| 1. Title: Women's perspective in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth. Author: Almeida CA; Tanaka OY Source: Revista De Saude Publica. 2009 Feb;43(1):98-104. Abstract: OBJECTIVE: To analyze the importance of inclusion, from women's perspective, in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth, carried out by the Brazilian Ministry of Health. METHODOLOGICAL PROCEDURES: This qualitative study was based on primary data collected in 2003 in an evaluation of the Program conducted in seven towns spread out among Brazil's five geographic regions. These sites were selected from a Federal Government data base utilized for quantitative analysis. Women attended by the Program were considered key informants when primary data was collected. Sixteen focal groups were performed in the primary care units. The Collective Subject Speech (CSS) method was used for qualitative analysis. The theoretical concepts of accessibility and Paideia Health within the framework of public health were used to interpret the findings. ANALYSIS OF RESULTS: The Program standardizes procedures to be taken in antenatal care and childbirth for all health services in the country, including the flow among these services. However, analysis of women's discourse in the focal groups elucidated the existence of dissonances between their needs and desires and many of the program's recommendations. Pregnant women thus choose among available services and professionals and try to set up their own schedules which, in turn, do not correspond to those set up by the program. This discrepancy damages the bond women establish with the health services and creates obstacles for the control of the activities actually provided by the health services to the women. CONCLUSIONS: Analysis of the Program based on women's perspective identified aspects that might result in more humanized and effective antenatal care, if they are taken into account in the redefinition or correction of the Program schedule Miolo abstract Miolo abstract Miolo abstract. Language: EnglishPortuguese Keywords: BRAZIL | RESEARCH REPORT | FOCUS GROUPS | PREGNANT WOMEN | ANTENATAL CARE | MATERNAL-CHILD HEALTH SERVICES | DELIVERY OF HEALTH CARE | NEEDS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Maternal Health Services | Primary Health Care | Health Services | Health | Economic Factors | Programs | Organization and Administration Document Number: 341988 |
2.  Title: Promoting and protecting the health of orphans and vulnerable children in Monkey Bay, Malawi. Author: Asibu W; Chingoni J; Majawa D; Jambo H; Kambewankako T Source: Harare, Zimbabwe, EQUINET, 2009. 32 p. Abstract: This report presents results from participatory action research (PRA) that focused on coordinating support from service providers and community organizations working to improve the sexual and reproductive health of orphans and vulnerable children in Monkey Bay, Malawi. Language: English Keywords: MALAWI | SUMMARY REPORT | ACTION RESEARCH | FOCUS GROUPS | ORPHANS AND VULNERABLE CHILDREN | CHILD HEALTH | AIDS | PRIMARY HEALTH CARE | QUALITY OF HEALTH CARE | PROGRAM ACTIVITIES | IMPACT | IMPLEMENTATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Collection | Family and Household | Sociocultural Factors | Health | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Communication Document Number: 342033 |
3.  Title: Experience with side effects among users of injectables, the IUD, and oral contraceptive pills in four urban areas of Honduras. Author: Barden-O'Fallon J; Speizer I; Rodriguez F; Calix J Source: Health Care For Women International. 2009 Jun;30(6):475-83. Abstract: Contraceptive side effects are often the most commonly reported reason for method discontinuation, particularly of modern methods. We use data from eight focus groups and 800 exit interviews to examine women's experiences with contraceptive side effects in four urban areas of Honduras. Ease of treatment and differences in motivation to avoid pregnancy are suggested explanations for why side effects cause some women to continue and others to discontinue. Although side effects are a common reason for discontinuation in this population, less than half of the surveyed women were informed about potential side effects by a health worker on the day of the interview. Language: English Keywords: HONDURAS | RESEARCH REPORT | FOCUS GROUPS | URBAN AREAS | HEALTH PERSONNEL | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | INJECTABLES | IUD SIDE EFFECTS | PROGRAM ACCEPTABILITY | Developing Countries | Central America | Latin America | Americas | Data Collection | Research Methodology | Geographic Factors | Population | Delivery of Health Care | Health | Demographic Factors | Contraceptive Safety | Safety | Public Health | Contraceptive Methods | Contraception | Family Planning | IUD | Program Evaluation | Programs | Organization and Administration Document Number: 341018 |
| 4. Peer Reviewed Title: Teenagers and emergency contraception in the UK: a focus group study of salient beliefs using concepts from the Theory of Planned Behaviour. Author: Bayley J; Brown K; Wallace L Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):196-206. Abstract: OBJECTIVES: To explore teenagers' beliefs about emergency contraception (EC) within a Theory of Planned Behaviour (TPB) framework. METHODS: Six single sex focus groups comprising a total of 25 female and 23 male pupils aged 13-16 years conducted in schools in Central England. RESULTS: Attitudes to emergency contraception (EC) were mainly positive about the rewards of avoiding teenage pregnancy. Participants had positive beliefs about the effectiveness of EC, although knowledge of crucial time limits varied. EC use was more socially acceptable than teenage pregnancy, yet both outcomes were perceived negatively. Motivation to comply with social pressure was influenced by the appraisal of individuals' intentions. Participants reported high self efficacy in accessing EC, but had concerns over confidentiality and access. CONCLUSIONS: Desire to avoid pregnancy was high in this group, but practical factors and attitudes may be more important for those ambivalent about pregnancy. Adolescents perceive accessing EC as difficult, are concerned about confidentiality, and anticipate negative reactions from staff. Data support the TPB as a suitable framework for understanding attitudes to EC use. Further research should apply quantitative TPB measures to EC use in a wider teenage sample in order to identify potential psychological factors to target in an intervention. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | FOCUS GROUPS | ADOLESCENTS | STUDENTS | EMERGENCY CONTRACEPTION | ATTITUDES | BELIEFS | KNOWLEDGE | PEER PRESSURE | MOTIVATION | CONTRACEPTIVE USAGE | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Contraception | Family Planning | Psychological Factors | Behavior | Culture | Sociocultural Factors | Psychosocial Factors Document Number: 341801 |
| 5. Peer Reviewed Title: The persistence of induced abortion in Cuba: exploring the notion of an "abortion culture". Author: Belanger D; Flynn A Source: Studies in Family Planning. 2009 Mar;40(1):13-26. Abstract: Cuba's annual induced abortion rate persistently ranks among the highest in the world, and abortion plays a prominent role in Cuban fertility regulation despite widespread contraceptive prevalence and state promotion of modern contraceptives. We explore this phenomenon using the concept of an "abortion culture," typically used in reference to Soviet and post-Soviet countries. We synthesize existing literature to provide a historical account of abortion and contraception in Cuba. We also provide a qualitative analysis of abortion and contraceptive use based on in-depth interviews conducted in 2005 in Havana with 24 women who have had an abortion and 10 men whose partners have had an abortion. Information gained from a focus-group discussion with medical professionals also informed the study. Our four principal findings are: (a) longstanding awareness of abortion, (b) the view of abortion as a personal decision, (c) the influence of economic constraints on the decision to induce an abortion, and (d) general skepticism toward contraceptives. We discuss our results on abortion in Cuba in relation to the notion of social diffusion, an approach commonly used to explain the spread of fertility control throughout a population. Language: English Keywords: CUBA | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | WOMEN IN DEVELOPMENT | MEN | ABORTION RATE | CULTURE | COMMUNISM | PERCEPTION | ATTITUDES | KNOWLEDGE | MICROECONOMIC FACTORS | DECISION MAKING | CONTRACEPTIVE USAGE | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Economic Development | Economic Factors | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Socialism | Political Systems | Political Factors | Psychological Factors | Behavior | Contraception Document Number: 341079 |
| 6. Peer Reviewed Title: Potential acceptability of microbicides in HIV prevention in stable marital relationships in Malawi. Author: Bisika T Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):115-7. Abstract: BACKGROUND: The XVII International Conference on AIDS held in Mexico City in August 2008 emphasised the importance of dual prevention using both vaccines and microbicides in the fight against HIV and AIDS. Microbicides are important because they constitute one of the potentially important female-controlled methods of HIV and sexually transmitted infection prevention, especially in Malawi where the use of the female condom has not yet been fully embraced. METHODS: A qualitative study utilising focus group discussions was used to assess the acceptability of the microbicide nonoxynol-9 (N-9) as part of the ongoing Preparatory AIDS Vaccine Evaluation (PAVE) studies. RESULTS: The study observed that men oppose the use of N-9, and that although women consider themselves at risk for HIV they caution against the unintended consequence of altering the vaginal environment with the use of microbicides, which can interfere with the men's preference for dry sex. DISCUSSION AND CONCLUSIONS: Although N-9 did not produce the desired results, these can inform the development of other promising microbicide candidates. The study concludes that it is important to pay attention to how new microbicides are formulated rather than just concentrating solely on an individual product's effectiveness. Language: English Keywords: MALAWI | RESEARCH REPORT | FOCUS GROUPS | CURRENTLY MARRIED | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | MICROBICIDES | NONOXYNOL-9 | HUSBAND-WIFE COMPARISONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Marital Status | Nuptiality | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Spermicidal Contraceptive Agents | Contraceptive Agents | Contraception | Family Planning | Comparative Studies | Studies Document Number: 341651 |
| 7. Peer Reviewed Title: Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-plus family treatment model: role of depression in declining adherence over time. Author: Byakika-Tusiime J; Crane J; Oyugi JH; Ragland K; Kawuma A; Musoke P; Bangsberg DR Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S82-S91. Abstract: The authors conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings. Language: English Keywords: UGANDA | RESEARCH REPORT | FOCUS GROUPS | PARENTS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | QUESTIONNAIRES | DEPRESSION | PACKAGING | STIGMA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Mental Disorders | Marketing | Economic Factors | Social Problems Document Number: 341904 |
| 8. Title: Male perceptions on female sterilization: a community-based study in rural central India. Author: Char A; Saavala M; Kulmala T Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):131-138. Abstract: CONTEXT: Use of modern contraceptive methods has increased fourfold in India since the 1970s, characterized by a predominance of female sterilization. There has been considerable investigation about women's choice of female sterilization, but little from the male perspective. METHODS: Seven focus group discussions were conducted among 58 men currently married to women aged 15-45, followed by a cross-sectional survey among 793 men currently married to same-aged women. Bivariate analysis was used for the survey data, and content analysis was used for the qualitative data. RESULTS: Men's primary source of reproductive health information was mass media, although they expressed interest in getting information through discussion with knowledgeable sources. Men understood family planning and contraception to be two separate issues: Men viewed "family planning" as synonymous with female sterilization, whereas they saw "contraception" as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilized; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilized. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health; however, only one-third of survey respondents did so. CONCLUSION: Men are interested in acquiring family planning information, but lack knowledge about available information sources, which hampers their ability to make informed family planning choices. Family planning service providers and program planners need to be aware of males' knowledge and perceptions pertaining to family planning, and make appropriate modifications to communication strategies. Spanish Abstract: Contexto: El uso de métodos anticonceptivos modernos se ha cuadruplicado en India desde los años setenta y se ha caracterizado por el predominio de la esterilización femenina. Ha habido considerables esfuerzos de investigación sobre la elección de la esterilización femenina que hacen las mujeres, pero existen pocos estudios desde la perspectiva masculina. Métodos: Siete sesiones de grupos focales se condujeron con 58 hombres actualmente casados con mujeres en edades de 15-45 años, seguidas por una encuesta transversal aplicada a 793 hombres actualmente casados con mujeres del mismo grupo de edad. Se usó análisis bivariado para los datos de la encuesta y análisis de contenido para los datos cualitativos. Resultados: Para los hombres, la fuente primaria de información sobre salud reproductiva fue los medios masivos, aunque ellos expresaron interés en obtener información a través de charlas con gente informada en el tema. Los hombres encuestados entendieron la planificación familiar y la anticoncepción como dos temas separados: los hombres percibieron la "planificación familiar" como sinónimo de esterilización femenina, mientras que se refirieron a la "anticoncepción" como métodos de espaciamiento, cuyo conocimiento fue limitado. Treinta y cuatro por ciento de los hombres reportaron que sus esposas habían sido esterilizadas; 79% de los hombres que no dependían de algún método permanente dijeron que querían que sus esposas fueran esterilizadas. En las sesiones de grupo, la mayoría de los hombres se identificó como el único tomador de decisiones en su familia respecto a la salud reproductiva; sin embargo, solamente un tercio de los hombres encuestados se identificó de esa forma. Conclusión: Los hombres están interesados en obtener información sobre planificación familiar, pero desconocen las fuentes disponibles que pueden consultar, lo cual limita su capacidad para tomar decisiones informadas sobre planificación familiar. Los prestadores de servicios y planificadores de programas de planificación familiar deben estar conscientes del conocimiento y percepciones de los hombres en relación con la planificación familiar, y realizar las modificaciones apropiadas a sus estrategias de comunicación. French Abstract: Contexte: La pratique de la contraception moderne a quadruplé en Inde depuis les années 1970. Elle se caractérise par une prédominance de la stérilisation féminine. De nombreuses études ont été menées sur le choix féminin de la stérilisation. La perspective masculine n'est en revanche guère connue. Méthodes: Sept réunions de groupe ont été organisées avec 58 hommes mariés à des femmes de 15 à 45 ans. Une enquête transversale a ensuite été menée auprès de 793 hommes mariés à des femmes de la même tranche d'âge. L'analyse bivariée a été utilisée pour les données d'enquête, et l'analyse de contenu pour les données qualitatives. Résultats: Pour les hommes, les médias représentent la principale source d'information sur la santé génésique. Ils expriment cependant un certain intérêt à s'informer par discussion auprès de sources compétentes. Les hommes voient dans la planification familiale et la contraception deux questions distinctes: la «planification familiale» est pour eux synonyme de stérilisation féminine, tandis que la «contraception» désigne les méthodes d'espacement, au sujet desquelles ils ne sont guère informés. Trente-quatre pour cent des hommes ont déclaré que leur femme était stérilisée; 79% de ceux qui n'avaient pas eu recours à une méthode permanente ont indiqué désirer que leur femme se fasse stériliser. Lors des discussions de groupe, la plupart des hommes se sont déclarés les seuls décideurs de leur famille en matière de santé génésique, par rapport à un tiers seulement des répondants à l'enquête. Conclusion: Les hommes désirent s'informer sur la planification familiale mais ils ignorent les sources d'information disponibles, ce qui entrave leur aptitude à opérer des choix éclairés en la matière. Les prestataires de services et les planifi- cateurs de programmes de planification familiale doivent être sensibles aux connaissances et aux perceptions masculines et ajuster en conséquence leurs stratégies de communication. Language: English Keywords: INDIA | RESEARCH REPORT | FOCUS GROUPS | CROSS SECTIONAL ANALYSIS | MEN | CURRENTLY MARRIED | REPRODUCTIVE HEALTH | PERCEPTION | FEMALE STERILIZATION | INFORMATION SOURCES | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Health | Psychological Factors | Behavior | Sterilization, Sexual | Family Planning | Information Document Number: 343003 |
| 9. Peer Reviewed Title: The prevention of mother-to-child HIV transmission programme in Lilongwe, Malawi: why do so many women drop out. Author: Chinkonde JR; Sundby J; Martinson F Source: Reproductive Health Matters. 2009 May;17(33):143-151. Abstract: Mother-to-child transmission of HIV constitutes a substantial burden of new HIV infections in sub-Saharan Africa, and losses to follow-up continue to undermine prevention of mother-to-child transmission of HIV (PMTCT) programmes. This qualitative study sought to clarify why some women who were enrolled in a PMTCT programme in Lilongwe, Malawi, did not fully participate in follow-up visits in the first six months after testing HIV-positive. Twenty-eight women, 14 who participated fully in the programme and 14 who dropped out, were purposively selected for in-depth interview at two clinics. Focus group discussions with 15 previously interviewed and 13 newly recruited women were also conducted. Discussions with 12 of the women's husbands were also carried out. Although the proportion of women being tested has reportedly increased, losses to follow-up have shifted and are occurring at every step after testing. Major emerging themes associated with dropping out of the PMTCT programme within six months after delivery were to avoid involuntary HIV disclosure and negative community reactions, unequal gender relations, difficulties accessing care and treatment, and lack of support from husbands. The whole approach to the delivery of the PMTCT programme and home visits must be reconsidered, to improve confidentiality and minimise stigmatization. Women need to be empowered economically and supported to access HIV treatment and care with their partners, to benefit their whole family. Spanish Abstract: En África subsahariana, gran parte de nuevas infecciones por VIH se deben a la transmisión materno-infantil, y las pérdidas de seguimiento continúan socavando los programas de prevención de la transmisión materno-infantil del VIH (PTMI). El objetivo de este estudio cualitativo era aclarar por qué algunas de las mujeres inscritas en un programa de PTMI en Lilongwe, Malaui, no participaron al máximo en las consultas de control durante los primeros seis meses posteriores a haber sido diagnosticadas VIH-positivas. Se seleccionaron 28 mujeres para entrevistas a profundidad en dos clínicas: 14 participaron al máximo en el programa y 14 lo abandonaron. Además, se realizaron discusiones en grupos focales con 15 mujeres entrevistadas anteriormente y 13 recién reclutadas, así como discusiones con 12 de los esposos. Aunque la proporción de mujeres que se someten a la prueba del VIH ha aumentado, las pérdidas de seguimiento continúan ocurriendo en cada paso posterior a las pruebas. Los principales motivos emergentes asociados con abandonar el programa de PTMI dentro de los seis meses posteriores al parto fueron: para evitar la divulgación involuntaria del estado de VIH y reacciones negativas de la comunidad, relaciones desiguales entre los sexos, dificultades accediendo a los servicios y el tratamiento, y la falta de apoyo del esposo. Para mejorar la confidencialidad y minimizar el estigma, es necesario reconsiderar la estrategia de ejecución del programa y las visitas a domicilio. Las mujeres necesitan autonomía económica y apoyo para poder acceder al tratamiento y los servicios de VIH con sus parejas, a fin de beneficiar a toda su familia. French Abstract: La transmission mère-enfant du VIH représente une part importante des nouvelles infections en Afrique subsaharienne et les pertes du suivi continuent de saper les programmes de prévention de la transmission mère-enfant (PTME). Cette étude qualitative souhaitait déterminer pourquoi certaines participantes d'un programme de PTME à Lilongwe, Malawi, avaient manqué des visites de suivi les six premiers mois après avoir découvert leur séropositivité lors d'un dépistage. Vingt-huit femmes – 14 participant pleinement au programme et 14 l'ayant abandonné – ont fait l'objet d'un entretien approfondi dans deux dispensaires. Des discussions en groupe avec 15 femmes interrogées précédemment et 13 nouvelles recrues ont aussi été organisées, de même qu'avec 12 conjoints des femmes. Bien que la proportion déclarée de femmes se faisant dépister ait augmenté, les pertes pour le suivi ont évolué et se produisent désormais à toutes les étapes après le test. Les principales raisons de l'abandon du programme de PTME dans les six mois après l'accouchement étaient la crainte d'une révélation involontaire de la séropositivité et des réactions communautaires négatives, le manque de parité entre les sexes, les difficultés d'accès aux soins et au traitement, et le soutien insuffisant des maris. Toute l'approche de l'application du programme de PTME et des visites à domicile doit être revue, pour améliorer la confidentialité et minimiser la stigmatisation. Il faut donner aux femmes les moyens économiques de s'autonomiser et les aider à avoir accès au traitement et aux soins du VIH avec leur partenaire et leurs enfants ce qui profitera à toute la famille. Language: English Keywords: MALAWI | RESEARCH REPORT | FOCUS GROUPS | PREGNANT WOMEN | DROPOUTS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | INTERVIEWS | HOME VISITS | FEAR | STIGMA | CONFIDENTIAL INFORMATION | GENDER RELATIONS | PROGRAM ACCESSIBILITY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | Communication | Emotions | Psychological Factors | Behavior | Social Problems | Sociocultural Factors | Ethics | Gender Issues | Program Evaluation Document Number: 342023 |
| 10. Peer Reviewed Title: Malaria-related perceptions and practices of women with children under the age of five years in rural Ethiopia. Author: Deressa W; Ali A Source: BMC Public Health. 2009 Jul 23;9(1):259. Abstract: ABSTRACT: BACKGROUND: Malaria remains to be the major cause of morbidity and mortality among pregnant women and children in Ethiopia. The aim of this study was to investigate the local perceptions, practices and treatment seeking behaviour for malaria among women with children under the age of five years. METHODS: This community-based study was conducted in 2003 in an area of seasonal malaria transmission in Adami Tulu District, south-central Ethiopia. Total samples of 2087 rural women with children less than five years of age from 18 rural kebeles (the smallest administrative units) were interviewed about their perceptions and practices regarding malaria. In addition, focus group discussions and in-depth interviews were conducted on similar issues to complement the quantitative data. RESULTS: Malaria, locally known as busaa, is perceived as the main health problem in the study area. Mosquitoes are perceived to be the main cause of the disease, and other misperceptions were also widespread. The use of prevention measures was very low. Most mothers were familiar with the main signs and symptoms of mild malaria, and some of them indicated high grade fever, convulsions and mental confusion as a manifestation of severe malaria. Very few households (5.6%) possessed one or two nets. More than 60% of the mothers with recent episodes of malaria received initial treatment from non-public health facilities such as community health workers (CHWs) (40%) and private care providers (21%). Less than 40% of the reported malaria cases among women were treated by public health facilities. CONCLUSION: Malaria was perceived as the main health problem among women and children. The use of malaria preventive measures was low. A significant proportion of the respondents received initial malaria treatments from CHWs, private care providers and public health facilities. Concerted effort is needed to scale-up the distribution of insecticide-treated nets and improve the knowledge of the community about the link between malaria and mosquitoes. Effective antimalarial drugs should also be available at the grassroots level where the problem of malaria is rampant. Language: English Keywords: ETHIOPIA | RESEARCH REPORT | SAMPLING STUDIES | FOCUS GROUPS | MOTHERS | RURAL POPULATION | MALARIA | PERCEPTION | KNOWLEDGE | BED NETS | UTILIZATION OF HEALTH CARE | ANTIMALARIAL DRUGS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Data Collection | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Psychological Factors | Behavior | Parasite Control | Public Health | Health | Health Services | Delivery of Health Care Document Number: 342286 |
| 11. Peer Reviewed Title: "When in the body, it makes you look fat and HIV negative": the constitution of antiretroviral therapy in local discourse among youth in Kahe, Tanzania. Author: Ezekiel MJ; Talle A; Juma JM; Klepp K Source: Social Science and Medicine. 2009 Mar;68(5):957-964. Abstract: Antiretroviral therapy (ART) is becoming increasingly more accessible within the health care system in Tanzania. However, the impact of the increased availability of ART on local conceptions about medicines, health and physical wellbeing has not been fully explored. In this article we examine how ART is constituted within local discourses about treatment and healing. Based on 21 focus group discussions with young people aged 14-24 years in a rural area (Kahe), we examine how local terms and descriptions of antiretroviral therapy relate to wider definitions about the body, health, illness and drug efficacy. Findings illustrate how local understandings of ART draw on a wider discourse about the therapeutic functions of medicines and clinical dimensions of HIV/AIDS. Therapeutic efficacy of antiretroviral medication appeared to overlap and sometimes contradict locally shared understandings of the clinical functions of medicines in the body. Implications of ART on bodily appearance and HIV signs may influence conceptions about sick role, perpetuate stigma and affect local strategies for HIV prevention. Structural inequities in access, limited information on therapeutic efficacy of ART and perceived difficulties with status disclosure appear to inform local conceptions and possible implications of ART. Policy and programme interventions to foster public understanding and acceptability of ART should emphasize treatment education about the benefits and limitations of therapy and increased access to ART in rural areas, and should integrate voluntary status disclosure and HIV prevention. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | FOCUS GROUPS | RURAL AREAS | YOUTH | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | HIV | STIGMA | SELF-PERCEPTION | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Geographic Factors | Population | Age Factors | Population Characteristics | Demographic Factors | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Perception | Psychological Factors | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325348 |
| 12. Peer Reviewed Title: Perceptions of HIV and fertility among adolescents in Soweto, South Africa: stigma and social barriers continue to hinder progress. Author: Forrest JI; Kaida A; Dietrich J; Miller CL; Hogg RS; Gray G Source: AIDS and Behavior. 2009 Jun;13 Suppl 1:55-61. Abstract: The scale up of highly active antiretroviral therapy (HAART) for the treatment of HIV has raised new concerns relating to fertility desires and outcomes. Among these concerns is social stigma surrounding HIV and childbearing. High rates of infection and patterns of high fertility make adolescents a crucial demographic to qualify perceptions of HIV and fertility. We conducted two focus groups (n = 11 males, n = 8 females) with participants ascertained from an HIV adolescent community advisory board in Soweto, South Africa. Adolescents raised concern over re-infection by HIV positive couples attempting to conceive. They also used this concern to justify their attitudes that HIV positive couples should adopt when faced with the desire to have children. Lastly, participants spoke of a need to revise adolescent sexual and reproductive health services to make them more youth-friendly where users could avoid stigma generated by community healthcare workers. This study adds to the growing literature that calls for an evaluation of adolescent HIV educational programs and a healthcare worker intervention that specifically targets stigma surrounding HIV and childbearing. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | FOCUS GROUPS | ADOLESCENTS | HIV INFECTIONS | FERTILITY PREFERENCES | REPRODUCTIVE BEHAVIOR | PERCEPTION | STIGMA | ATTITUDES | ADOLESCENT HEALTH SERVICES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Fertility | Population Dynamics | Psychological Factors | Behavior | Social Problems | Sociocultural Factors | Health Services | Delivery of Health Care | Health Document Number: 342355 |
| 13. Title: Family Health Program professionals' view on family structures and health implications. Author: Gabardo RM; Junges JR; Selli L Source: Revista De Saude Publica. 2009 Feb;43(1):91-7. Abstract: OBJECTIVE: To describe perception of family structures and understanding of a healthy family by Programa Saude da Familia (Family Health Program) team members. METHODS: Research with a qualitative approach, employing the focus group technique, and involving the Program professionals from the city of Campo Bom, Southern Brazil, between June and August 2005. Sample was comprised of 12 professionals, including doctors, nurses, nursing technicians and community health agents. The following issues were investigated: the meaning of family; the meaning of the role of family; type of family most frequently cared for by professionals; the meaning of a healthy family; and types of family causing more difficulties of care. The methodological instrument used was content analysis. RESULTS: Two main categories were observed: family structures, where a great diversity of arrangements was found; and healthy family, where the predominance of speech is consistent with a multifaceted view on health, involving political, social, economic and cultural aspects. Professionals identify and respect distinct family structures and adapt medical treatment accordingly. CONCLUSIONS: Findings reveal that professionals are willing to deal with the different family structures present in their routine. Language: EnglishPortuguese Keywords: BRAZIL | URBAN AREAS | RESEARCH REPORT | FOCUS GROUPS | HEALTH PERSONNEL | FAMILY AND HOUSEHOLD | PERCEPTION | SOCIOCULTURAL FACTORS | HEALTH SERVICES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Data Collection | Research Methodology | Delivery of Health Care | Health | Psychological Factors | Behavior Document Number: 341989 |
| 14. Title: Contraceptive attitudes among inner-city African American female adolescents: Barriers to effective hormonal contraceptive use. Author: Gilliam ML; Davis SD; Neustadt AB; Levey EJ Source: Journal of Pediatric and Adolescent Gynecology. 2009 Apr;22(2):97-104. Abstract: STUDY OBJECTIVE: To better understand the contraceptive attitudes of low-income, inner-city African American female adolescents. DESIGN: We conducted four focus group sessions with African American female adolescents. SETTING: An urban, community health clinic serving low-income patients on Chicago's south side. PARTICIPANTS: African American female adolescents (n = 15) between 14 and 19 years of age. INTERVENTIONS: Focus group sessions lasting approximately 90 minutes in length were conducted using a pre-determined script with set probes and open-ended questions. MAIN OUTCOME MEASURES: Qualitative analysis was conducted to identify major themes related to adolescents' contraceptive attitudes. RESULTS: Six themes related to the contraceptive attitudes of these adolescents emerged: Concerns About Hormones, Concerns About Privacy, Concerns About Compliance, Limited Awareness of New Methods of Hormonal Contraception (HC), Preference for Condoms, and Acceptability of Emergency Contraception (EC). Overall, adolescents in these sessions expressed skepticism and unwillingness to use continuous methods of HC. For some adolescents, concerns about hormones, privacy, and compliance outweighed their concerns about pregnancy. CONCLUSION: Concerns about perceived side effects and long-term health risks associated HC and privacy in obtaining contraception and reproductive health care, as well as concerns about ability to comply with daily and weekly HC regimens are common among African American female adolescents and may deter consistent HC use. Although condoms and EC appear to be highly acceptable among this group, adolescents also report a number of barriers to their consistent use. Efforts to reduce early, unintended pregnancy among African American youth should focus on addressing adolescents' HC-related concerns, improving access to EC, and helping female adolescents effectively negotiate condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | BLACKS | LOW INCOME POPULATION | ADOLESCENTS, FEMALE | URBAN POPULATION | ATTITUDES | CONTRACEPTIVE SAFETY | PRIVACY | CONTRACEPTION CONTINUATION | CONDOM USE | CONTRACEPTIVE METHODS | KNOWLEDGE | EMERGENCY CONTRACEPTION | Developed Countries | North America | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Adolescents | Youth | Age Factors | Psychological Factors | Behavior | Safety | Public Health | Health | Contraceptive Usage | Contraception | Family Planning | Risk Reduction Behavior | Sociocultural Factors Document Number: 330953 |
| 15. Peer Reviewed Title: Health discourse, sexual slang and ideological contradictions among Mozambican youth: implications for method. Author: Groes-Green C Source: Culture, Health and Sexuality. 2009 Aug;11(6):655-668. Abstract: Findings from fieldwork on condom use among young people in Mozambique confirm the need to remain alert to the ideological and linguistic bias of applied research methods. Using conventional health discourse to interview young people about their sexuality resulted in incorrect or socially acceptable answers rather than accurate information about their sexual behavior. In order to gain a deeper understanding of sexual cultures and to make HIV prevention efforts relevant to young people, the author suggests that researchers and policy-makers approach respondents with a language that is sensitive to the local ideological and linguistic context. Language: English Keywords: MOZAMBIQUE | CRITIQUE | RESEARCH METHODOLOGY | FOCUS GROUPS | STUDENTS | CONDOM USE | SEX BEHAVIOR | SEXUALITY | LANGUAGE | INTERVIEWS | INTERPERSONAL COMMUNICATION | VALIDITY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Education | Risk Reduction Behavior | Behavior | Personality | Psychological Factors | Communication | Measurement Document Number: 339891 |
| 16. Peer Reviewed Title: The emergency contraceptive pill rescheduled: a focus group study of women's knowledge, attitudes and experiences. Author: Hobbs M; Taft AJ; Amir LH Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):87-91. Abstract: BACKGROUND AND METHODOLOGY: The levonorgestrel-containing emergency contraceptive pill (ECP), amongst other strategies, has the potential to assist in reducing unintended pregnancy and abortion rates. Since the rescheduling of the ECP in January 2004 to over-the-counter (OTC) status from pharmacies in Australia, there is little information about Australian women's ECP knowledge, attitudes or practice. The aim of the study was to explore Australian women's knowledge of, attitudes towards and experiences of using the ECP, particularly since it has been available OTC. This paper reports a qualitative study using six focus groups, which were conducted between February and June 2007 in four Australian states with 29 women aged 16-29 years. RESULTS: Participants had a lack of specific knowledge about the ECP. Most were positive about the ECP being available OTC, however some expressed concerns about younger women misusing it. Women's experiences obtaining the ECP from the pharmacy were both positive and negative. Most women said they would use the ECP again if required and would recommend it to a friend. Pharmacists were seen as important suppliers of the ECP but women felt it was not their role to provide advice about contraception or sexually transmitted infections. DISCUSSION AND CONCLUSIONS: The findings from this study confirm views from other studies, which suggest that although women have some concerns in relation to OTC supply of the ECP, they believe that the deregulation of the ECP is a positive step. The data also suggest that women need to be provided with more information and education about the ECP. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | FOCUS GROUPS | WOMEN | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | LEVONORGESTREL | CONTRACEPTIVE USAGE | CONTRACEPTIVE AVAILABILITY | AGE FACTORS | Oceania | Developed Countries | Data Collection | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Population Characteristics Document Number: 330948 |
| 17. Peer Reviewed Title: The persistence and challenges of homebirths: perspectives of traditional birth attendants in urban Kenya. Author: Izugbara C; Ezeh A; Fotso JC Source: Health Policy and Planning. 2009 Jan;24(1):36-45. Abstract: Through an analysis of focus group discussion data, we examine Kenyan traditional birth attendants' (TBAs) accounts of the persistence of homebirths and the key challenges they present. TBAs associated the continued demand for homebirths with the wide-ranging character and quality of their services. They did not consider their lack of formal training on matters of pregnancy and birthing to be a particular challenge to their work. Rather, they identified the non-cooperative and disrespectful attitudes of their counterparts in hospital settings as the most important issue. Further efforts are needed to make TBAs realize how much better their services could become if they adopted more modern ways of assisting in deliveries, unlearnt their belief in the superiority of their particular type of practice, and understood how their lack of formal training is a key issue. Language: English Keywords: KENYA | RESEARCH REPORT | FOCUS GROUPS | TRADITIONAL BIRTH ATTENDANTS | CHILDBIRTH | OBSTACLES | QUALITY OF HEALTH CARE | MATERNAL HEALTH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Organization and Administration | Health Services Evaluation | Program Evaluation | Programs Document Number: 330475 |
| 18. Peer Reviewed Title: Sexual risk behaviour for women working in recreational venues in Mwanza, Tanzania: considerations for the acceptability and use of vaginal microbicide gels. Author: Lees S; Desmond N; Allen C; Bugeke G; Vallely A; Ross D Source: Culture, Health and Sexuality. 2009 May 14;:1. Abstract: Qualitative research was conducted to explore the social context of sexual-risk behaviour among women working in recreational occupations, during a feasibility study in preparation for the Phase III clinical trial of vaginal microbicides in Mwanza, Tanzania. Participant observation was conducted in 68 recreational venues. Six focus group discussions were conducted with women working in recreational occupations and two with male customers at these venues. Findings revealed that these women are at risk of HIV due their dependence on sexual transactions to improve their economic circumstances, which take place in environments and relationships where condom use is difficult. However, the findings revealed that, in spite of constraints, women did take actions to prevent HIV by negotiating for condom use or avoiding perceived risky practices or partnerships, in particular moving to more casual partnerships where condom negotiation is more acceptable. This indicates that, given their perception of their own risk, women working in recreational occupations will welcome an effective microbicide. However, sustained use will depend on how formulations overcome the difficulties women currently experience with condom negotiation and the specific environments and relationships in which they engage in sex. Language: English Keywords: TANZANIA | RESEARCH REPORT | FOCUS GROUPS | WOMEN IN DEVELOPMENT | WORKERS | PARKS AND RECREATIONAL FACILITIES | MICROBICIDES | VAGINAL GEL | CONDOM USE | HIV PREVENTION | SEX BEHAVIOR | RISK ASSESSMENT | PERCEPTION | PARTNER COMMUNICATION | SELF-PERCEPTION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Economic Development | Economic Factors | Labor Force | Human Resources | Natural Resources | Environment | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Risk Reduction Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Evaluation | Psychological Factors | Interpersonal Relations Document Number: 341493 |
| 19. Peer Reviewed Title: Brazilian mothers' beliefs, attitudes and practices related to child weight status and early feeding within the context of nutrition transition. Author: Lindsay AC; Machado MT; Sussner KM; Hardwick CK; Kerr LR; Peterson KE Source: Journal of Biosocial Science. 2009 Jan;41(1):21-37. Abstract: With the rapid pace of the nutrition transition worldwide, understanding influences of child feeding practices within a context characterized by the co-existence of overweight and undernutrition in the same population has increasing importance. This qualitative study describes Brazilian mothers' child feeding practices and their perceptions of their association with child weight status and explores the role of socioeconomic, cultural and organizational factors on these relationships. Forty-one women enrolled in the Family Health/Community Health Workers Programme were selected from rural, urban, coastal and indigenous areas in Ceara State, north-east Brazil, to participate in four focus group discussions. Content analysis identified fourteen emergent themes showing mothers' child feeding practices in this setting were influenced by economic resources, mothers' immediate social support networks (e.g. neighbours and family members) and participation in nutrition assistance programmes. Child malnutrition was the most common nutritional concern; nevertheless, mothers were aware of the negative health consequences of obesity but misunderstood its causes (e.g. foods filled with fat would make a person fat; others thought that birth control pills and stimulants given to children were causes of obesity); several reported their own struggles with overweight. Food assistance programmes emerged as an important influence on children's dietary adequacy, especially among mothers describing dire economic situations. The findings have implications for targeting food assistance as well as health and nutrition education strategies in low-income families undergoing the nutrition transition in north-east Brazil. Language: English Keywords: BRAZIL | RESEARCH REPORT | DATA ANALYSIS | FOCUS GROUPS | LOW INCOME POPULATION | MOTHERS | INFANT | INFANT NUTRITION | BODY WEIGHT | PERCEPTION | BEHAVIOR | DIET | CALORIC INTAKE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Physiology | Biology | Psychological Factors Document Number: 330517 |
| 20. Peer Reviewed Title: Managing men: women's dilemmas about overt and covert use of barrier methods for HIV prevention. Author: Macphail C; Terris-Prestholt F; Kumaranayake L; Ngoako P; Watts C; Rees H Source: Culture, Health and Sexuality. 2009 May 27;:1. Abstract: Women in sub-Saharan Africa are at high risk of HIV infection and may struggle to negotiate condom use. This has led to a focus on the development of female-controlled barrier methods such as the female condom, microbicides and the diaphragm. One of the advantages of such products is their contribution to female empowerment through attributes that make covert use possible. We used focus groups to discuss covert use of barrier methods with a sample of South African women aged 18-50 years from Eastern Johannesburg. Women's attitudes towards covert use of HIV prevention methods were influenced by the overarching themes of male dislike of HIV and pregnancy prevention methods, the perceived untrustworthiness of men and social interpretations of female faithfulness. Women's discussions ranged widely from overt to covert use of barrier methods for HIV prevention and were influenced by partner characteristics and previous experience with contraception and HIV prevention. The discussions indicate that challenging gender norms for HIV prevention can be achieved in quite subtle ways, in a manner that suits individual women's relationships and previous experiences with negotiation of either HIV or pregnancy prevention. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | WOMEN IN DEVELOPMENT | SEXUAL PARTNERS | URBAN POPULATION | HIV PREVENTION | BARRIER METHODS | ATTITUDES | PARTNER COMMUNICATION | PERCEPTION | GENDER RELATIONS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Economic Development | Economic Factors | Sex Behavior | Behavior | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Interpersonal Relations | Gender Issues | Sociocultural Factors Document Number: 341491 |
| 21. Peer Reviewed Title: Attitudes toward HPV vaccination among parents of adolescent girls in Mysore, India. Author: Madhivanan P; Krupp K; Yashodha MN; Marlow L; Klausner JD; Reingold AL Source: Vaccine. 2009 Aug 20;27(38):5203-8. Abstract: This study investigates attitudes toward human papillomavirus (HPV) vaccination among parents of adolescent girls in Mysore, India. Seven focus group discussions were held among parents of adolescent girls stratified by sex, religion and region to explore attitudes about cervical cancer and HPV vaccination. The study found that while parents have limited knowledge about HPV or cervical cancer, most are still highly accepting an HPV vaccine. In addition, high acceptability levels appear to reflect positive attitudes toward the government universal immunization program in general, rather than to the HPV vaccine in particular. The results highlight the need for additional education and health promotion regarding HPV and cervical cancer prevention in India. Language: English Keywords: INDIA | RESEARCH REPORT | FOCUS GROUPS | ADOLESCENTS, FEMALE | PARENTS | CERVICAL CANCER | HPV | VACCINATION | FEES | ATTITUDES | KNOWLEDGE | RELIGIOUS ASPECTS | PROGRAM ACCEPTABILITY | FEAR | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Cancer | Neoplasms | Diseases | Viral Diseases | Immunization | Primary Health Care | Health Services | Delivery of Health Care | Health | Financial Activities | Economic Factors | Psychological Factors | Behavior | Religion | Program Evaluation | Programs | Organization and Administration | Emotions Document Number: 342810 |
| 22. Peer Reviewed Title: Gender norms in South Africa: implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution. Author: Mantell JE; Needham SL; Smit JA; Hoffman S; Cebekhulu Q Source: Culture, Health and Sexuality. 2009 Feb;11(2):139-157. Abstract: In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women's ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students, who are a relatively 'privileged' group, there is little information on gender norms that might shape responses to HIVprevention programmes. To elicit gender norms regarding women's and men's roles, condom and contraceptive use, sexual communication and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students in order to understand how norms might be used to buttress HIV- and pregnancy-prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women's rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women's freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women's protection against unintended pregnancy and HIV/STIs. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | FOCUS GROUPS | CROSS-CULTURAL COMPARISONS | WOMEN | ASIANS | ETHNIC GROUPS | STUDENTS | WOMEN IN DEVELOPMENT | UNIVERSITIES | VALUE ORIENTATION | GENDER RELATIONS | HIV PREVENTION | PREGNANCY | PREVENTION AND CONTROL | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Cultural Background | Population Characteristics | Education | Economic Development | Economic Factors | Schools | Psychological Factors | Behavior | Gender Issues | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Reproduction Document Number: 341087 |
| 23. Title: Couples' communication on sexual and relational issues among the Akamba in Kenya. Author: Miller AN; Golding L; Ngula KW; Wambua M; Mutua E; Kitizo MN; Teti C; Booker N; Mwithia K; Rubin DL Source: African Journal of AIDS Research. 2009 Apr;8(1):51-60. Abstract: A large portion of HIV transmission in sub-Saharan Africa occurs among married couples, yet the majority of research on safer-sex communication has focused on communication between couples in casual relationships. This paper explores how committed Kamba couples in Machakos District, Kenya, communicate about sensitive relational issues. The findings from focus group discussions with five groups of males and five groups of females are presented. The couples freely shared their thoughts about daily and economic issues and certain aspects of family planning and sexuality. Methods for raising sensitive issues with partners included monitoring the spouse's mood, gradual or indirect revelation, mentioning topics during sex, and use of third-party intermediaries. Interference by extended family members, especially husbands' mothers, and male authoritarian roles emerged as hindrances to effective communication between couples. The implications for HIV prevention regarding gender differences and the role of families in couples' communication are discussed. Language: English Keywords: KENYA | RESEARCH REPORT | FOCUS GROUPS | ETHNIC GROUPS | COUPLES | HIV PREVENTION | PARTNER COMMUNICATION | GENDER ISSUES | SAFER SEX | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Interpersonal Relations | Behavior | Sex Behavior Document Number: 341287 |
| 24. Peer Reviewed Title: Women's perceptions of quality of family planning services in Tabriz, Iran. Author: Mohammad-Alizadeh S; Wahlstrom R; Vahidi R; Johansson A Source: Reproductive Health Matters. 2009 May;17(33):171-80. Abstract: In this qualitative study, women's perceptions and experiences of the quality of family planning services at public primary health centres were explored in the city of Tabriz, Iran. Nine focus group discussions were carried out with a total of 53 married women of reproductive age. The public services were appreciated for being accessible and affordable, but important shortcomings were identified. The need for improved privacy, a wider choice of contraceptive methods and accurate and more comprehensive information about methods and side effects were stressed. The issue of marital counselling was raised as an important unmet need, especially in one discussion group. The women's sense of having the right to make autonomous, informed choices and to be treated with dignity and respect emerged as the main theme. A second, cross-cutting theme was their wish for their husbands to be more strongly involved in family planning and marital counselling and education. Women's experiences and suggestions for improvements in service delivery should be considered in future plans. Multifaceted interventions are needed to narrow the existing gap between women's needs and rights and the actual quality of services. Language: English Keywords: IRAN | RESEARCH REPORT | FOCUS GROUPS | WOMEN | FAMILY PLANNING PROGRAMS | QUALITY OF HEALTH CARE | PERCEPTION | NEEDS | PRIVACY | MEN'S INVOLVEMENT | COUNSELING | Middle East | Developing Countries | Data Collection | Research Methodology | Demographic Factors | Population | Family Planning | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Psychological Factors | Behavior | Economic Factors | Clinic Activities | Program Activities Document Number: 341667 |
| 25. Peer Reviewed Title: The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania. Author: Mrisho M; Obrist B; Schellenberg JA; Haws RA; Mushi AK; Mshinda H; Tanner M; Schellenberg D Source: BMC Pregnancy and Childbirth. 2009;9:10. Abstract: BACKGROUND: Although antenatal care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of postnatal care, by which we mean the care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health care providers on the use of antenatal and postnatal services. METHODS: From March 2007 to January 2008, we conducted in-depth interviews with health care providers and village based informants in 8 villages of Lindi Rural and Tandahimba districts in southern Tanzania. Eight focus group discussions were also conducted with women who had babies younger than one year and pregnant women. The discussion guide included information about timing of antenatal and postnatal services, perceptions of the rationale and importance of antenatal and postnatal care, barriers to utilisation and suggestions for improvement. RESULTS: Women were generally positive about both antenatal and postnatal care. Among common reasons mentioned for late initiation of antenatal care was to avoid having to make several visits to the clinic. Other concerns included fear of encountering wild animals on the way to the clinic as well as lack of money. Fear of caesarean section was reported as a factor hindering intrapartum care-seeking from hospitals. Despite the perceived benefits of postnatal care for children, there was a total lack of postnatal care for the mothers. Shortages of staff, equipment and supplies were common complaints in the community. CONCLUSION: Efforts to improve antenatal and postnatal care should focus on addressing geographical and economic access while striving to make services more culturally sensitive. Antenatal and postnatal care can offer important opportunities for linking the health system and the community by encouraging women to deliver with a skilled attendant. Addressing staff shortages through expanding training opportunities and incentives to health care providers and developing postnatal care guidelines are key steps to improve maternal and newborn health. Language: English Keywords: TANZANIA | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | RURAL POPULATION | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | HEALTH PERSONNEL | ANTENATAL CARE | MATERNAL-CHILD HEALTH SERVICES | QUALITY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | PERCEPTION | ATTITUDES | FEAR | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Delivery of Health Care | Health | Maternal Health Services | Primary Health Care | Health Services | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Psychological Factors | Behavior | Emotions Document Number: 331236 |
| 26. Title: The Male Involvement Programme and men's sexual and reproductive health in northern Namibia. Author: Mufune P Source: Current Sociology. 2009 Mar;57(2):231-248. Abstract: Sexual and reproductive health (SRH) issues affect both males and females and relate to gender inequalities and HIV/AIDS. In the past, the focus of SRH has not been on men but on women, who get pregnant and nurture the young. This is despite evidence showing that males exercise decision-making power in different social-cultural spheres including the transmission of sexually transmitted diseases (STDs). This article describes research on the impact of the Male Involvement programme in Namibia. The objectives of the programme were to train groups of males (nurses, clergy, police, soldiers and sportsmen) in SRH knowledge and communication skills. The research investigated the extent to which male participants gained SRH knowledge from the programme and the extent to which the knowledge gained affected their views on cultural conceptions of masculinity and femininity that influence their orientation towards SRH. The research utilized focus group interviews with participating males exposed to the programme. The findings showed that male participants increased their knowledge of human sexuality and sexual health. There were, however, differences in the extent of knowledge gained among the different male groups. The implications of these findings for gender relations were noted. Many of the males consequently appreciated the tensions existing in their own relationships with spouses as partly due to lack of appreciation of the other. They now saw that wives were not simply appendages of their husbands and that women are not quite as inferior as their culture had taught them to believe. They appreciated the reality of `emotional abuse' (a concept de-emphasized in their culture). They could perceive the benefits that accrued to them personally as males from greater female empowerment and from changing their attitudes towards them. This study raises the possibility that masculine behaviours driven by culture can be changed through education. Language: English Keywords: NAMIBIA | RESEARCH REPORT | FOCUS GROUPS | MEN'S INVOLVEMENT | REPRODUCTIVE HEALTH | HEALTH EDUCATION | TRAINING ACTIVITIES | PROGRAM EVALUATION | HIV INFECTIONS | AIDS | CONTRACEPTIVE USAGE | KNOWLEDGE | SOCIAL BEHAVIOR | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Programs | Organization and Administration | Health | Education | Training Programs | Viral Diseases | Diseases | Contraception | Family Planning | Sociocultural Factors | Behavior Document Number: 341976 |
| 27. Peer Reviewed Title: Women living with HIV in South Africa and their concerns about fertility. Author: Nduna M; Farlane L Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S62-S65. Abstract: Health and quality of life benefits accrued from the availability of highly active antiretroviral therapy (HAART) are commendable, but the social milieu continues to pose challenges for women's decision making around having children. This paper qualitatively explored women's questions and concerns around living with HIV, being on HAART and pregnancy. Women of reproductive age were recruited from Eastern Cape and Gauteng Provinces, South Africa. Information on women's fertility desires and pregnancy planning was collected through participatory workshop, focus groups, and one-on-one interviews. Three main themes emerged. Women living with HIV require information on the impact of HIV on pregnancy outcomes and vice versa. Women who are young, lost a child, not consistently using contraception or who have not been seriously ill have positive reproductive aspirations. Ambivalent attitudes of health care workers towards pregnancy impacts women's fertility aspirations. Unbiased pre-conceptual communication should form part of HIV treatment and care services, despite expressed pregnancy intentions. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | FOCUS GROUPS | WOMEN | PERSONS LIVING WITH HIV/AIDS | HEALTH PERSONNEL | ANTIRETROVIRAL THERAPY | PREGNANCY | DECISION MAKING | FERTILITY PREFERENCES | ATTITUDES | INTERVIEWS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | HIV | Reproduction | Behavior | Fertility | Population Dynamics | Psychological Factors Document Number: 341902 |
| 28. Peer Reviewed Title: Reproductive tract infections in northern Vietnam: health providers' diagnostic dilemmas. Author: Nguyen MH; Gammeltoft T; Christoffersen SV; Tran TT; Rasch V Source: Women and Health. 2009 Mar-May;49(2-3):229-45. Abstract: Research was conducted on reproductive tract infections among women obtaining induced abortions at Ph[image omitted]-[image omitted] hospital in Haiphong City, a major maternity hospital in northern Vietnam. The research aimed to explore how clinicians and lab-technicians diagnose reproductive tract infections and the difficulties they experience in establishing exact diagnoses. A combination of both quantitative and qualitative research methodologies was employed. The quantitative research involved 748 abortion-seeking women; the qualitative research was conducted with 10 doctors and 10 lab-technicians providing reproductive health services. A marked tendency was observed among both clinicians and lab-technicians to overdiagnose reproductive tract infections and to prescribe antibiotics routinely. Social, cultural, and clinical factors associated with the tendency to overdiagnose reproductive tract infections included: inadequate training of health staff, lack of equipment, and cultural assumptions regarding the overwhelming prevalence of reproductive tract infections in Vietnamese women, especially among those who receive abortion services. Misconceptions of reproductive tract infections led to substantial over-diagnosis and unnecessary treatment of reproductive tract infections in this hospital. To enhance reproductive tract infection care, providers need to be sensitized to the social and medical consequences of their own cultural perceptions and to increase their awareness of the risks associated with overuse of antibiotics. Language: English Keywords: VIETNAM | RESEARCH REPORT | CLINICAL RESEARCH | FOCUS GROUPS | ABORTION | PROVIDERS WITH CLIENTS | REPRODUCTIVE TRACT INFECTIONS | PREVALENCE | PHYSICAL EXAMINATIONS AND DIAGNOSES | LABORATORY EXAMINATIONS AND DIAGNOSES | ANTIBIOTICS | INTERVIEWS | PERCEPTION | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Data Collection | Fertility Control, Postconception | Family Planning | Health Services | Delivery of Health Care | Health | Infections | Diseases | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Drugs | Treatment | Psychological Factors | Behavior Document Number: 342405 Notification |
| 29. Peer Reviewed Title: Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Author: Okal J; Luchters S; Geibel S; Chersich MF; Lango D; Temmerman M Source: Culture, Health and Sexuality. 2009 May 29;:1. Abstract: Knowledge about sexual practices and life experiences of men having sex with men in Kenya, and indeed in East Africa, is limited. Although the impact of male same-sex HIV transmission in Africa is increasingly acknowledged, HIV prevention initiatives remain focused largely on heterosexual and mother-to-child transmission. Using data from ten in-depth interviews and three focus group discussions (36 men), this analysis explores social and behavioural determinants of sexual risks among men who sell sex to men in Mombasa, Kenya. Analysis showed a range and variation of men by age and social class. First male same-sex experiences occurred for diverse reasons, including love and pleasure, as part of sexual exploration, economic exchange and coercion. Condom use is erratic and subject to common constraints, including notions of sexual interference and motivations of clients. Low knowledge compounds sexual risk taking, with a widespread belief that the risk of HIV transmission through anal sex is lower than vaginal sex. Traditional family values, stereotypes of abnormality, gender norms and cultural and religious influences underlie intense stigma and discrimination. This information is guiding development of peer education programmes and sensitisation of health providers, addressing unmet HIV prevention needs. Such changes are required throughout Eastern Africa. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | URBAN POPULATION | SEX WORKERS | MEN HAVING SEX WITH MEN | PERCEPTION | CULTURE | HIV TRANSMISSION | SELF-PERCEPTION | STIGMA | RISK BEHAVIOR | SEX BEHAVIOR | CONDOM USE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Population Characteristics | Demographic Factors | Population | Behavior | Psychological Factors | |