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Title: Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002-2003 El Salvador National Family Health Survey.
Author: Gribble JN; Murray NJ; Menotti EP
Source: Maternal and Child Nutrition. 2009 Jan;5(1):49-63.
Abstract: It is well understood that undernutrition underpins much of child morbidity and mortality in less developed countries, but the causes of undernutrition are complex and interrelated, requiring a multipronged approach for intervention. This paper uses a subsample of 3853 children under age 5 from the most recent family health survey in El Salvador to examine the relationship between birth spacing and childhood undernutrition (stunting and underweight). While recent research and guidance suggest that birth spacing of three to five years contributes to lower levels of infant and childhood mortality, little attention has been given to the possibility that short birth intervals have longer-term effects on childhood nutrition status. The analysis controls for clustering effects arising from siblings being included in the subsample, as well as variables that are associated with household resources, household structure, reproductive history and outcomes, and household social environment. The results of the multiple regression analyses find that in comparison to intervals of 36-59 months, birth intervals of less than 24 months and intervals of 24-35 months significantly increase the odds of stunting (<24 months Odds Ratio (OR) = 1.52; 95% confidence interval (CI): 1.21-1.92; 25-36 months OR = 1.30; 95% CI: 1.05-1.64). Other factors related to stunting and underweight include standard of living index quintile, child's age, mother's education, low birthweight, use of prenatal care, and region of the country where the child lives. Policy and program implications include more effective use of health services and outreach programs to counsel mothers on family planning, breastfeeding, and well child care.
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | ANTHROPOMETRY | CHILDREN | CHILD HEALTH | CHILD DEVELOPMENT | CHILD NUTRITION | BIRTH SPACING | BIRTH INTERVALS | LOW BIRTH WEIGHT | FAMILY PLANNING | BREASTFEEDING | NEEDS | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Biology | Nutrition | Fertility Measurements | Fertility | Population Dynamics | Birth Weight | Body Weight | Physiology | Infant Nutrition | Economic Factors | Programs | Organization and Administration
Document Number: 329593

Title: Exploring factors in the decision to choose sterilization vs alternatives in rural El Salvador.
Author: Cremer ML; Holland E; Monterroza M; Duran S; Singh R
Source: Medscape Journal of Medicine. 2008;10(8):183.
Abstract: CONTEXT: To explore the factors that influence rural Salvadoran women to undergo tubal sterilization versus opting for alternative methods of family planning. EVIDENCE ACQUISITION: A moderator fluent in English and Spanish conducted eleven 90-minute focus groups consisting of 5-10 women each. Eligible women in the municipality of San Pedro Perulapan, El Salvador, were identified and recruited by local health workers. Participant demographics and information about family planning decisions were collected through detailed notes and tape-recorded sessions. The tapes were transcribed verbatim, and all data were analyzed using grounded theory procedures to identify common themes. EVIDENCE SYNTHESIS: Eighty women aged 24-45 years who had previously been sterilized participated in the study. Three major themes influenced a woman's decision to undergo sterilization instead of opting for alternative forms of family planning: (1) availability: tubal sterilization is readily available, (2) fears about side effects of other methods: these women associated negative side effects with other forms of family planning, (3) effectiveness: the women in these focus groups thought sterilization was more effective than other forms of family planning. CONCLUSIONS: This study shows that there is a lack of information, and misinformation, about other effective methods of contraception, especially the intrauterine device and oral contraceptives. Reproductive health education projects, especially those providing services in locations similar to rural El Salvador, should focus on providing accurate information about all forms of contraception, including tubal sterilization.
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | FOCUS GROUPS | RURAL POPULATION | WOMEN | TUBAL LIGATION | FEMALE STERILIZATION | CONTRACEPTIVE METHODS | SIGNS AND SYMPTOMS | DECISION MAKING | PROGRAM ACCESSIBILITY | Central America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Sterilization, Sexual | Family Planning | Contraception | Diseases | Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 329801

Peer Reviewed

Title: Childhood abuse as a risk factor for adolescent pregnancy in El Salvador.
Author: Pallitto CC; Murillo V
Source: Journal of Adolescent Health. 2008 Jun;42(6):580-6.
Abstract: The purpose was to determine whether having been abused as a child increases the risk of adolescent pregnancy in El Salvador and whether intimate partner violence during adolescence affects the association. Using data from 3753 women between the ages of 15 and 24 from a nationally representative household health survey of Salvadoran women (FESAL 2002/2003), the association between history of childhood abuse (emotional, physical, or sexual abuse, and witnessing abuse of one's mother) and adolescent pregnancy was explored using multiple logistic regression analyses. The effect of intimate partner violence during adolescence on the relationship was explored among a subgroup of 15-19-year-olds. The risk of adolescent pregnancy was significantly higher among women abused as children. Women who were sexually abused, physically abused, or who experienced any type of abuse had a 48%, 42%, and 31% higher risk, respectively, of adolescent pregnancy than those without a history of abuse, after adjusting for confounding factors. Intimate partner violence during adolescence was also strongly and significantly linked with adolescent pregnancy risk. This is the first study from a Latin American country to demonstrate a relationship between childhood abuse and adolescent pregnancy. Greater efforts are needed to promote detection of abuse, expand knowledge about sexual and reproductive health, protect vulnerable youth, and to advocate for greater rights and social protections to Salvadoran children and adolescents. (author's)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | HEALTH SURVEYS | CORRELATION STUDIES | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | RISK FACTORS | CHILD ABUSE | VIOLENCE AGAINST WOMEN | Developing Countries | Central America | Latin America | Americas | Health | Statistical Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Biology | Crime | Social Problems | Sociocultural Factors | Domestic Violence
Document Number: 325390

Title: Achieving the MDGs: the contribution of family planning, El Salvador.
Author: Constella Futures. Health Policy Initiative
Source: Washington, D.C., Constella Futures, Health Policy Initiative, [2007]. [2] p. (USAID Contract No. HRN-C-00-00-00006-00USAID Contract No. GPO-I-01-05-00040-00)
Abstract: The Millennium Development Goals (MDGs)-a set of eight important, time-bound goals ranging from reducing poverty by half to providing universal primary education-represent a blueprint for global development agreed to by member states of the United Nations and international development institutions. However, achieving them will be a major challenge for El Salvador and many other developing countries. As stated by former United Nations Secretary-General Kofi Annan, it will take time and commitment to mobilize the necessary resources, train the required personnel, and establish the needed infrastructure to meet the MDGs. In El Salvador and other Latin American countries, one major factor contributing to the challenge is the continued rapid growth of the population. The number of people in need of health, education, economic, and other services is large and increasing, which, in turn, means that the amount of resources, personnel, and infrastructure required to meet the MDGs is also increasing. In light of this fact, development efforts in support of the MDGs should not overlook the importance and benefits of slowing population growth. (excerpt)
Language: English
Keywords:
EL SALVADOR | TECHNICAL REPORT | FAMILY PLANNING | DEVELOPMENT PLANNING | GOALS | POVERTY | EDUCATION | WOMEN'S EMPOWERMENT | CHILD MORTALITY | MATERNAL HEALTH | HIV PREVENTION | AIDS PREVENTION | DISEASE PREVENTION | SUSTAINABLE DEVELOPMENT | Developing Countries | Central America | Latin America | Americas | Economic Factors | Planning | Organization and Administration | Socioeconomic Factors | Women's Status | Mortality | Population Dynamics | Demographic Factors | Population | Health | HIV Infections | Viral Diseases | Diseases | AIDS | Prevention and Control | Economic Development
Document Number: 320938

Title: Final report for the Implementing AIDS Prevention and Care (IMPACT) project in El Salvador, June 1998 to August 2005.
Author: Family Health International [FHI]. Implementing AIDS Prevention and Care Project [IMPACT]
Source: Arlington, Virginia, FHI, IMPACT, 2007 Apr. [15] p. (USAID Cooperative Agreement No. HRN-A-00-97-00017-00USAID Development Experience Clearinghouse DocID / Order No. PD-ACJ-383)
Abstract: The Implementing AIDS Prevention and Care (IMPACT) Project in El Salvador focused on two crucial elements of HIV prevention and care: voluntary counseling and testing (VCT), and sexually transmitted infection (STI) services. These two activities achieved IMPACT's direct and intensive assistance to the El Salvador Ministry of Health (MOH), for activities in these two areas accomplished the project's stated goal: "to enhance and strengthen VCT programs throughout the country and strengthen the STI program in the MOH/National AIDS Control Program (NACP)." The program was a success, in spite of delays caused by the devastation from Hurricane Mitch in 1998, a dengue fever outbreak in 2000, and a catastrophic earthquake in 2001. The MOH/NACP made implementing VCT a priority, emphasizing the importance of training health professionals in counseling and testing. Consequently, IMPACT supported a VCT specialist to train facilitators and trainers in counseling and testing; conduct evaluation and follow-up visits to the trained facilitators and trainers; draft a manual for training facilitators in counseling and testing. (excerpt)
Language: English
Keywords:
EL SALVADOR | SUMMARY REPORT | USAID | MANUAL | AIDS PREVENTION | HIV PREVENTION | VOLUNTARY COUNSELING AND TESTING | SEXUALLY TRANSMITTED DISEASE PREVENTION | PROGRAM ACTIVITIES | IMPLEMENTATION | Central America | Latin America | Americas | Developing Countries | Government Agencies | Organizations | Political Factors | Sociocultural Factors | AIDS | HIV Infections | Viral Diseases | Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Programs | Organization and Administration
Document Number: 318671

Title: Contraceptive security committees: their role in Latin America and the Caribbean.
Author: Betancourt VS
Source: Washington, D.C., Constella Futures, Health Policy Initiative, 2007 Sep. 34 p. (USAID Contract No. GPO-I-01-05-00040-00) This report is also available in Spanish: Los comit�s para la disponibilidad asegurada de insumos anticonceptivos: su aporte en Am�rica Latina y el Caribe at http://www.healthpolicyinitiative.com/index.cfm?ID=publications&get=pubID&pubID=447
Abstract: Contraceptive security exists when all individuals are able to choose, obtain, and use high-quality contraceptives when they need them. This report summarizes portions of four case studies about the innovative regional strategies that LAC countries have been implementing since 2003 to achieve contraceptive security. In numerous countries, locally formed contraceptive security committees have been spearheading and coordinating these CS efforts, generally operating at a technical level. The objective of this study was to analyze the experience of six committees and assess their role in working to achieve contraceptive security. The study focused on the activities of CS committees in Bolivia, the Dominican Republic, El Salvador, Honduras, Nicaragua, and Paraguay from 2003 to early 2007. According to the results of the analysis, these committees played a key role in making progress toward contraceptive security. Several other LAC countries made significant political and legislative progress without establishing CS committees.
Language: English
Keywords:
BOLIVIA | DOMINICAN REPUBLIC | EL SALVADOR | HONDURAS | NICARAGUA | PARAGUAY | TECHNICAL REPORT | CASE STUDIES | PUBLIC SECTOR | NEEDS | CONTRACEPTIVE SECURITY | ADVOCACY | FINANCIAL ACTIVITIES | LEADERSHIP | POLICY DEVELOPMENT | REPRODUCTIVE HEALTH | FAMILY PLANNING | Developing Countries | South America, Central | South America | Latin America | Americas | Caribbean | Central America | Studies | Research Methodology | Macroeconomic Factors | Economic Factors | Contraceptive Availability | Contraception | Communication | Organization and Administration | Planning | Health
Document Number: 323049

Title: Constructing an alternative masculine identity: The experience of the Centro Bartolome de las Casas and Oxfam America in El Salvador.
Author: Bird S; Delgado R; Madrigal L; Ochoa JB; Tejeda W
Source: Gender and Development. 2007 Mar;15(1):111-121.
Abstract: The hegemonic model of masculinity under which men in El Salvador grow up and live emphasises control, physical force, and rational intelligence. Aspects of these elements vary in each society and time period, but the elements themselves have remained a constant part of a man's notion of his identity in the Central American, twentieth-century context, and a real risk for gender-based violence. There is a need for alternative male behaviour patterns. While these alternatives exist in diverse environments, they are largely invisible to the general society. This article presents and discusses working with men in the context of a wide civil society and Oxfam America campaign to prevent gender-based violence in El Salvador. (author's)
Language: English
Keywords:
EL SALVADOR | PROGRESS REPORT | MEN | GENDER ISSUES | VIOLENCE AGAINST WOMEN | CULTURE | NONGOVERNMENTAL ORGANIZATIONS | WOMEN'S STATUS | CAMPAIGNS | Developing Countries | Central America | Latin America | Americas | Demographic Factors | Population | Sociocultural Factors | Domestic Violence | Crime | Social Problems | Organizations | Political Factors | Socioeconomic Factors | Economic Factors | Communication Programs | Communication
Document Number: 326684

10.

Peer Reviewed

Title: Women's organizations and local democracy: Promoting effective participation of women in Central America.
Author: Clulow M
Source: Development. 2007;50(1):86-89.
Abstract: Michael Clulow presents four feminist non-governmental organizations that have played a leading role in democratizing local activities to include the participation of women. Las Dignas and Las Melidas from El Salvador, CEM-H from Honduras and Grupo Venancia from Nicaragua individually and collectively have successfully developed many tools and approaches to promote women's participation. He suggests at the heart of all their work, and the key to their successes are the building of strong participatory organizations and the empowerment and training of women. (author's)
Language: English
Keywords:
NICARAGUA | EL SALVADOR | HONDURAS | PROGRESS REPORT | CRITIQUE | WOMEN | NONGOVERNMENTAL ORGANIZATIONS | FEMINISM | WOMEN'S EMPOWERMENT | GENDER ISSUES | GOVERNMENT | POLITICAL FACTORS | DEMOCRACY | SOCIAL CHANGE | Central America | Latin America | Americas | Developing Countries | Demographic Factors | Population | Organizations | Sociocultural Factors | Women's Status | Socioeconomic Factors | Economic Factors | Political Systems
Document Number: 317533

11.
Title: Crack use sites and HIV risk in El Salvador.
Author: Dickson-Gomez J; Bodnar G; Guevara A; Rodriguez K; Gaborit M
Source: Journal of Drug Issues. 2007 Spring;37(2):445-474.
Abstract: "The Social Context of Crack Use and Related Sexual Risk in El Salvador" study was designed to increase knowledge of the locations where drugs are consumed in urban San Salvador, the social dynamics within such sites, and their implications for HIV risk and prevention efforts. In-depth interviews with crack smokers reveal several different types of sites where drugs are consumed and risky sex may occur including trances (generally houses where crack is sold and consumed), brothels, motels, drug users' own homes, abandoned buildings, the street, parks, or cantinas. These range from private sites, where site "gatekeepers" strictly control access, to public sites where access is more open. However, even in more public sites there is considerable social interaction, rules regarding site usage, and in some cases gatekeeper control of the site. Social dynamics already normative at drug use sites may support a site-based, peer-led intervention approach. (author's)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | KAP SURVEYS | URBAN POPULATION | PERSONS LIVING WITH HIV/AIDS | SOCIAL NETWORKS | SUBSTANCE ADDICTION | DRUG USE AND ABUSE | SEX BEHAVIOR | RISK BEHAVIOR | HIV TRANSMISSION | SOCIAL BEHAVIOR | Developing Countries | Central America | Latin America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Friends and Relatives | Family and Household | Sociocultural Factors | Social Problems | Behavior
Document Number: 320689

12.

Title: Using data and information to advance contraceptive security in Latin America and the Caribbean.
Author: Menotti E; Sharma S
Source: Washington, D.C., Constella Futures, Health Policy Initiative, 2007 Sep. 19 p. (USAID Contract No. GPO-I-01-05-00040-00) This report is also available in Spanish: Utilizaci�n de datos e informaci�n para el avance de la disponibilidad asegurada de insumos anticonceptivos en Am�rica Latina y el Caribe at http://www.healthpolicyinitiative.com/index.cfm?ID=publications&get=pubID&pubID=429
Abstract: Contraceptive security exists when all women and men are able to choose, obtain, and use high-quality family planning (FP) products and services. Countries and donors have employed four key strategies in strengthening the policy environment for contraceptive security (CS): awareness raising, advocacy, policy dialogue, and planning. None of these strategies can be effective unless they are credible and presented for debate in a clear manner in which policymakers and stakeholders can understand the issues and implications for policy change. This paper presents information collected in 67 key informant interviews in six countries that have established CS committees (Bolivia, Dominican Republic, El Salvador, Honduras, Nicaragua, and Paraguay), and features some further examples from Guatemala and Peru, where improvements in contraceptive security took place in the absence of CS committees. One of the study objectives was to understand how committee members used data and information in supporting a variety of awareness-raising, advocacy, policy analysis, and planning activities.
Language: English
Keywords:
BOLIVIA | DOMINICAN REPUBLIC | EL SALVADOR | HONDURAS | NICARAGUA | PARAGUAY | TECHNICAL REPORT | CONTRACEPTIVE SECURITY | CASE STUDIES | INTERVIEWS | ADVOCACY | POLICY DEVELOPMENT | FAMILY PLANNING PROGRAMS | DATA ANALYSIS | Developing Countries | South America, Central | South America | Latin America | Americas | Caribbean | Central America | Contraceptive Availability | Contraception | Family Planning | Studies | Research Methodology | Data Collection | Communication | Planning | Organization and Administration
Document Number: 323050

13.

Peer Reviewed

Title: Building health where peace is new in near post-war El Salvador.
Author: Smith L
Source: Development. 2007 Jun;50(2):127-133.
Abstract: In October 1992, after the Peace Accords that ended twelve years of armed civil conflict, but before the actual disarmament, I arrived in El Salvador invited by community leaders in South-Eastern Morazan, and became the coordinator of a French non-governmental organization (NGO) until the end of 1998. I was privileged to be invited by and then to accompany communities as they changed their own destiny. We built together a health project, helped heal communities divided by conflict, developed the concept of 'Liberation Medicine,' and in the process started a social movement association in the United States called Doctors for Global Health. The work continued in El Salvador after I was no longer needed. What follows in this paper is an exploration of what can happen when a community living in poverty is enabled by an invited outsider who not only provides resources but also shows respect and listens so that together they change the community's destiny. While every place and time is different, this article outlines concrete steps for how North and South can work together. (excerpt)
Language: English
Keywords:
EL SALVADOR | SUMMARY REPORT | GROUPS | HEALTH SERVICES | COMMUNITY PARTICIPATION | HUMAN RIGHTS | POVERTY | PROGRAM ACCESSIBILITY | TRAINING PROGRAMS | Central America | Latin America | Americas | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Delivery of Health Care | Health | Organization and Administration | Socioeconomic Factors | Economic Factors | Program Evaluation | Programs | Education
Document Number: 319945

14.

Title: A cross-national comparison of youth risk behaviors in Latino secondary school students living in El Salvador and the USA.
Author: Springer A; Kelder S; Orpinas P; Baumler E
Source: Ethnicity and Health. 2007 Jan;12(1):69-88.
Abstract: As Latin Americans' exposure to the USA increases through migration patterns and US political and economic ties to their countries of origin, they become susceptible to adopting not only the cultural expressions of the USA such as fashion, but also the health-related behaviors of the US population. In assessing potential health risks for Salvadoran youth that may result from the connection between Latin Americans and the USA, this study compared the prevalence of health risk behaviors from four behavior domains (aggression and victimization, depression and suicidal ideation, substance use, and sexual behavior) between Salvadoran and US Latino secondary school students aged 14-17 years. A secondary analysis was performed on two 1999 cross-sectional survey data. In the USA, results were based on 1,063 Latino high school students who answered the nationally representative Youth Risk Behavior Survey (YRBS) conducted by the Centers for Disease Control and Prevention. In El Salvador, results were based on 793 public secondary school students who answered a local YRBS survey conducted in coordination with the Ministry of Education of El Salvador. The prevalence rates for aggression/victimization and for depression and suicidal ideation behaviors were similar between Salvadoran and US Latino adolescents. Substance use prevalence, however, was 10-40% higher for US Latino adolescents. While the prevalence of sexual intercourse was higher among US Latino youth (between 13 and 27% higher, depending on age), the prevalence of condom use was lower among sexually active Salvadoran youth (between 11 and 42% lower, depending on age). In the context of the transnationalization of the Salvadoran population, with potential for increased influence of the USA in Salvadoran culture, these differences in risk behavior are important for targeting effective interventions for Latino adolescents in El Salvador and in the USA. (author's)
Language: English
Keywords:
EL SALVADOR | UNITED STATES OF AMERICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | STUDENTS | SECONDARY SCHOOLS | RISK BEHAVIOR | SUICIDE | AGGRESSION | DRUG USE AND ABUSE | SEX BEHAVIOR | Developing Countries | Central America | Latin America | Americas | North America | Developed Countries | Research Methodology | Sampling Studies | Studies | Education | Schools | Behavior | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 314452

15.

Title: Securing essential contraceptive supplies for all who need them. State of the practice brief.
Author: John Snow [JSI]. DELIVER
Source: Arlington, Virginia, JSI, DELIVER, 2006 Oct. [4] p. (El Salvador State of the Practice BriefUSAID Contract No. HRN-C-00-00-00010-00USAID Development Experience Clearinghouse DocID / Order No. PN-ADI-969)
Abstract: As the most densely populated country in Latin America, El Salvador crowds approximately 7 million people into 8,000 square miles, and it is growing at an annual rate of 1.8 percent. Thirty-six percent of the population is under 15 years of age; the median age is approximately 22 years, which means that the country is predominantly young, with a high percentage (26 percent) of women of reproductive age. In 2003, the total fertility rate in El Salvador was 3 children per woman, having dropped slightly from 3.6 children in 1998. Although the overall fertility rate disguises some differences between urban (2.4) and rural (3.8) rates, this gradual change in total fertility indicates a return on the investments in family planning that were made by the government and donors during the 1990s. In addition, these investments directly resulted in rapid increases in the contraceptive prevalence rate (CPR) for all methods-which rose from 60 percent in 1998 to 67 percent in 2003. More specifically, the use of modern methods among married women of reproductive age (62 percent) include voluntary sterilizations, 53 percent; injectables, 30 percent; pills, 9 percent; condoms, 5 percent; IUDs, 2 percent; and other modern methods 1 percent. (excerpt)
Language: English
Keywords:
LATIN AMERICA | EL SALVADOR | SUMMARY REPORT | CONTRACEPTIVE SECURITY | EQUIPMENT AND SUPPLIES | FUNDS | TOTAL FERTILITY RATE | HEALTH SERVICES | DECENTRALIZATION | LOGISTICS | FAMILY PLANNING PROGRAMS | Americas | Developing Countries | Central America | Contraceptive Availability | Contraception | Family Planning | Medical Procedures | Medicine | Delivery of Health Care | Health | Financial Activities | Economic Factors | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Political Factors | Sociocultural Factors | Management | Organization and Administration
Document Number: 318855

16.

Title: Empowering young women to lead change: a training manual.
Author: World YWCA
Source: Geneva, Switzerland, World YWCA, 2006. 119 p. Also available in Spanish and French.
Abstract: Young women encounter challenges everyday. Apart from sharing their communities' struggles over limited resources like water, land or jobs, many systematically face discrimination simply by virtue of being female. This includes physical and sexual violence, being kept out of school, disproportionate vulnerability to HIV infection and lack of access to property and other rights. Yet young women around the globe possess the collective power to change their lives, their communities and the world we live in. Just as they face daily challenges, young women are continually developing innovative, effective ways to improve their lives. By bringing together their wisdom and creativity, young women are leading change. Understanding that investing in young women's leadership is essential to social change now and for the future, the World YWCA with the generous support of UNFPA, has developed this training resource for and by young women. Empowering Young Women to Lead Change is designed to support the development of young women's skills and to enable them to provide leadership on the issues that concern them. It offers engaging and dynamic activities to motivate and enable young women to believe in their abilities to catalyse change and to mobilise others to do the same. It is a flexible tool for learning and exploring issues from human rights and violence against women to body image, self-esteem and developing leadership skills. Young women in Africa, Asia, the Caribbean, Europe and Latin America in five workshops have field-tested this manual. (excerpt)
Language: English
Keywords:
BELARUS | EL SALVADOR | JAMAICA | LEBANON | PHILIPPINES | ZAMBIA | MANUAL | WORKSHOPS | TRAINING ACTIVITIES | WOMEN | YOUTH | WOMEN'S EMPOWERMENT | HUMAN RIGHTS | SEXUALITY | REPRODUCTIVE HEALTH | SEX EDUCATION | VIOLENCE | SELF ESTEEM | HIV INFECTIONS | AIDS | Developing Countries | Europe, Eastern | Europe | Central America | Latin America | Americas | Caribbean | Middle East | Asia, Southeastern | Asia | Africa, Southern | Africa, Sub Saharan | Africa | Education | Training Programs | Demographic Factors | Population | Age Factors | Population Characteristics | Women's Status | Socioeconomic Factors | Economic Factors | Political Factors | Sociocultural Factors | Personality | Psychological Factors | Behavior | Health | Viral Diseases | Diseases
Document Number: 311223

17.

Title: Report on gender integration consultancy with USAID / El Salvador.
Author: Alberti A
Source: [Washington, D.C.], DevTech Systems, 2006 Apr. 22 p. (USAID Development Experience Clearinghouse DocID / Order No: PN-ADF-906)
Abstract: The purpose of the consultancy was to assist USAID/El Salvador to implement the recommendations of the Gender Assessment to achieve greater gender integration in its programs, and to help the recently established Mission Gender Committee obtain the necessary skills to enable its members to work and support their respective SO Teams in the process of incorporating gender considerations in the design, implementation and evaluation of programs and activities. First, in the interval since the Gender Assessment was completed in March 2004, it was evident that Mission personnel have demonstrated increased interest and commitment to improving gender integration within USAID projects and programs. It was also evident that additional support and training is necessary to better enable Mission personnel to work toward achieving gender integration. Part of the need for support and training has been addressed through the activities completed under this contract. However, the need remains for additional support and training for Mission personnel in general, and the Gender Committee in particular, to continue to provide on-going guidance in gender considerations to partners, contractors, and grantees for projects and programs. Second, the Mission Order presupposes the existence of a mission gender strategy. The El Salvador Mission does not currently have a mission gender strategy. (excerpt)
Language: EnglishSpanish
Keywords:
EL SALVADOR | EVALUATION REPORT | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | POLICYMAKERS | USAID | GENDER ISSUES | TECHNICAL ASSISTANCE | INTEGRATED PROGRAMS | MONITORING | WOMEN'S EMPOWERMENT | Developing Countries | Central America | Latin America | Americas | Economic Development | Economic Factors | Administrative Personnel | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Programs | Women's Status | Socioeconomic Factors
Document Number: 306785

18.
Peer Reviewed

Title: Association between intestinal parasitic infections and type of sanitation system in rural El Salvador.
Author: Corrales LF; Izurieta R; Moe CL
Source: Tropical Medicine and International Health. 2006 Dec;11(12):1821-1831.
Abstract: The objective was to identify demographic, behavioural and environmental determinants of intestinal parasitic infection, evaluate the impact of a variety of dry sanitation systems on intestinal parasitic infection, and evaluate the safety of using stored biosolids in agriculture in order to guide future sanitation interventions in rural areas of El Salvador. Interviews were conducted with 109 households in eight communities where double-vaulted and solar urine-diverting desiccating latrines, pit latrines or no latrines were used. Faecal samples from 499 individuals were tested for enteric helminths and protozoa. Users of solar desiccating latrines had the lowest prevalence of enteric parasite infection. Double-vault, urine-diverting desiccating latrines effectively reduced the transmission of some pathogens, but may not achieve the conditions sufficient for the complete destruction of the more environmentally persistent pathogens, Ascaris lumbricoides and Trichuris trichiura. Contact with inadequately treated latrine biosolids was associated with an increased risk of Ascaris infection. Solar latrines were associated with the overall lowest prevalence of enteric parasitic infections. Members of households where latrine biosolids were used in agriculture had a higher prevalence of infection than those where biosolids were buried. We therefore recommend the promotion of solar latrines in rural areas of El Salvador over other dry sanitation systems, and recommend that stored biosolids not be used in agriculture. (author's)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | INTERVIEWS | RURAL AREAS | HOUSEHOLDS | SANITATION | GASTROINTESTINAL EFFECTS | PARASITIC DISEASES | IMPACT | Developing Countries | Central America | Latin America | Americas | Data Collection | Research Methodology | Geographic Factors | Population | Family and Household | Sociocultural Factors | Public Health | Health | Physiology | Biology | Diseases | Communication
Document Number: 310926

19.

Title: Childhood sexual abuse and HIV risk among crack-using commercial sex workers in San Salvador, El Salvador: A qualitative analysis.
Author: Dickson-Gomez J; Bodnar G; Gueverra A; Rodriguez K; Gaborit M
Source: Medical Anthropology Quarterly. 2006 Dec;20(4):545-574.
Abstract: This article explores the relationship between childhood sexual abuse (CSA) and later HIV risk. It draws on qualitative, in-depth interviews with 40 women who either used crack or engaged in commercial sex work in the greater metropolitan area of San Salvador, El Salvador, 28 of whom experienced CSA. Although the relationship between CSA and later HIV risk has been clearly demonstrated, the processes that lead women who have experienced CSA to experience HIV risk are unclear. The theoretical model presented here incorporates the psychological effects of CSA, particularly stigmatization, as well as its social consequences and the larger context of poverty in which these women live. The meanings women draw from past abuse experiences and their rationale for choices made help explain the association between CSA and later risk as mediated through sex work and crack addiction. Self-report data gathered in this study indicate that HIV prevalence may be considerably higher in this high-risk population than Salvadoran national rates. (author's)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | INTERVIEWS | WOMEN | SEX WORKERS | DRUG USE AND ABUSE | SUBSTANCE ADDICTION | SEXUAL ABUSE | PSYCHOLOGICAL FACTORS | RISK FACTORS | HIV INFECTIONS | PREVALENCE | Developing Countries | Central America | Latin America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Social Problems | Sociocultural Factors | Crime | Biology | Viral Diseases | Diseases | Measurement
Document Number: 314727

20.
Peer Reviewed

Title: Migration, risk, and liquidity constraints in El Salvador.
Author: Halliday T
Source: Economic Development and Cultural Change. 2006 Jul;54(4):893-925.
Abstract: There is a vast literature in development economics that has investigated how households in less developed countries (LDCs) cope with exogenous economic shocks in the face of imperfect insurance markets. This literature has two strands. In the first, researchers have looked at informal means of allocating risk across space in which households within a group such as a village insure each other via state-contingent transfers. In the second strand, researchers have looked at the household's use of asset accumulation and depletion, in autarky, as a means of self-insurance. This article adds to this part of the literature by treating the number of migrants within a household as a productive asset and investigating how and why various exogenous economic shocks affect its movement. (excerpt)
Language: English
Keywords:
EL SALVADOR | RURAL AREAS | RESEARCH REPORT | HOUSEHOLDS | MIGRANTS | ECONOMIC CONDITIONS | NATURAL DISASTERS | MIGRATION | AGRICULTURE | REMITTANCES | INCOME | Central America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Family and Household | Sociocultural Factors | Population Dynamics | Demographic Factors | Macroeconomic Factors | Economic Factors | Environment | Microeconomic Factors | Socioeconomic Factors
Document Number: 302554

21.
Peer Reviewed

Title: Supportive social relationships and adolescent health risk behavior among secondary school students in El Salvador. [Relaciones sociales de apoyo y conductas adolescentes de riesgo para la salud entre estudiantes secundarios de El Salvador]
Author: Springer A; Parcel G; Baumler E; Ross M
Source: Social Science and Medicine. 2006 Apr;62(7):1628-1640.
Abstract: An increasing number of studies suggest that supportive social relationships in the family and school may exert a protective effect against a number of youth health risk behaviors. This study examines the association between perceived parental social support and perceived social cohesion at school with selected youth risk behavior outcomes (physical fighting, victimization, suicidal ideation, substance use, and sexual intercourse) among 930 female and male public secondary school students studying in the central region of El Salvador. The study questionnaire comprised closed-ended items of parent/school relationships and risk behaviors based on the United States Center for Disease Control and Prevention's Youth Risk Behavior Survey. In regression analyses, female students who perceived low parental social support were significantly more likely to report engaging in all risk behaviors examined, and female students with perceptions of low school social cohesion were more likely to report suicidal ideation, binge drinking, and drug use. Perceptions of parental social support and school social cohesion held fewer but still significant associations across risk behaviors for male students. Male students who reported low parental social support were significantly more likely to report suicidal ideation, drug use and physical fighting, while male students with low perceived school social cohesion were more likely to report physical fighting but less likely to report binge drinking. This study lends support to the importance of supportive social relationships for understanding youth risk behavior and suggests that supportive families and schools may operate differently for female and male students living in El Salvador. (author's)
Spanish Abstract: Un n�mero cada vez mayor de estudios sugiere que las relaciones sociales de apoyo familiar y escolar pueden ejercer un efecto de protecci�n contra una serie de conductas de los j�venes que entra�an un riesgo para su salud. El presente estudio analiza la asociaci�n existente entre los grados percibidos de apoyo social de los padres y de cohesi�n social escolar, y los resultados espec�ficos de conductas juveniles de riesgo (agresiones f�sicas, discriminaci�n, pensamientos suicidas, consumo de sustancias y relaciones sexuales) entre 930 alumnas y alumnos de escuelas secundarias p�blicas de la regi�n central de El Salvador. El cuestionario del estudio incluy� preguntas cerradas (por s� o por no, o con respuestas breves) sobre las relaciones con los padres/la escuela y las conductas de riesgo, basadas en la Encuesta sobre Conductas Juveniles de Riesgo del Centro Estadounidense para el Control y la Prevenci�n de Enfermedades. En los an�lisis de regresi�n, las estudiantes que percib�an escaso apoyo social de sus padres fueron m�s propensas a comunicar todas las conductas de riesgo analizadas, y aquellas que percib�an escasa cohesi�n social escolar tendieron a informar pensamientos suicidas, borracheras y consumo de drogas. Las percepciones de apoyo social de los padres y de cohesi�n social en la escuela mostraron menos asociaciones (aunque significativas) con las distintas conductas de riesgo de los varones. La mayor�a de los varones que comunicaron un escaso apoyo social de los padres fueron significativamente m�s propensos a comunicar pensamientos suicidas, consumo de drogas y agresiones f�sicas, mientras que los varones con una baja percepci�n de cohesi�n social escolar fueron m�s propensos a informar agresiones f�sicas pero menos propensos a informar borracheras. Este estudio sostiene la importancia de las relaciones de apoyo social para comprender las conductas juveniles de riesgo y sugiere que las familias y escuelas que apoyan a los j�venes pueden tener distintos efectos para las alumnas y los alumnos de El Salvador. (del autor)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | STATISTICAL REGRESSION | PARENTS | ADOLESCENTS, MALE | ADOLESCENTS, FEMALE | STUDENTS | SECONDARY SCHOOLS | SOCIAL NETWORKS | RISK BEHAVIOR | PARENTAL INVOLVEMENT | GENDER ISSUES | Developing Countries | Central America | Latin America | Americas | Data Analysis | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Friends and Relatives | Behavior | Child Rearing
Document Number: 297429

22.

Title: A descriptive study of youth risk behavior in urban and rural secondary school students in El Salvador.
Author: Springer AE; Selwyn BJ; Kelder SH
Source: BMC International Health and Human Rights. 2006 Apr 11;6:[11] p..
Abstract: Adolescence is an important stage of life for establishing healthy behaviors, attitudes, and lifestyles that contribute to current and future health. Health risk behavior is one indicator of health of young people that may serve both as a measure of health over time as well as a target for health policies and programs. This study examined the prevalence and distribution of youth health risk behaviors from five risk behavior domains-aggression, victimization, depression and suicidal ideation, substance use, and sexual behaviors-among public secondary school students in central El Salvador. We employed a multi-stage sampling design in which school districts, schools, and classrooms were randomly selected. Data were collected using a self-administered questionnaire based on the United States Center for Disease Control and Prevention's Youth Risk Behavior Survey. Sixteen schools and 982 students aged 12-20 years participated in the study. Health risk behaviors with highest prevalence rates included: engagement in physical fight (32.1%); threatened/injured with a weapon (19.9%); feelings of sadness/hopelessness (32.2%); current cigarette use (13.6%); and no condom use at last sexual intercourse (69.1%). Urban and male students reported statistically significant higher prevalence of most youth risk behaviors; female students reported statistically significant higher prevalence of feelings of sadness/hopelessness (35.6%), suicidal ideation (17.9%) and, among the sexually experienced, forced sexual intercourse (20.6%). A high percentage of Salvadoran adolescents in this sample engaged in health risk behaviors, warranting enhanced adolescent health promotion strategies. Future health promotion efforts should target: the young age of sexual intercourse as well as low condom use among students, the higher prevalence of risk behaviors among urban students, and the important gender differences in risk behaviors, including the higher prevalence of reported feelings of sadness, suicidal ideation and forced sexual intercourse among females and higher sexual intercourse and substance use among males. Relevance of findings within the Salvadoran and the cross-national context and implications for health promotion efforts are discussed. (author's)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | STUDY DESIGN | ADOLESCENTS | STUDENTS | SECONDARY SCHOOLS | LIFE STYLE | ADOLESCENT HEALTH | RISK BEHAVIOR | SEX BEHAVIOR | DEPRESSION | SUBSTANCE ADDICTION | SUICIDE | AGGRESSION | Developing Countries | Central America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Behavior | Health | Mental Disorders | Diseases | Social Problems | Sociocultural Factors | Mortality | Population Dynamics
Document Number: 310901

23.

Title: Strategic Objective No. 519-003: "Health of Salvadorans, Primarily Women, Youth and Children, Improved". 1997-2005. Close-out report.
Author: United States. Agency for International Development [USAID]
Source: La Libertad, El Salvador, USAID, Health Office, 2005. [20] p. (USAID Development Experience Clearinghouse DocID / Order No: PD-ACG-712)
Abstract: Although El Salvador's health system had improved after years of civil war, serious inequalities between urban and rural areas existed by June 17, 1996, when USAID's new health strategy was approved. Maternal and child morbidity and mortality rates were high, mainly due to preventable causes such as respiratory infections and diarrhea disease. Rural Salvadorans lacked access to adequate health care, especially preventive maternal and child health services, water and sanitation services and proper hygiene practices. On June 7, 1996, Strategic Objective (SO) No, 519-003 "Sustainable Improvements in Health of Women and Children" was approved under USAID/El Salvador 1997 -- 2002 Strategy "Sustainable Development and Democracy in El Salvador." On April 2, 1997, the Mission Director approved Results Package "Increased Access to Potable Water and Sanitation Systems" to finance $9.755 million for water and sanitation activities. Subsequently, on August 7, 1997, three other results packages (RP) were approved under the SO No. 519-003 at a funding level not to exceed $53,930,000 for the period 1997 through 2002. These RPs were an integral part of the USAID's 1997 - 2002 health strategy. Thus the SO 519-003 framework comprised four RPs: "Increased use of appropriate child survival practices and services," "Increased use of appropriate reproductive health practices and services," "Enhanced policy environment to support sustainability of child survival and reproductive health programs" and "Increased Access to Potable Water and Sanitation Systems." (excerpt)
Language: English
Keywords:
EL SALVADOR | SUMMARY REPORT | USAID | WOMEN'S HEALTH | CHILD HEALTH | ADOLESCENT HEALTH | WATER SUPPLY | SANITATION | CHILD SURVIVAL | REPRODUCTIVE HEALTH | HEALTH SERVICES EVALUATION | PROGRAM ACCESSIBILITY | Central America | Latin America | Americas | Developing Countries | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Health | Natural Resources | Environment | Public Health | Survivorship | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Program Evaluation | Programs | Organization and Administration
Document Number: 305459

24.

Title: USAID country health statistical report: El Salvador, June 2005. [Informe estad�stico nacional sobre salud de USAID: EL Salvador, junio de 2005]
Author: United States. Agency for International Development [USAID]
Source: Washington, D.C., Jorge Scientific Corporation, Population, Health and Nutrition Information Project [PHNI], 2005 Jun. [15] p. (USAID Contract No. HRN-C-00-00-00004-00USAID Development Experience Clearinghouse DocID / Order No. PN-ADF-819)
Abstract: This report is one of a series of Country Health Statistical Reports produced on behalf of the United States Agency for International Development (USAID) by the Population, Health and Nutrition Information (PHNI) Project. Each profile contains statistical data on current health conditions, population dynamics, health and family planning behavior, and health and population trends in a given developing country. Information is compiled from PHNI's health statistics database, which draws data from a diverse range of sources listed at the end of this profile. (excerpt)
Spanish Abstract: Este informe es uno de la serie de informes Estad�sticas de Salud Nacional redactados por el Proyecto Informaci�n sobre Poblaci�n, Salud y Nutrici�n (PHNI, Population, Health and Nutrition Information) en nombre de la Agencia Estadounidense para el Desarrollo Internacional (USAID, U. S. Agency for International Development). Cada perfil contiene datos estad�sticos sobre condiciones actuales de salud, din�mica demogr�fica, conductas sanitarias y de planificaci�n familiar, tendencias sanitarias y demogr�ficas de un pa�s concreto en v�as de desarrollo. La informaci�n se extrae de las bases de datos de estad�sticas sanitarias del Proyecto, que recaba datos de una amplia serie de fuentes que se incluyen al final de cada perfil. (extracto)
Language: English
Keywords:
EL SALVADOR | GOVERNMENT PUBLICATION | STATISTICAL STUDIES | USAID | DEMOGRAPHIC FACTORS | SOCIOECONOMIC FACTORS | FAMILY PLANNING | MATERNAL HEALTH | HIV PREVENTION | DISEASE TRANSMISSION CONTROL | INFECTION PREVENTION | POPULATION PROJECTION | VACCINATION | HEALTH STATUS INDEXES | INFANT MORTALITY | DEATH RATE | CHILD SURVIVAL | FERTILITY RATE | Central America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Population | Economic Factors | Health | HIV Infections | Viral Diseases | Diseases | Prevention and Control | Infections | Estimation Techniques | Immunization | Primary Health Care | Health Services | Delivery of Health Care | Mortality | Population Dynamics | Survivorship | Length of Life | Birth Rate | Fertility Measurements | Fertility
Document Number: 303461

25.

Peer Reviewed

Title: Pregnancy intentions among Salvadoran fathers: results from the 2003 National Male Reproductive Health Survey. [Intenciones de embarazo en los padres salvadore�os: resultados de la Encuesta Nacional de Salud Reproductiva Masculina]
Author: Carter M; Speizer IS
Source: International Family Planning Perspectives. 2005 Dec;31(4):179-182.
Abstract: In El Salvador, fathers less commonly say that pregnancies are unintended than mothers do. However, men's pregnancy intentions are not understood as well as women's. Data from 425 fathers participating in the 2003 National Male Reproductive Health Survey of El Salvador were analyzed to examine their intentions in regard to partners' pregnancies that had ended in a live birth in the last five years. They were asked whether they had been trying to avoid pregnancy at the time of conception, whether they had been trying to get their partner pregnant, how they had felt about the pregnancy and what they thought their partner's pregnancy intentions had been. Descriptive analyses were based on the most recent pregnancy reported by each man. A quarter of the pregnancies had been unintended from the men's perspective--13% had been mistimed and 11% had been unwanted. Almost half (46%) of unintended pregnancies had been conceived when the father was trying to avoid pregnancy. However, 36% of men reporting an unintended pregnancy said they had been happy when they found out about it. For 20% of all pregnancies, men perceived that their partner's pregnancy intentions differed from their own. Family planning services in El Salvador need improvement, and services and outreach should target men. Men's experiences with unintended pregnancies--in particular, contraceptive failure and discordance within couples about pregnancy intention--are complex and merit further investigation. (author's)
Spanish Abstract: En El Salvador, los padres reconocen menos que las madres que los embarazos no han sido programados. Sin embargo, las intenciones de embarazo de los hombres no se comprenden tan bien como las de las mujeres. Se analizaron los datos de 425 hombres que participaron de la Encuesta Nacional de Salud Reproductiva Masculina de El Salvador para estudiar sus intenciones en relaci�n con los embarazos de sus parejas que finalizaron en nacimientos de ni�os vivos en los �ltimos cinco a�os. Se les pregunt� si hab�an intentado evitar el embarazo en el momento de la concepci�n, si hab�an estado intentando dejar embarazada a su pareja, c�mo se hab�an sentido acerca del embarazo y cu�les pensaban que hab�an sido las intenciones de embarazo de sus parejas. Los an�lisis descriptivos se basaron en el embarazo m�s reciente informado por cada hombre. Desde la perspectiva de los hombres, el 25% de los embarazos no hab�a sido programado: 13% fue inoportuno y el 11% no deseado. Pr�cticamente la mitad (46%) de los embarazos no programados hab�a sido concebido cuando el padre intentaba evitar el embarazo. No obstante, el 36% de los hombres que informaron un embarazo no programado comunic� haberse sentido feliz al enterarse. En el 20% del total de embarazos, los hombres percib�an que las intenciones de embarazo de sus parejas eran diferentes a las de ellos. Los servicios de planificaci�n familiar en El Salvador se deben mejorar y tanto �stos como las actividades de difusi�n se deber�an centrar en los hombres. Las experiencias de los hombres con respecto a embarazos no programados, en especial, con la falla en los anticonceptivos y el desacuerdo en las parejas acerca de la intenci�n de embarazo, son complejas y ameritan investigaciones m�s exhaustivas. (del autor)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | HEALTH SURVEYS | FATHERS | COUPLES | REPRODUCTIVE HEALTH | PREGNANCY | PREGNANCY, UNPLANNED | PREGNANCY, PLANNED | Developing Countries | Central America | Latin America | Americas | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 297763

26.
Peer Reviewed

Title: Digital camera assessment for detection of cervical intraepithelial neoplasia in rural El Salvador. [Evaluaci�n con c�mara digital para la detecci�n de neoplasia intraepitelial cervical en zonas rurales de El Salvador]
Author: Cremer M; Jamshidi RM; Muderspach L; Tsao-Wei D; Felix JC
Source: International Journal of Gynecology and Obstetrics. 2005;91:42-46.
Abstract: The objective was to explore the feasibility of digital photography for primary cervical cancer screening in a low-resource setting in El Salvador. Three independent examiners performed Pap test, visual inspection, digital camera assessment and colposcopy on each subject. Lesions were detected in 99 of 504 patients (20%) by visual inspection, 72/504 (14%) by DART and 90/504 (18%) by colposcopic impression. Seven of 504 patients (1.3%) had CIN on histology. Pap detected 2 of 7 subjects (29% sensitivity) (C.I. 4%, 56%), visual inspection detected 5 of 7 (71% sensitivity, C.I. 34%, 95%), digital assessment detected 6 of 7 (86% sensitivity C. I. 45%, 99%), and colposcopic impression detected 5 of 7 (71% sensitivity, C.I. 34%, 95%). This small pilot trial demonstrates the potential value and feasibility of performing digital camera assessment of the reproductive tract on women in a developing country setting. (author's)
Spanish Abstract: El objetivo fue investigar la factibilidad de la fotograf�a digital en la detecci�n primaria del c�ncer cervical primario en un �mbito de bajos recursos de El Salvador. Tres examinadores independientes practicaron Papanicolaou, inspecci�n visual, evaluaci�n con c�mara digital y colposcop�a a cada participante. Se detectaron lesiones en 99 de 504 pacientes (20%) mediante inspecci�n visual, 72/504 (14%) mediante DART y 90/504 (18%) mediante impresi�n colposc�pica. Siete de 504 pacientes (1,3%) presentaron neoplasia intraepitelial cervical (NIC) en las pruebas histol�gicas. El Papanicolaou detect� 2 de 7 pacientes (29% de sensibilidad) (intervalo de confianza [IC] 4%, 56%), la inspecci�n visual detect� 5 de 7 (71% de sensibilidad, IC 34%, 95%), la evaluaci�n digital detect� 6 de 7 (86% de sensibilidad IC 45%, 99%), y la impresi�n colposc�pica detect� 5 de 7 (71% de sensibilidad, IC 34%, 95%). Este peque�o ensayo piloto demuestra el valor y la factibilidad potenciales del desarrollo de la evaluaci�n con c�mara digital del aparato reproductor femenino en los pa�ses en v�as de desarrollo. (del autor)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | CLINICAL RESEARCH | PILOT PROJECTS | RURAL POPULATION | WOMEN IN DEVELOPMENT | CERVICAL CANCER | PHYSICAL EXAMINATIONS AND DIAGNOSES | SCREENING | PAP SMEAR | COLPOSCOPY | HISTOLOGY | Developing Countries | Central America | Latin America | Americas | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Cancer | Neoplasms | Diseases | Examinations and Diagnoses | Laboratory Examinations and Diagnoses | Endoscopy | Biology
Document Number: 290662

27.
Peer Reviewed

Title: Liquid-based cytologic specimen studies to screen for cervical dysplasia in rural El Salvador. [Estudios de muestras citol�gicas de base l�quida para detectar displasia cervical en zonas rurales de El Salvador]
Author: Cremer M; de LasCasas L; Kurtycz DF; Schink J
Source: International Journal of Gynecology and Obstetrics. 2005 Aug;90(2):167-170.
Abstract: The objective was to evaluate an alternative tool (ThinPrep; Cytye Corporation, Boxborough, Mass, USA) for cervical cancer screening in rural El Salvador. Cervical samples were obtained from 471 women attending health fairs in rural El Salvador. The samples were read by American and Salvadoran pathologists after a 1-week training course in liquid-based cytologic studies in the United States. The system evaluated detected a significantly higher number of high-grade and above lesions than conventional cytologic studies (P =0.01). There were 0.4% and 1.7% of high-grade lesions and above detected with conventionally prepared slides in the United States and El Salvador, respectively, and 3.2% and 3.8% of such lesions detected with liquid-based samples in the United States and El Salvador. Intraobserver agreement among the pathologists reading the samples was substantial for the ThinPrep system, with a j value of 0.6. A short workshop is effective in training pathologists to use ThinPrep. In the studied population, liquid-based studies appear to offer significant advantages over conventional cytologic studies for detecting high-grade lesions. (author's)
Spanish Abstract: El objetivo fue evaluar una herramienta alternativa (ThinPrep; Corporaci�n Cytye, Boxborough, Massachussets, Estados Unidos) para la detecci�n del c�ncer cervical en las zonas rurales de El Salvador. Se extrajeron muestras cervicales de 471 mujeres que asist�an a ferias de salud en las zonas rurales de El Salvador. Pat�logos estadounidenses y salvadore�os interpretaron las muestras despu�s de un curso de capacitaci�n de una semana de duraci�n sobre estudios citol�gicos de base l�quida realizado en Estados Unidos. El sistema en estudio detect� un n�mero significativamente mayor de lesiones de alto grado y de grado superior que las pruebas citol�gicas convencionales (P = 0,01). En Estados Unidos y en El Salvador, se detectaron 0,4% y 1,7% de lesiones de alto grado y de grado superior con frotis convencionales, respectivamente, y 3,2% y 3,8% con muestras de base l�quida. El acuerdo intraobservador entre los pat�logos que interpretaban las muestras fue sustancial para el sistema ThinPrep (valor j = 0,6). Un taller de corta duraci�n resulta efectivo para capacitar a los pat�logos en el uso de ThinPrep. En la poblaci�n analizada, los estudios de base l�quida parecen ofrecer ventajas sustanciales sobre los estudios citol�gicos convencionales para la detecci�n de lesiones de alto grado. (del autor)
Language: English
Keywords:
EL SALVADOR | UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | CROSS-CULTURAL COMPARISONS | WOMEN IN DEVELOPMENT | PHYSICIANS | WORKSHOPS | TRAINING PROGRAMS | PAP SMEAR | Developing Countries | Central America | Latin America | Americas | North America | Developed Countries | Research Methodology | Comparative Studies | Studies | Economic Development | Economic Factors | Health Personnel | Delivery of Health Care | Health | Education | Laboratory Examinations and Diagnoses | Examinations and Diagnoses
Document Number: 290992

28.
Title: She walked from El Salvador. Caring for an immigrant nation. [Ella vino caminando desde El Salvador. La atenci�n en una naci�n de inmigrantes.]
Author: Flores G
Source: Health Affairs. 2005 Mar-Apr;24(2):506-510.
Abstract: Living in a diverse nation inevitably requires working closely with people from a variety of backgrounds. In medicine it means that physicians must care for patients whose race, ethnicity, and language are often different from their own. What does this do to the sensitive, often complicated interactions that take place between a doctor and a patient? Does the preponderance of nonblack, non-Hispanic physicians in a country that is increasingly black and Hispanic explain the poorer health outcomes that are frequently seen in these populations? Glenn Flores, a pediatrician from the Medical College of Wisconsin, explores the varieties and effects of physicians� attitudes in a short story about a recent El Salvadoran immigrant and her infant daughter. Attitude matters. Next, Alok Khorana wrestles with the �nonconcordance� between doctor and patient most often present in his own practice, pointing out that �I am neither black nor white. I am brown, but not Hispanic.� Humanism, he would seem to conclude, is a more important factor than racial/ethnic concordance in the practice of good medicine. (author's)
Spanish Abstract: Vivir en una naci�n de poblaci�n heterog�nea implica inexorablemente trabajar en estrecho contacto con personas de distinto origen. En medicina significa que los m�dicos deben atender a pacientes cuya raza, etnia e idioma son diferentes de los suyos. �Cu�les son las consecuencias de esta situaci�n sobre la delicada y, a menudo, complicada relaci�n m�dico - paciente? �El predominio de m�dicos que no son negros ni hispanos en un pa�s con crecientes poblaciones negras e hispanas explica los resultados sanitarios m�s deficientes que suelen observarse en estas poblaciones? Glenn Flores, un pediatra de la Facultad de Medicina de Wisconsin, analiza las variedades y efectos de las actitudes de los m�dicos en un relato breve sobre una inmigrante reci�n llegada de El Salvador y su beba. La actitud cuenta. M�s adelante, Alok Khorana lucha contra la falta de concordancia entre m�dico y paciente normalmente presente en su pr�ctica, se�ala: "No soy ni blanco ni negro. Soy oscuro, pero no soy hispano." La conclusi�n a la que parecer�a llegar es que el humanismo es un factor m�s importante que la concordancia racial o �tnica en la pr�ctica de un buen m�dico. (del autor)
Language: English
Keywords:
EL SALVADOR | UNITED STATES OF AMERICA | CRITIQUE | ILLEGAL MIGRANTS | WOMEN | CLIENTS | HEALTH INSURANCE | SOCIAL SECURITY | SOCIAL WELFARE | HEALTH SERVICES | Developing Countries | Central America | Latin America | Americas | Developed Countries | North America | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Financial Activities | Economic Factors | Government Financing | Delivery of Health Care | Health
Document Number: 285945

29.

Peer Reviewed

Title: Cultivating men's interest in family planning in rural El Salvador. [Incentivaci�n del inter�s de los hombres en la planificaci�n familiar en comunidades rurales de El Salvador]
Author: Lundgren RI; Gribble JN; Greene ME; Emrick GE; de Monroy M
Source: Studies in Family Planning. 2005 Sep;36(3):173-188.
Abstract: A pilot project in rural El Salvador tested the integration of family planning into a water and sanitation program as a strategy for increasing male involvement in family planning decision-making and use. The organizations involved posited that integrating family planning into a resource management and community development project would facilitate male involvement by diffusing information, by referring men and women to services, and by expanding method choice to include the new Standard Days Method through networks established around issues men cared about and were already involved in. This article examines data from a community-based household survey to assess the impact of the intervention and finds significant changes in contraceptive knowledge, attitudes, and behavior from baseline to endline. Because the differences between baseline and endline are greater than the differences between participants and nonparticipants at endline, the study demonstrates the power of informal networks for spreading information. (author's)
Spanish Abstract: Un proyecto piloto en comunidades rurales de El Salvador evalu� la integraci�n de la planificaci�n familiar a un programa de suministro de agua y servicios sanitarios como estrategia para aumentar la participaci�n masculina en la toma de decisiones y la utilizaci�n de servicios de planificaci�n familiar. Las organizaciones intervinientes plantearon que integrar la planificaci�n familiar a un proyecto de administraci�n de recursos y desarrollo de la comunidad facilitar�a la participaci�n masculina al difundir informaci�n, derivar a hombres y mujeres a los servicios, e incorporar el nuevo M�todo de d�as fijos a la gama de opciones de anticoncepci�n disponibles, a trav�s de redes establecidas en torno a aspectos que interesaran a los hombres y en los que ya estuvieran involucrados. Este art�culo analiza los datos de una encuesta de hogares basada en una comunidad con el objeto de evaluar el impacto de la intervenci�n y revela cambios significativos en el conocimiento, las actitudes y las conductas inherentes a la anticoncepci�n desde el inicio hasta el final de la encuesta. Dado que las diferencias entre los datos iniciales y los finales son mayores que las existentes entre los participantes y los no participantes al finalizar la encuesta, el estudio demuestra el poder de las redes informales en la difusi�n de la informaci�n. (del autor)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | PILOT PROJECTS | KAP SURVEYS | CASE CONTROL STUDIES | RURAL POPULATION | MEN | HOUSEHOLDS | INTEGRATED PROGRAMS | FAMILY PLANNING PROGRAM EVALUATION | SANITATION | WATER SUPPLY | MALE ROLE | CONTRACEPTIVE METHODS CHOSEN | RHYTHM METHOD, CALENDAR | Developing Countries | Central America | Latin America | Americas | Studies | Research Methodology | Surveys | Sampling Studies | Population Characteristics | Demographic Factors | Population | Family and Household | Programs | Organization and Administration | Family Planning Programs | Family Planning | Public Health | Health | Natural Resources | Environment | Social Behavior | Behavior | Contraceptive Usage | Contraception | Family Planning, Behavioral Methods
Document Number: 295351

30.
Peer Reviewed

Title: Predictors of contraception knowledge and use among postpartum adolescents in El Salvador. [Predictores de conocimiento y uso de anticonceptivos en pu�rperas adolescentes en El Salvador]
Author: Newmann SJ; Goldberg AB; Aviles R; Molina de Perez O; Foster-Rosales AF
Source: American Journal of Obstetrics and Gynecology. 2005 May;192(5):1391-1394.
Abstract: This study was undertaken to describe demographics and contraceptive familiarity and use among postpartum adolescents in El Salvador. Questionnaire-guided interviews were conducted in Spanish with 50 postpartum adolescents at an urban, public hospital in El Salvador. Open-ended questions included assessments of education, partnership status, and contraceptive knowledge and use patterns. The median age of subjects was 17 years, 84% were nulliparous, 80% had partners, and 6% were married. Eighty-four percent of the women reported contraception knowledge and 18% reported contraception use. Educational experience and literacy predicted contraceptive knowledge (P = .008 and .001, respectively), but not use. After delivery and postpartum contraception education, 58% of the subjects stated intention to use contraception. Having a partner and living with him were predictors of intent to use contraception (P = .001 and .002, respectively). Being single negatively predicted intention to use contraception (P = .001). Education and literacy predicted contraceptive knowledge; however, contraceptive knowledge did not predict contraceptive use. Adolescent contraception use depends on more than just contraceptive knowledge. (author's)
Spanish Abstract: Este estudio se llev� a cabo a fin de describir las caracter�sticas demogr�ficas y la familiaridad con los anticonceptivos y su utilizaci�n en las pu�rperas adolescentes de El Salvador. Se realizaron entrevistas guiadas por cuestionarios en idioma espa�ol a 50 pu�rperas adolescentes en un hospital p�blico urbano de El Salvador. Las preguntas abiertas inclu�an evaluaciones sobre educaci�n, estado de la pareja, conocimientos sobre anticoncepci�n y patrones de uso de anticonceptivos. La media de edad de las adolescentes fue de 17 a�os, el 84% eran nul�paras, el 80% ten�an pareja y el 6% estaban casadas. El 84% de las mujeres comunic� tener conocimientos sobre anticonceptivos y el 18% utilizarlos. La experiencia acad�mica y el alfabetismo fueron factores predictivos de conocimientos sobre anticoncepci�n (P = 0,008 y 0,001, respectivamente), pero no de uso. Despu�s de recibir instrucci�n acerca del parto y de la anticoncepci�n posparto, el 58% de las entrevistadas declar� su intenci�n de utilizar anticonceptivos. Tener pareja y convivir fueron factores predictivos de intenci�n de uso de anticonceptivos (P = 0,001 y 0,002, respectivamente). Ser soltera fue un predictor negativo de intenci�n de uso de anticonceptivos (P = 0,001). La educaci�n y el alfabetismo predijeron conocimientos sobre anticoncepci�n; sin embargo, �stos no constituyeron un factor predictivo de uso de anticonceptivos. El uso de anticonceptivos por parte de las adolescentes depende de m�s factores que su mero conocimiento. (del autor)
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT |