1.  Title: Cesarean section deliveries in the occupied Palestinian territory (oPt): An analysis of the 2006 Palestinian Family Health Survey. Author: Abdul-Rahim HF; Abu-Rmeileh NM; Wick L Source: Health Policy. 2009 Aug 10; Abstract: OBJECTIVE: Against the backdrop of a rise in cesarean section deliveries from 6.0% in 1996 to 14.8% in 2006, the objective of this study was to investigate socio-demographic, clinical and service-related factors associated with cesarean sections in the occupied Palestinian territory. METHODS: Data from the Palestinian Family Health Survey 2006 were used to examine last births in the 5 years preceding the survey to women aged 15-49 years. Bivariate and multivariate associations between type of delivery (dependent variable) and selected factors were analyzed using logistic regression. Selected maternal outcomes were also investigated with type of delivery as the independent variable. RESULTS: Cesarean section deliveries were significantly associated with maternal age (35+ years), primiparity, low birth weight and residence area in the West Bank and Gaza. There was no significant difference in the prevalence of cesarean deliveries by sector in the West Bank, but in Gaza, they were significantly more common in the governmental sector. CONCLUSIONS: There is a need for detailed audits of cesarean section deliveries, nationally and at the facility level, in order to avoid unnecessary interventions in the context of high fertility, rising poverty and fragmented health services. Variations by governorate should be studied further for focused interventions. Language: English Keywords: MIDDLE EAST | DEVELOPING COUNTRIES | PREVALENCE | HEALTH SURVEYS | WOMEN | CESAREAN SECTION | HEALTH SERVICES | DELIVERY OF HEALTH CARE | Measurement | Research Methodology | Health | Demographic Factors | Population | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine Document Number: 342538 |
2.  Title: Assessment of family planning services in Kenya: Evidence from the 2004 Kenya Service Provision Assessment Survey. Author: Agwanda A; Khasakhala A; Kimani M Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [51] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 4) Based on further analysis of the 2004 Kenya Service Provision Assessment Survey. Abstract: This study focused on factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to family planning clientele; the degree to which health care providers foster informed selection of an appropriate contraceptive method; and the extent to which clients perceive services to be of high quality. Data was obtained from the 2004 Kenya Service Provision Assessment. The composite indicators scores for facility readiness were generally low and many facilities lacked simple items like visual aids, guidelines, towels, speculum, etc. There were marked differences in facility readiness by region, facility type, and managing authority. Provider service provision scores were generally high but the only important difference was by region. Client satisfaction was dependent on the facility type, managing authority, sex of the provider, and the waiting time to receive services. Clients were more likely to be satisfied with female rather than male providers. Clients were less satisfied in Nyanza, although the facilities were more ready with high-performing providers. In contrast, North Eastern Province had less ready facilities, but high client satisfaction and high provider performance. Health centre, clinics, and dispensaries need to be revamped to appropriate standards so as to include all basic elements of family planning service provision. North Eastern Province, with motivated workers, highly satisfied clients but poor facilities, deserves proper attention. Facilities in Nairobi need improvements in staff supervision and retraining. There is need to educate the clientele on the availability of appropriate services within the government facilities. Language: English Keywords: KENYA | RESEARCH REPORT | RECOMMENDATIONS | HEALTH SURVEYS | KAP SURVEYS | EVALUATION INDEXES | FAMILY PLANNING PERSONNEL CHARACTERISTICS | FAMILY PLANNING PERSONNEL EVALUATION | FAMILY PLANNING PROGRAM EVALUATION | PERCEPTION | HUMAN GEOGRAPHY | SATISFACTION | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Family Planning Personnel | Family Planning Programs | Family Planning | Psychological Factors | Behavior | Geography | Social Sciences | Science | Sociocultural Factors | Population Characteristics | Demographic Factors | Population Document Number: 329890 |
| 3. Title: Mainstreaming early and exclusive breastfeeding for improving child survival. Author: Dadhich JP; Agarwal RK Source: Indian Pediatrics. 2009 Jan;46(1):11-7. Abstract: India is home to maximum number of under-five deaths and underweight children in the world. In 2006, for the first time, the number of children in the world dying before their fifth birthday fell below 10 million, to 9.7 million annually. South Asia's contribution to this figure was 3.1 million out of which 2.1 million deaths occurred in India i.e., 21 percent of the global burden of under five deaths. Most of these deaths occur during the neonatal period. A reduction in the number of deaths among the under-five children reflects the country's progress on the fourth Millennium Development Goal (MDG 4). About 55 million, or one-third of the world's underweight children under the age of five years, live in India. Malnutrition has been estimated to be an underlying cause of up to 50-60 percent of under five deaths. The number of young underweight children reflects the country's progress on the first Millennium Development Goal (MDG 1), which deals with eradication of extreme poverty and hunger. In India, the average annual rate of decline in malnutrition has been around 0.9% since 1990. Considerably accelerated progress is needed for India to meet its MDG target of halving the percentage of underweight children by 2015. Despite breastfeeding's numerous recognized advantages, early and exclusive breastfeeding rates in most states of the India are low. There are many gaps in policy and programs related to infant and young child feeding in India. The big challenge is how to mainstream IYCF counseling and support interventions to help women to succeed both in early and exclusive breastfeeding. The rationale for supporting a major program to protect, promote and support breastfeeding action, backed by a budgetary support, is compelling for our country. Child health and development policies should urgently address this major concern. Language: English Keywords: INDIA | RECOMMENDATIONS | HEALTH SURVEYS | MOTHERS | INFANT | BREASTFEEDING, EXCLUSIVE | CHILD SURVIVAL | MALNUTRITION | BODY WEIGHT | TIME FACTORS | POSTPARTUM PROGRAMS | LONGTERM EFFECTS | INTELLIGENCE | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Asia, Southern | Asia | Developing Countries | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Infant Nutrition | Nutrition | Survivorship | Length of Life | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Physiology | Biology | Family Planning Programs | Family Planning | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Disease Transmission Control | Prevention and Control Document Number: 331250 |
| 4. Title: Determinants of condom use: results of the Canadian Community Health Survey 3.1. Author: Dhalla S; Poole G Source: Canadian Journal of Public Health / Revue Canadienne De Sante Publique. 2009 Jul-Aug;100(4):299-303. Abstract: OBJECTIVES: To examine the independent effects of mood disorder, age, race/ethnicity, personal income, being a current student, having a regular medical doctor and substance use in relationship to condom use at last intercourse in a Canadian population stratified by sex. METHODS: We used Cycle 3.1 of the 2006 Canadian Community Health Survey (CCHS 3.1), a population-based, voluntary, cross-sectional survey of subjects ages 12-85 years. Data collection took place between January and December 2005. From the survey, a study sample of 20,975 people was drawn, consisting of individuals providing valid responses (yes/no) to mood disorder and last-time condom use. The question of sexual behaviours was asked only of those ages 15-49 years. Logistic regression was used to examine individual variables as potential determinants of last-time condom use stratified by sex. RESULTS: The relationship between mood disorder and condom use was non-significant in both males (AOR = 0.85, 95% CI = 0.70-1.04) and females (AOR = 0.90, 95% CI = 0.78-1.03). Increasing age was found to be inversely associated with last-time condom use in both males and females. Male factors significantly associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.64-0.79) and being a current student (AOR = 1.28, 95% CI =1.16-1.42). Female factors associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.63-0.79) and being a former drinker (AOR = 2.25, 95% CI = 1.63-3.11). CONCLUSION: Our results identify important determinants of last-time condom use in both males and females in the CCHS 3.1. These findings may have important implications for the devising and implementation of safe sex programs in a Canadian population ages 15-49 years. Language: English Keywords: CANADA | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ETHNIC GROUPS | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | MENTAL DISORDERS | SEX FACTORS | AGE FACTORS | ALCOHOL USE AND ABUSE | Developed Countries | North America, Northern | Americas | Health | Data Analysis | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior Document Number: 342618 |
| 5. Peer Reviewed Title: Multiple sexual partnership mediates the association between early sexual debut and sexually transmitted infection among adolescent and young adult males in Nigeria. Author: Fatusi A; Wang W Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):134-43. Abstract: The study was cross-sectional analytical in design and involved 1,278 Nigerian males aged 15-24 years. Logistic regression was used in assessing the statistical relationship between early sexual debut (<16 years) and self-reported STIs (history of at least one of three symptoms-painful urination, genital discharge, and genital ulcer/sore within the past 12 months), with demographic factors, sexual behaviors, and psychosocial measures controlled for. The prevalence of self-reported symptoms was 4.2% for genital discharge, 4.1% for painful urination, and 2.0% for genital sore/ulcer. Overall, 6.8% had STI symptoms. At bivariate analysis, early sexual debut (p = 0.021), multiple partners (p < 0.001), concurrent partners (p = 0.002), and sex with casual/commercial partners (p = 0.013) were associated with STIs. At multivariate analysis, early sexual debut (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.17-3.84) remained significantly associated with STIs. Multiple sexual partnership (OR = 2.00, 95% CI = 1.13-3.52) was also significantly associated with STIs and is a mediator of the association between early debut and STI. Language: English Keywords: NIGERIA | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ADOLESCENTS, MALE | YOUTH | MULTIPLE PARTNERS | FIRST INTERCOURSE | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Health | Data Analysis | Research Methodology | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Sex Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases Document Number: 341447 |
| 6. Title: Sexual and reproductive health of persons aged 10-24 years - United States, 2002-2007. Author: Gavin L; MacKay AP; Brown K; Harrier S; Ventura SJ; Kann L; Rangel M; Berman S; Dittus P; Liddon N; Markowitz L; Sternberg M; Weinstock H; David-Ferdon C; Ryan G Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Surveillance Summaries. 2009 Jul 17;58(6):1-58. Abstract: This report presents data for 2002-2007 concerning the sexual and reproductive health of persons aged 10-24 years in the United States. Data were compiled from the National Vital Statistics System and multiple surveys and surveillance systems that monitor sexual and reproductive health outcomes into a single reference report that makes this information more easily accessible to policy makers, researchers, and program providers who are working to improve the reproductive health of young persons in the United States. The report addresses three primary topics: 1) current levels of risk behavior and health outcomes; 2) disparities by sex, age, race/ethnicity, and geographic residence; and 3) trends over time. The data presented in this report indicate that many young persons in the United States engage in sexual risk behavior and experience negative reproductive health outcomes. In 2004, approximately 745,000 pregnancies occurred among U.S. females aged <20 years. In 2006, approximately 22,000 adolescents and young adults aged 10-24 years in 33 states were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and approximately 1 million adolescents and young adults aged 10-24 years were reported to have chlamydia, gonorrhea, or syphilis. One-quarter of females aged 15-19 years and 45% of those aged 20-24 years had evidence of infection with human papillomavirus during 2003-2004, and approximately 105,000 females aged 10--24 years visited a hospital emergency department (ED) for a nonfatal sexual assault injury during 2004-2006. Although risks tend to increase with age, persons in the youngest age group (youths aged 10--14 years) also are affected. For example, among persons aged 10-14 years, 16,000 females became pregnant in 2004, nearly 18,000 males and females were reported to have sexually transmitted diseases (STDs) in 2006, and 27,500 females visited a hospital ED because of a nonfatal sexual assault injury during 2004-2006. Noticeable disparities exist in the sexual and reproductive health of young persons in the United States. For example, pregnancy rates for female Hispanic and non-Hispanic black adolescents aged 15-19 years are much higher (132.8 and 128.0 per 1,000 population) than their non-Hispanic white peers (45.2 per 1,000 population). Non-Hispanic black young persons are more likely to be affected by AIDS: for example, black female adolescents aged 15-19 years were more likely to be living with AIDS (49.6 per 100,000 population) than Hispanic (12.2 per 100,000 population), American Indian/Alaska Native (2.6 per 100,000 population), non-Hispanic white (2.5 per 100,000 population) and Asian/Pacific Islander (1.3 per 100,000 population) adolescents. In 2006, among young persons aged 10-24 years, rates for chlamydia, gonorrhea, and syphilis were highest among non-Hispanic blacks for all age groups. The southern states tend to have the highest rates of negative sexual and reproductive health outcomes, including early pregnancy and STDs. Although the majority of negative outcomes have been declining for the past decade, the most recent data suggest that progress might be slowing, and certain negative sexual health outcomes are increasing. For example, birth rates among adolescents aged 15-19 years decreased annually during 1991-2005 but increased during 2005-2007, from 40.5 live births per 1,000 females in 2005 to 42.5 in 2007 (preliminary data). The annual rate of AIDS diagnoses reported among males aged 15-19 years has nearly doubled in the past 10 years, from 1.3 cases per 100,000 population in 1997 to 2.5 cases in 2006. Similarly, after decreasing for >20 years, gonorrhea infection rates among adolescents and young adults have leveled off or had modest fluctuations (e.g., rates among males aged 15-19 years ranged from 285.7 cases per 100,000 population in 2002 to 250.2 cases per 100,000 population in 2004 and then increased to 275.4 cases per 100,000 population in 2006), and rates for syphilis have been increasing (e.g., rates among females aged 15-19 years increased from 1.5 cases per 100,000 population in 2004 to 2.2 cases per 100,000 population in 2006) after a significant decrease during 1997-2005. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | HEALTH SURVEYS | YOUTH | ETHNIC GROUPS | REPRODUCTIVE HEALTH | SEX BEHAVIOR | RISK BEHAVIOR | ADOLESCENT PREGNANCY | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | AIDS | ABORTION | VIOLENCE | Developed Countries | North America | Americas | Health | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Fertility Control, Postconception | Family Planning Document Number: 342146 Notification |
| 7. Peer Reviewed Title: HIV/AIDS and the health of older people in the slums of Nairobi, Kenya: results from a cross sectional survey. Author: Kyobutungi C; Ezeh AC; Zulu E; Falkingham J Source: BMC Public Health. 2009 May 27;9(1):153. Abstract: ABSTRACT: BACKGROUND: The proportion of older people is increasing worldwide. Globally, it is estimated that older people (those 60 years or older) constitute more than 11% of the population. As the HIV/AIDS pandemic rages in sub-Saharan Africa (SSA), its impact on older people needs closer attention given the increased economic and social roles older people have taken on as a result of increased mortality among adults in the productive age groups. Few studies have looked at older people and their health in SSA or indeed the impact of HIV/AIDS on their health. This study aims to assess the effect of being directly or indirectly affected by HIV/AIDS on the health of older people in two Nairobi slums. METHODS: Data were collected from residents of the Nairobi Urban Health and Demographic Surveillance area, who on 1st October 2006, were 50 years and older. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health) form and two outcome measures - self-rated health and a composite health score - were generated. To assess HIV/AIDS affected status, respondents were asked: Have you personally been affected by HIV/AIDS? If yes, a follow up question: "How have you been personally affected by HIV/AIDS?" was asked. Ordinal logistic regression was used in models with self-rated health and linear regression in models with the health score. RESULTS: About 18% of respondents reported being affected by HIV/AIDS in at least one way, although less than 1% reported being infected with HIV. Nearly 60% of respondents reported being in good health, 27% in fair health and 14% in poor health. The overall mean health score was 70.6 (SD: 13.9). Females reported worse health outcomes than males. Respondents directly or indirectly affected by HIV/AIDS reported worse health outcomes than those not affected: mean health score: 68.5 and 71.1 respectively (t=3.21), and an adjusted odds ratio of reporting "poor health" of 1.42 (95%CI: 1.12-1.80). CONCLUSION: Poor health outcomes among older people affected by HIV/AIDS highlight the need for policies that target them in the fight against HIV/AIDS if they are to play their envisaged care giving and other traditional roles. Language: English Keywords: KENYA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | STATISTICAL REGRESSION | KAP SURVEYS | HEALTH SURVEYS | OLDER ADULTS | SLUMS | PERSONS LIVING WITH HIV/AIDS | HEALTH STATUS INDEXES | SEX FACTORS | SELF-PERCEPTION | AIDS | HIV INFECTIONS | HEALTH POLICY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Surveys | Sampling Studies | Studies | Health | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Viral Diseases | Diseases | Perception | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 341484 |
| 8. Peer Reviewed Title: Determinants of transitions to first sexual intercourse, marriage and pregnancy among female adolescents: evidence from South Nyanza, Kenya. Author: Magadi MA; Agwanda AO Source: Journal of Biosocial Science. 2009 May;41(3):409-27. Abstract: The timing of transitions to sexual activity, marriage and childbearing in sub-Saharan Africa is undergoing profound changes. This study investigates the determinants of adolescent transitions in South Nyanza, a socioeconomically deprived setting in Kenya where adolescent reproductive health is a particular concern. The analysis is based on Cox regression of timing of first sexual intercourse, first marriage and first pregnancy, using data from a survey of 1247 females aged 12-19 years. The results show that higher household socioeconomic status and educational attainment are associated with delayed onset of all three transition events. Furthermore, mother's higher educational attainment is protective for initiation of sexual intercourse while rural residence is protective for pregnancy experience. Other protective factors include communication with parents or with fellow girlfriends. However, discussing sexual matters with boyfriends, high internal locus of control, and gender bias are associated with early onset of the three transition events. Language: English Keywords: KENYA | RESEARCH REPORT | HEALTH SURVEYS | ADOLESCENTS, FEMALE | FIRST INTERCOURSE | MARRIAGE AGE | REPRODUCTIVE BEHAVIOR | SOCIOECONOMIC STATUS | INTERPERSONAL COMMUNICATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Marriage Patterns | Marriage | Nuptiality | Fertility | Population Dynamics | Socioeconomic Factors | Economic Factors | Communication Document Number: 341401 |
| 9. Title: Usefulness of highly active antiretroviral therapy on health-related quality of life of adult recipients in Tanzania. Author: Magafu MG; Moji K; Igumbor EU; Hashizume M; Mizota T; Komazawa O; Cai G; Yamamoto T Source: AIDS Patient Care and STDs. 2009 Jul;23(7):563-70. Abstract: This study assessed health-related quality of life (HRQOL) of highly active antiretroviral therapy (HAART) recipients aged 18 or older and associated factors, 2 years after HAART administration had started in Kagera, Tanzania. Using the 36-Item Short Form Health Survey (SF-36), 329 HAART recipients were interviewed in May 2007. Questions on sociodemographic characteristics, chronic diseases (besides HIV/AIDS), HAART side effects and adherence to antiretroviral drugs were added. Treatment data, the first and latest available CD4 counts were retrieved from patients' records. Gender and age-adjusted mean scale scores of the sample were compared to those of the general Tanzanian population of the late 1990 s using t test. Logistic regression was used to explore the effect of sex, age, education level, income, chronic diseases, CD4 count, HAART side effects and adherence to antiretroviral drugs on recipients' physical functioning and mental health scale scores. The mean scale scores of HAART recipients were generally lower than those of the general population except for general health perceptions (p = 0.191) and mental health (p = 0.161). HAART recipients with chronic disease comorbidity were more likely to score below the general population's mean score for mental health (p = 0.007). While the effect of chronic disease comorbidity on physical functioning among those who recorded a CD4 count increase was negative (odds ratio [OR] = 13.6, 95% confidence interval [CI] = 3.7, 49.9), there was no effect on those who did not have such an increase. The control of chronic diseases among recipients should be given priority to improve their HRQOL. Language: English Keywords: TANZANIA | RESEARCH REPORT | HEALTH SURVEYS | CLIENTS | SOCIOECONOMIC FACTORS | DISEASES | HIV INFECTIONS | AIDS | HIV | ANTIRETROVIRAL THERAPY | TREATMENT | QUALITY OF LIFE | PERCEPTION | MENTAL HEALTH | TESTING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Health | Program Activities | Programs | Organization and Administration | Economic Factors | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Social Welfare | Psychological Factors | Behavior | Measurement | Research Methodology Document Number: 342980 |
| 10. Peer Reviewed Title: Trends in sexual experience, contraceptive use, and teenage childbearing: 1992-2002. Author: Manlove J; Ikramullah E; Mincieli L; Holcombe E; Danish S Source: Journal of Adolescent Health. 2009 May;44(5):413-23. Abstract: PURPOSE: To examine how cohort trends in family, individual, and relationship characteristics are linked to trends in adolescent reproductive health outcomes to provide a better understanding of factors behind recent declines in teenage birth rates. METHODS: We examine a sample of three cohorts of females and males aged 15-19 in 1992, 1997, and 2002, based on retrospective information from the 2002 National Survey of Family Growth. We identify how family, individual, and relationship characteristics are associated with the transition to sexual intercourse, contraceptive use at first sex, and the transition to a teen birth. RESULTS: Cohort trends and multivariate analyses indicate changes in family and relationship characteristics among American teens have been associated with positive trends in reproductive health since the early 1990s. Factors associated with improvement in adolescent reproductive health include positive changes in family environments (including increases in parental education and a reduced likelihood of being born to a teen mother) and positive trends in sexual relationships (including an increasing age at first sex and reductions in older partners). These positive trends may be offset, in part, by negative changes in family environments (including an increased likelihood of being born to unmarried parents) and the changing racial/ethnic composition of the teen population. CONCLUSIONS: Recent increases in the U.S. teen birth rate highlight the continued importance of improving reproductive health outcomes. Our research suggests that it is important for programs to take into consideration how family, individual, and relationship environments influence decision-making about sex, contraception, and childbearing. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | MULTIVARIATE ANALYSIS | HEALTH SURVEYS | ADOLESCENTS, FEMALE | PREGNANT WOMEN | SEX BEHAVIOR | CONTRACEPTIVE USAGE | ADOLESCENT PREGNANCY | FAMILY RELATIONSHIPS | BIRTH RATE | REPRODUCTIVE HEALTH | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Health | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Measurements Document Number: 331077 |
| 11. Peer Reviewed Title: Rich-poor gap in utilization of reproductive and child health services in India, 1992-2005. Author: Mohanty SK; Pathak PK Source: Journal of Biosocial Science. 2009 May;41(3):381-98. Abstract: This paper examines the trends in utilization of five indicators of reproductive and child health services, namely, childhood immunization, medical assistance at delivery, antenatal care, contraceptive use and unmet need for contraception, by wealth index of the household in India and two disparate states, Uttar Pradesh and Maharashtra. The data from three rounds of the National Family and Health Survey conducted during 1992-2005 are analysed. The wealth index is computed using principal component derived weights from a set of consumer durables, land size, housing quality and water and sanitation facilities of the household, and classified into quintiles for all three rounds. Bivariate analyses, rich-poor ratio and concentration index are used to understand the trends in utilization of, and inequality in, reproductive and child health services. The results indicate huge disparities in utilization of these services, largely to the disadvantage of the poor. Utilization of basic childhood immunization among the poorest and the poor stagnated in India, as well as in both states, during 1998-2005 compared with 1992-1998. The use of maternal care services such as medical assistance at delivery and antenatal care remained at a low level among the poor over this period. However, contraceptive use increased relatively faster among the poor, even with higher unmet need. Of all these services, the inequality in medical assistance at delivery is consistently large, while that of contraceptive use is small. The state-level differences in service coverage by wealth quintiles over time are large. Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | HOUSEHOLDS | REPRODUCTIVE HEALTH | CHILD HEALTH SERVICES | UTILIZATION OF HEALTH CARE | SOCIOECONOMIC STATUS | INEQUALITIES | ANTENATAL CARE | NEEDS | IMMUNIZATION | Asia, Southern | Asia | Developing Countries | Health | Family and Household | Sociocultural Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Socioeconomic Factors | Economic Factors | Maternal Health Services Document Number: 341404 |
| 12. Title: Adolescent marriage and childbearing in India: current situation and recent trends. Author: Moore AM; Singh S; Ram U; Remez L; Audam S Source: New York, New York, Guttmacher Institute, 2009 Apr. 31 p. Abstract: Over the last decade and a half, little progress has been made in reducing the proportion of adolescents in India who become brides. While a range of socioeconomic and cultural factors may influence when a young woman gets married, past research has shown that areas where girls achieve higher levels of education have lower rates of early marriage. Keeping girls in school longer has also been found to delay early childbearing, which is rare outside of marriage in India. Language: English Keywords: INDIA | ADMINISTRATIVE DISTRICTS | TECHNICAL REPORT | HEALTH SURVEYS | ADOLESCENTS, FEMALE | REPRODUCTIVE HEALTH | MARRIAGE AGE | MARRIAGE POSTPONEMENT | REPRODUCTIVE BEHAVIOR | CONTRACEPTIVE USAGE | NEEDS | EDUCATIONAL STATUS | POLICY | LEGISLATION | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Health | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Marriage Patterns | Marriage | Nuptiality | Fertility | Population Dynamics | Contraception | Family Planning | Economic Factors | Socioeconomic Status | Socioeconomic Factors | Political Factors | Sociocultural Factors Document Number: 341003 |
| 13. Peer Reviewed Title: Comparison of HIV prevalence estimates from sentinel surveillance and a national population-based survey in Uganda, 2004-2005. Author: Musinguzi J; Kirungi W; Opio A; Montana L; Mishra V; Madraa E; Biryahwaho B; Mermin J; Bunnell R; Cross A; Hladik W; McFarland W; Stoneburner R Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51(1):78-84. Abstract: OBJECTIVE: HIV programs in generalized epidemics have traditionally relied on antenatal clinic (ANC) sentinel surveillance data to guide prevention and to model epidemic trends. ANC data, however, come from a subset of the population, and their representativeness of the population has been debated. METHODS: Data from a national population-based Uganda HIV/AIDS Sero-Behavioral Survey (UHSBS) were compared with those from ANC sentinel surveillance. Using geographic information system, UHSBS clusters within a 30 km radius of the ANC sites were mapped. Estimates of HIV prevalence from ANC surveillance were compared with those from UHSBS. RESULTS: The ANC-based HIV prevalence, 6.0% [confidence interval (CI) 5.5% to 6.5%], was similar to that from UHSBS, 5.9% (CI 5.4% to 6.4%). The ANC-based estimate correlated with that of UHSBS catchment area women who were pregnant and those who had given birth in the 2 years preceding the survey. ANC data overestimated prevalence in the 15-year to 19-year age group, were similar to UHSBS for ages 20-29 years, and underestimated prevalence in older respondents. ANC data underestimated HIV prevalence among women (6.0% vs. 7.4%; CI 6.6% to 8.2%) and urban women (7.6% vs. 12.7%) but was similar for rural women (5.3% vs. 4.9%). CONCLUSIONS: ANC-based surveillance remains an important tool for monitoring HIV/AIDS programs. ANC and UHSBS data were similar overall and for 15-year to 29-year olds, women who were pregnant, and women who had a birth in the 2 years before the survey. ANC estimates were lower in those > or = 30 years and in urban areas. Periodic serosurveys to adjust ANC-based estimates are needed. Language: English Keywords: UGANDA | RESEARCH REPORT | ESTIMATION TECHNIQUES | COMPARATIVE STUDIES | HEALTH SURVEYS | HIV INFECTIONS | PREVALENCE | ANTENATAL CARE | MONITORING | BIAS | HIV TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Health | Viral Diseases | Diseases | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Evaluation | Error Sources | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 342359 |
| 14. Title: Decentralizing Kenya's health management system: an evaluation. January 2009. Based on further analysis of the 2004 Kenya Service Provision Assessment Survey. Author: Ndavi PM; Ogola S; Kizito PM; Johnson K Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [37] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 1) Abstract: Kenya's Ministry of Health (MOH) commitment to address the inherent constraints in the health sector has included deliberate decentralization efforts aimed at strengthening the effective implementation of activities at the district level, and fostering closer coordination and collaboration amongst the line ministries, donors, organizations, and other stakeholders. Among these efforts, local District Health Management Boards (DHMBs) and District Health Management Teams (DHMTs) gradually assumed responsibilities for the operation of the facilities under their jurisdiction through a single line grant, annual work plans, and procurement plans. To assess the current effectiveness of the district health management systems in meeting their responsibilities, we analyze data from a special District Health Management module of the 2004 Kenya Service Provision Assessment Survey to discern the degree to which the DHMTs and DHMBs meet norms and standards in the areas of governance and management, human resource development and management, commodity management, infrastructure development, health care financing, budgeting and management, and performance monitoring. Notably, data on DHMTs and DHMBs were missing for 20 percent of the districts. This level of nonresponse has the potential to weaken the validity of the findings, particularly when the excluded DHMTs are in provinces with some of the worst health indicators in the country. Their exclusion was due to difficult terrain and insecure environment, both of which imply that the right of the population to health care services is compromised. The results of this descriptive analysis indicate that although most of the DHMTs hold meetings frequently, the unavailability of the guidelines on the functioning of the DHMTs made it difficult to determine compliance of DHMTs with any existing norms and standards. The survey missed the opportunity to assess the activities and achievements of the HFMCs and HCMTs, which are important for decentralization. Although most of the DHMTs had documented plans for improving reproductive health, less than a quarter reported implementing their plans on time. Lack of funds and transport were the most cited reasons for failure by DHMTs to meet their supervision targets despite the near universal existence of documented supervision plans. In terms of support of human resources, continuing professional development is an accepted norm in the districts, but there is urgent need to strengthen and expand the scope of updates to serving staff through the establishment of district health training committees and regular monitoring of their activities. An assessment of available infrastructure indicated that repair and maintenance units existed in most districts, with nearly all of the districts contracted with the provincial workshop for repair and maintenance work. Communication facilities between most district hospitals and close to three quarters of the health centers with referral facilities under government management had capacity to communicate easily by telephone or two-way radio with a referral facility to arrange transport during emergencies. The situation was much better for NGO/mission-run facilities. Regarding financing issues, despite existence of both recurrent and development funds, funding for medicines, equipment, and maintaining buildings was inadequate for most districts. Sources for funding for district health services included central government funding supplemented by local government, revolving funds, and other sources. Increased annual budgetary allocations to the agreed 15 percent to ministries of health, in agreement with the Abuja accord, may increase financial resources required for medicines, equipment, and maintenance of buildings. Language: English Keywords: KENYA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | HEALTH SURVEYS | ADMINISTRATIVE PERSONNEL | POLICYMAKERS | HEALTH PERSONNEL | GOVERNMENT AGENCIES | DECENTRALIZATION | HEALTH SERVICES EVALUATION | DELIVERY OF HEALTH CARE | QUALITY OF HEALTH CARE | MONITORING | PERFORMANCE IMPROVEMENT | GOVERNMENT FINANCING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Health | Organization and Administration | Organizations | Political Factors | Sociocultural Factors | Program Evaluation | Programs | Evaluation | Management | Financial Activities | Economic Factors Document Number: 329888 |
| 15. Peer Reviewed Title: Insecticide-treated net coverage in Africa: mapping progress in 2000-07. Author: Noor AM; Mutheu JJ; Tatem AJ; Hay SI; Snow RW Source: Lancet. 2009 Jan 3;373(9657):58-67. Abstract: BACKGROUND: Insecticide-treated bednets (ITNs) provide a means to improve child survival across Africa. Sales figures of these nets and survey coverage data presented nationally mask inequities in populations at biological and economic risk, and do not allow for precision in the estimation of unmet commodity needs. We gathered subnational ITN coverage sample survey data from 40 malaria-endemic countries in Africa between 2000 and 2007. METHODS: We computed the projected ITN coverage among children aged less than 5 years for age-adjusted population data that were stratified according to malaria transmission risks, proximate determinants of poverty, and methods of ITN delivery. FINDINGS: In 2000, only 1.7 million (1.8%) African children living in stable malaria-endemic conditions were protected by an ITN and the number increased to 20.3 million (18.5%) by 2007 leaving 89.6 million children unprotected. Of these, 30 million were living in some of the poorest areas of Africa: 54% were living in only seven countries and 25% in Nigeria alone. Overall, 33 (83%) countries were estimated to have ITN coverage of less than 40% in 2007. On average, we noted a greater increase in ITN coverage in areas where free distribution had operated between survey periods. INTERPRETATION: By mapping the distribution of populations in relation to malaria risk and intervention coverage, we provide a means to track the future requirements for scaling up essential disease-prevention strategies. The present coverage of ITN in Africa remains inadequate and a focused effort to improve distribution in selected areas would have a substantial effect on the continent's malaria burden. Language: English Keywords: AFRICA | RESEARCH REPORT | LONGITUDINAL STUDIES | HEALTH SURVEYS | CHILDREN | HUMAN GEOGRAPHY | BED NETS | PESTICIDES | CHILD SURVIVAL | INEQUALITIES | MALARIA PREVENTION | MAPS | Developing Countries | Studies | Research Methodology | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Geography | Social Sciences | Science | Sociocultural Factors | Parasite Control | Public Health | Ingredients and Chemicals | Survivorship | Length of Life | Mortality | Population Dynamics | Socioeconomic Factors | Economic Factors | Malaria | Parasitic Diseases | Diseases Document Number: 330036 |
| 16. Title: Influence of provider training on quality of emergency obstetric care in Kenya. January 2009. Based on further analysis of the 2004 Kenya Service Provision Assessment Survey. Author: Olenja J; Godia P; Kibaru J; Egondi T Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [33] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 3) Abstract: In addition to infectious diseases, maternal and neonatal conditions account for a substantial part of the health gap between rich and poor countries. For example, more than 99 percent of maternal deaths occur in the developing world. The majority of the deaths are caused by direct obstetric complications, including haemorrhage, sepsis, eclampsia, obstructed labour, and unsafe abortion practices. In Kenya, complications related to pregnancy and childbirth are leading causes of morbidity and mortality, translating to 414 maternal deaths per 100,000 live births. Although 88 percent of Kenyan women attend antenatal care, only 40 percent deliver in the health facilities, and only 42 percent of all deliveries have skilled attendance at delivery. In the Kenyan context, access to and use of quality emergency obstetric care (EmOC) are essential to efforts aimed at reducing maternal morbidity and mortality. We examine data from the 2004 Kenya Service Provision Assessment (KSPA) to assess the availability of EmOC services in Kenya, and to demonstrate the importance of health worker training in the delivery of these life-saving services. We find that less than 20 percent of maternal health workers interviewed had received training in focused antenatal or postnatal care in the last three years. Among caregivers providing delivery services, only 18 percent had received training in lifesaving skills, and only 37 percent had received training in the prevention of mother-to-child transmission of HIV during the last three years. Our analysis also demonstrates that training is a critical element in the detection and management of complications. Recent training in relevant subject matter was found to be significantly and positively associated with the ability to provide quality care in the event of unsafe abortion and postpartum haemorrhage. Training was also positively associated with the ability to provide appropriate care in the event of a retained placenta. The obvious recommendation is to ensure that up-to-date, quality training is provided to a broad base of health workers at all types of facilities, particularly at the local facilities that are the first point of contact for women experiencing an obstetric emergency. It is recognized that there are logistical obstacles to increasing the number of health workers who receive training. Further, although we isolated the element of training for this analysis, it is clear from these findings that for optimal service outcome, quality-of-care training has to be undertaken within the context of improved infrastructure and as a support to service delivery. Language: English Keywords: KENYA | RESEARCH REPORT | HEALTH SURVEYS | HEALTH PERSONNEL | EMERGENCY PERSONNEL | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | EMERGENCY SERVICES | OBSTETRICS | QUALITY OF HEALTH CARE | EDUCATIONAL STATUS | PREGNANCY COMPLICATIONS | DELIVERY OF HEALTH CARE | HEALTH SERVICES EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Services | Medicine | Program Evaluation | Programs | Organization and Administration | Socioeconomic Status | Socioeconomic Factors | Diseases Document Number: 329886 |
| 17. Peer Reviewed Title: PREVALENCE OF CONSANGUINEOUS MARRIAGES IN SYRIA. Author: Othman H; Saadat M Source: Journal of Biosocial Science. 2009 May 12;:1-8. Abstract: SummaryConsanguineous marriage is the union of individuals having at least one common ancestor. The present cross-sectional study was done in order to illustrate the prevalence and types of consanguineous marriages in the Syrian Arab Republic. Data on consanguineous marriages were collected using a simple questionnaire. The total number of couples in this study was 67,958 (urban areas: 36,574 couples; rural areas: 31,384 couples) from the following provinces: Damascus, Hamah, Tartous, Latakia, Al Raqa, Homs, Edlep and Aleppo. In each province urban and rural areas were surveyed. Consanguineous marriage was classified by the degree of relationship between couples: double first cousins (F=1/8), first cousins (F=1/16), second cousins (F=1/64) and beyond second cousins (F<1/64). The coefficient of inbreeding (F) was calculated for each couple and the mean coefficient of inbreeding (alpha) estimated for the population of each province, stratified by rural and urban areas. The results showed that the overall frequency of consanguinity was 30.3% in urban and 39.8% in rural areas. Total rate of consanguinity was found to be 35.4%. The equivalent mean inbreeding coefficient (alpha) was 0.0203 and 0.0265 in urban and rural areas, respectively. The mean proportion of consanguineous marriages ranged from 67.5% in Al Raqa province to 22.1% in Latakia province. The alpha-value ranged from 0.0358 to 0.0127 in these two provinces, respectively. The western and north-western provinces (including Tartous, Lattakia and Edlep) recorded lower levels of inbreeding than the central, northern and southern provinces. The overall alpha-value was estimated to be about 0.0236 for the studied populations. First cousin marriages (with 20.9%) were the most common type of consanguineous marriages, followed by double first cousin (with 7.8%) and second cousin marriages (with 3.3%), and beyond second cousin was the least common type. Language: English Keywords: SYRIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HEALTH SURVEYS | COUPLES | MARRIAGE PATTERNS | CONSANGUINITY | PREVALENCE | HUMAN GEOGRAPHY | Developing Countries | Middle East | Research Methodology | Health | Family Characteristics | Family and Household | Sociocultural Factors | Marriage | Nuptiality | Demographic Factors | Population | Genetics | Biology | Measurement | Geography | Social Sciences | Science Document Number: 341478 |
| 18. Peer Reviewed Title: Patterns and distribution of HIV among adult men and women in India. Author: Perkins JM; Khan KT; Subramanian SV Source: PloS One. 2009;4(5):e5648. Abstract: BACKGROUND: While the estimated prevalence of HIV in India experienced a downward revision in 2007, the patterning and distribution of HIV in the population remains unclear. We examined the individual and state-level socioeconomic patterning of individual HIV status among adult men and women in India as well as the patterning of other individual demographic and behavioral determinants of HIV status. METHODOLOGY/PRINCIPAL FINDINGS: We conducted logistic regression models accounting for the survey design using nationally representative, cross-sectional data on 100,030 women and men from the 2005-2006 India National Family Health survey which, for the first time, provided objective assessments of HIV seroprevalence. Although there was a weak relationship between household wealth and risk of being HIV-positive, there was a clear negative relationship between individual education attainment and risk of being HIV-positive among both men and women. A 1000 Rupee change in the per capita net state domestic product was associated with a 4% and 5% increase in the risk for positive HIV status among men and women, respectively. State-level income inequality was associated with increased risk of HIV for men. Marital status and selected sexual behavior indicators were significant predictors of HIV status among women whereas the age effect was the most dominant predictor of HIV infection among men. CONCLUSIONS/SIGNIFICANCE: Although the prevalence of HIV in India is low, the lack of strong wealth patterning in the risk of HIV suggests a more generalized distribution of HIV risk than some of India's high-risk group HIV prevention policies have assumed. The positive association between state economic development and individual risk for HIV is intriguing and requires further scrutiny. Language: English Keywords: INDIA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ADULTS | HIV INFECTIONS | RISK FACTORS | SOCIOECONOMIC STATUS | AGE FACTORS | MARITAL STATUS | CONDOM USE | SEX BEHAVIOR | INEQUALITIES | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Health | Data Analysis | Research Methodology | Population Characteristics | Demographic Factors | Viral Diseases | Diseases | Socioeconomic Factors | Economic Factors | Nuptiality | Risk Reduction Behavior | Behavior Document Number: 342161 |
| 19. Peer Reviewed Title: An assessment of fetal loss among currently married women in India. Author: Rajaram S; Zottarelli LK; Sunil TS Source: Journal of Biosocial Science. 2009 May;41(3):309-27. Abstract: The present paper assesses fetal loss among currently married women in India. In addition, the effects of social, economic, demographic and health factors on fetal loss are studied. The study uses data from the second National Family Health Survey conducted in India during 1998-2000. The results show wide variations in fetal loss (induced abortion, spontaneous abortion and still-birth) measures across the country. The importance of mother's nutritional status, birth spacing, risky behaviours such as smoking, drinking and chewing tobacco and age at marriage for pregnancy outcomes in India is also discussed. The study results imply a broad understanding of reproductive health in India, and emphasize the importance of widening the scope of community-based reproductive health education programmes to improve the reproductive health of women. Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | CURRENTLY MARRIED | WOMEN | PREGNANCY OUTCOMES | FETAL DEATH | ABORTION | ABORTION, SPONTANEOUS | RISK FACTORS | PREGNANCY INTERVALS | Asia, Southern | Asia | Developing Countries | Health | Marital Status | Nuptiality | Demographic Factors | Population | Pregnancy | Reproduction | Mortality | Population Dynamics | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Fertility Measurements | Fertility Document Number: 341400 |
| 20. Peer Reviewed Title: Patient teenagers? A comparison of the sexual behavior of virginity pledgers and matched nonpledgers. Author: Rosenbaum JE Source: Pediatrics. 2009 Jan;123(1):e110-e120. Abstract: The US government spends more than $200 million annually on abstinencepromotion programs, including virginity pledges. This study compares the sexual activity of adolescent virginity pledgers with matched nonpledgers by using more robust methods than past research. The subjects for this study were National Longitudinal Study of Adolescent Health respondents, a nationally representative sample of middle and high school students who, when surveyed in 1995, had never had sex or taken a virginity pledge and who were >15 years of age (n = 3440). Adolescents who reported taking a virginity pledge on the 1996 survey (n = 289) were matched with nonpledgers (n = 645) by using exact and nearest-neighbor matching within propensity score calipers on factors including prepledge religiosity and attitudes toward sex and birth control. Pledgers and matched nonpledgers were compared 5 years after the pledge on self-reported sexual behaviors and positive test results for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, and safe sex outside of marriage by use of birth control and condoms in the past year and at last sex. Five years after the pledge, 82% of pledgers denied having ever pledged. Pledgers and matched nonpledgers did not differ in premarital sex, sexually transmitted diseases, and anal and oral sex variables. Pledgers had 0.1 fewer past-year partners but did not differ in lifetime sexual partners and age of first sex. Fewer pledgers than matched nonpledgers used birth control and condoms in the past year and birth control at last sex. The sexual behavior of virginity pledgers does not differ from that of closely matched nonpledgers, and pledgers are less likely to protect themselves from pregnancy and disease before marriage. Virginity pledges may not affect sexual behavior but may decrease the likelihood of taking precautions during sex. Clinicians should provide birth control information to all adolescents, especially virginity pledgers. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | HEALTH SURVEYS | COMPARATIVE STUDIES | ADOLESCENTS | VIRGINITY | ABSTINENCE | ATTITUDES | RELIGION | CONTRACEPTION | SEX BEHAVIOR | RISK BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | EXTRAMARITAL SEX BEHAVIOR | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Family Planning, Behavioral Methods | Family Planning | Psychological Factors | Sociocultural Factors | Reproductive Tract Infections | Infections | Diseases Document Number: 328034 |
| 21. Peer Reviewed Title: Does type of household affect maternal health? Evidence from India. Author: Saikia N; Singh A Source: Journal of Biosocial Science. 2009 May;41(3):329-53. Abstract: The present paper examines the association between the type of household and maternal health in India using data from the National Family Health Survey 1998-99. The indicators of maternal health used in the analysis are contraceptive use, visit to obtain antenatal care in the first trimester, safe delivery and nutritional status of women measured in terms of body mass index (BMI). Binary and multinomial logistic regressions are used to establish associations. The type of household is coded into three categories, viz. nuclear household, joint household with in-laws and joint household without in-laws. The other independent variables used in the analysis are age, children ever born, work status, education of women, religion, caste, standard of living, exposure to mass media, women's autonomy and presence of others at the time of interview. The findings clearly suggest that type of household is significantly associated with the utilization of the above-mentioned services that positively affect maternal health. Women in nuclear households are more likely to utilize these services compared with women in joint households. However, an association between type of household and BMI was not found. Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | EVER MARRIED | WOMEN | FAMILY AND HOUSEHOLD | SOCIOECONOMIC STATUS | INTERVIEWS | CONTRACEPTIVE USAGE | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | NUTRITION | Asia, Southern | Asia | Developing Countries | Health | Marital Status | Nuptiality | Demographic Factors | Population | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Data Collection | Research Methodology | Contraception | Family Planning | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care Document Number: 341402 |
| 22. Title: Women's autonomy in decision making for health care in South Asia. Author: Senarath U; Gunawardena NS Source: Asia-Pacific Journal of Public Health. 2009 Apr;21(2):137-43. Abstract: This article aims to discuss women's autonomy in decision making on health care, and its determinants in 3 South Asian countries, using nationally representative surveys. Women's participation either alone or jointly in household decisions on their own health care was considered as an indicator of women's autonomy in decision making. The results revealed that decisions of women's health care were made without their participation in the majority of Nepal (72.7%) and approximately half of Bangladesh (54.3%) and Indian (48.5%) households. In Sri Lanka, decision making for contraceptive use was a collective responsibility in the majority (79.7%). Women's participation in decision making significantly increased with age, education, and number of children. Women who were employed and earned cash had a stronger say in household decision making than women who did not work or worked not for cash. Rural and poor women were less likely to be involved in decision making than urban or rich women. Language: English Keywords: ASIA, SOUTHERN | RESEARCH REPORT | HEALTH SURVEYS | WOMEN | WOMEN'S HEALTH | GENDER ISSUES | WOMEN'S RIGHTS | INEQUALITIES | DECISION MAKING | Asia | Developing Countries | Health | Demographic Factors | Population | Sociocultural Factors | Human Rights | Political Factors | Socioeconomic Factors | Economic Factors | Behavior Document Number: 331088 |
| 23. Peer Reviewed Title: Association of maternal height with child mortality, anthropometric failure, and anemia in India. Author: Subramanian SV; Ackerson LK; Davey Smith G; John NA Source: JAMA. 2009 Apr 22;301(16):1691-701. Abstract: CONTEXT: Prior research on the determinants of child health has focused on contemporaneous risk factors such as maternal behaviors, dietary factors, and immediate environmental conditions. Research on intergenerational factors that might also predispose a child to increased health adversity remains limited. OBJECTIVE: To examine the association between maternal height and child mortality, anthropometric failure, and anemia. DESIGN, SETTING, AND POPULATION: We retrieved data from the 2005-2006 National Family Health Survey in India (released in 2008). The study population constitutes a nationally representative cross-sectional sample of singleton children aged 0 to 59 months and born after January 2000 or January 2001 (n = 50 750) to mothers aged 15 to 49 years from all 29 states of India. Information on children was obtained by a face-to-face interview with mothers, with a response rate of 94.5%. Height was measured with an adjustable measuring board calibrated in millimeters. Demographic and socioeconomic variables were considered as covariates. Modified Poisson regression models that account for multistage survey design and sampling weights were estimated. MAIN OUTCOME MEASURES: Mortality was the primary end point; underweight, stunting, wasting, and anemia were included as secondary outcomes. RESULTS: In adjusted models, a 1-cm increase in maternal height was associated with a decreased risk of child mortality (relative risk [RR], 0.978; 95% confidence interval [CI], 0.970-0.987; P < .001), underweight (RR, 0.971; 95% CI, 0.968-0.974; P < .001), stunting (RR, 0.971; 95% CI, 0.968-0.0973; P < .001), wasting (RR, 0.989; 95% CI, 0.984-0.994; P < .001), and anemia (RR, 0.998; 95% CI, 0.997-0.999; P = .02). Children born to mothers who were less than 145 cm in height were 1.71 times more likely to die (95% CI, 1.37-2.13) (absolute probability, 0.09; 95% CI, 0.07-0.12) compared with mothers who were at least 160 cm in height (absolute probability, 0.05; 95% CI, 0.04-0.07). Similar patterns were observed for anthropometric failure related to underweight and stunting. Paternal height was not associated with child mortality or anemia but was associated with child anthropometric failure. CONCLUSION: In a nationally representative sample of households in India, maternal height was inversely associated with child mortality and anthropometric failure. Language: English Keywords: INDIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | HEALTH SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | MOTHERS | CHILDREN | PREVALENCE | CHILD MORTALITY | BODY HEIGHT | ANTHROPOMETRY | ANEMIA | RISK FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Health | Economic Development | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Mortality | Population Dynamics | Physiology | Biology | Diseases Document Number: 331241 |
| 24. Title: Child health services in Kenya. January 2009. Based on further analysis of the 2004 Kenya Service Provision Assessment Survey. Author: Wamae A; Kichamu G; Kundu F; Muhunzu I Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [38] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 2) Abstract: Given the worrying trends in infant and child mortality rates, there is a clear need to assess current practices in the management of childhood illnesses and to identify opportunities for intervention. The 2004 Kenya Service Provision Assessment Survey (KSPA) findings indicate that most health care providers are not taking care of sick children holistically, but rather are treating children only for the presenting illness. Using data obtained from the 2004 KSPA, this study aims to establish the factors that are associated with the promotion of child health using a holistic approach, such as the Integrated Management of Childhood Illness (IMCI) strategy to manage a sick child. The IMCI strategy aims to reduce morbidity and infant and child mortality by implementing three main components: improving health workers' skills in case management; improving the health systems; and improving family and community childcare practices. Three composite dependent variables representing the holistic approach to child health care were created to measure the following: full assessment of sick child; proper counseling of the child's caretaker; and facility support services for holistic care of sick children. The independent variables used in the analysis include facility type, facility managing authority, region, qualifications of the provider, and sex of the provider. Almost all health providers surveyed missed critical opportunities to conduct a full assessment of the sick children who presented to them for care. According to the survey, enrolled nurses and doctors were doing better in full assessment and counseling of sick children compared to registered nurses and clinical officers. This difference can be attributed to the fact that doctors and enrolled nurses were likely to have received IMCI training in the previous year compared to registered nurses. Notably, about twice as many female health providers as male health providers assessed major signs and thrice as many female health workers assessed for all three danger signs. Female providers were also more likely than male providers to properly monitor child growth. Counseling caretakers on children's illnesses was generally poor, with only one in every five caretakers being counseled in clinics and one in every ten caretakers being counseled in health centres. Male providers were more likely to counsel caretakers than their female counterparts. Providers in private facilities were twice as likely to counsel caretakers as providers in public facilities. The full range of essential equipment was lacking in almost all facilities. Hospitals were more likely to be stocked with all essential equipment, followed by dispensaries and maternities with health centers and clinics the least likely. The results reveal that the quality of care provided to sick children at the first level of health facilities should be improved. Also, help is needed to determine the areas that should be emphasized during the training and supervision of IMCI and other child survival strategies. The KSPA results also suggest the need to improve the skills of more health workers managing children younger than five years and to mobilize more resources for child health. Language: English Keywords: KENYA | RESEARCH REPORT | HEALTH SURVEYS | CHILDREN | HEALTH PERSONNEL | CHILD HEALTH SERVICES | HEALTH SERVICES EVALUATION | QUALITY OF HEALTH CARE | INTEGRATED PROGRAMS | HEALTH SERVICES ADMINISTRATION | COMMUNITY HEALTH SERVICES | COUNSELING | SEX FACTORS | EXAMINATIONS AND DIAGNOSES | PRIVATE SECTOR | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Maternal-Child Health Services | Primary Health Care | Health Services | Program Evaluation | Programs | Organization and Administration | Management | Clinic Activities | Program Activities | Medical Procedures | Medicine | Macroeconomic Factors | Economic Factors Document Number: 329887 |
| 25. Title: Validation of neonatal tetanus elimination in selected states -- India, 2007. Source: Weekly Epidemiological Record. 2008 May 23;83(21):185-192. Abstract: In India, the global goal of eliminating neonatal tetanus has been validated for the states of Andhra Pradesh, Haryana, Karnataka, Kerala, Maharashtra, Tamil Nadu and West Bengal; thus, these states have had <1 case of neonatal tetanus (NT)/1000 live births in every district. In November 2007, community-based surveys were carried out to assess whether NT had been eliminated in the states of Goa, Punjab and Sikkim, and the Union Territory of Chandigarh; these surveys were undertaken by the Immunization Division of the Ministry of Health and Family Welfare of the Government of India and the departments of family welfare of the state governments in collaboration with UNICEF, WHO, PATH (the Program for Appropriate Technology in Health), the Indian Council of Medical Research and Immunization Basics. This survey was conducted following a data review in January 2007, during which the union territories of Lakshdweep and Pondicherry were also considered to have eliminated NT. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | MOTHERS | MATERNAL HEALTH | NEONATAL DISEASES AND ABNORMALITIES | TETANUS | PREVENTION AND CONTROL | IMMUNIZATION | IMPLEMENTATION | TRAINING ACTIVITIES | PROGRAM EVALUATION | Developing Countries | Asia, Southern | Asia | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Diseases | Infections | Primary Health Care | Health Services | Delivery of Health Care | Programs | Organization and Administration | Training Programs | Education Document Number: 327264 |
| 26. Title: 2006 Bangladesh Urban Health Survey (UHS). Volume I. Author: Bangladesh. National Institute of Population Research and Training [NIPORT]; University of North Carolina at Chapel Hill. Carolina Population Center. MEASURE Evaluation; International Centre for Diarrhoeal Disease Research, Bangladesh [ICDDR,B]; Associates for Community and Population Research [ACPR] Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2008 Dec. [310] p. (USAID Contract No. GPO-A-00-03-00003-00TR-08-68a) Abstract: Nearly all of the global population growth in the next three decades will occur in urban areas, primarily as a massive migration occurs from the rural areas of middle and lower-income societies to their cities. Many, if not most of these migrants, who are generally possessed of low human and financial capital on arrival in the city, will settle in slums, the areas of concentrated poverty and environmental vulnerability that are already a dominant feature of much of the urban landscape of the developing world. Bangladesh will be no exception to these trends. The growth in her urban population is set to outstrip by a wide margin that in rural areas. Moreover, the urban growth already experienced in recent decades demonstrates that slums will likely be an increasingly important feature of urban existence in Bangladesh. Anticipating these developments, USAID and the Government of Bangladesh tasked a research team based in Bangladesh and the United States (at the University of North Carolina at Chapel Hill) with conducting a survey designed to obtain a broad health profile of the urban population of Bangladesh. The ultimate fruit of this effort was the 2006 Urban Health Survey (2006 UHS), a rich, microlevel health-interview survey of communities, households, and individuals throughout the City Corporations and a sample of District Municipalities. The principal objectives of the 2006 UHS were: 1) To obtain a profile of health problems and health-care seeking behavior in urban areas of Bangladesh; 2) To identify vulnerable groups and examine their health profile and health-care seeking behavior; and 3) To examine the individual, household, and neighborhood-level factors associated with health outcomes and health behaviors in urban areas. Language: English Keywords: BANGLADESH | SUMMARY REPORT | HEALTH SURVEYS | QUESTIONNAIRES | HOUSEHOLDS | FAMILY CHARACTERISTICS | CHILD LABOR | SANITATION | WATER QUALITY | SOCIOECONOMIC FACTORS | EDUCATIONAL STATUS | HEALTH | EMPLOYMENT | MIGRATION | QUALITY OF LIFE | DISEASES | VIOLENCE AGAINST WOMEN | FERTILITY | REPRODUCTIVE HEALTH | INFANT NUTRITION | MENTAL HEALTH | Developing Countries | Asia, Southern | Asia | Family and Household | Sociocultural Factors | Labor Force | Human Resources | Economic Factors | Public Health | Water | Natural Resources | Environment | Socioeconomic Status | Macroeconomic Factors | Population Dynamics | Demographic Factors | Population | Social Welfare | Domestic Violence | Crime | Social Problems | Nutrition Document Number: 329544 |
| 27. Title: Indonesia Young Adult Reproductive Health Survey, 2007. Author: Indonesia. Badan Pusat Statistik [BPS]; Indonesia. National Family Planning Coordinating Board [BKKBN]; Indonesia. Ministry of Health; Macro International. MEASURE DHS Source: Calverton, Maryland, BPS and Macro International, 2008 Dec. xxiii, 199 p. Abstract: The IYARHS focuses on young women and men, ages 15-24, and covers topics including education, knowledge and attitudes about reproductive health and family planning, knowledge of HIV/AIDS and sexually transmitted infections, attitudes about sexual activity and marriage, smoking, and use of alcohol and drugs. Language: English Keywords: INDONESIA | RESEARCH REPORT | HEALTH SURVEYS | YOUTH | PERSONS LIVING WITH HIV/AIDS | REPRODUCTIVE HEALTH | SOCIOECONOMIC FACTORS | EDUCATIONAL STATUS | INFORMATION SOURCES | CONTRACEPTIVE USAGE | DRUG USE AND ABUSE | ALCOHOL USE AND ABUSE | HIV | AIDS | KNOWLEDGE | ATTITUDES | Developing Countries | Asia, Southeastern | Asia | Health | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Economic Factors | Socioeconomic Status | Information | Contraception | Family Planning | Behavior | Sociocultural Factors | Psychological Factors Document Number: 339980 |
| 28. Title: Iraq Family Health Survey 2006/7. Author: Iraq. Ministry of Health; Iraq. Central Organization for Statistics and Information Technology; Iraq. Kurdistan. Ministry of Health; Iraq. Kurdistan. Regional Statistics Office; World Health Organization [WHO] Source: [Amman, Jordan], WHO, [2008]. [64] p. Abstract: The Iraq Family Health Survey (IFHS) 2006/7 is a nationally representative survey of 9,345 households and 14,675 women of reproductive age and covers all governorates in Iraq. This is the second nationally representative health survey since the Family Gulf Survey in 1989, although it is the first survey to disseminate the results. The IFHS 2006/7 was conducted in the central and southern governorates during August and September 2006, in Anbar during October and November 2006, while fieldwork in the Kurdistan region was carried out during February and March 2007. The survey had gone through a detailed and intensive planning and preparatory phases which was particularly important given the dire security situation in Iraq at the time of the survey. Not only were rigorous training and pre-testing undertaken, but a planning approach based on a number of different scenarios was adopted to respond to anticipated challenges. All interview teams were carefully supervised and given continuous support through out the period of the survey. The principle objective of the survey is to provide critical information for policy-makers and programme managers working in health and development. It complements other surveys recently conducted in Iraq on the situation of women and children, namely the Iraq Child and Maternal Mortality Survey (ICMMS 1999), the Iraq Living Conditions Survey ILCS 2004, and the Multiple Indicators Cluster Survey MICS III 2006. Also the survey results will present data on a wide range of indicators related to women's and family health. It is also the first national survey ever conducted to present data on adult mortality, including the causes of deaths. The IFHS is the first national survey in Iraq to investigate domestic violence, as well as chronic illnesses. Detailed information was also collected on health expenditures and health care seeking behaviour, as well as a range of other health and demographic indicators. Blood test was carried out to measure the level of anaemia among women of reproductive age including pregnant and lactating women. (excerpt) Language: English Keywords: IRAQ | RESEARCH REPORT | HEALTH SURVEYS | HEALTH | HEALTH STATUS INDEXES | HEALTH AND WELFARE PLANNING | MORTALITY | MORBIDITY | DOMESTIC VIOLENCE | ANEMIA | MENTAL HEALTH | TOBACCO USE | PREGNANCY OUTCOMES | HIV | AIDS | SEXUALLY TRANSMITTED DISEASES | KNOWLEDGE | UTILIZATION OF HEALTH CARE | MARRIAGE PATTERNS | Middle East | Developing Countries | Social Planning | Economic Factors | Population Dynamics | Demographic Factors | Population | Diseases | Crime | Social Problems | Sociocultural Factors | Behavior | Pregnancy | Reproduction | HIV Infections | Viral Diseases | Reproductive Tract Infections | Infections | Health Services | Delivery of Health Care | Marriage | Nuptiality Document Number: 327824 |
| 29. Peer Reviewed Title: Domestic violence and chronic malnutrition among women and children in India. Author: Ackerson LK; Subramanian SV Source: American Journal of Epidemiology. 2008;167(10):1188-1196. Abstract: Domestic violence has harmful physical and psychological health correlates, but there is little evidence regarding a relation between domestic violence and malnutrition. To investigate this relation, the authors analyzed data from 69,072 women aged 15-49 years and 14,552 children aged 12-35 months in the 1998-1999 Indian National Family Health Survey. Physical domestic violence victimization was self-reported by the women. Aspects of nutritional status included in this study were anemia and underweight. Anemia was measured with a blood test for hemoglobin. Underweight was calculated from anthropometric measurements and was determined as body mass index for women, and it included stunting and wasting for children. Results indicate associations of multiple incidents of domestic violence in the previous year with anemia (odds ratio = 1.11, 95% confidence interval: 1.04, 1.18) and underweight (odds ratio = 1.21, 95% confidence interval: 1.13, 1.29) in women and a suggested relation among children. Possible mechanisms for this relation include withholding of food as a form of abuse and stress-mediated influences of domestic violence on nutritional outcomes. These findings indicate that reducing domestic violence is important not only from a moral and intrinsic perspective but also because of the instrumental health benefits likely to accrue. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | WOMEN | CHILDREN | DOMESTIC VIOLENCE | VIOLENCE AGAINST WOMEN | MALNUTRITION | ANEMIA | Developing Countries | Asia, Southern | Asia | Health | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Crime | Social Problems | |