1.  Title: The long wait: reproductive health care in Haiti. Author: John Snow [JSI]. Research and Training Institute, Inc. Source: Arlington, Virginia, JSI, Research and Training Institute, Inc., 2009. 22 p. Abstract: The reproductive health status of Haiti's communities contributes to a life expectancy of 62.8 years for women in comparison to 75.5 years in neighboring Dominican Republic or 80.8 years for women in the U.S. According to Haiti's 2005-2006 Demography Health Survey, 37.5% of women have unmet family planning needs. Additionally, youth and rural area residents report greater unmet needs for family planning than the national average. Unmet family planning contributes to a high total fertility rate of 4.79 (5 in rural versus 2.8 in urban areas), a high infant morality (57 deaths per 1000 live births) and the highest maternal mortality rate in the western world-630 deaths per 100,000 live births. These alarming RH indicators prompted a team from JSI Research & Training Institute, Inc. (JSI) to visit Haiti in January 2009. The objectives of the study were: 1) to identify gaps in the availability and accessibility of comprehensive RH services including: Safer motherhood and emergency obstetric care (EmOC), Family planning, HIV/AIDS and sexually transmitted infections (STI) prevention, care and support, Gender-based violence (GBV) prevention, care and support, and Adolescent-focused RH programming for each of the above RH components. 2) to identify community-level responses and opportunities for strengthening the quality and availability of comprehensive RH services. This report presents the findings of this assessment. Language: English Keywords: HAITI | SUMMARY REPORT | MOTHERS | SAFE MOTHERHOOD | REPRODUCTIVE HEALTH | HIV PREVENTION | AIDS PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | VIOLENCE AGAINST WOMEN | PREVENTION AND CONTROL | FAMILY PLANNING | HEALTH SERVICES | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | Developing Countries | Caribbean | Americas | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Maternal Health | Health | HIV Infections | Viral Diseases | Diseases | AIDS | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Domestic Violence | Crime | Social Problems | Program Evaluation | Programs | Organization and Administration Document Number: 341307 |
| 2. Title: PRISM tools for assessing, monitoring, and evaluating RHIS performance. Author: Aqil A; Lippeveld T Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. [32] p. (MS-09-34USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: PRISM Framework and its tools applications have expanded since 2004. Now it has been applied in Pakistan, Uganda, South Africa, Mexico, Paraguay, Honduras, Haiti, China and Cote d'Ivore for assessment and evaluation. It has been applied in diverse countries of Africa, Asia, Latin America and Carribean continents. While these applications showed the strengths and appropriateness of PRISM Framework and its tools in identifying strengths and weaknesses of the routine information systems, they brought some challenges to attention. First, to make a distinction between RHIS performance indicators -accuracy, timeliness and completeness, from their counterpart processes. Second, to keep minimum variables in various tools for triangulation of information to avoid respondent's burden of filling the details. Third, better measurement of use of information. Thus, there was a need to revise the PRISM tools. Uganda PRISM evaluation in 2007 for testing its reliability and validity also helped to make the revisions. PRISM tools version 3.0 meets old and new challenges in assessing, monitoring and evaluation of RHIS. Language: English Keywords: PAKISTAN | MEXICO | HONDURAS | HAITI | CHINA | PARAGUAY | SOUTH AFRICA | UGANDA | SUMMARY REPORT | EVALUATION | INFORMATION PROCESSING | DATA COLLECTION | MANAGEMENT | PROGRAM ACTIVITIES | Developing Countries | Asia, Southern | Asia | North America | Americas | Central America | Latin America | Caribbean | Asia, Eastern | South America, Central | South America | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Information | Research Methodology | Organization and Administration | Programs Document Number: 339994 |
3.  Peer Reviewed Title: A feeding education program to prevent mother-to-child transmission of HIV in Haiti. Author: Deschamps MM; Devieux JG; Theodore H; Saint-Jean G; Antillus L; Cadot I; Pape JW; Malow RM Source: AIDS Care. 2009 Mar;21(3):349-54. Abstract: In Haiti, as in most of the developing world, vertical transmission of HIV from infected mother to infant through postpartum breastfeeding remains a significant mode of transmission. As part of their prevention of mother-to-child transmission program, the Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Centers developed a feeding education program in which over 83% of the HIV-positive pregnant women who were eligible to participate, enrolled. Bivariate and adjusted multivariate logistic regression analyses were used to compare feeding choices of the 290 women who participated in the feeding education program to 58 who did not. Of those who participated, 91.7% chose to use replacement formulas for their newborns, while 75.9% of those who did not participate chose replacement feeding. After adjustment for socio-demographic variables, analyses revealed that the no education group was less likely to adopt replacement feeding and more likely to use mixed feeding (OR=0.31, p=0.004; and OR=2.74, p=0.05, respectively). This suggests that a targeted and culturally appropriate education program can be effective in encouraging replacement feeding, even in those countries where breastfeeding is the norm. Language: English Keywords: HAITI | RESEARCH REPORT | CONTROL GROUPS | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HEALTH EDUCATION | BREASTFEEDING, EXCLUSIVE | WEANING | SUPPLEMENTARY FEEDING | ANTIRETROVIRAL THERAPY | Developing Countries | Caribbean | Americas | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Education | Breastfeeding | Infant Nutrition | Nutrition | Health | HIV Document Number: 341855 |
| 4. Peer Reviewed Title: Prevention of mother-to-child transmission of HIV in Haiti. Author: Deschamps MM; Noel F; Bonhomme J; Devieux JG; Saint-Jean G; Zhu Y; Wright P; Pape JW; Malow RM Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2009 Jan;25(1):24-30. Abstract: OBJECTIVES: To describe the effectiveness of a program designed to reduce the rate of mother-to-child transmission (MTCT) of HIV at the primary HIV testing and treatment center in Haiti between 1999 and 2004. METHODS: All pregnant, HIV-positive women who attended the major HIV testing and treatment clinic in Port-au-Prince, Haiti, between March 1999 and December 2004 were asked to participate in an MTCT prevention program. Of the 650 women who participated, 73.3% received zidovudine (AZT), 2.9% received nevirapine (NVP), and 10.1% received triple-drug therapy when it became available in 2003 and if clinical/laboratory indications were met. Approximately 13.8% received no antiretroviral medication. All participants received cotrimoxazole prophylaxis and infant formula for their children. Kaplan-Meier survival analysis and the log rank test were used to evaluate program impact on child survival. RESULTS: Complete data were available for 348 mother-infant pairs who completed the program to prevent MTCT of HIV. The rate of MTCT in the study was 9.2% (95% CI: 6.14-12.24), in contrast to the historical mother-to-child transmission rate of 27% in Haiti. HIV-positive infants were less likely to survive than HIV-negative infants at 18 months of follow-up (chi(2) = 19.06, P < .001, log rank test). Infant survival improved with early pediatric diagnosis and antiretroviral treatment. CONCLUSIONS: The MTCT prevention program described proved to be feasible and effective in reducing vertical HIV transmission in Haiti. The authors emphasize the need to expand testing, extend services to rural areas, and implement early HIV diagnosis to reduce infant mortality. Language: English Keywords: HAITI | RESEARCH REPORT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTENATAL CARE | HIV TRANSMISSION | HIV INFECTIONS | PROGRAM EFFECTIVENESS | Developing Countries | Caribbean | Americas | Disease Transmission Control | Prevention and Control | Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Viral Diseases | Program Evaluation | Programs | Organization and Administration Document Number: 341542 |
| 5. Title: Knowledge, attitudes, and behaviors among a sample of HIV-positive and HIV-negative females visiting an urban VCT center in Haiti. Author: Devieux JG; Deschamps MM; Malow RM; Jean-Gilles M; Saint-Jean G; Saint-Jean G; Marcelin A; Pape JW Source: Journal of Health Care For the Poor and Underserved. 2009 May;20(2):554-68. Abstract: The knowledge, attitudes, and behaviors of over 43,000 women attending the Groupe Hatien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Centers in Haiti between 1999-2004 were examined. Comparative analyses were conducted for several sub-samples. Analyses revealed that across the entire sample, HIV-positive women appeared to engage in more risky behaviors than HIV-negative women (p< .01); however, as a group, pregnant HIV-positive women reported safer behaviors than non-pregnant HIV-positive women (p<.01). Women from all groups were generally knowledgeable about the risk of HIV transmission through dirty needles and mother to child. However, inaccurate information about transmission through supernatural means and mosquitoes was very common. These results suggest that knowledge and education are negatively associated with HIV status in this sample. Addressing gaps in knowledge and behavior and reducing the risky behaviors of HIV-positive individuals are important directions for future programs. Language: English Keywords: HAITI | RESEARCH REPORT | KAP SURVEYS | WOMEN | RISK BEHAVIOR | VOLUNTARY COUNSELING AND TESTING | HIV INFECTIONS | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | Developing Countries | Caribbean | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Behavior | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Sociocultural Factors | Psychological Factors Document Number: 341812 |
| 6. Peer Reviewed Title: High early mortality in patients with chronic acquired immunodeficiency syndrome diarrhea initiating antiretroviral therapy in Haiti: a case-control study. Author: Dillingham RA; Pinkerton R; Leger P; Severe P; Guerrant RL; Pape JW; Fitzgerald DW Source: American Journal of Tropical Medicine and Hygiene. 2009 Jun;80(6):1060-4. Abstract: This case-control study examines whether chronic diarrhea at initiation of antiretroviral therapy (ART) affects survival of human immunodefiency virus-infected patients. Cases (288) were treatment-naive, non-pregnant, adults with self report of frequent loose stool for > 3 weeks at the time ART was initiated. One-third of patients had an enteric pathogen identified including Cryptosporidium spp., Giardia spp., Isospora belli, Cyclospora cayetanensis, and Entamoeba histolytica. Control patients (400) did not have diarrhea when initiating ART. At six weeks, mortality was 10% in the patients with diarrhea and 5% in the patients without diarrhea (P = 0.009). Chronic diarrhea in patients requesting ART in Haiti is associated with increased early mortality. Language: English Keywords: HAITI | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | ADULTS | PERSONS LIVING WITH HIV/AIDS | AIDS | ANTIRETROVIRAL THERAPY | DIARRHEA | GASTROINTESTINAL EFFECTS | ANTIBIOTICS | MORTALITY | Developing Countries | Caribbean | Americas | Research Methodology | Program Activities | Programs | Organization and Administration | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics Document Number: 341760 |
| 7. Title: Haiti: Going to scale with a performance incentive model. Author: Eichler R; Auxila P; Antoine U; Desmangles B Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :165-188. Abstract: Rewarding NGOs for increasing access to a package of basic services and paying them for achieving population-based performance targets can result in significant increases in essential services such as immunizations and assisted deliveries. Paying NGOs for results strengthens institutional capacity to deliver services from the bottom up. Changes in the design throughout the six years offer lessons for other contexts. Language: English Keywords: HAITI | RESEARCH REPORT | PILOT PROJECTS | MATERNAL HEALTH | CHILD HEALTH | REPRODUCTIVE HEALTH | FAMILY PLANNING | MEASUREMENT | PERFORMANCE IMPROVEMENT | PROGRAM ACTIVITIES | NONGOVERNMENTAL ORGANIZATIONS | ORGANIZATION AND ADMINISTRATION | PROGRAM EVALUATION | MONITORING | Developing Countries | Caribbean | Americas | Studies | Research Methodology | Health | Management | Programs | Organizations | Political Factors | Sociocultural Factors | Evaluation Document Number: 331456 |
| 8. Peer Reviewed Title: Sexual violence and reproductive health among youth in Port-au-Prince, Haiti. Author: Gomez AM; Speizer IS; Beauvais H Source: Journal of Adolescent Health. 2009 May;44(5):508-10. Abstract: The authors examined sexual violence and reproductive health outcomes among sexually experienced youth in Port-au-Prince, Haiti, using the Priorities for Local AIDS Control methodology to identify participants in locations where sexual partnerships are formed. Their findings indicated that sexual violence is common and is significantly associated with condom use, pregnancy experience, and recent STI symptoms. Language: English Keywords: HAITI | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | YOUTH | RAPE | VIOLENCE AGAINST WOMEN | REPRODUCTIVE HEALTH | CONDOM USE | PREGNANCY | SIGNS AND SYMPTOMS | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Caribbean | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Age Factors | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Domestic Violence | Health | Risk Reduction Behavior | Behavior | Reproduction | Diseases | Reproductive Tract Infections | Infections Document Number: 331242 |
| 9. Peer Reviewed Title: High mortality among patients with AIDS who received a diagnosis of tuberculosis in the first 3 months of antiretroviral therapy. Author: Koenig SP; Riviere C; Leger P; Joseph P; Severe P; Parker K; Collins S; Lee E; Pape JW; Fitzgerald DW Source: Clinical Infectious Diseases. 2009 Mar 15;48(6):829-31. Abstract: We analyzed mortality among 201 patients with AIDS and tuberculosis in Haiti. Patients who received a diagnosis of tuberculosis during the first 3 months after the initiation of antiretroviral therapy were 3.25 times more likely to die than were other patients with AIDS and tuberculosis. Failure to recognize active tuberculosis at initiation of antiretroviral therapy leads to increased mortality. Language: English Keywords: HAITI | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | PERSONS LIVING WITH HIV/AIDS | TIME FACTORS | ANTIRETROVIRAL THERAPY | AIDS | TUBERCULOSIS | COMPLICATIONS | DEATH RATE | Developing Countries | Caribbean | Americas | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Dynamics | Demographic Factors | Population | HIV | Infections | Mortality Document Number: 330706 |
| 10. Peer Reviewed Title: 5-year survival of patients with AIDS receiving antiretroviral therapy in Haiti [letter] Author: Leger P; Charles M; Severe P; Riviere C; Pape JW; Fitzgerald DW Source: New England Journal of Medicine. 2009 Aug 20;361(8):828-9. Abstract: This letter to the editor reports on the 5-year outcomes of over 900 AIDS patients receiving antiretroviral therapy in Port au Prince, Haiti. Language: English Keywords: HAITI | RESEARCH REPORT | CLINICAL RESEARCH | CLIENTS | AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | ANTIRETROVIRAL DRUGS | IMMUNOLOGIC FACTORS | CASE FATALITY RATE | TIME FACTORS | TUBERCULOSIS | Developing Countries | Caribbean | Americas | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunity | Immune System | Physiology | Biology | Death Rate | Mortality | Population Dynamics | Demographic Factors | Population | Infections Document Number: 342648 |
| 11. Title: Effects of a culturally adapted HIV prevention intervention in Haitian youth. Author: Malow RM; Stein JA; McMahon RC; Devieux JG; Rosenberg R Source: Journal of the Association of Nurses in AIDS Care. 2009 Mar-Apr;20(2):110-121. Abstract: This study assessed the impact of an 8-week community-based translation of Becoming a Responsible Teen (BART), an HIV intervention that has been shown to be effective in other at-risk adolescent populations. A sample of Haitian adolescents living in the Miami area was randomized to a general health education control group (n = 101) or the BART intervention (n = 145), which was based on the information- motivation-behavior (IMB) model. Improvement in various IMB components (i.e., attitudinal, knowledge, and behavioral skills variables) related to condom use was assessed 1 month after the intervention. Longitudinal structural equation models using a mixture of latent and measured multi-item variables indicated that the intervention significantly and positively impacted all IMB variables tested in the model. These BART intervention-linked changes reflected greater knowledge, greater intentions to use condoms in the future, higher safer sex self-efficacy, an improved attitude about condom use, and an enhanced ability to use condoms after the 8-week intervention. (author's) Language: English Keywords: HAITI | RESEARCH REPORT | YOUTH | ADOLESCENTS | HIV PREVENTION | RISK BEHAVIOR | SEX BEHAVIOR | Developing Countries | Caribbean | Americas | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Behavior Document Number: 328102 |
| 12. Title: AWARENESS Project. Haiti country report, 2005-2007. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [11] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: MSH and the MOH officially launched the SDM in November 2005, with IRH participation. At that time, a total of 141 key Haitian trainers and service providers received general training. MSH also conducted official launches in each province and trained trainers in some provinces, using materials developed by IRH that MSH translated and adapted. MSH procured 25,000 sets of CycleBeads, some of which were distributed at regional launches and trainings, and provided technical assistance to the MOH for follow-on cascade training. The 14 institutions where MSH offers direct support initiated SDM services, as did a number of government sites and clinics of some FBOs. In February 2007, IRH conducted a service assessment that showed SDM integration in Haiti did not follow an optimal process due to the weak central government, lack of stakeholder commitment, lack of a central supervision system, insufficient funding for technical assistance, and the lack of an organized commodities procurement system. Many providers had not been formally trained but were offering the SDM with incomplete information. Although some services collect SDM data, the SDM has not been included in the national database for family planning. The SDM is sporadically available in more than 20 clinics countrywide, and more than 700 users have been registered (although the actual number is unknown). Interest is high on the part of clients and providers, but there is little coordinated effort on the part of stakeholders. Introducing the SDM in an unstable environment without consistent technical assistance is extremely difficult. Further discussions with the USAID mission on implementing organizations are needed to assess the potential for future success. (excerpt) Language: English Keywords: HAITI | SUMMARY REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | CONTRACEPTIVE USAGE | FAMILY PLANNING EDUCATION | AWARENESS | PROGRAM ACCESSIBILITY | PROGRAM ACTIVITIES | CAPACITY BUILDING | Caribbean | Americas | Developing Countries | Family Planning | Contraception | Education | Knowledge | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Program Sustainability Document Number: 327622 |
| 13. Title: HIV / AIDS in Haiti: Key findings of the Mortality, Morbidity, and Utilization of Services Survey, EMMUS-IV, 2005-2006. VIH / sida en Haiti. Resultats de Enquete Mortalite, Morbidite et Utilisation des Services, EMMUS-IV, 2005-2006. Author: Macro International. MEASURE DHS Source: Calverton, Maryland, Macro International, MEASURE DHS, [2008]. [26] p. Abstract: The Mortality, Morbidity, and Utilization of Services Survey (Enquete Mortalite, Morbidite et Utilisation des Services en Haiti), or EMMUS-IV, was carried out on a nationally representative sample. It is the fourth survey of its kind in Haiti and it updates the health and demographic indicators collected during the previous surveys of 1994-1995 and 2000. EMMUS-IV field staff interviewed approximately 10,000 households between October 2005 and June 2006, including 10,000 women between the ages of 15 and 49 and 5,000 men between the ages of 15 and 59. The data are representative at the national level, for urban and rural residence, for the Capital Area, and for all administrative departments (North, North-East, North-West, Center, Artibonite, South, South-East, Grande-Anse, Nippes, and West excluding the Capital Area of greater Port-au-Prince). In the course of the EMMUS-IV, approximately 10,000 respondents agreed to provide a small blood sample for an anonymous HIV test. The results of this test were used to estimate HIV prevalence in the general population. This report presents survey findings on HIV prevalence in Haiti and other related results, including knowledge of HIV/AIDS, attitudes toward people living with HIV, and sexual behavior. (excerpt) Language: EnglishFrench Keywords: HAITI | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | HIV INFECTIONS | PREVALENCE | HIV | AIDS | KNOWLEDGE | PERSONS LIVING WITH HIV/AIDS | ATTITUDES | STIGMA | SEX BEHAVIOR | RISK BEHAVIOR | MULTIPLE PARTNERS | CONDOM USE | VOLUNTARY COUNSELING AND TESTING | ORPHANS AND VULNERABLE CHILDREN | Developing Countries | Caribbean | Americas | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Research Methodology | Sociocultural Factors | Psychological Factors | Behavior | Social Problems | Sexual Partners | Risk Reduction Behavior | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Family and Household Document Number: 327001 |
| 14. Title: Promoting family planning during the postpartum period can increase contraceptive acceptance. DR, Haiti, Nicaragua integration. Author: Population Council. Frontiers in Reproductive Health Source: Washington, D.C., Population Council, Frontiers in Reproductive Health, 2008 Feb. [2] p. (OR Summary 74USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: In the Dominican Republic, Haiti, and Nicaragua, providing family planning information during the postpartum period had a greater effect on contraceptive use in the six months following delivery than information given during antenatal care. Language: English Keywords: DOMINICAN REPUBLIC | HAITI | NICARAGUA | RESEARCH REPORT | WOMEN | POSTPARTUM WOMEN | POSTPARTUM | ANTENATAL CARE | AWARENESS | PERCEPTION | CONTRACEPTIVE METHOD ACCEPTABILITY | FAMILY PLANNING | COUNSELING | Developing Countries | Caribbean | Americas | Central America | Latin America | Demographic Factors | Population | Puerperium | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Knowledge | Sociocultural Factors | Psychological Factors | Behavior | Contraceptive Usage | Contraception | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 331604 |
| 15. Peer Reviewed Title: Bayesian melding for estimating uncertainty in national HIV prevalence estimates. Author: Alkema L; Raftery AE; Brown T Source: Sexually Transmitted Infections. 2008 Aug;84 Suppl 1:i11-i16. Abstract: OBJECTIVE: To construct confidence intervals for HIV prevalence in countries with generalised epidemics. METHODS: In the Bayesian melding approach, a sample of country-specific epidemic curves describing HIV prevalence over time is derived based on time series of antenatal clinic prevalence data and general information on the parameters that describe the HIV epidemic. The prevalence trends at antenatal clinics are calibrated to population-based HIV prevalence estimates from national surveys. For countries without population based estimates, a general calibration method is developed. Based on the sample of calibrated epidemic curves, we derive annual 95% confidence intervals for HIV prevalence. The curve that best represents the data at antenatal clinics and population-based surveys, as well as general information about the epidemic, is chosen to represent the best estimates and predictions. RESULTS: We present results for urban areas in Haiti and Namibia to illustrate the estimates and confidenceintervals that are derived with the methodology. Language: English Keywords: NAMIBIA | HAITI | RESEARCH REPORT | HIV INFECTIONS | PREVALENCE | ESTIMATION TECHNIQUES | DATA COLLECTION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Caribbean | Americas | Viral Diseases | Diseases | Measurement | Research Methodology Document Number: 328285 |
| 16. Peer Reviewed Title: Perceptions of pregnancy complications in Haiti. Author: Anderson FW; Naik SI; Feresu SA; Gebrian B; Karki M Source: International Journal of Gynecology and Obstetrics. 2008 Feb;100(2):116-123. Abstract: The objective was to determine the incidence of perceived pregnancy complications and associated factors. During a census, 450 women identified themselves as pregnant and 388 were interviewed postpartum. Complications were reported by 58.6%. Bleeding post-delivery was the most frequent complication (42.5%), followed by great pain (33.8%), bleeding during pregnancy (20.1%), and fever post-delivery (11.6%). Prenatal care at either a dispensary or a clinic was associated with reports of bleeding during pregnancy (odds ratio [OR] 9.06; 95% confidence interval [CI], 1.71-48.00 and OR 7.58; 95% CI, 1.53-37.48, respectively). Women who visited a doctor were less likely to report bleeding during pregnancy (OR 0.20; 95% CI, 0.08-0.55) or fever post-delivery (P=0.015). Herb use was associated with reported bleeding during pregnancy (OR 2.22; 95% CI, 1.12-4.40) and great pain (OR 1.94; 95% CI, 1.05-3.58). The perceived pregnancy complication rate in Haiti is high and is associated with access to health care.The association between use of herbs and pregnancy complications warrants investigation. (author's) Language: English Keywords: HAITI | RESEARCH REPORT | INTERVIEWS | CROSS SECTIONAL ANALYSIS | WOMEN | PREGNANCY COMPLICATIONS | PERCEPTION | TRADITIONAL HEALTH PRACTICES | PROGRAM ACCESSIBILITY | UTILIZATION OF HEALTH CARE | Developing Countries | Caribbean | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Diseases | Psychological Factors | Behavior | Culture | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Health Services | Delivery of Health Care | Health Document Number: 308624 |
| 17. Title: Linking sexual and reproductive health and HIV/AIDS. Gateways to integration: A case study from Haiti. Voluntary HIV counselling and testing: an entry point for comprehensive sexual and reproductive health services. Author: Armstrong S Source: Geneva, Switzerland, World Health Organization, 2008. 24 p. Also available in Spanish: http://149.120.32.2/upload/lib_pub_file/794_filename_ippf_linkages_haiti_sp.pdf and French: http://149.120.32.2/upload/lib_pub_file/828_filename_linking_sexual_rh_fr.pdf Abstract: The process of linking sexual and reproductive health and HIV/AIDS needs to work in both directions: traditional sexual and reproductive health services need to integrate HIV/AIDS interventions, and programmes set up to address the AIDS epidemic need to integrate more general services for sexual and reproductive health. The case studies featured in this series have been chosen to demonstrate this two-way flow and to reflect the diversity of integration models. While these case studies focus primarily on service delivery components, structures, systems and policy issues are also important elements of successful integration. Language: English Keywords: HAITI | RESEARCH REPORT | RECOMMENDATIONS | EVALUATION | PERSONS LIVING WITH HIV/AIDS | INTEGRATED PROGRAMS | REPRODUCTIVE HEALTH | HIV PREVENTION | VOLUNTARY COUNSELING AND TESTING | CONDOM USE | PROMOTION | FAMILY PLANNING PROGRAMS | REPRODUCTIVE RIGHTS | RAPE | Caribbean | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Risk Reduction Behavior | Behavior | Marketing | Economic Factors | Family Planning | Human Rights | Political Factors | Sociocultural Factors | Crime | Social Problems Document Number: 327836 |
| 18. Peer Reviewed Title: Haiti's forgotten emergency. Author: Chatterjee P Source: Lancet. 2008 Aug 23;372(9639):615-618. Abstract: Haiti's new Prime Minister has stated that improving health care on the island will be one of her top priorities. But repairing the health system in a country plagued by turmoil, natural disasters, and a serious HIV/AIDS epidemic is not going to be an easy task. Initiatives to improve the situation are derailed by the constant political upheavals and bloodshed on the island. Haiti's high population density and its decrepit infrastructure mean that it is also vulnerable to devastation from natural disasters such as floods, mudslides, and hurricanes. The author reports on Haiti's political issues and their affect on health care. Language: English Keywords: HAITI | CRITIQUE | EVALUATION | WOMEN IN DEVELOPMENT | CHILDREN | DISASTER RELIEF | NATURAL DISASTERS | POLITICAL FACTORS | WAR | DELIVERY OF HEALTH CARE | QUALITY OF HEALTH CARE | GOVERNMENT FINANCING | HEALTH SERVICES EVALUATION | CHILD NUTRITION | BRAIN DRAIN | Caribbean | Americas | Developing Countries | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Financial Activities | Environment | Sociocultural Factors | Health | Program Evaluation | Programs | Organization and Administration | Nutrition | International Migration | Migration | Population Dynamics Document Number: 308336 |
| 19. Title: USAID / Haiti: Social marketing assessment, 2008. Author: Clary TA Source: Washington, D.C., Global Health Technical Assistance Project, 2008 Sep. [54] p. (Report No. 01-008-153USAID Contract No. GHS-I-00-05-00005-00) Abstract: Despite nearly 20 years of social marketing programs in Haiti, the country is still facing many challenges. Suboptimal coordination and poor infrastructure have resulted in some geographic areas having a plethora of overlapping socially marketed products, while others face fairly frequent stockouts within the social marketing system. Further, the concept of social marketing is still, in some cases, not well understood or fully supported by partner organizations, including the host country government, local organizations, and the private commercial sector. USAID / Haiti, the main funder of social marketing programs during the last several years, is now redefining what it hopes to accomplish through its support. During the course of this assignment numerous meetings and interviews were held, a dozen site visits conducted, and nearly 50 documents reviewed. The main conclusion from this intelligence gathering is this: social marketing programs in Haiti have benefited the health of Haitians, need to becontinued, but also need strengthening in a number of areas. (Excerpts) Language: English Keywords: HAITI | SUMMARY REPORT | USAID | SOCIAL MARKETING | FUNDS | COORDINATION | LOGISTICS | DATA QUALITY | PRIVATE SECTOR | TRAINING ACTIVITIES | PROMOTION | CONTRACEPTIVE DISTRIBUTION | PROGRAM EVALUATION | FEES | Developing Countries | Caribbean | Americas | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Marketing | Economic Factors | Financial Activities | Organization and Administration | Management | Data Analysis | Research Methodology | Macroeconomic Factors | Training Programs | Education | Distributional Activities | Program Activities | Programs Document Number: 331439 |
| 20. Peer Reviewed Title: Clients of female sex workers in Gonaives and St-Marc, Haiti characteristics, sexually transmitted infection prevalence and risk factors. Author: Couture MC; Soto JC; Akom E; Labbe AC; Joseph G; Zunzunegui MV Source: Sexually Transmitted Diseases. 2008 Oct;35(10):849-855. Abstract: Few data exist on the role of clients of female sex workers (FSWs) in STI transmission. This study examined sociodemographic characteristics, risk behaviors, and STI prevalence among clients of FSWs in Haiti. A cross-sectional survey among clients of FSWs (n = 378). Clients were recruited by collaborating local FSWs directly on commercial sex sites. Dried blood spot samples were used to determine prevalence of HIV, syphilis, and herpes simplex virus 2 (HSV-2). Of the respondents, 88% were younger than 30 years, and 60.7% were living with a partner. Fifty-nine percent of clients reported always using condoms with FSWs, 32.8% did so with their stable partners, and 44.9% with casual partners. Clients had a high number of partners; 39.9% had 10 or more within the previous 3 months. The prevalence of HIV-1, previous or active syphilis, and HSV-2 was 7.2%, 13.4%, and 22%, respectively. Multivariate analysis indicated that clients who had tried marijuana, were practicing Voodoo, had a history of STI or were infected with HSV-2 were more often HIV-positive. Living in Gonaives, not being Protestant, being employed, and having tried marijuana were associated with syphilis infection. Older clients, residents of Gonaives and Voodoo practitioners were more likely to be infected with HSV-2. STI prevalence was remarkably high among clients of FSWs. These men had many sex partners and condom use differed, depending on the category of partner. Clients of FSWs likely act as a bridge population, facilitating the spread of STI throughout the general population in Haiti, and should be targeted in prevention programs. Language: English Keywords: HAITI | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | SEX WORKERS | SEXUAL PARTNERS | WOMEN IN DEVELOPMENT | PREVALENCE | SEXUALLY TRANSMITTED DISEASES | DEMOGRAPHIC FACTORS | AGE FACTORS | RISK BEHAVIOR | SEX BEHAVIOR | DRUG USE AND ABUSE | RELIGION | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Economic Development | Economic Factors | Measurement | Reproductive Tract Infections | Infections | Diseases | Population | Population Characteristics | Sociocultural Factors Document Number: 322770 |
| 21. Title: No one to turn to. The under-reporting of child sexual exploitation and abuse by aid workers and peacekeepers. Author: Csaky C Source: London, United Kingdom, Save the Children, 2008. [35] p. Abstract: In this report we focus on ways to improve the international community's response to the sexual exploitation and abuse of children by aid workers, peacekeepers and others acting on their behalf in emergencies. Every instance of such abuse is a gross violation of children's rights and a betrayal of the core principles of humanitarian action. This report draws particular attention to the problem of the under-reporting of such abuse and addresses a range of related issues. It is not a detailed technical document, but aims to bring new evidence into discussions among policy-makers, politicians and those grappling at the local level with the obstacles to effective action. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | SUDAN | COTE D'IVOIRE | HAITI | RESEARCH REPORT | FOCUS GROUPS | INTERVIEWS | CHILDREN | HUMANITARIAN ASSISTANCE | WORKERS | PEACEKEEPING | EMERGENCY PERSONNEL | SEXUAL ABUSE | SEXUAL EXPLOITATION | RECOMMENDATIONS | Africa, North | Africa | Africa, Western | Africa, Sub Saharan | Caribbean | Americas | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Financial Activities | Economic Factors | Labor Force | Human Resources | Political Factors | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Crime | Social Problems | Behavior Document Number: 327396 |
| 22. Title: Age differences at sexual debut and subsequent reproductive health: Is there a link? Author: Gomez AM; Speizer IS; Reynolds H; Murray N; Beauvais H Source: Reproductive Health. 2008;5:8. Abstract: ABSTRACT: BACKGROUND: Experiences at sexual debut may be linked to reproductive health later in life. Additionally, young women with older sexual partners may be at greater risk for HIV and sexually transmitted infections. This study examines sexual debut with an older partner and subsequent reproductive health outcomes among 599 sexually experienced women aged 15-24 who utilized voluntary counseling and testing or reproductive health services in Port-au-Prince, Haiti. METHODS: Logistic regression models, controlling for socioeconomic and demographic factors, examined whether age differences at first sex were significantly associated with STI diagnosis in the previous 12 months and family planning method use at last intercourse. RESULTS: Sixty-five percent of women reported sexual initiation with a partner younger or less than 5 years older, 28% with a partner 5 to 10 years older, and 7% with a partner 10 or more years older. There was a trend towards decreased likelihood of recent use of family planning methods in women who had first sexual intercourse with a partner 5 to 9 years older compared to women with partners who were younger or less than 5 years older. Age differences were not linked to recent STI diagnosis. CONCLUSION: Programs focusing on delaying sexual debut should consider age and gender-based power differentials between younger women and older men. Future research should examine whether wide age differences at sexual debut are predictive of continued involvement in cross-generational relationships and risky sexual behaviors and explore the mechanisms by which cross-generational first sex and subsequent reproductive health may be connected. Language: English Keywords: HAITI | METHODOLOGICAL STUDIES | RESEARCH REPORT | KAP SURVEYS | BASELINE SURVEYS | INDIRECT ESTIMATION TECHNIQUES | ADOLESCENTS, FEMALE | BLACKS | CONDOM USE | VALIDITY | TIME FACTORS | RELIABILITY | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Estimation Techniques | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Risk Reduction Behavior | Behavior | Measurement | Population Dynamics Document Number: 328027 |
| 23. Peer Reviewed Title: Overseas processing of dried blood spots for timely diagnosis of HIV in Haitian infants. Author: Ivers LC; Smith Fawzi MC; Mann J; Jerome JG; Raymonville M; Mukherjee JS Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2008 Nov;24(5):331-5. Abstract: OBJECTIVE: To determine the feasibility of sending dried blood spots (DBS) to an overseas processing center for the diagnosis of HIV infection in infants in rural Haiti. METHODS: The program took place in the Central Department of Haiti. Children under 18 months of age who were born to an HIV-infected mother or who had a positive HIV antibody test had blood collected on filter paper. Once dry, specimens were labeled with a unique identifying number, placed in sealed gas-impermeable envelopes containing a desiccant, stored at room temperature, and mailed to a commercial laboratory in The Netherlands, where blood was eluted from the filter paper and analyzed by the Retina(trade mark) rainbow HIV-1 RNA assay. Infants were tested at 1 month of age and again at 4 months of age. RESULTS: The DBS protocol was easily scaled up. During the study period, 138 infants had HIV status confirmed; 15 of them were found to be HIV infected and were enrolled in appropriate HIV care, and 123 were confirmed to be HIV uninfected, avoiding unnecessary prophylactic antibiotics and providing reassurance to caregivers. CONCLUSION: Central, overseas processing of DBS is a feasible solution for the timely diagnosis of HIV infection in infants where local capacity is unavailable. Regional processing centers for DBS could improve the access of millions of children in Latin America and the Caribbean to timely diagnosis of HIV infection. Language: English Keywords: HAITI | RESEARCH REPORT | EVALUATION | INFANT | BLOOD | LABORATORY PROCEDURES | HIV | LOGISTICS | HIV TESTING | EXAMINATIONS AND DIAGNOSES | Developing Countries | Caribbean | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Hemic System | Physiology | Biology | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Management | Organization and Administration Document Number: 330882 |
| 24. Peer Reviewed Title: A description of malaria-related knowledge, perceptions, and practices in the Artibonite Valley of Haiti: Implications for malaria control. Author: Keating J; Eisele TP; Bennett A; Johnson D; Macintyre K Source: American Journal of Tropical Medicine and Hygiene. 2008 Feb;78(2):262-269. Abstract: A two-stage cluster survey (n = 200 households) was conducted in the Artibonite Valley of Haiti during the high malaria transmission season in November-December 2006. Knowledge, perceptions, and practices related to malaria were obtained from household representatives using a standardized questionnaire. Blood drops were obtained on filter paper from all household members more than one month of age (n = 714). Determinants of malaria infections and correct malaria-related knowledge were assessed using logistic regression. Respondents in households with more assets were significantly more likely than those in households with fewer assets to have correct malaria-related knowledge. Respondents from households with at least one malaria infection were less likely to have correct malaria-related knowledge. Older children (5-9 years of age) were shown to be at increased risk of malaria infection. Results suggest malaria control in Haiti should focus on enhanced surveillance and case management, with expanded information campaigns about malaria prevention and treatment options. (author's) Language: English Keywords: HAITI | RESEARCH REPORT | QUESTIONNAIRES | HOUSEHOLDS | CHILDREN | MALARIA PREVENTION | TRANSMISSION | KNOWLEDGE | BED NETS | FEVER | TREATMENT | PROGRAM ACCEPTABILITY | Developing Countries | Caribbean | Americas | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Malaria | Parasitic Diseases | Diseases | Infections | Parasite Control | Public Health | Health | Body Temperature | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration Document Number: 324398 |
| 26. Peer Reviewed Title: Improving outcomes in infants of HIV-infected women in a developing country setting. Author: Noel F; Mehta S; Zhu Y; Rouzier Pde M; Marcelin A; Shi JR; Nolte C; Severe L; Deschamps MM; Fitzgerald DW; Johnson WD; Wright PF; Pape JW Source: PLoS One. 2008;3(11):e3723. Abstract: BACKGROUND: Since 1999 GHESKIO, a large voluntary counseling and HIV testing center in Port-au-Prince, Haiti, has had an ongoing collaboration with the Haitian Ministry of Health to reduce the rate of mother to child HIV transmission. There are limited data on the ability to administer complex regimens for reducing mother to child transmission and on risk factors for continued transmission and infant mortality within programmatic settings in developing countries. METHODS AND FINDINGS: We analyzed data from 551 infants born to HIV-infected mothers seen at GHESKIO, between 1999 and 2005. HIV-infected mothers and their infants were given "short-course" monotherapy with antiretrovirals for prophylaxis; and, since 2003, highly active antiretroviral therapy (HAART) when clinical or laboratory indications were met. Infected women seen in the pre-treatment era had 27% transmission rates, falling to 10% in this cohort of 551 infants, and to only 1.9% in infants of women on HAART. Mortality rate after HAART introduction (0.12 per year of follow-up [0.08-0.16]) was significantly lower than the period before the availability of such therapy (0.23 [0.16-0.30], P<0.0001). The effects of maternal health, infant feeding, completeness of prophylaxis, and birth weight on mortality and transmission were determined using univariate and multivariate analysis. Infant HIV-1 infection and low birth weight were associated with infant mortality in less than 15 month olds in multivariate analysis. CONCLUSIONS: Our findings demonstrate success in prevention of mother-to-child HIV transmission and mortality in a highly resource constrained setting. Elements contributing to programmatic success include provision of HAART in the context of a comprehensive program with pre and postnatal care for both mother and infant. Language: English Keywords: HAITI | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | MULTIVARIATE ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | MOTHERS | WOMEN IN DEVELOPMENT | INFANT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | ANTIRETROVIRAL THERAPY | INFANT NUTRITION | BIRTH WEIGHT | Caribbean | Americas | Developing Countries | Research Methodology | Data Analysis | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Youth | Age Factors | Disease Transmission Control | Prevention and Control | HIV | Nutrition | Health | Body Weight | Physiology | Biology Document Number: 330268 |
| 27. Title: Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in Haiti. Author: Rivero Fuentes ME; Vernon R; Boulos M; Boulos LM Source: [Port-au-Prince], Haiti, Population Council, Frontiers in Reproductive Health, 2008 Mar. [50] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: This report presents the results of a situation analysis of the provision and use of contraception in Postpartum, Postabortion and Prevention of Mother-to-Child transmission of HIV (PMTCT) Services in Haiti. The Centre d'Evaluation et de Recherche Apliquee (Center for Evaluation and Applied Research or CERA), a Haitian health research and evaluation consulting firm, was responsible for the data collection, cleaning, and entry processes. FRONTIERS provided CERA with technical assistance throughout these phases and analyzed the data. Data were collected between November and December 2006 from a sample of 41 public, private and mixed health establishments in five of Haiti's 10 departments, including the three most heavily populated departments. Data were collected through: content analysis of the National Family Planning and Maternal Health Norms; inventories of equipment, supplies, and service statistics in family planning, antenatal care, delivery care, maternal and child care in the extended postpartum, and PMTCT services; structured interviews with health providers; exit interviews with women in antenatal, delivery, and postpartum care and women in the six-month postpartum period visiting a health outlet for any reason; and with women living with HIV and receiving care in an integral care unit (ICU); observation of client-provider interactions in antenatal, delivery and postabortion care by non-participants; focus groups with women who had delivered recently, women who had delivered in the last six months and women who did not use reproductive health services. (excerpt) Language: English Keywords: HAITI | EVALUATION REPORT | KAP SURVEYS | FOCUS GROUPS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | POSTPARTUM WOMEN | HEALTH PERSONNEL | POSTABORTAL PROGRAMS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | POSTPARTUM PROGRAMS | PROGRAM EVALUATION | HIV PREVENTION | USAID | ANTENATAL CARE | Developing Countries | Caribbean | Americas | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Disease Transmission Control | Prevention and Control | Diseases | Programs | Organization and Administration | HIV Infections | Viral Diseases | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services Document Number: 326792 |
| 28. Peer Reviewed Title: Age-based preventive targeting of food assistance and behaviour change and communication for reduction of childhood undernutrition in Haiti: A cluster randomised trial. Author: Ruel MT; Menon P; Habicht JP; Loechl C; Bergeron G Source: Lancet. 2008;371(9612):588-595. Abstract: Food-assisted maternal and child health and nutrition programmes usually target underweight children younger than 5 years of age. Previous evidence suggests that targeting nutrition interventions earlier in life, before children become undernourished, might be more effective for reduction of childhood undernutrition. We used a cluster randomised trial to compare two World Vision programmes for maternal and child health and nutrition, which included a behaviour change and communication component: a preventive model, targeting all children aged 6-23 months; and a recuperative model, targeting underweight (weight-for-age Z score less than -2) children aged 6-60 months. Both models also targeted pregnant and lactating women. Clusters of communities (n=20) were paired on access to services and other factors and were randomly assigned to each model. Using two cross-sectional surveys (at baseline and 3 years later), we tested differences in undernutrition in children aged 12-41 months (roughly 1500 children per survey). Analyses were by intention to treat, both by pair-wise community-level comparisons and by child-level analyses adjusting for the clustering effect and child age and sex. This study is registered with ClinicalTrials.gov, number NCT00210418. There were no differences between programme groups at baseline. At follow-up, stunting, underweight, and wasting (using WHO 2006 reference data) were 4-6 percentage points lower in preventive than in recuperative communities; and mean anthropometric indicators were higher by +0.14 Z scores (height for age; p=0.07), and +0.24 Z scores (weight for age and weight for height; p less than 0.0001). The effect was greater in children exposed to the preventive programme for the full span between 6 and 23 months of age than in children exposed for shorter durations during this period. The quality of implementation did not differ between the two programmes; nor did use of services for maternal and child health and nutrition. The preventive programme was more effective for the reduction of childhood undernutrition than the traditional recuperative model. (author's) Language: English Keywords: HAITI | RESEARCH REPORT | CLINICAL TRIALS | CHILD | NUTRITION | INTERVENTIONS | FOOD SUPPLEMENTATION | BEHAVIOR | AGE FACTORS | MALNUTRITION | PREVENTION AND CONTROL | EVALUATION | Developing Countries | Caribbean | Americas | Clinical Research | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Health | Programs | Organization and Administration | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Nutrition Disorders | Diseases Document Number: 324557 |
| 29. Title: Intimate partner and nonpartner violence against pregnant women in rural Haiti. Author: Small MJ; Gupta J; Frederic R; Joseph G; Theodore M; Kershaw T Source: International Journal of Gynaecology and Obstetrics. 2008 Sep;102(3):226-31. Abstract: OBJECTIVE: To examine the association between violence experienced by pregnant Haitian women in the previous 6 months and pregnancy-related symptom distress. METHODS: A total of 200 women seeking prenatal care at community health dispensaries in the Artibonite Valley were interviewed. RESULTS: Over 4 in 10 women (44.0%) reported that they had experienced violence in the 6 months prior to interview; 77.8% of these women reported that the violence was perpetrated by an intimate partner. Those who experienced intimate partner violence reported significantly greater pregnancy-related symptom distress (beta=0.23, P=0.001). No significant differences between violence perpetrated by family members or others and reporting of symptoms were observed (beta=0.06, P=0.38). CONCLUSION: The findings indicate the need to integrate violence screening, resources, and primary prevention into prenatal care in rural Haiti. Language: English Keywords: HAITI | RESEARCH REPORT | KAP SURVEYS | EPIDEMIOLOGIC METHODS | RURAL POPULATION | PREGNANT WOMEN | SEXUAL PARTNERS | WOMEN IN DEVELOPMENT | VIOLENCE AGAINST WOMEN | DOMESTIC VIOLENCE | PREVALENCE | STRESS | PREGNANCY COMPLICATIONS | FAMILY RELATIONSHIPS | SCREENING | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Economic Development | Economic Factors | Crime | Social Problems | Sociocultural Factors | Measurement | Psychological Factors | Diseases | Family Characteristics | Family and Household | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329238 |
| 30. Title: HIV prevalence data from the 2005-2006 Haiti Survey on Mortality, Morbidity, and Utilization of Services. Author: Haiti. Institut Haitien de l'Enfance; Haiti. Institut Haitien de Statistique et d’Informatique; Macro International. MEASURE DHS Source: Petion-Ville, Haiti, Institut Haitien de l'Enfance, [2007]. [2] p. Also available in French. Abstract: The 2005-2006 Haiti Survey on Mortality, Morbidity and Utilization of Services included HIV testing of more than 10,000 women and men age 15-49. According to the survey, 2.2% of Haitians age 15-49 are HIV-infected. HIV prevalence is slightly higher among women than men. Prevalence is highest in cities outside of the capital area and lowest in the Capital. For women, prevalence increases with age until it reaches a peak at age 30-34 (4.1%). The peak for men occurs at age 40-44 (4.4%). Prevalence is higher among women than men until age 35. Among men, HIV prevalence decreases as education increases. Men with no education are more than twice as likely as those with secondary or more education to be HIV-positive. There is no clear relationship between education and prevalence among women. (excerpt) Language: English Keywords: HAITI | TABLES AND CHARTS | HEALTH SURVEYS | HIV INFECTIONS | PREVALENCE | Developing Countries | |