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Title: The economic burden of HIV and AIDS on households in Nigeria.
Author: Adedigba MA; Naidoo S; Abegunde A; Olagundoye O; Adejuyigbe E; Fakande I
Source: African Journal of AIDS Research. 2009 Apr;8(1):107-114.
Abstract: The study estimates the economic burden of HIV and AIDS on households in a Nigerian population. The data derive from a cross-sectional survey of households affected by HIV or AIDS in Ife-Ijesa Zone, Osun State, Nigeria. The sample consisted of 117 purposively selected, consenting adult HIV patients attending a general and teaching hospital. Participants were asked to self-report monetary expenses for HIV-related care, loss of savings, and funeral costs. The data show a significantly sharp drop in the participants' household income as a result of care for HIV-related illnesses, from the time of knowing one's HIV status to the time of illness, among three occupational categories (artisans, civil servants and unemployed; p = 0.02). Mean income among those in the unemployed category fell by 84.1%, income among artisans dropped by 72.6%, and income among civil servants decreased by 44.4%. The monetary loss during the course of HIV-related illnesses was heaviest for the artisan group, followed by the unemployed and the civil servants. Those who had lost a substantial part of their savings to HIV-related care were most numerous among the unemployed, followed by artisans and civil servants. Out of 16 households, 11 (42.3%) had received support from relatives during a funeral ceremony. There was a significant association between the occupational group and working for more hours after illness ( 2 = 9.28, df = 4; p = 0.05). Nearly all orphaned children were distributed to the extended family following the AIDS death of a parent. Among all the occupational groups, borrowing from a cooperative society during the course of HIV-related sickness was the commonest form. The findings add to data showing that despite the extended family support system, adult deaths due to AIDS continue to undermine the viability of sub-Saharan African households.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | AIDS | HIV INFECTIONS | ECONOMIC FACTORS | EXPENDITURES | INCOME | POVERTY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Financial Activities | Socioeconomic Factors
Document Number: 341292

Peer Reviewed

Title: Media saturation, communication exposure and HIV stigma in Nigeria.
Author: Babalola S; Fatusi A; Anyanti J
Source: Social Science and Medicine. 2009 Apr;68(8):1513-20.
Abstract: HIV-related stigma constitutes an impediment to public health as it hampers HIV/AIDS control efforts in many ways. To address the complex problems of increasing HIV infection rate, widespread misinformation about the infection and the rising level of HIV-related stigma, the various tiers of government in Nigeria are working with local and international non-governmental organizations to develop and implement strategic communication programs. This paper assesses the link between these communication efforts and HIV-related stigma using data from a nationally representative household survey. The results show that accepting attitudes towards people living with HIV are more prevalent among men than among women. Exposure to HIV-related communication on the media is associated with increased knowledge about HIV, which is in turn a strong predictor of accepting attitudes. Communication exposure also has a significant and positive association with accepting attitudes towards people living with HIV. In contrast, community media saturation is not strongly linked with accepting attitudes for either sex. The findings strongly suggest that media-based HIV programs constitute an effective strategy to combat HIV/AIDS-related stigma and should therefore be intensified in Nigeria.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | SURVEYS | HOUSEHOLDS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | AIDS | STIGMA | MASS MEDIA | COMMUNICATION PROGRAMS | ATTITUDES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Social Problems | Communication | Psychological Factors | Behavior
Document Number: 341694

Peer Reviewed

Title: Domestic violence against women in eastern India: a population-based study on prevalence and related issues.
Author: Babu BV; Kar SK
Source: BMC Public Health. 2009;9:129.
Abstract: BACKGROUND: Violence against women is now widely recognised as an important public health problem, owing to its health consequences. Violence against women among many Indian communities on a regularly basis goes unreported. The objective of this study is to report the prevalence and other related issues of various forms of domestic violence against women from the eastern zone of India. METHODS: It is a population-based study covering both married women (n = 1718) and men (n = 1715) from three of the four states of Eastern India selected through a systematic multistage sampling strategy. Interviews were conducted using separate pre-piloted structured questionnaires for women (victimization) and men (perpetration). Women were asked whether their husband or any other family members committed violent acts against them. And men were asked whether they had ever perpetrated violent acts against their wives. Three principle domestic violence outcome variables (physical, psychological and sexual violence) were determined by response to a set of questions for each variable. In addition, data on socio-economic characteristics were collected. Descriptive statistics, bi- and multivariate analyses were done. RESULTS: The overall prevalence of physical, psychological, sexual and any form of violence among women of Eastern India were 16%, 52%, 25% and 56% respectively. These rates reported by men were 22%, 59%, 17% and 59.5% respectively. Men reported higher prevalence of all forms of violence apart from sexual violence. Husbands were mostly responsible for violence in majority of cases and some women reported the involvement of husbands' parents. It is found that various acts of violence were continuing among majority of women who reported violence. Some socio-economic characteristics of women have significant association with the occurrence of domestic violence. Urban residence, older age, lower education and lower family income are associated with occurrence of domestic violence. Multivariate logistic regressions revealed that the physical violence has significant association with state, residence (rural or urban), age and occupation of women, and monthly family income. Similar associations are found for psychological violence (with residence, age, education and occupation of the women and monthly family income) and sexual violence (with residence, age and educational level of women). CONCLUSION: The prevalence of domestic violence in Eastern India is relatively high compared to majority of information available from India and confirms that domestic violence is a universal phenomenon. The primary healthcare institutions in India should institutionalise the routine screening and treatment for violence related injuries and trauma. Also, these results provide vital information to assess the situation to develop public health interventions, and to sensitise the concerned agencies to implement the laws related to violence against women.
Language: English
Keywords:
INDIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | DOMESTIC VIOLENCE | PREVALENCE | PHYSICAL ABUSE | PSYCHOLOGICAL ABUSE | SEXUAL ABUSE | SOCIOECONOMIC STATUS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | Crime | Social Problems | Measurement | Violence | Behavior | Aggression | Socioeconomic Factors | Economic Factors
Document Number: 341406

Peer Reviewed

Title: Women's use of private and government health facilities for childbirth in Nairobi's informal settlements.
Author: Bazant ES; Koening MA; Fotso JC; Mills S
Source: Studies in Family Planning. 2009 Mar;40(1):39-50.
Abstract: The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home.
Language: English
Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | REFUGEES | TRADITIONAL BIRTH ATTENDANTS | HOUSEHOLDS | CHILDBIRTH | REFUGEE CAMPS | UTILIZATION OF HEALTH CARE | PRIVATE SECTOR | GOVERNMENT PROGRAMS | HEALTH FACILITIES | DEMOGRAPHIC FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Population | Migrants | Migration | Population Dynamics | Health Personnel | Delivery of Health Care | Health | Family and Household | Sociocultural Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Residence Characteristics | Population Distribution | Geographic Factors | Health Services | Macroeconomic Factors | Programs | Organization and Administration
Document Number: 341077

Peer Reviewed

Title: Family composition and remarriage in pre-transitional Italy: a comparative study.
Author: Breschi M; Fornasin A; Manfredini M; Zacchigna M
Source: European Journal of Population. 2009 Aug;25(3):277-296.
Abstract: It is well known that timing and intensity of remarriage were strictly dependent upon dempgraphic, socio-economic, cultural and legislative factors specific to each community. Thus, the aim of this paper is to compare the extent to which such factors may affect the remarriage patterns of three pre-transitional Italian populations that were different in many respects. By using micro-level data of the sharecropping communities of Casalguidi and Madregolo and the Alpine village of Treppo Carnico, we highlighted similarities and differences in the respective remarriage patterns, in particular, the far lower intensity in the mountain community with respect to the sharecropping ones. Our findings show that along with differences in the demographic system, household structure and land tenure, normative elements concerning widows and the dotal system could part explain the differentials we found.
Language: English
Keywords:
ITALY | RESEARCH REPORT | COMPARATIVE STUDIES | HOUSEHOLDS | REMARRIAGE | MICROECONOMIC FACTORS | LAND TENURE | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Family and Household | Sociocultural Factors | Marriage Patterns | Marriage | Nuptiality | Demographic Factors | Population | Economic Factors | Socioeconomic Factors
Document Number: 339898

8.
Title: Community characteristics, sexual initiation, and condom use among young Black South Africans.
Author: Burgard SA; Lee-Rife SM
Source: Journal of Health and Social Behavior. 2009 Sep;50(3):293-309.
Abstract: Individual and household-level characteristics that influence sexual behavior have been extensively studied in South Africa, but community characteristics have received limited attention. We use multilevel discrete time hazard models and multilevel logistic regression models to analyze data from a representative sample of young people in KwaZulu Natal, and from several sources of community data. Results suggest that, net of individual and household characteristics, higher levels of community concentrated disadvantage are associated with increased hazard of sexual initiation and higher risk of unprotected sex. Social disorder increases the hazard of sexual initiation, while greater community social cohesion is associated with delayed sexual debut, although the latter association appears stronger for young men than for young women. We discuss these results and the ways they vary from predictions based on US. theory in light of conditions prevailing in contemporary South Africa.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | DATA ANALYSIS | BLACKS | YOUTH | HOUSEHOLDS | SEX BEHAVIOR | AGE FACTORS | SOCIOECONOMIC FACTORS | RISK FACTORS | EXPOSURE | POPULATION CHARACTERISTICS | COMMUNITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Ethnic Groups | Cultural Background | Demographic Factors | Population | Family and Household | Sociocultural Factors | Behavior | Economic Factors | Health | Residence Characteristics | Population Distribution | Geographic Factors
Document Number: 342565

Peer Reviewed

Title: [Child health in poor areas: findings from a population-based study in Caracol, Piaui, and Garrafao do Norte, Para, Brazil] Saude infantil em areas pobres: resultados de um estudo de base populacional nos municipios de Caracol, Piaui, e Garrafao do Norte, Para, Brasil.
Author: Cesar JA; Chrestani MA; Fantinel EJ; Goncalves TS; Neumann NA
Source: Cadernos�de Saude Publica. 2009 Apr;25(4):809-818.
Abstract: The aim of this study was to evaluate child health indicators in the municipalities (counties) of Caracol, Piau� State, and Garraf�o do Norte, Par� State, Brazil. Through household visits using systematic sampling, previously trained interviewers applied a standard questionnaire to mothers of under-five children, investigating socioeconomic status, housing and environmental sanitation, demographic characteristics, disease patterns, and prenatal and childbirth care. The analysis used the t-test and chi-square test to compare indicators between the two municipalities. Of the 1,728 children studied, 60% were from families with incomes less than one monthly minimum wage (approximately U$200), 41% had no type of sewage treatment or disposal, 10% of mothers reported zero prenatal visits, 30% of the children were born in the same municipality, and 30% had been taken to a pediatric consultation in the previous 3 months; 20% had a height-for-age deficit > 2 standard deviations. All target indicators were deficient in both the municipalities (especially in Garraf�o do Norte). Expanding health care supply and improving housing and sanitation conditions are priorities in both municipalities.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | INTERVIEWS | MOTHERS | CHILD HEALTH | SOCIOECONOMIC STATUS | HOUSEHOLDS | SANITATION | POPULATION CHARACTERISTICS | ANTENATAL CARE | BEHAVIOR | UTILIZATION OF HEALTH CARE | INCOME | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Health | Socioeconomic Factors | Economic Factors | Public Health | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341867

10.
Peer Reviewed

Title: [Child health in poor areas: findings from a population-based study in Caracol, Piaui, and Garrafao do Norte, Para, Brazil] Saude infantil em areas pobres: resultados de um estudo de base populacional nos
Author: Cesar JA; Chrestani MA; Fantinel EJ; Goncalves TS; Neumann NA
Source: Cadernos De Saude Publica. 2009 Apr;25(4):809-18.
Abstract: The aim of this study was to evaluate child health indicators in the municipalities (counties) of Caracol, Piaui State, and Garrafao do Norte, Para State, Brazil. Through household visits using systematic sampling, previously trained interviewers applied a standard questionnaire to mothers of under-five children, investigating socioeconomic status, housing and environmental sanitation, demographic characteristics, disease patterns, and prenatal and childbirth care. The analysis used the t-test and chi-square test to compare indicators between the two municipalities. Of the 1,728 children studied, 60% were from families with incomes less than one monthly minimum wage (approximately U$200), 41% had no type of sewage treatment or disposal, 10% of mothers reported zero prenatal visits, 30% of the children were born in the same municipality, and 30% had been taken to a pediatric consultation in the previous 3 months; 20% had a height-for-age deficit > 2 standard deviations. All target indicators were deficient in both the municipalities (especially in Garrafao do Norte). Expanding health care supply and improving housing and sanitation conditions are priorities in both municipalities.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | EVALUATION | HOUSEHOLDS | LOW INCOME POPULATION | CHILD HEALTH | SOCIOECONOMIC STATUS | SANITATION | ANTENATAL CARE | INCOME | SOCIAL WELFARE | NEEDS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Family and Household | Sociocultural Factors | Social Class | Socioeconomic Factors | Economic Factors | Health | Public Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 342662

11.

Peer Reviewed

Title: High retention and appropriate use of insecticide-treated nets distributed to HIV-affected households in Rakai, Uganda: results from interviews and home visits.
Author: Cohee L; Mills LA; Kagaayi J; Jacobs I; Galiwango R; Ludigo J; Ssekasanvu J; Reynolds SJ
Source: Malaria Journal. 2009;8:76.
Abstract: BACKGROUND: Distribution of insecticide-treated nets (ITNs) has recently been incorporated into comprehensive care strategies for HIV-positive people in malaria-endemic areas. WHO now recommends free or low-cost distribution of ITNs to all persons in malaria-endemic areas, regardless of age, pregnancy and HIV status. Knowledge about and appropriate use of ITNs among HIV-positive ITN recipients and their household members has not been well characterized. METHODS: 142 randomly selected adults were interviewed in July-August 2006 to assess knowledge, retention, and appropriate use of ITNs they had received through a PEPFAR-funded comprehensive HIV care programme in rural Uganda. RESULTS: Among all participants, 102 (72%, CI: 65%-79%) reported they had no ITNs except those provided by the programme. Of 131 participants who stated they were given >or= 1 ITN, 128 (98%, CI: 96%-100%) stated they still possessed at least one programme-provided ITN. Reported programme-ITN (pITN) use by participants was high: 119 participants (91%, CI: 86%-96%) reported having slept under pITN the night prior to the survey and 115 (88%, CI: 82%-94%) reported sleeping under pITN seven days per week. Being away from home and heat were the most common reasons given for not sleeping under an ITN. A sub-study of thirteen random home visits demonstrated concordance between participants' survey reports and actual use of ITNs in homes. CONCLUSION: There was excellent self-reported retention and appropriate use of ITNs distributed as a part of a community-based outpatient HIV care programme. Participants perceived ITNs as useful and were unlikely to have received ITNs from other sources.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | HOUSEHOLDS | RURAL POPULATION | PESTICIDES | BED NETS | HOME VISITS | HIV INFECTIONS | MALARIA PREVENTION | KNOWLEDGE | PARTICIPATION | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Ingredients and Chemicals | Parasite Control | Public Health | Health | Communication | Malaria | Parasitic Diseases | Social Behavior | Behavior | Programs | Organization and Administration
Document Number: 341152

12.
Peer Reviewed

Title: Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations.
Author: El Mouzan MI; Al Omar AA; Al Salloum AA; Al Herbish AS; Qurachi MM
Source: Annals of Saudi Medicine. 2009 Jan-Feb;29(1):20-3.
Abstract: BACKGROUND AND OBJECTIVE: The WHO recommends exclusive breastfeeding in the first 6 months of life. Our objective was to evaluate trends in infant nutrition in Saudi Arabia and the degree of compliance with WHO recommendations. SUBJECTS AND METHODS: A nationwide nutritional survey of a sample of Saudi households was selected by the multistage probability sampling procedure. A validated questionnaire was administered to mothers of children less than 3 years of age. RESULTS: Of 5339 children in the sample, 4889 received breast milk at birth indicating a prevalence of initiation of 91.6%. Initiation of breastfeeding was delayed beyond 6 hours after birth in 28.1% of the infants. Bottle feeding was introduced by 1 month of age to 2174/4260 (51.4%) and to 3831/4260 (90%) by 6 months of age. The majority of infants 3870/4787 (80.8%) were introduced to "solid foods" between 4 to 6 months of age and whole milk feedings were given to 40% of children younger than 12 months of age. CONCLUSIONS: The current practice of feeding of Saudi infants is very far from compliance with even the most conservative WHO recommendations of exclusive breastfeeding for 4 to 6 months. The high prevalence of breastfeeding initiation at birth indicates the willingness of Saudi mothers to breastfeed. However, early introduction of complementary feedings reduced the period of exclusive breastfeeding. Research in infant nutrition should be a public health priority to improve the rate of breastfeeding and to minimize other inappropriate practices.
Language: English
Keywords:
SAUDI ARABIA | RESEARCH REPORT | NUTRITION SURVEYS | INFANT | HOUSEHOLDS | INFANT NUTRITION | WHO | STANDARDS | BREASTFEEDING, EXCLUSIVE | PREVALENCE | TIME FACTORS | SUPPLEMENTARY FEEDING | AGE FACTORS | BREASTFEEDING | Middle East | Developing Countries | Nutrition | Health | Youth | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | UN | International Agencies | Organizations | Political Factors | Research Methodology | Measurement | Population Dynamics
Document Number: 331138

13.

Peer Reviewed

Title: Health-seeking behaviour for childhood malaria: household dynamics in rural Senegal.
Author: Franckel A; Lalou R
Source: Journal of Biosocial Science. 2009 Jan;41(1):1-19.
Abstract: Research on health care behaviour in sub-Saharan Africa usually considers the mother as the reference in the household when a child is sick. The study of health care management within the family is a key issue for understanding therapeutic rationales. This study was conducted in the region of Fatick in Senegal among 902 children with malaria-related fever. The data were taken from a retrospective quantitative survey conducted in all compounds of the DSS (Demographic Surveillance Site) of Niakhar. The results show that child care-taking is fundamentally a collective process: in 70.9% of out-of-home resorts, the treatment decision was collective. The health care process of 68.1% of morbid episodes involved several individuals. The involvement of the mother, the father and other relatives in the collective management of health care followed different logics. Each care-giver had a specific and complementary function depending on gender norms, intergenerational relations and characteristics of the family unit. Family management of illness aims at optimizing financial and human resources given the economic, logistical and social constraints on health care. Nevertheless, collective management also favoured home-based care, prevented good treatment compliance and delayed the resort to health facilities. These results suggest that health education campaigns should focus on an early involvement of fathers in health care-giving and also on the strengthening of the autonomy of mothers. Mothers' empowerment should give women more autonomy in their child's treatment choice. Lastly, there is a need to develop community health facilities and establish shared funding at the community level.
Language: English
Keywords:
SENEGAL | SUMMARY REPORT | RURAL AREAS | HOUSEHOLDS | CHILDREN | MALARIA | UTILIZATION OF HEALTH CARE | BEHAVIOR | HEALTH SERVICES | TREATMENT | HOME CARE | DECISION MAKING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Geographic Factors | Population | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Delivery of Health Care | Health | Medical Procedures | Medicine | Care and Support
Document Number: 330567

14.

Title: Family planning and economic well-being: new evidence from Bangladesh.
Author: Gribble J; Maj-Lis V
Source: Washington, D.C., Population Reference Bureau, 2009 May. 4 p.
Abstract: A new policy brief from the Population Reference Bureau looks at the effects of long-term investment in an integrated family planning and maternal and child health program. Drawing on research and data that spans more than 30 years, the evidence reinforces the importance of sustained investment in reproductive health programs, showing that families in communities where the program was implemented became wealthier and healthier than families who lived in other, similar communities.
Language: English
Keywords:
BANGLADESH | SUMMARY REPORT | GOALS | HOUSEHOLDS | MATERNAL HEALTH | CHILD HEALTH | FAMILY PLANNING | POVERTY | PREVENTION AND CONTROL | ECONOMIC FACTORS | SOCIOECONOMIC FACTORS | DEVELOPMENT PLANS | INCOME | EDUCATION | WOMEN'S HEALTH | Developing Countries | Asia, Southern | Asia | Planning | Organization and Administration | Family and Household | Sociocultural Factors | Health | Diseases
Document Number: 328046

15.

Title: The social context of childcare practices and child malnutrition in Niger's recent food crisis.
Author: Hampshire K; Casiday R; Kilpatrick K; Panter-Brick C
Source: Disasters. 2009 Mar;33(1):132-51.
Abstract: In 2004-05, Niger suffered a food crisis during which global attention focused on high levels of acute malnutrition among children. In response, decentralised emergency nutrition programmes were introduced into much of southern Niger. Child malnutrition, however, is a chronic problem and its links with food production and household food security are complex. This qualitative, anthropological study investigates pathways by which children are rendered vulnerable in the context of a nutritional 'emergency'. It focuses on household-level decisions that determine resource allocation and childcare practices in order to explain why practices apparently detrimental to children's health persist. Risk aversion, the need to maintain self-identity and status, and constrained decision making result in a failure to invest extra necessary resources ingrowth-faltering children. Understanding and responding to the social context of child malnutrition will help humanitarian workers to integrate their efforts more effectively with longer-term development programmes aimed at improving livelihood security.
Language: English
Keywords:
NIGER | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | HOUSEHOLDS | CHILD NUTRITION | MALNUTRITION | FAMINE | DECENTRALIZATION | NUTRITION PROGRAMS | ANTHROPOLOGY, CULTURAL | DECISION MAKING | RESOURCE ALLOCATION | HOME ECONOMICS | CHILD CARE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Nutrition | Health | Nutrition Disorders | Diseases | Food Supply | Natural Resources | Environment | Political Factors | Primary Health Care | Health Services | Delivery of Health Care | Anthropology | Social Sciences | Science | Behavior | Financial Activities | Economic Factors | Microeconomic Factors | Child Rearing
Document Number: 331289

16.
Title: Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys.
Author: Hanson K; Marchant T; Nathan R; Mponda H; Jones C; Bruce J; Mshinda H; Schellenberg JA
Source: BMJ. 2009;339:b2434.
Abstract: OBJECTIVES: To evaluate the impact of the Tanzania National Voucher Scheme on the coverage and equitable distribution of insecticide treated nets, used to prevent malaria, to pregnant women and their infants. DESIGN: Plausibility study using three nationally representative cross sectional household and health facility surveys, timed to take place early, mid-way, and at the end of the roll out of the national programme. SETTING: The Tanzania National Voucher Scheme was implemented in antenatal services, and phased in on a district by district basis from October 2004 covering all of mainland Tanzania in May 2006. PARTICIPANTS: 6115, 6260, and 6198 households (in 2005, 2006, and 2007, respectively) in a representative sample of 21 districts (out of a total of 113). INTERVENTIONS: A voucher worth $2.45 ( pound1.47, euro1.74) to be used as part payment for the purchase of a net from a local shop was given to every pregnant woman attending antenatal services. MAIN OUTCOME MEASURES: Insecticide treated net coverage was measured as household ownership of at least one net and use of a net the night before the survey. Socioeconomic distribution of nets was examined using an asset based index. RESULTS: Steady increases in net coverage indicators were observed over the three year study period. Between 2005 and 2007, household ownership of at least one net (untreated or insecticide treated) increased from 44% (2686/6115) to 65% (4006/6198; P<0.001), and ownership of at least one insecticide treated net doubled from 18% (1062/5961) to 36% (2229/6198) in the same period (P<0.001). Among infants under 1 year of age, use of any net increased from 33% (388/1180) to 56% (707/1272; P<0.001) and use of an insecticide treated net increased from 16% (188/1180) to 34% (436/1272; P<0.001). After adjusting for potential confounders, household ownership was positively associated with time since programme launch, although this association did not reach statistical significance (P=0.09). Each extra year of programme operation was associated with a 9 percentage point increase in household insecticide treated net ownership (95% confidence interval -1.6 to 20). In 2005, only 7% (78/1115) of nets in households with a child under 1 year of age had been purchased with a voucher; this value increased to 50% (608/1211) in 2007 (P<0.001). In 2007, infants under 1 year in the least poor quintile were more than three times more likely to have used an insecticide treated net than infants in the poorest quintile (54% v 16%; P<0.001). CONCLUSIONS: The Tanzania National Voucher Scheme was associated with impressive increases in the coverage of insecticide treated nets over a two year period. Gaps in coverage remain, however, especially in the poorest groups. A voucher system that facilitates routine delivery of insecticide treated nets is a feasible option to "keep up" coverage.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HOUSEHOLDS | PREGNANT WOMEN | INFANT | MALARIA PREVENTION | BED NETS | COST EFFECTIVENESS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 342233

17.

Peer Reviewed

Title: Cost of dengue and other febrile illnesses to households in rural Cambodia: a prospective community-based case-control study.
Author: Huy R; Wichmann O; Beatty M; Ngan C; Duong S; Margolis HS; Vong S
Source: BMC Public Health. 2009;9:155.
Abstract: BACKGROUND: The average annual reported dengue incidence in Cambodia is 3.3/1,000 among children < 15 years of age (2002-2007). To estimate the economic burden of dengue, accurate cost-of-illness data are essential. We conducted a prospective, community-based, matched case-control study to assess the cost and impact of an episode of dengue fever and other febrile illness on households in rural Cambodia. METHODS: In 2006, active fever surveillance was conducted among a cohort of 6,694 children aged < or = 15 years in 16 villages in Kampong Cham province, Cambodia. Subsequently, a case-control study was performed by individually assigning one non-dengue febrile control from the cohort to each laboratory-confirmed dengue case. Parents of cases and controls were interviewed using a standardized questionnaire to determine household-level, illness-related expenditures for medical and non-medical costs, and estimated income loss (see Additional file 1). The household socio-economic status was determined and its possible association with health seeking behaviour and the ability to pay for the costs of a febrile illness. RESULTS: Between September and November 2006, a total of 60 household heads were interviewed: 30 with dengue-positive and 30 with dengue-negative febrile children. Mean total dengue-related costs did not differ from those of other febrile illnesses (31.5 vs. 27.2 US dollars, p = 0.44). Hospitalization almost tripled the costs of dengue (from 14.3 to 40.1 US dollars) and doubled the costs of other febrile illnesses (from 17.0 to 36.2 US dollars). To finance the cost of a febrile illness, 67% of households incurred an average debt of 23.5 US dollars and higher debt was associated with hospitalization compared to outpatient treatment (23.1 US dollars vs. 4.5 US dollars, p < 0.001). These costs compared to an average one-week expenditure on food of 9.5 US dollars per household (range 2.5-21.3). In multivariate analysis, higher socio-economic status (odds ratio [OR] 4.4; 95% confidence interval [CI] 1.4-13.2), duration of fever (OR 2.1; 95%CI 1.3-3.5), and age (OR 0.8; 95%CI 0.7-0.9) were independently associated with hospitalization. CONCLUSION: In Cambodia, dengue and other febrile illnesses pose a financial burden to households. A possible reason for a lower rate of hospitalization among children from poor households could be the burden of higher illness-related costs and debts.
Language: English
Keywords:
CAMBODIA | RESEARCH REPORT | PROSPECTIVE STUDIES | RURAL POPULATION | DENGUE | FEVER | FEES | HOUSEHOLDS | MICROECONOMIC FACTORS | MORBIDITY | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Body Temperature | Physiology | Biology | Financial Activities | Economic Factors | Family and Household | Sociocultural Factors
Document Number: 342904

18.

Peer Reviewed

Title: Household survey of hepatitis B vaccine coverage among Brazilian children.
Author: Luna EJ; Veras MA; Flannery B; de Moraes JC
Author: the Vaccine Coverage Survey 2007 Group
Source: Vaccine. 2009 Jul 16;
Abstract: We conducted a multi-stage household cluster survey to calculate hepatitis B vaccine coverage among children 18-30 months of age in 27 Brazilian cities. Hepatitis B vaccine is administered at birth, 1 month and 6 months of age by Brazil's national immunization program. Among 17,749 children surveyed, 40.2% received a birth dose until the first day of life, 94.8% received at least one dose of hepatitis B vaccine, and 86.7% completed the three-dose series by 12 months of age. Increased coverage with the birth dose and administration of hepatitis B in combination with diphtheria-tetanus-pertussis-Haemophilus influenzae type b antigens could improve protection against hepatitis B.
Language: English
Keywords:
BRAZIL | URBAN AREAS | RESEARCH REPORT | SURVEYS | COHORT ANALYSIS | HOUSEHOLDS | CHILDREN | HEPATITIS | IMMUNIZATION SCHEDULE | GOVERNMENT PROGRAMS | VACCINATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Viral Diseases | Diseases | Immunization | Primary Health Care | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration
Document Number: 342281

19.

Peer Reviewed

Title: Effect of HIV/AIDS-related mortality on household dependency ratios in rural South Africa, 2000-2005.
Author: Madhavan S; Schatz E; Clark B
Source: Population Studies. 2009 Mar;63(1):37-51.
Abstract: With data from a surveillance system that uses verbal autopsies to identify cause of death in rural South Africa, we investigated whether mortality from HIV/AIDS differs from other causes of death in its effect on household dependency ratio, and to what extent the effect is mediated by the baseline dependency ratio. Findings: (i) the impact of death from HIV/AIDS on the dependency ratio in 2005 is marginally positive compared with other causes of death, but (ii) the impact is overpowered by the effect of death at working age, and (iii) the baseline dependency ratio mediates the effects on the 2005 ratio of cause of death and of the individual's sex and age at death. Migration into and out of the household--anticipating or responding to a death--seems to be a key source of change in the household dependency ratio.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | RURAL AREAS | HOUSEHOLDS | HIV INFECTIONS | AIDS | DEPENDENCY BURDEN | MORTALITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Microeconomic Factors | Economic Factors | Population Dynamics | Demographic Factors
Document Number: 341033

20.

21.

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

22.

Title: Sex differentials in the use of centres for voluntary counselling and testing for HIV in Cameroon.
Author: Ngwakongnwi E; Quan H
Source: African Journal of AIDS Research. 2009 Apr;8(1):43-49.
Abstract: Part of the strategic response to HIV in Cameroon, West Africa, has been the institutionalisation of voluntary testing and counselling (VCT) for HIV services across the country. The study addresses the general level of awareness and use of VCT centres in Cameroon. The data were extracted from the national, cross-sectional, 2004 Cameroon Demographic and Health Survey (DHS). The survey collected information on respondents' demographic characteristics and awareness and utilisation of VCT services, through a standard behavioural surveillance survey, administered in face-to-face interviews with males aged 15 years or older and females aged 15 to 49 years. Chi-square and logistic regression were employed for data analysis. A total of 5 280 males and 10 656 females responded to the 2004 Cameroon DHS. More of the male than female respondents had a secondary or higher education (51.8% versus 39%), slightly more of the males than females resided in urban areas (57.3% versus 54.8%), and males were more likely than females to have heard of VCT centres (37.8% versus 26.8%) and were also much more likely to have had an HIV test at a VCT centre (5.9% males versus 1.3% females). The findings indicate that awareness and use of centres offering VCT for HIV is very low in Cameroon. Further research in Cameroon is needed to assess individuals' reasons for not using VCT, as well as studies to identify patterns of information flow regarding the dissemination of knowledge about HIV and AIDS and about VCT centres.
Language: English
Keywords:
CAMEROON | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | HOUSEHOLDS | VOLUNTARY COUNSELING AND TESTING | HIV PREVENTION | UTILIZATION OF HEALTH CARE | AWARENESS | KNOWLEDGE | SEX FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Family and Household | Sociocultural Factors | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Population Characteristics
Document Number: 341286

23.

Title: Purchase of drinking water is associated with increased child morbidity and mortality among urban slum-dwelling families in Indonesia.
Author: Semba RD; de Pee S; Kraemer K; Sun K; Thorne-Lyman A; Moench-Pfanner R; Sari M; Akhter N; Bloem MW
Source: International Journal of Hygiene and Environmental Health. 2009 Jul;212(4):387-97.
Abstract: In developing countries, poor families in urban slums often do not receive municipal services including water. The objectives of our study were to characterize families who purchased drinking water and to examine the relation between purchasing drinking water and child morbidity and mortality in urban slums of Indonesia, using data collected between 1999 and 2003. Of 143,126 families, 46.8% purchased inexpensive drinking water from street vendors, 47.4% did not purchase water, i.e., had running or spring/well water within household, and 5.8% purchased more expensive water in the previous 7 days. Families that purchased inexpensive drinking water had less educated parents, a more crowded household, a father who smoked, and lower socioeconomic level compared with the other families. Among children of families that purchased inexpensive drinking water, did not purchase drinking water, or purchased more expensive water, the prevalence was, respectively, for diarrhea in last 7 days (11.2%, 8.1%, 7.7%), underweight (28.9%, 24.1%, 24.1%), stunting (35.6%, 30.5%, 30.5%), wasting (12.0%, 10.5%, 10.9%), family history of infant mortality (8.0%, 5.6%, 5.1%), and of under-five child mortality (10.4%, 7.1%, 6.4%) (all P<0.0001). Use of inexpensive drinking water was associated with under-five child mortality (Odds Ratio [O.R.] 1.32, 95% Confidence Interval [C.I.] 1.20-1.45, P<0.0001) and diarrhea (O.R. 1.43, 95% C.I. 1.29-1.60, P<0.0001) in multivariate logistic regression models, adjusting for potential confounders. Purchase of inexpensive drinking water was common and associated with greater child malnutrition, diarrhea, and infant and under-five child mortality in the family. Greater efforts must be made to ensure access to safe drinking water, a basic human right and target of the Millennium Development Goals, in urban slums.
Language: English
Keywords:
INDONESIA | SLUMS | RESEARCH REPORT | SAMPLING STUDIES | CHILDREN | HOUSEHOLDS | WATER SUPPLY | EXPENDITURES | CHILD MORTALITY | INFANT MORTALITY | DIARRHEA | MALNUTRITION | PREVALENCE | Developing Countries | Asia, Southeastern | Asia | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Family and Household | Sociocultural Factors | Natural Resources | Environment | Financial Activities | Economic Factors | Mortality | Population Dynamics | Diseases | Nutrition Disorders | Measurement
Document Number: 342114

24.
Title: Towards a sustainable community database: taking advantage of the Road-to-Health cards to monitor and evaluate health interventions targeting under fives.
Author: Simba DO
Source: Tanzania Journal of Health Research. 2009 Jan;11(1):46-50.
Abstract: The Road-to-Health (RTH) card has served as a tool for monitoring nutrition and vaccination status individual child for several decades. The card has the potential to serve as a community database for research if kept by the caretaker for a considerable period. This study aimed to assess whether the magnitude of possession and retention of RTH cards is adequate to serve as a community database for monitoring and evaluating health interventions targeting under fives. This cross-sectional study was conducted among under fives in Korogwe town and its suburbs in Tanzania. Six wards and four villages were randomly selected and all under fives found were included. Using a structured questionnaire, demographic information was obtained from the parent/guardian of the child. Information was collected on the presence of RTH card from which the date of birth was recorded. A total of 4899 households were involved and information obtained for 6364 under fives. The overall card possession rate was 74.3%. Possession of RTH cards was found to be highest among the last born under fives (78.3%) than the third-from-last born under fives (45.1%). Caretakers who were married and educated had higher card possession rate. In conclusion the possession of RTH cards was adequate to serve as a community database for monitoring health status and evaluating health interventions targeting the under fives. However, the low retention rate poses a limitation for the cards to serve as a permanent community database. This paper discusses some of the strategies to increase retention of the cards by caretakers.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | COMMUNITY | HOUSEHOLDS | CHILD HEALTH | PERSONAL IDENTIFICATION SYSTEMS | INFORMATION RETRIEVAL SYSTEMS | MONITORING | INTERVENTIONS | PROGRAM EVALUATION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Family and Household | Sociocultural Factors | Health | Records | Information Processing | Information | Data Storage and Retrieval | Evaluation | Programs | Organization and Administration
Document Number: 341671

25.

Peer Reviewed

Title: A community perspective on young people's knowledge of HIV/AIDS in three African countries.
Author: Stephenson R
Source: AIDS Care. 2009 Mar;21(3):378-383.
Abstract: Individual, household and community-level influences on young people's (15-24) knowledge of HIV/AIDS in three African countries (Burkina Faso, Ghana and Zambia) are explored. The focus of the analysis is on the roles of demographic, economic and behavioral dimensions of the community environment in shaping knowledge of HIV/AIDS. Data from Demographic and Health Surveys, collected independently for males and females in each of the countries, are analyzed. There are clear pathways through which the community environment shapes knowledge, and the community influences on knowledge vary greatly by country and gender. For young women, residences in communities with demographic and behavioral patterns that are indicative of greater opportunities are associated with increased knowledge of HIV/AIDS. The results highlight community-level factors that can be harnessed in the development of community-based interventions to improve knowledge of HIV/AIDS among young people, and reinforce the need to focus on the community environment in designing behavioral change interventions. (author's)
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | DEMOGRAPHIC AND HEALTH SURVEYS | COMMUNITY | HOUSEHOLDS | YOUTH | HIV TRANSMISSION | DEMOGRAPHIC FACTORS | SOCIOECONOMIC FACTORS | SEX BEHAVIOR | RISK BEHAVIOR | SEX FACTORS | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Demographic Surveys | Population Dynamics | Population | Residence Characteristics | Population Distribution | Geographic Factors | Family and Household | Sociocultural Factors | Age Factors | Population Characteristics | HIV Infections | Viral Diseases | Diseases | Economic Factors | Behavior
Document Number: 325333

26.

Peer Reviewed

Title: Religious teachings and influences on the ABCs of HIV prevention in Malawi.
Author: Trinitapoli J
Source: Social Science and Medicine. 2009 Jul;69(2):199-209.
Abstract: This study examines the relationship between religion and HIV risk behaviors in rural Malawi, giving special attention to the role of religious congregations, the organizations with which rural Africans have most immediate contact. It draws on 2004 data from a household survey in 3 districts (N=3386), and quantitative and qualitative data collected in 2005 from 187 leaders of religious congregations previously identified in the survey. The first aim is descriptive--to identify overall patterns and variations in what religious leaders in rural Malawi teach about HIV and about sexual behavior in light of the epidemic. The second aim is to assess how religious organizations impact the behavior of individual members. I examine three outcomes that correspond with the ABCs of HIV prevention: abstinence (for never married persons), fidelity (for married persons), and condom use (among sexually active persons). Multi-level models reveal that religious affiliation and involvement are not correlated with the sexual behavior of congregation members, but that beliefs about appropriate sexual behavior and particular congregational characteristics are associated with adherence to A, B, and C. Individuals belonging to congregations led by clergy who 1) frequently deliver formal messages about HIV, 2) monitor the sexual behavior of members, and 3) privately encourage condom use report greater adherence to the ABCs of HIV prevention, suggesting that religious congregations are relevant for the sexual behavior of members and for better understanding the forces shaping individual behavior in the context of the African AIDS epidemic.
Language: English
Keywords:
MALAWI | RURAL AREAS | RESEARCH REPORT | SURVEYS | HOUSEHOLDS | INFLUENTIALS | HIV PREVENTION | ABSTINENCE, BE FAITHFUL, CONDOM USE | SEX BEHAVIOR | RELIGIOUS ASPECTS | BELIEFS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Knowledge Sources | Communication | HIV Infections | Viral Diseases | Diseases | Behavior | Religion | Culture
Document Number: 342855

27.
Title: Gender differences in educational attainments and occupational status in Thailand: a study based on Kanchanaburi DSS data.
Author: Viswanathan PK; Thongthai V
Source: Journal of Population and Social Studies. 2009 Jan;17(2):83-122.
Abstract: This paper examines the gender differences in educational attainments and occupational roles in Thailand based on the Kanchanaburi Demographic Surveillance System (hereafter referred as the KDSS) data. The important objectives of the study are: a) to examine the gender composition in educational attainments and delineate the magnitude and extent of inter-generational disparity in educational attainments across gender and strata over time; b) to dissect the gender wise occupational composition of the economically productive age groups and thereby to bring out the occupational dynamism among women across strata over the KDSS rounds; c) to examine the influence of demographic and socio-economic variables including education on occupational status of the households; and d) to reflect upon the important policy imperatives emerging from the study.
Language: English
Keywords:
THAILAND | RESEARCH REPORT | DEMOGRAPHIC SURVEYS | HOUSEHOLDS | EDUCATIONAL STATUS | OCCUPATIONAL STATUS | SEX FACTORS | WOMEN'S STATUS | INEQUALITIES | GEOGRAPHIC FACTORS | Developing Countries | Asia, Southeastern | Asia | Population Dynamics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Employment Status | Population Characteristics
Document Number: 339864

28.

Title: A Qualitative Analysis of the Economic Impact of HIV and Antiretroviral Therapy on Individuals and Households in Uganda.
Author: Wagner G; Ryan G; Huynh A; Kityo C; Mugyenyi P
Source: AIDS Patient Care and STDs. 2009 Aug 10;
Abstract: Abstract Despite the acceleration of antiretroviral therapy (ART) scale-up in sub-Saharan Africa, little is known about the social and economic effects of ART on individuals and households. In January 2008, we conducted semistructured interviews with 24 adult ART clients attending urban and rural HIV clinics operated by Joint Clinical Research Center in Uganda. Using content analysis we explored changes in physical health, work activity and asset management from before HIV to after ART. Twenty-one (88%) participants were working prior to HIV (mostly microenterprises and subsistence farming), of whom 18 had to stop work at least temporarily after onset of HIV. After ART, 20 (83% of the sample) were engaged in some type of work, but for many it was not at the same level as before HIV. Also, most that previously had salaried employment were unable to return to the formal labor market. Two thirds of the sample reported having to sell off at least some of their land, capital, or household property after HIV, and few were able to buy it back after ART. A majority (67%) reported that economic support from family was instrumental after the onset of HIV, and for 38% this support continued to be necessary after ART. These findings highlight that while ART helps people to regain a capacity to work, other economic supports are needed to enable individuals and households to reestablish their livelihoods, especially in resource-constrained settings.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | INTERVIEWS | QUALITATIVE RESEARCH | HOUSEHOLDS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | IMPACT | ECONOMIC FACTORS | QUALITY OF LIFE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | HIV | Communication | Social Welfare
Document Number: 342532

29.

Title: China's excess males, sex selective abortion, and one child policy: analysis of data from 2005 national intercensus survey.
Author: Zhu WX; Lu L; Hesketh T
Source: BMJ. 2009;338:b1211.
Abstract: OBJECTIVES: To elucidate current trends and geographical patterns in the sex ratio at birth and in the population aged under 20 in China and to determine the roles played by sex selective abortion and the one child policy. DESIGN: Analysis of household based cross sectional population survey done in November 2005. SETTING: All of China's 2861 counties. Population 1% of the total population, selected to be broadly representative of the total. MAIN OUTCOME MEASURE: Sex ratio defined as males per 100 females. RESULTS: 4 764 512 people under the age of 20 were included. Overall sex ratios were high across all age groups and residency types, but they were highest in the 1-4 years age group, peaking at 126 (95% confidence interval 125 to 126) in rural areas. Six provinces had sex ratios of over 130 in the 1-4 age group. The sex ratio at birth was close to normal for first order births but rose steeply for second order births, especially in rural areas, where it reached 146 (143 to 149). Nine provinces had ratios of over 160 for second order births. The highest sex ratios were seen in provinces that allow rural inhabitants a second child if the first is a girl. Sex selective abortion accounts for almost all the excess males. One particular variant of the one child policy, which allows a second child if the first is a girl, leads to the highest sex ratios. CONCLUSIONS: In 2005 males under the age of 20 exceeded females by more than 32 million in China, and more than 1.1 million excess births of boys occurred. China will see very high and steadily worsening sex ratios in the reproductive age group over the next two decades. Enforcing the existing ban on sex selective abortion could lead to normalisation of the ratios.
Language: English
Keywords:
CHINA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HOUSEHOLDS | ONE CHILD POLICY | ABORTION | SEX PREFERENCE | SEX RATIO | HUMAN GEOGRAPHY | AGE FACTORS | POPULATION PROJECTION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Family and Household | Sociocultural Factors | Antinatalist Policy | Population Policy | Social Policy | Policy | Political Factors | Fertility Control, Postconception | Family Planning | Value Orientation | Psychological Factors | Behavior | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Geography | Social Sciences | Science | Estimation Techniques
Document Number: 331270 Notification

30.


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