'expérience d'une grossesse étaient évaluées par régressions logistiques. Résultats: Trente pour cent des femmes ont déclaré avoir été enceintes avant l'âge de 20 ans, tandis que 21% des hommes déclaraient avoir eu moins de 20 ans au moment de la fécondation de leur partenaire. De ces groupes, 34% des femmes et 31% des hommes ont déclaré que leur mère avait accouché pour la première fois à ce même âge. Tant les femmes que les hommes sont apparus plus susceptibles d'avoir connu une grossesse précoce si leur mère avait eu un enfant avant l'âge de 20 ans (rapports de probabilités, 2,0 et 2,3, respectivement). Côté féminin, cette association positive disparaît dans le modèle final après correction du niveau d'instruction; côté masculin, elle se maintient après correction similaire (1,8). Conclusions: Le niveau d'instruction des filles comme des fils semble jouer un rôle important dans la répétition de la fécondité adolescente d'une génération à l'autre. Des efforts sont nécessaires pour accroître l'accès à l'éducation et encourager les jeunes à poursuivre leur scolarisation.
Language: English

Keywords:
BRAZIL | RESEARCH REPORT | SURVEYS | MOTHERS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | AGE FACTORS | FIRST BIRTH | EDUCATIONAL STATUS | REPRODUCTIVE BEHAVIOR | FERTILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Population Dynamics | Pregnancy History | Fertility Measurements | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 343004  

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Title: Does where you live influence what you know? Community effects on health knowledge in Ghana.
Author: Andrzejewski CS; Reed HE; White MJ
Source: Health and Place. 2009 Mar;15(1):228-38.
Abstract: This paper examines community effects on health knowledge in a developing country setting. We examine knowledge about the etiology and prevention of child illnesses using a unique 2002 representative survey of communities and households in Ghana. We find that community context matters appreciably, even after adjusting for the anticipated positive effects of an individual's education, literacy, media exposure and household socioeconomic status. The proportion of literate adults and the presence of a market in a community positively influence a person's health knowledge. In other words, even if a person herself is not literate, living in a community with high levels of literacy or a regular market can still positively affect her health knowledge. Our results suggest that social networks and diffusion play a key role in these community effects. In turn, these results offer policy implications for Ghana and sub-Saharan Africa.
Language: English

Keywords:
GHANA | RESEARCH REPORT | KAP SURVEYS | COMMUNITY | CHILDREN | SOCIAL NETWORKS | KNOWLEDGE | LOCALE | CHILD HEALTH | DISEASE PREVENTION | EDUCATIONAL STATUS | LITERACY | MASS MEDIA | SOCIOECONOMIC STATUS | SOCIAL POLICY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Friends and Relatives | Family and Household | Sociocultural Factors | Health | Prevention and Control | Diseases | Socioeconomic Factors | Economic Factors | Communication | Policy | Political Factors
Document Number: 330296  

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Peer Reviewed

Title: Education gender gaps in Pakistan: Is the labor market to blame?
Author: Aslam M
Source: Economic Development and Cultural Change. 2009 Jul;57(4):747-784.
Abstract: Differential labor market returns to male and female education are one potential explanation for large gender gaps in education in Pakistan. We empirically test this explanation by estimating private returns to education separately for male and female wage earners. This article contributes to the literature by using a variety of methodologies (ordinary least squares, Heckman correction, two-stage least squares, and household fixed effects) in order to estimate economic returns to education. The latest nationally representative data-the Pakistan Integrated Household Survey (2002)-are used. Earnings function estimates consistently reveal a sizable gender asymmetry in economic returns to education, with returns to women's education being substantially and statistically significantly higher than men's. The return to an additional year of schooling ranges between 7% and 11% for men and between 13% and 18% for women. There are also large, direct returns to women's education at low levels of schooling, and the education-earnings profile is more convex for women than for men. However, a decomposition of the gender wage gap (into the component "explained" by differing male and female endowments and the residual component) suggests that there is highly differentiated treatment by employers. We conclude that the total labor market returns are much higher for men, despite returns to education being higher for women. This suggests that parents may have an investment motive in allocating more resources to boys than to girls within households.
Language: English

Keywords:
PAKISTAN | RESEARCH REPORT | STATISTICAL REGRESSION | MULTIVARIATE ANALYSIS | MATHEMATICAL MODEL | LABOR FORCE | SPOUSE | EDUCATIONAL STATUS | GENDER ISSUES | SEX FACTORS | INEQUALITIES | INCOME | PARENTAL INVOLVEMENT | Developing Countries | Asia, Southern | Asia | Data Analysis | Research Methodology | Theoretical Models | Human Resources | Economic Factors | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior
Document Number: 341095  

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Peer Reviewed

Title: Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe?
Author: Birdthistle I; Floyd S; Nyagadza A; Mudziwapasi N; Gregson S; Glynn JR
Source: Social Science and Medicine. 2009 May;68(10):1810-1818.
Abstract: This study explored the role of education in explaining the excess sexual risk previously documented among unmarried female orphans in urban Zimbabwe. School attendance and attainment were assessed by type of orphanhood, and for their association with markers of sexual risk (HIV and/or HSV-2 infection) among 743 participants drawn from a random sample of 15- to 19-year-old girls identified in a cross-sectional survey in Highfield, Harare in 2004. Multivariable logistic regression was used to assess the role of educational status in explaining the higher prevalence of adverse sexual outcomes among unmarried orphans compared to non-orphans, adjusting for possible confounders. Double orphans had significantly lower educational attendance and attainment than non-orphans. Maternal orphans had higher odds of school drop-out, although this association disappeared when adjusted for recent mobility. Educational status was strongly associated with HIV/HSV-2 risk, but explained only a small part of double orphans' sexual risk and did not explain the HIV/HSV-2 risk of maternal and paternal orphans. High overall levels of secondary school participation and school fee assistance provided to vulnerable families may have reduced the schooling disparities between orphans and non-orphans in Highfield. However, further efforts are needed to rectify the schooling inequities that persist, while additional research is needed to identify other socioeconomic and emotional factors driving orphans' sexual risk so that prevention and support programs can meet the needs of this growing population.
Language: English

Keywords:
ZIMBABWE | URBAN AREAS | RESEARCH REPORT | SAMPLING STUDIES | ADOLESCENTS, FEMALE | ORPHANS AND VULNERABLE CHILDREN | HIV INFECTIONS | HERPES GENITALIS | EDUCATIONAL STATUS | SEX BEHAVIOR | RISK FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior | Health
Document Number: 341411  

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Title: [Assessment of factors associated with patients' comprehension of treatment at the start of antiretroviral therapy] Evaluacion de factores asociados a la comprension del tratamiento en pacientes
Author: Braga Ceccato MG; Acurcio Fde A; Vallano A; Comini Cesar C; Crosland Guimaraes MD
Source: Enfermedades Infecciosas Y Microbiologia Clinica. 2009 Jan;27(1):7-13.
Abstract: OBJECTIVE: The aim of this study was to evaluate factors associated with patients' comprehension of antiretroviral therapy (ART). METHOD: Cross-sectional analysis in which patients at 2 HIV/AIDS public referral centers (Belo Horizonte, Brazil) were interviewed after initiating ART. Information was recorded on variables related to the patient's characteristics, the treatment prescribed, and the healthcare professional involved. A score indicating the patients' level of comprehension regarding the medications prescribed was obtained using a latent trait model estimated by the item response theory. RESULTS: A total of 406 patients were interviewed. Mean (SD) age was 35 (10) years, 227 were men (56%), 302 of Afro-American ethnicity (77%), and 213 had <8 years of education (53%). The regression model determined that 52.25% of the variability of comprehension was explained by the individual's characteristics. Variables associated (P<0.05) with poorest understanding about ART were lower education (<8 years), lack of knowledge about treatment duration and clinical severity, inadequate information provided by physicians, inability to understand pharmaceutical information, daily number of tablets, and the ART regimen prescribed. CONCLUSION: Comprehension of information about the ART regimen prescribed varies considerably between individuals. Nonetheless, several factors were found to be associated with the level of understanding: characteristics of the patient (education, clinical severity), characteristics of treatment (daily number of tablets, ART regimen prescribed), and contribution of healthcare professionals (information from physicians and pharmacists). Strategies to reinforce information about ART should be a priority for patients with a low level of understanding.
Language: Spanish

Keywords:
BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INTERVIEWS | CLIENTS | ETHNIC GROUPS | PRESCRIPTIONS | EDUCATIONAL STATUS | KNOWLEDGE | TREATMENT | INFORMATION | PHYSICIAN-PATIENT RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Demographic Factors | Population | Distributional Activities | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior
Document Number: 341238  

8.    Full text document

Title: Evaluating the impact of community-based interventions on schooling outcomes among orphans and vulnerable children in Lusaka, Zambia.
Author: Chatterji M; Hutchinson P; Murray N; Buek K; Mulenga Y
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Apr. 34 p. (MEASURE Evaluation Working Paper Series WP-09-110USAID Cooperative Agreement No. GPO-A-00-03-00003-00USAID Task Order GHS-I-00-07-00002-00)
Abstract: This paper evaluates the impact of a community-based program implemented by a Zambian nongovernmental agency (NGO) on educational outcomes among orphans and vulnerable children (OVC) in Lusaka, Zambia. These outcomes included school enrollment and being at the correct age-for-grade. The study design included two rounds of post-intervention data collection, in 2003 and 2006. There were 2,302 children, ages 6-19, interviewed in 2003; and 3,105 children or young adults, ages 8-22, interviewed in 2006. A sub-sample of 2,922 orphans and vulnerable children, ages 8-19, was used. The effectiveness of Bwafwano Community Home-Based Care Organization, an NGO working in Lusaka, was evaluated, first using the individual cross-sectional samples and then using a differences-in-differences model on the pooled sample. Both cross-sectional analyses found positive and statistically significant effects of the intervention on school enrollment, with marginal effects of 0.104 and 0.168 respectively. The differences-in-differences estimates for school enrollment were positive, but small and not statistically significant. For the estimations of the effects of Bwafwano on the outcome of appropriate age-for-grade, only the difference-in-difference models showed positive program effect, with participation in the program being associated with a 15.7 percentage point increase in appropriate age-for-grade for intervention children, relative to control children. This study suggests that the Bwafwano program is a promising approach to improving educational outcomes among orphans and vulnerable children in urban Zambia.
Language: English

Keywords:
ZAMBIA | RESEARCH REPORT | ORPHANS AND VULNERABLE CHILDREN | EDUCATIONAL STATUS | PRIMARY SCHOOLS | INTERVENTIONS | HIV PREVENTION | HOME CARE | PROGRAM EVALUATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Schools | Education | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Care and Support | Health Services | Delivery of Health Care | Health
Document Number: 339995  

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Title: Mother's education and child health: is there a nurturing effect?
Author: Chen Y; Li H
Source: Journal of Health Economics. 2009 Mar;28(2):413-26.
Abstract: In this paper, we examine the effect of maternal education on the health of young children by using a large sample of adopted children from China. As adopted children are genetically unrelated to the nurturing parents, the educational effect on them is most likely to be the nurturing effect. We find that the mother's education is an important determinant of the health of adopted children even after we control for income, the number of siblings, health environments, and other socioeconomic variables. Moreover, the effect of the mother's education on the adoptee sample is similar to that on the own birth sample, which suggests that the main effect of the mother's education on child health is in post-natal nurturing. We also find suggestive evidence that the effect is causal. Our work provides new evidence to the general literature that examines the determinants of health and that examines the intergenerational immobility of socioeconomic status.
Language: English

Keywords:
CHINA | RESEARCH REPORT | CHILDREN | CHILD HEALTH | MATERNAL HEALTH | EDUCATION | EDUCATIONAL STATUS | IMPACT | Asia, Eastern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Communication
Document Number: 341556  

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Peer Reviewed

Title: Mental distress in the general population in Zambia: impact of HIV and social factors.
Author: Chipimo PJ; Fylkesnes KM
Source: BMC Public Health. 2009 Aug 18;9(1):298.
Abstract: ABSTRACT: BACKGROUND: Population level data on mental health from Africa are limited, but available data indicate mental problems to represent a substantial public health problem. The negative impact of HIV on mental health suggests that this could particularly be the case in high prevalence populations. We examined the prevalence of mental distress, distribution patterns and the ways HIV might influence mental health among men and women in a general population. METHODS: The relationship between HIV infection and mental distress was explored using a sample of 4466 participants in a population-based HIV survey conducted in selected rural and urban communities in Zambia in 2003. The Self-reporting questionnaire-10 (SRQ-10) was used to assess global mental distress. Weights were assigned to the SRQ-10 responses based on DSM IV criteria for depression and a cut off point set at 7/20 for probable cases of mental distress. A structural equation modeling (SEM) was established to assess the structural relationship between HIV infection and mental distress in the model, with maximum likelihood ratio as the method of estimation. RESULTS: The HIV prevalence was 13.6% vs. 18% in the rural and urban populations, respectively. The prevalence of mental distress was substantially higher among women than men and among groups with low educational attainment vs. high. The results of the SEM showed a close fit with the data. The final model revealed that self-rated health and self perceived HIV risk and worry of being HIV infected were important mediators between underlying factors, HIV infection and mental distress. The effect of HIV infection on mental distress was both direct and indirect, but was particularly strong through the indirect effects of health ratings and self perceived risk and worry of HIV infection. CONCLUSION: These findings suggest a strong effect of HIV infection on mental distress. In this population where few knew their HIV status, this effect was mediated through self-perceptions of health status, found to capture changes in health perceptions related to HIV, and self-perceived risk and worry of actually being HIV infected.
Language: English

Keywords:
ZAMBIA | RESEARCH REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | MENTAL HEALTH | HIV INFECTIONS | EDUCATIONAL STATUS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Viral Diseases | Diseases | Health | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 342549  

11.
Peer Reviewed

Title: Causes of maternal mortality decline in Matlab, Bangladesh.
Author: Chowdhury ME; Ahmed A; Kalim N; Koblinsky M
Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):108-23.
Abstract: Bangladesh is distinct among developing countries in achieving a low maternal mortality ratio (MMR) of 322 per 100,000 livebirths despite the very low use of skilled care at delivery (13% nationally). This variation has also been observed in Matlab, a rural area in Bangladesh, where longitudinal data on maternal mortality are available since the mid-1970s. The current study investigated the possible causes of the maternal mortality decline in Matlab. The study analyzed 769 maternal deaths and 215,779 pregnancy records from the Health and Demographic Surveillance System (HDSS) and other sources of safe motherhood data in the ICDDR,B and government service areas in Matlab during 1976-2005. The major interventions that took place in both the areas since the early 1980s were the family-planning programme plus safe menstrual regulation services and safe motherhood interventions (midwives for normal delivery in the ICDDR,B service area from the late 1980s and equal access to comprehensive emergency obstetric care [EmOC] in public facilities for women from both the areas). National programmes for social development and empowerment of women through education and microcredit programmes were implemented in both the areas. The quantitative findings were supplemented by a qualitative study by interviewing local community care providers for their change in practices for maternal healthcare over time. After the introduction of the safe motherhood programme, reduction in maternal mortality was higher in the ICDDR,B service area (68.6%) than in the government service area (50.4%) during 1986-1989 and 2001-2005. Reduction in the number of maternal deaths due to the fertility decline was higher in the government service area (30%) than in the ICDDR,B service area (23%) during 1979-2005. In each area, there has been substantial reduction in abortion-related mortality--86.7% and 78.3%--in the ICDDR,B and government service areas respectively. Education of women was a strong predictor of the maternal mortality decline in both the areas. Possible explanations for the maternal mortality decline in Matlab are: better access to comprehensive EmOC services, reduction in the total fertility rate, and improved education of women. To achieve the Millenium Development Goal 5 targets, policies that bring further improved comprehensive EmOC, strengthened family-planning services, and expanded education of females are essential.
Language: English

Keywords:
BANGLADESH | RURAL AREAS | RESEARCH REPORT | MATERNAL MORTALITY | MORTALITY DECLINE | CAUSES OF DEATH | RISK FACTORS | SAFE MOTHERHOOD | OBSTETRICS | EMERGENCY SERVICES | PROGRAM ACCESSIBILITY | FERTILITY DECLINE | EDUCATIONAL STATUS | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Mortality | Population Dynamics | Demographic Factors | Health | Maternal Health | Medicine | Health Services | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration | Fertility Changes | Fertility | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 341939  

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Peer Reviewed

Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population.
Author: Deboosere P; Gadeyne S; Oyen HV
Source: European Journal of Population. 2008 May;25(2):175-196.
Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level.
Language: English

Keywords:
BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics
Document Number: 340174  

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Peer Reviewed

Title: Determinants of nonadherence to a single-dose nevirapine regimen for the prevention of mother-to-child HIV transmission in Rwanda.
Author: Delvaux T; Elul B; Ndagije F; Munyana E; Roberfroid D; Asiimwe A
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Feb 1;50(2):223-30.
Abstract: OBJECTIVES: To describe experiences, and identify factors associated with nonadherence to a single-dose nevirapine (SD-NVP) regimen for the prevention of mother-to-child transmission (PMTCT) of HIV in Rwanda. METHODS: In April to May 2006, using a case-control design at 12 PMTCT sites, we interviewed HIV-infected women who did not adhere (n = 111) and who adhered (n = 125) to the PMTCT prophylaxis regimen. Nonadherence was defined as mother and/or infant not ingesting SD-NVP at the recommended time or not at all and adherence as mother-infant pairs who ingested it as recommended. RESULTS: Only 61% of nonadherent women had received SD-NVP during pregnancy or delivery. Among nonadherent women who received SD-NVP, 80% ingested it at the recommended time, representing 49% of all nonadherent women. Only 7% of their newborns ingested SD-NVP. Multivariate logistic regression showed that unmarried women, less educated women, women who made 2 or less antenatal care visits, and those offered HIV testing after their first antenatal care visit were more likely to be nonadherent to PMTCT prophylaxis. Not disclosing one's HIV status to someone aside from a partner was also associated with nonadherence in mother-infant pairs. CONCLUSIONS: Sociodemographic factors, health services delivery factors, and a lack of communication and social support contributed to nonadherence to PMTCT prophylaxis in Rwanda.
Language: English

Keywords:
RWANDA | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | USER COMPLIANCE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | ADMINISTRATION AND DOSAGE | PREVALENCE | EDUCATIONAL STATUS | ANTENATAL CARE | PARTNER COMMUNICATION | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | HIV Infections | Viral Diseases | Diseases | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Behavior | Disease Transmission Control | Prevention and Control | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Socioeconomic Status | Socioeconomic Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Interpersonal Relations
Document Number: 330370  

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Title: Domestic violence on pregnant women in Turkey.
Author: Ergonen AT; Ozdemir MH; Can IO; Sonmez E; Salacin S; Berberoglu E; Demir N
Source: Journal of Forensic and Legal Medicine. 2009 Apr;16(3):125-9.
Abstract: OBJECTIVE: Domestic violence is accepted worldwide as an important health problem. Besides diagnosis and treatment process, there are difficulties when considering of medico-legal evaluation of pregnant women subjected to domestic violence. As a signatory of the ''Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW)'' Turkey has certain commitments regarding domestic violence and made regulations on national law. The purpose of the present study is to demonstrate the prevalence of domestic violence during pregnancy among the women who applied to obstetrics clinics and evaluating of the participants' knowledge level about the legal legislation concerning domestic violence. FINDINGS: Pregnant women attending for antenatal care to department of Gynecology and Obstetrics were interviewed using an anonymous and confidential questionnaire. The questionnaire used was a version of Abuse Assessment Screen with guidance of references. 28 (13.4%) women stated that they had been subjected to violence before pregnancy. Only 10 (4.67%) women had stated experience of violence during pregnancy. 148 (69.2%) of them had stated that they had no knowledge about any legislation concerning domestic violence in our country. CONCLUSION: We believe that society awareness should be increased and the health workers should be informed about their ethical and legal responsibilities concerning domestic violence during pregnancy. The knowledge and sensitivity of health care personnel in Prenatal Clinics and Family Planning Services should be increased and examination protocols should be provided about domestic violence against pregnant women.
Language: English

Keywords:
TURKEY | RESEARCH REPORT | PREGNANT WOMEN | DOMESTIC VIOLENCE | PREVALENCE | LEGISLATION | KNOWLEDGE | EDUCATIONAL STATUS | QUESTIONNAIRES | TREATIES | ANTENATAL CARE | Europe, Southeastern | Europe | Developing Countries | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Measurement | Research Methodology | Political Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health
Document Number: 342189  

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Peer Reviewed

Title: The impact of distance of residence from a peripheral health facility on pediatric health utilisation in rural western Kenya.
Author: Feikin DR; Nguyen LM; Adazu K; Ombok M; Audi A; Slutsker L; Lindblade KA
Source: Tropical Medicine and International Health. 2009 Jan;14(1):54-61.
Abstract: OBJECTIVE: To explore the impact of distance on utilisation of peripheral health facilities for sick child visits in Asembo, rural western Kenya. METHODS: As part of a demographic surveillance system (DSS), censuses of all households in the Asembo population of 55,000 are conducted three times a year, data are collected at all outpatient pediatric visits in seven DSS clinics in Asembo, and all households are GIS-mapped and linkable to a child's unique DSS identification number. Between May 1, 2003 and April 30, 2004, 3501 clinic visits were linked to 2432 children among 10,973 DSS-resident children < 5 years of age. RESULTS: Younger children and children with more severe illnesses travelled further for clinic visits. The median distance travelled varied by clinic. The rate of clinic visits decreased linearly at 0.5 km intervals up to 4 km, after which the rate stabilised. Using Poisson regression, controlling for the nearest DSS clinic for each child, socio-economic status and maternal education, and accounting for household clustering of children, for every 1 km increase in distance of residence from a DSS clinic, the rate of clinic visits decreased by 34% (95% CI, 31-37%) from the previous kilometer. CONCLUSION: Achieving equity in access to health care for children in rural Kenya will require creative strategies to address a significant distance-decay effect in health care utilisation.
Language: English

Keywords:
KENYA | RESEARCH REPORT | DEMOGRAPHIC SURVEYS | STATISTICAL REGRESSION | RURAL POPULATION | CHILDREN | DISTANCE | HEALTH FACILITIES | UTILIZATION OF HEALTH CARE | HUMAN GEOGRAPHY | SOCIOECONOMIC STATUS | EDUCATIONAL STATUS | AGE FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Population Dynamics | Demographic Factors | Population | Data Analysis | Research Methodology | Population Characteristics | Youth | Geographic Factors | Delivery of Health Care | Health | Health Services | Geography | Social Sciences | Science | Sociocultural Factors | Socioeconomic Factors | Economic Factors
Document Number: 330260  

16.
Peer Reviewed

Title: Influence of wasting and stunting at the onset of the rainy season on subsequent malaria morbidity among rural preschool children in Senegal.
Author: Fillol F; Cournil A; Boulanger D; Cisse B; Sokhna C; Targett G; Trape JF; Simondon F; Greenwood B; Simondon KB
Source: American Journal of Tropical Medicine and Hygiene. 2009 Feb;80(2):202-8.
Abstract: In sub-Saharan Africa, malaria and malnutrition are major causes of morbidity and mortality in children less than five years of age. To explore the impact of malnutrition on subsequent susceptibility to malaria, a cohort of 874 rural preschool children in Senegal was followed-up during one malaria transmission season from July through December. Data on nutritional status and Plasmodium falciparum parasitemia were collected at baseline. Malaria morbidity was monitored through weekly home visits. Wasted children (weight-for-height z-score < -2) were at lower risk of having at least one subsequent clinical malaria attack (odds ratio = 0.33; 95% confidence interval = 0.13-0.81, P = 0.02), whereas stunting (height-for-age z-score < -2) or being underweight (weight-for-age z-score < -2) was not associated with clinical malaria. Although non-biological explanations such as overprotection of wasted children by their mothers should be considered, immunomodulation according to nutritional status could explain the lower risk of malaria attack among wasted children.
Language: English

Keywords:
IRAN | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | MOTHERS | CHILD CARE | KNOWLEDGE | ATTITUDES | BREASTFEEDING | DEMOGRAPHIC FACTORS | TIME FACTORS | BREASTFEEDING, EXCLUSIVE | SUPPLEMENTARY FEEDING | EDUCATIONAL STATUS | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Child Rearing | Behavior | Psychological Factors | Infant Nutrition | Nutrition | Health | Population | Population Dynamics | Socioeconomic Status | Socioeconomic Factors
Document Number: 330300  

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Peer Reviewed

Title: What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya.
Author: Fotso J; Ezeh A; Madise N; Ziraba A; Ogollah R
Source: Maternal and Child Health Journal. 2009 Jan;13(1):130-7.
Abstract: Objectives: The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings. The objective of this paper is to identify the factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and "appropriate" health facilities. Methods: The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either "inappropriate" or "appropriate". Place of delivery is the dependent variable. Ordered logit models were used to quantify the effects of covariates on the choice of place of delivery, defined as a three-category ordinal variable. Results: Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy "wantedness", and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Conclusion: Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women.
Language: English

Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS | SLUMS | URBAN POPULATION | WOMEN IN DEVELOPMENT | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | CHILDBIRTH | EDUCATIONAL STATUS | PROMOTION | ANTENATAL CARE | MULTIPARITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Economic Development | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Socioeconomic Status | Socioeconomic Factors | Marketing | Parity | Fertility Measurements | Fertility | Population Dynamics
Document Number: 308031  

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Title: Knowledge of HIV risk factors among immigrants in Thailand.
Author: Fuller TD; Chamratrithirong A
Source: Journal of Immigrant and Minority Health. 2009 Apr;11(2):83-91.
Abstract: This study is based on a sample of 3,374 immigrants from Cambodia and Myanmar who worked in 17 different provinces in Thailand. Many immigrants workers had not even heard of HIV/AIDS before coming to Thailand, but most have received instruction about HIV/AIDS from some source in Thailand, and a large majority are now aware of HIV/AIDS. While immigrant workers in Thailand are fairly knowledgeable about the risk factors for HIV transmission, important gaps remain. Women, persons with less than five years of education, seafarers, agricultural workers, those who do not personally know anyone affected by HIV/AIDS, and those who have not yet received instruction in HIV/AIDS are the ones most likely to have gaps in their knowledge of HIV/AIDS risk factors.
Language: English

Keywords:
THAILAND | CAMBODIA | RESEARCH REPORT | KAP SURVEYS | IMMIGRANTS | AGRICULTURAL WORKERS | KNOWLEDGE | HIV TRANSMISSION | RISK BEHAVIOR | SEX BEHAVIOR | INFORMATION SOURCES | SEX FACTORS | EDUCATIONAL STATUS | SEX EDUCATION | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Labor Force | Human Resources | Economic Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Behavior | Information | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Education
Document Number: 331116  

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Title: Determinants of HIV knowledge and condom use among women in Madagascar: an analysis using matched household and community data.
Author: Glick P; Randriamamonjy J; Sahn DE
Source: African Development Review. 2009 Apr;21(1):147-179.
Abstract: The authors estimated the determinants of HIV/AIDS knowledge and related behavior (use of condoms) among women in Madagascar, a country where prevalence remains low but conditions are ripe for a rapid increase in infections. In both rural and urban areas, more educated and wealthier women are more likely to know about means of preventing infection, less likely to have misconceptions about transmission, and more likely to use condoms. Community factors such as availability of health centers and access to roads also are associated with greater HIV knowledge. However, most of the large rural-urban difference in mean knowledge is due not to location per se but to differences in schooling and wealth; rather than simply being geographically targeted, AIDS education efforts must be designed to target and be understood by uneducated and poor subpopulations.
Language: English

Keywords:
MADAGASCAR | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN | HIV INFECTIONS | AIDS | KNOWLEDGE | ATTITUDES | CONDOM USE | QUESTIONNAIRES | EDUCATIONAL STATUS | MISINFORMATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Sociocultural Factors | Psychological Factors | Behavior | Risk Reduction Behavior | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Communication
Document Number: 341878  

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Peer Reviewed

Title: Recent increase in sex ratio at birth in Viet Nam.
Author: Guilmoto CZ; Hoang X; Van TN
Source: PLoS One. 2009;4(2):e4624.
Abstract: INTRODUCTION: Since the 1980s, sex ratio at birth (male births per 100 female births) has increased in many Asian countries as a result of selective abortions, but to date there has been no such evidence for Viet Nam. Our aim in this paper is to ascertain the situation with respect to sex ratio at birth in Viet Nam over the past five years. MATERIALS AND METHODS: Original data were obtained from sample population surveys in Viet Nam recording annual birth rates since 2000 of about 450,000 women, as well as from two successive birth surveys conducted for the first time in 2007 (1.1 million births). The annual population surveys include specific information on birth history and mothers' characteristics to be used for the analysis of trends and differentials in sex ratio at birth. RESULTS AND DISCUSSION: Birth history statistics indicate that the SRB in Viet Nam has recorded a steady growth since 2001. Starting from a level probably close to the biological standard of 105, the SRB reached 108 in 2005 and 112 in 2006, a value significantly above the normal level. An independent confirmation of these results comes from the surveys of births in health facilities which yielded a SRB of 110 in 2006-07. High SRB is linked to various factors such as access to modern health care, number of prenatal visits, level of higher education and employment status, young age, province of residence and prenatal sex determination. These results suggest that prenatal sex determination followed by selective abortion has recently become more common in Viet Nam. This recent trend is a consequence of various factors such as preference for sons, declining fertility, easy access to abortion, economic development as well as the increased availability of ultrasonography facilities.
Language: English

Keywords:
VIETNAM | RESEARCH REPORT | DATA ANALYSIS | SONS | SEX RATIO | MATERNAL HEALTH SERVICES | EMPLOYMENT STATUS | SOCIOECONOMIC STATUS | ABORTION | EDUCATIONAL STATUS | ANTENATAL CARE | SEX PREFERENCE | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors | Fertility Control, Postconception | Family Planning | Value Orientation | Psychological Factors | Behavior
Document Number: 331220   Notification

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Title: Use of family planning services in Darfur, Sudan.
Author: Haggaz A; Ahmed S; Adam I
Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):247-8.
Abstract: High fertility rates and inadequate spacing between births can lead to high maternal and infant mortality. An estimated 600 000 maternal deaths occur worldwide each year, and the vast majority take place in low-income countries. The World Health Organization estimates that 13% of these deaths are due to unsafe abortions. Worldwide, where approximately 50 million women resort to induced abortion, this frequently results in high rates of maternal morbidity and mortality. Family planning and adequate spacing between births are important methods to help avoid these deaths. Little published data are available regarding the use of family planning services in Sudan-the largest country in Africa, with 40 million inhabitants-although high maternal mortality and inadequate utilization of prenatal care in Darfur have been reported previously. In Alfasher, the area considered in the present study, the Sudanese Family Planning Association has an office that provides services such as contraceptive pills and intrauterine contraceptive devices free of charge. A community-based cross-sectional household survey was conducted in Alfashar, in April and June 2008, to investigate the use of and factors associated with family planning services. (excerpt)
Language: English

Keywords:
SUDAN | RESEARCH REPORT | STATISTICAL STUDIES | WOMEN | FAMILY PLANNING PROGRAMS | UTILIZATION OF HEALTH CARE | AGE FACTORS | EDUCATIONAL STATUS | PARITY | FAMILY PLANNING EDUCATION | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Demographic Factors | Population | Family Planning | Health Services | Delivery of Health Care | Health | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Education
Document Number: 341389  

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Title: Domestic violence against women during pregnancy: the case of Palestinian refugees attending an antenatal clinic in Lebanon.
Author: Hammoury N; Khawaja M; Mahfoud Z; Afifi RA; Madi H
Source: Journal of Women's Health. 2009 Mar;18(3):337-45.
Abstract: OBJECTIVES: To determine the factors associated with domestic violence against pregnant Palestinian refugee women residing in Lebanon and currently using the United Nation Relief and Work Agency's (UNRWA) primary healthcare services. METHODS: This was a cross-sectional study conducted at a polyclinic of primary healthcare of the UNRWA in South Lebanon during the years 2005-2006. The sample was 351 pregnant women who were 15-42 years of age and not accompanied by their husbands or relatives. All women were invited by the midwife to participate in the study during their visit to the clinic for their first checkup or during a follow-up visit. The Abuse Assessment Screen instrument was used to screen for past and recent history of physical and emotional abuse among the participants. RESULTS: Domestic violence was significantly associated with education, gestational age, fear of husband or someone else in the house, and unintended pregnancy. The odds of abuse for women with an elementary or lower education were 6.86 (95% CI 1.2-38.1) and for women with an intermediate or secondary education 6.84 (95% CI 1.4-33.3) compared with women with a university education. The odds of abuse during pregnancy for women whose husbands did not desire their pregnancy were 3.80 (95% CI 1.5-9.7) compared with other women. CONCLUSIONS: Domestic violence against women in Lebanon was associated with educational level, gestational age, fear of husband or someone else in the house, and unintended pregnancy.
Language: English

Keywords:
LEBANON | RESEARCH REPORT | PREVALENCE | PREGNANT WOMEN | REFUGEES | ANTENATAL CARE | VIOLENCE AGAINST WOMEN | PHYSICAL ABUSE | SIGNS AND SYMPTOMS | EDUCATIONAL STATUS | FEAR | PREGNANCY, UNPLANNED | Middle East | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Violence | Behavior | Diseases | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Emotions | Psychological Factors | Reproductive Behavior | Fertility
Document Number: 341353  

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Title: Education, prenatal care, and poor perinatal outcome in Khartoum, Sudan.
Author: Hassan AA; Abubaker MS; Radi EA; Adam I
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):66-7.
Abstract: Perinatal outcome is an important indicator of obstetric care and health status. Reducing the incidence of low birth weight neonates by at least one third between 2000 and 2010 is one of the major goals of the United Nations resolution "A World Fit for Children" and is an important contribution toward Millennium Development Goal (MDG) 4 which is to reduce child mortality by two thirds by 2015. Local surveillance and basic epidemiology can more accurately assess perinatal outcome and identify areas to which interventions should be targeted. The aims of the present study were to identify and quantify the risk factors for low birth weight neonates and perinatal mortality in Sudan, and to assess the role of sociodemographic factors.
Language: English

Keywords:
SUDAN | RESEARCH REPORT | STATISTICAL STUDIES | MOTHERS | ANTENATAL CARE | LOW BIRTH WEIGHT | RISK FACTORS | EDUCATIONAL STATUS | ANTHROPOMETRY | PREGNANCY OUTCOMES | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Birth Weight | Body Weight | Physiology | Biology | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Measurement | Pregnancy | Reproduction
Document Number: 341386  

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Title: Condom use among married women at risk for sexually transmitted infections and HIV in rural China.
Author: Hong H; Qin QR; Li LH; Ji GP; Ye DQ
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 13;
Abstract: OBJECTIVE: To assess factors associated with condom use among married women in rural China, and provide evidence for implementing education strategies to prevent sexually transmitted infections and HIV. METHODS: A total of 737 sexually active married rural women who were aged between 18 and 49 years and had heard of AIDS were selected by cluster sampling and interviewed in 8 villages of Anhui province, China. RESULTS: The rate of condom use was only 5.4%.There were no significant differences in sexual behavior and condom use between married women whose husbands were away as migrant workers and the wives of nonmigrant men, except in knowledge of free condom sources. Significant factors associated with condom use included age, level of education, knowledge about condoms, training about condoms, sources of condoms, and husbands' attitude toward condoms. CONCLUSIONS: More educational interventions are needed to increase condom knowledge and promotion, especially among less educated women and married women left behind by migrant husbands.
Language: English

Keywords:
CHINA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN IN DEVELOPMENT | RURAL POPULATION | CURRENTLY MARRIED | MIGRANT WORKERS | SPOUSE | CONDOM USE | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | AGE FACTORS | EDUCATIONAL STATUS | ATTITUDES | KNOWLEDGE | Asia, Eastern | Asia | Developing Countries | Family Planning Surveys | Family Planning | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Labor Force | Human Resources | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Risk Reduction Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Socioeconomic Status | Socioeconomic Factors | Psychological Factors
Document Number: 341460  

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Peer Reviewed

Title: Effects of neighbourhood-level educational attainment on HIV prevalence among young women in Zambia.
Author: Kayeyi N; Sandoy IF; Fylkesnes K
Source: BMC Public Health. 2009 Aug 25;9(310):1-11.
Abstract: This study reanalyzed data from a cross-sectional population survey conducted in Zambia in 2003. The analyses were restricted to women ages 15–24 years (n=1,295). Stratified random cluster sampling was used to select 10 urban and 10 rural clusters. A measure for neighborhood-level educational attainment was constructed by aggregating individual-level years-in-school. Multi-level mixed effects regression models were run to examine the neighborhood-level educational effect on HIV prevalence after adjusting for individual-level underlying variables (education, currently a student, marital status) and selected proximate determinants (ever given birth, sexual activity, lifetime sexual partners). HIV prevalence among young women ages 15–24 years was 12.5% in the urban and 6.8% in the rural clusters. Neighborhood educational attainment was found to be a strong determinant of HIV infection in both urban and rural populations. HIV prevalence decreased substantially by increasing level of neighborhood education. The likelihood of infection in low educational attainment areas was 3.4 times higher among rural women and 1.8 times higher among the urban women after adjusting for age and other individual-level underlying variables, including education. However, the association was not significant for urban young women after this adjustment. After adjusting for level of education in the neighborhood, the effect of the individual-level education differed by residence: there was a strong protective effect among urban women whereas it tended to be a risk factor among rural women.
Language: English

Keywords:
ZAMBIA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | WOMEN | HIV INFECTIONS | PREVALENCE | EDUCATIONAL STATUS | GEOGRAPHIC FACTORS | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior
Document Number: 339907  

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Title: Use of the internet by patients attending specialist clinics in Sri Lanka: a cross sectional study.
Author: Kommalage M
Source: BMC Medical Informatics and Decision Making. 2009;9:12.
Abstract: BACKGROUND: The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. METHODS: The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. RESULTS: Three hundred and fifty five patients (or guardians in the Pediatric clinic) participated in the study. One hundred seventy two (48.3%) participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97%) have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%). CONCLUSION: Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka.
Language: English

Keywords:
SRI LANKA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | TARGET POPULATION | INTERNET | INFORMATION SOURCES | AGE FACTORS | EDUCATIONAL STATUS | CLINIC ACTIVITIES | EXAMINATIONS AND DIAGNOSES | HEALTH EDUCATION | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Program Design | Programs | Organization and Administration | Information Networks | Communication | Information | Population Characteristics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Program Activities | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education
Document Number: 331071  

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Peer Reviewed

Title: Acceptability of intrapartum HIV counselling and testing in Cameroon.
Author: Kongnyuy EJ; Mbu ER; Mbopi-Keou FX; Fomulu N; Nana PN; Tebeu PM; Tonye RN; Leke RJ
Source: BMC Pregnancy and Childbirth. 2009;9:9.
Abstract: BACKGROUND: To assess the acceptability of intrapartum HIV testing and determine the prevalence of HIV among labouring women with unknown HIV status in Cameroon. METHOD: The study was conducted in four hospitals (two referral and two districts hospitals) in Cameroon. Labouring women with unknown HIV status were counselled and those who accepted were tested for HIV. RESULTS: A total of 2413 women were counselled and 2130 (88.3%) accepted to be tested for HIV. Of the 2130 women tested, 214 (10.1%) were HIV positive. Acceptability of HIV testing during labour was negatively associated with maternal age, parity and number of antenatal visits, but positively associated with level of education. HIV sero-status was positively associated with maternal age, parity, number of antenatal visits and level education. CONCLUSION: Acceptability of intrapartum HIV testing is high and the prevalence of HIV is also high among women with unknown HIV sero-status in Cameroon. We recommend an opt-out approach (where women are informed that HIV testing will be routine during labour if HIV status is unknown but each person may decline to be tested) for Cameroon and countries with similar social profiles.
Language: English

Keywords:
CAMEROON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PERSONS LIVING WITH HIV/AIDS | VOLUNTARY COUNSELING AND TESTING | CHILDBIRTH | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MATERNAL AGE | PARITY | ANTENATAL CARE | CLINIC VISITS | EDUCATIONAL STATUS | PREVALENCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | HIV Infections | Viral Diseases | Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Disease Transmission Control | Prevention and Control | Parental Age | Age Factors | Fertility Measurements | Fertility | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Service Statistics | Program Activities | Programs | Organization and Administration | Socioeconomic Status | Socioeconomic Factors | Measurement
Document Number: 331239  

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Peer Reviewed

Title: Knowledge and practice among healthcare providers in rural Vietnam regarding sexually transmitted infections.
Author: Lan PT; Mogren I; Phuc HD; Stalsby Lundborg C
Source: Sexually Transmitted Diseases. 2009 Jul;36(7):452-8.
Abstract: OBJECTIVES: To assess knowledge and reported practice regarding sexually transmitted infections (STI) among healthcare providers in rural Vietnam and to examine background characteristics possibly associated with knowledge and practice. METHODS: A cross-sectional study using a self-completed questionnaire was carried out in 2006 among 465 healthcare providers in rural Vietnam. The questionnaire included questions on providers' characteristics, STI knowledge, and case scenarios of 4 common STI syndromes. Correct answer was scored 1, "do not know" or incorrect answer was scored 0. Linear and logistic regressions were applied. RESULTS: Diseases considered as STI were gonorrhea and syphilis by 83% of the respondents, 70% believed partner treatment necessary for bacterial vaginosis or candidiasis cases. Sharing clothes/food or kissing was commonly mentioned as transmission routes (60%). Median scores of knowledge and reported practice were 29 (range: 0-50) and 2 (range: 0-20), respectively. Among the respondents, 34% had a knowledge score of less than 25 and 78% had a practice score of less than 10. Characteristics predicting higher level of knowledge were being a medical doctor, assistant medical doctor, midwife, or serving STI patients. Characteristics predicting higher level of practice were serving STI patients, being a midwife or female provider, and having participated in STI or reproductive tract infection training courses. Respondents who reported treating STI patients had a higher level of knowledge and reported practice than the others.
Language: English

Keywords:
VIETNAM | RURAL AREAS | RESEARCH REPORT | HEALTH PERSONNEL | SEXUALLY TRANSMITTED DISEASES | KNOWLEDGE | QUESTIONNAIRES | SIGNS AND SYMPTOMS | RISK FACTORS | EDUCATIONAL STATUS | MISINFORMATION |