| 1. Title: Reducing health inequities through action on the social determinants of health. Author: World Health Assembly (62nd: 2009: Geneva) Source: Geneva, Switzerland, World Health Assembly, 2009 May 22. 5 p. (WHA62.14) Agenda item 12.5 Abstract: The Sixty-second World Health Assembly calls upon the international community, including United Nations agencies, intergovernmental bodies, civil society and the private sector: (1) to take note of the final report of the Commission on Social Determinants of Health and its recommendations; (2) to take action in collaboration with WHO's Member States and the WHO Secretariat on assessing the impacts of policies and programmes on health inequities and on addressing the social determinants of health; (3) to work closely with WHO's Member States and the WHO Secretariat on measures to enhance health equity in all policies in order to improve health for the entire population and reduce inequities; (4) to consider health equity in working towards achievement of the core global development goals and to develop indicators to monitor progress, and to consider strengthening international collaboration in addressing the social determinants of health and in reducing health inequities. (Excerpts) Language: English Keywords: GLOBAL | CONFERENCES AND CONGRESSES | WHO | HEALTH | INEQUALITIES | SOCIOECONOMIC FACTORS | HEALTH POLICY | SOCIAL POLICY | GOALS | INTERNATIONAL COOPERATION | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Economic Factors | Policy | Planning | Organization and Administration Document Number: 331421 |
2.  Title: Integrating gender into HIV / AIDS programmes in the health sector: Tool to improve responsiveness to women’s needs. Author: World Health Organization [WHO]. Department of Gender, Women and Health Source: Geneva, Switzerland, WHO, 2009. [130] p. Abstract: This hands-on WHO tool helps programme managers and health-care providers in the public and private sectors integrate gender into HIV / AIDS programmes they wish to set up, implement and evaluate so they are more responsive to women's needs. In addition to describing basic steps in gender-responsive programming, which can be applied to all HIV / AIDS programmes, the tool suggests practical actions to address key gender issues in four service delivery areas: HIV testing and counseling; Prevention of mother-to-child transmission of HIV; HIV / AIDS treatment and care; Home-based care and support for people living with HIV. The tool also provides examples of gender-responsive interventions from the field, and resources such as: counseling role plays for risk reduction and HIV treatment adherence; examples of gender-sensitive communication messages; and protocols for addressing the risk of violence among women as a result of HIV status disclosure. Language: English Keywords: GLOBAL | MANUAL | HIV PREVENTION | AIDS PREVENTION | WOMEN'S HEALTH | GENDER ISSUES | INEQUALITIES | NEEDS | PROGRAM DESIGN | PROGRAM ACCESSIBILITY | HIV TESTING | COUNSELING | ANTIRETROVIRAL THERAPY | HOME CARE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV Infections | Viral Diseases | Diseases | AIDS | Health | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Programs | Organization and Administration | Program Evaluation | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Clinic Activities | Program Activities | HIV | Care and Support | Disease Transmission Control | Prevention and Control Document Number: 331798 |
3.  Peer Reviewed Title: Examining the geographical heterogeneity associated with risk of mistimed and unwanted pregnancy in Ghana. Author: Amoako Johnson F; Madise NJ Source: Journal of Biosocial Science. 2009 Mar;41(2):249-67. Abstract: After a decade of fertility decline, Ghana's fertility and the level of unmet need for contraception stalled in mid-transition in the late 1990s. Although the literature acknowledges this, the geographical patterns in unmet need have not been adequately documented. Spatial analysis of unmet need can reveal differences in usage and provision of contraceptive commodities, thereby pointing to geographical areas where contraceptive programmes should be strengthened. This study examines the geographical variation of the risk of mistimed and unwanted pregnancies between rural communities and also between urban communities of the three ecological zones of Ghana. The study also investigates if geographical differences in the risks of mistimed and unwanted pregnancies changed during the period when unmet need stalled at the national level. A multilevel regression model was applied to pooled data from the 1998 and 2003 Ghana Demographic and Health Surveys to examine the determinants of the risk of unintended pregnancies, while controlling for clustering of outcomes within communities. The results show that between the two surveys, there was no significant change in the levels of risk of mistimed and unwanted pregnancy. However, geographical heterogeneity in the risk of mistimed and unwanted pregnancy was observed, after controlling for relevant predictors. This showed concentration of mistimed pregnancies in some rural communities relative to others, and variation in the risk of unwanted pregnancies between urban communities. The results give a clear indication that bridging the inequality gap in contraceptive use requires programmes that are area-specific. Language: English Keywords: GHANA | RESEARCH REPORT | NEEDS | HETEROGENEITY | FERTILITY DECLINE | GEOGRAPHIC FACTORS | PREGNANCY, UNPLANNED | CONTRACEPTIVE USAGE | INEQUALITIES | NEEDS ASSESSMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Economic Factors | Population Characteristics | Demographic Factors | Population | Fertility Changes | Fertility | Population Dynamics | Reproductive Behavior | Contraception | Family Planning | Socioeconomic Factors | Evaluation Document Number: 331181 |
| 4. Peer Reviewed Title: Impact of the Family Health Project on infant mortality in Brazilian municipalities. Author: Aquino R; de Oliveira NF; Barreto ML Source: American Journal of Public Health. 2009 Jan;99(1):87-93. Abstract: The authors evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. They collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. They performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. The authors observed a statistically significant negative association between FHP coverage and infant mortality rate. After controlling for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MATHEMATICAL MODEL | EVALUATION INDEXES | INFANT | URBAN POPULATION | INFANT MORTALITY | AGE SPECIFIC DEATH RATE | PRIMARY HEALTH CARE | HEALTH STATUS INDEXES | INEQUALITIES | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Theoretical Models | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Death Rate | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors Document Number: 328585 |
| 5. Peer Reviewed Title: Education gender gaps in Pakistan: Is the labor market to blame? Author: Aslam M Source: Economic Development and Cultural Change. 2009 Jul;57(4):747-784. Abstract: Differential labor market returns to male and female education are one potential explanation for large gender gaps in education in Pakistan. We empirically test this explanation by estimating private returns to education separately for male and female wage earners. This article contributes to the literature by using a variety of methodologies (ordinary least squares, Heckman correction, two-stage least squares, and household fixed effects) in order to estimate economic returns to education. The latest nationally representative data-the Pakistan Integrated Household Survey (2002)-are used. Earnings function estimates consistently reveal a sizable gender asymmetry in economic returns to education, with returns to women's education being substantially and statistically significantly higher than men's. The return to an additional year of schooling ranges between 7% and 11% for men and between 13% and 18% for women. There are also large, direct returns to women's education at low levels of schooling, and the education-earnings profile is more convex for women than for men. However, a decomposition of the gender wage gap (into the component "explained" by differing male and female endowments and the residual component) suggests that there is highly differentiated treatment by employers. We conclude that the total labor market returns are much higher for men, despite returns to education being higher for women. This suggests that parents may have an investment motive in allocating more resources to boys than to girls within households. Language: English Keywords: PAKISTAN | RESEARCH REPORT | STATISTICAL REGRESSION | MULTIVARIATE ANALYSIS | MATHEMATICAL MODEL | LABOR FORCE | SPOUSE | EDUCATIONAL STATUS | GENDER ISSUES | SEX FACTORS | INEQUALITIES | INCOME | PARENTAL INVOLVEMENT | Developing Countries | Asia, Southern | Asia | Data Analysis | Research Methodology | Theoretical Models | Human Resources | Economic Factors | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior Document Number: 341095 |
| 6. Peer Reviewed Title: The health and health system of South Africa: historical roots of current public health challenges. Author: Coovadia H; Jewkes R; Barron P; Sanders D; McIntyre D Source: Lancet. 2009 Sep 5;374(9692):817-34. Abstract: The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa. Language: English Keywords: SOUTH AFRICA | HISTORICAL REVIEW | PUBLIC HEALTH | COLONIALISM | POLITICAL FACTORS | ECONOMIC FACTORS | SOCIAL DISCRIMINATION | SEX DISCRIMINATION | INEQUALITIES | FAMILY LIFE | VIOLENCE | HEALTH SERVICES | HUMAN RESOURCES | POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Health | Political Systems | Sociocultural Factors | Social Problems | Socioeconomic Factors | Family and Household | Behavior | Delivery of Health Care Document Number: 342803 |
| 7. Peer Reviewed Title: The impact of gender and income on survival and retention in a South African antiretroviral therapy programme. Author: Cornell M; Myer L; Kaplan R; Bekker LG; Wood R Source: Tropical Medicine and International Health. 2009 Jul;14(7):722-31. Abstract: OBJECTIVES: Despite the rapid expansion of antiretroviral therapy (ART) services in Africa, there are few data on whether outcomes differ for women and men and what factors may drive such variation. We investigated the association of gender and income with survival and retention in a South African ART programme. METHODS: A total of 2196 treatment-naive adults were followed for 1 year on ART. Proportional hazards regression was used to explore associations between baseline characteristics and survival and loss-to-follow-up (LTFU). RESULTS: Patients were predominantly female (67%). Men presented at an older age and with more advanced HIV disease, and during early ART the crude death rate was higher among men than women (22.8 vs 12.5/100 person-years; P = 0.002). However in multivariate analysis, gender was not significantly associated with survival after adjusting for baseline clinical and immunovirological status (HR = 1.46, 95% CI = 0.96-2.22; P = 0.076). In late ART (4-12 months), there was no gender difference in mortality rates (3.5 vs 3.8/100 person-years; P = 0.817). In multivariate analysis, survival was strongly associated with age (HR = 1.05, 95% CI = 1.02-1.09; P < 0.001), CD4 count >150 vs <50 cells/microl (HR = 0.35, 95% CI = 0.14-0.87; P = 0.023) and any monthly income vs none (HR = 0.47, 95% CI = 0.25-0.88; P = 0.018). Having some monthly income was protective against LTFU at 1 year on ART (adjusted HR = 0.56, 95% CI = 0.39-0.82; P = 0.002). CONCLUSION: Men's high early mortality on ART appears due largely to their presentation with more advanced HIV disease. Efforts are needed to enroll men into care earlier in HIV disease and to reduce socio-economic inequalities in ART programme outcomes. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | MORTALITY | INEQUALITIES | INCOME | SEX FACTORS | IMMUNOLOGIC FACTORS | SOCIOECONOMIC STATUS | AGE FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | HIV | Population Dynamics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Population Characteristics | Immunity | Immune System | Physiology | Biology Document Number: 342641 |
| 8. Peer Reviewed Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population. Author: Deboosere P; Gadeyne S; Oyen HV Source: European Journal of Population. 2008 May;25(2):175-196. Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level. Language: English Keywords: BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics Document Number: 340174 |
| 9. Peer Reviewed Title: Gender, empowerment, and health: what is it? How does it work? Author: Ehrhardt AA; Sawires S; McGovern T; Peacock D; Weston M Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51 Suppl 3:S96-S105. Abstract: As the HIV/AIDS epidemic has progressed, the role of gender inequality in its transmission has become increasingly apparent. Nearly half of those living with the virus worldwide are women, and women's subordination to men increases their risk of infection and makes it harder for them to access treatment once infected. Men, too, suffer from harmful gender norms-the expectation that they will behave in ways that heighten their risk of HIV infection and that they will be cavalier about seeking health care increases their vulnerability to the disease. In the Middle East and North Africa, HIV infection rates are low, but changing gender norms have the potential to accelerate the spread of the disease if gender inequality is not addressed. Improving women's education, workforce participation, and social and political opportunities is crucial to strengthening health in the region. Work with men to shift gender imbalances is a further important task for the region's policy-makers and civil society groups. Language: English Keywords: MIDDLE EAST | AFRICA, NORTH | RESEARCH REPORT | WOMEN | GENDER RELATIONS | INEQUALITIES | HIV INFECTIONS | AIDS | WOMEN'S EMPOWERMENT | Africa | Developing Countries | Demographic Factors | Population | Gender Issues | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Viral Diseases | Diseases | Women's Status Document Number: 342677 |
| 10. Peer Reviewed Title: Tackling health inequities in Chile: maternal, newborn, infant, and child mortality between 1990 and 2004. Author: Gonzalez R; Requejo JH; Nien JK; Merialdi M; Bustreo F; Betran AP Author: Chile Maternal, Newborn, and Child Health Writing Group Source: American Journal of Public Health. 2009 Jul;99(7):1220-6. Abstract: OBJECTIVES: We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions. METHODS: Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4,000,000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles. RESULTS: During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100,000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile. CONCLUSIONS: During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions. Language: English Keywords: CHILE | RESEARCH REPORT | DATA ANALYSIS | INFANT | CHILDREN | CHILD MORTALITY | MATERNAL MORTALITY | DEATH RATE | PARITY SPECIFIC BIRTH RATE | INEQUALITIES | PREVENTION AND CONTROL | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Socioeconomic Factors | Economic Factors | Diseases Document Number: 342239 |
| 11. Peer Reviewed Title: [Sexuality, bodily experiences, and gender: an ethnographic study of persons living with HIV in Greater Metropolitan Buenos Aires, Argentina] Sexualidad, experiencias corporales y género: un estudio etnográfi co entre personas viviendo con VIH en el Área Metropolitana de Buenos Aires, Argentina. Author: Grimberg M Source: Cadernos de Saude Publica. 2009 Jan;25(1):133-141. Abstract: Based on the results of an ethnographic study on daily experience with HIV in Greater Metropolitan Buenos Aires, Argentina, the article discusses behavioral approaches that reduce the sexuality of persons living with HIV to an issue of safety and protection. By articulating a social construction perspective and the notion of hegemony, the author proposes that sexuality can be understood as a process of individual and social construction shaped by power relations and social regulations. The analysis of the experiences of living with HIV in marginalized populations shows how chronic social inequality, violence, discrimination, and stigmatization generate particular characteristics of sexual issues. These social processes become driving forces that shape sexual experience as a field of danger, repression, and restriction rather than pleasure and exploration. Finally, daily confrontation with social metaphors places strain on gender relations, practices, and identities. Language: Portuguese Keywords: ARGENTINA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ETHNIC GROUPS | SEXUALITY | SEX BEHAVIOR | SAFETY | INEQUALITIES | South America, Southern | South America | Latin America | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Cultural Background | Population Characteristics | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Public Health | Health | Socioeconomic Factors | Economic Factors Document Number: 341871 |
| 12. Peer Reviewed Title: [Sexuality, bodily experiences, and gender: an ethnographic study of persons living with HIV in Greater Metropolitan Buenos Aires, Argentina] Sexualidad, experiencias corporales y genero: un estudio etnografico entre Author: Grimberg M Source: Cadernos De Saude Publica. 2009 Jan;25(1):133-41. Abstract: Based on the results of an ethnographic study on daily experience with HIV in Greater Metropolitan Buenos Aires, Argentina, the article discusses behavioral approaches that reduce the sexuality of persons living with HIV to an issue of safety and protection. By articulating a social construction perspective and the notion of hegemony, the author proposes that sexuality can be understood as a process of individual and social construction shaped by power relations and social regulations. The analysis of the experiences of living with HIV in marginalized populations shows how chronic social inequality, violence, discrimination, and stigmatization generate particular characteristics of sexual issues. These social processes become driving forces that shape sexual experience as a field of danger, repression, and restriction rather than pleasure and exploration. Finally, daily confrontation with social metaphors places strain on gender relations, practices, and identities. Language: Spanish Keywords: ARGENTINA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | SEXUALITY | BEHAVIOR CHANGE | SAFETY | SOCIAL DISCRIMINATION | STIGMA | INEQUALITIES | VIOLENCE | PROGRAM APPROPRIATENESS | South America, Southern | South America | Latin America | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Personality | Psychological Factors | Behavior | Public Health | Health | Social Problems | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration Document Number: 342671 |
| 13. Peer Reviewed Title: Increasing uptake of HIV testing and counseling among the poorest in sub-Saharan countries through home-based service provision. Author: Helleringer S; Kohler HP; Frimpong JA; Mkandawire J Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jun 1;51(2):185-93. Abstract: BACKGROUND: Uptake of HIV testing and counseling (HTC) is lower among members of the poorest households in sub-Saharan countries, thereby creating significant inequalities in access to HTC and possibly antiretroviral treatment. OBJECTIVES: To measure uptake of home-based HTC and estimate HIV prevalence among members of the poorest households in a sub-Saharan population. METHODS: Residents of 6 villages of Likoma Island (Malawi) aged 18-35 and their spouses were offered home-based HTC services. Socioeconomic status, HIV testing history, and HIV risk factors were assessed. Differences in HTC uptake and HIV infection rates between members of households in the lowest income quartile and the rest of the population were estimated using logistic regression. RESULTS: Members of households in the lowest income quartile were significantly less likely to have ever used facility-based HTC services than the rest of the population (odds ratio = 0.60, 95% confidence interval (CI): 0.36 to 0.97). In contrast, they were significantly more likely to use home-based HTC services provided during the study (adjusted odds ratio = 1.70, 95% CI: 1.04 to 2.79). Socioeconomic differences in uptake of home-based HTC were not due to underlying differences in socioeconomic characteristics or HIV risk factors. The prevalence of HIV was significantly lower among members of the poorest households tested during home-based HTC than among the rest of the population (adjusted odds ratio = 0.37, 95% CI: 0.14 to 0.96). CONCLUSIONS: HTC uptake was high during a home-based HTC campaign on Likoma Island, particularly among the poorest. Home-based HTC has the potential to significantly reduce existing socioeconomic gradients in HTC uptake and help mitigate the impact of AIDS on the most vulnerable households. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | STATISTICAL REGRESSION | LOW INCOME POPULATION | COUNSELING | HIV TESTING | HOME VISITS | UTILIZATION OF HEALTH CARE | HIV INFECTIONS | PREVALENCE | ANTIRETROVIRAL THERAPY | INEQUALITIES | Africa | Developing Countries | Data Analysis | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Communication | Viral Diseases | Diseases | Measurement | HIV Document Number: 341774 |
| 14. Title: [Nutritional situation for mothers and children in South Africa] Ernaeringssituasjonen for mor og barn i Sor-Afrika. Author: Iversen PO Source: Tidsskrift For Den Norske Laegeforening. 2009 Jun 25;129(13):1362-5. Abstract: BACKGROUND: Even 15 years after the downfall of the apartheid regime, there are significant inequalities regarding resources, welfare and social benefits among the people of South Africa. Poverty prevails and conditions are bad with respect to sanitation, health and living conditions; a situation which is likely to affect nutritional health. We have reviewed the nutritional status in South Africa. MATERIAL AND METHODS: This article is based on literature retrieved from non-systematic reviews of the databases PubMed and High Wire Press, in addition to information from official documents and African journals. The author's recent field work in South Africa was also a source of information. RESULTS: Nationwide surveys, as well as smaller studies have documented high rates of stunting, malnutrition and deficiency of micronutrients among South African children. Daily hunger is reported from more than half of South African households. There is also a rise in the number of overweight and obese children and mothers. HIV/aids is highly prevalent and often coexists with tuberculosis. Many of these patients have a poor nutritional status, which in turn reduces the effect of antiviral treatment. INTERPRETATION: The high rate of malnutrition and HIV/aids among mothers and children in South Africa will delay improvement of general health in this population with generations. Language: Norwegian Keywords: SOUTH AFRICA | RESEARCH REPORT | LITERATURE REVIEW | PERSONS LIVING WITH HIV/AIDS | MOTHERS | CHILDREN | INEQUALITIES | NUTRITION INDEXES | CHILD HEALTH | MALNUTRITION | NUTRITION DISORDERS | HIV INFECTIONS | TUBERCULOSIS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Nutrition | Health | Infections Document Number: 342051 |
| 15. Title: On the spatial inequalities of institutional versus home births in Ghana: a multilevel analysis. Author: Johnson FA; Padmadas SS; Brown JJ Source: Journal of Community Health. 2009;34:64-72. Abstract: Spatial inequalities related to the choice of delivery care have not been studied systematically in Sub-Saharan Africa where maternal and perinatal health outcomes continue to worsen despite a range of safe motherhood interventions. Using retrospective data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the extent of changes in spatial inequalities associated with type of delivery care in Ghana with a focus on rural-urban differentials within and across the three ecological zones (Savannah, Forest and Coastal). More than one-half of births in Ghana continue to occur outside health institutions without any skilled obstetric care. While this is already known, we present evidence from multilevel analyses that there exist considerable and growing inequalities, with regard to birth settings between communities, within rural and urban areas and across the ecological zones. The results show evidence of poor and disproportionate use of institutional care at birth; the inequalities remained high and unchanged in both urban and rural communities within the Savannah zone and widening in urban communities of the Forest and Coastal zones. The key policy challenges in Ghana, therefore, include both increasing the uptake of institutional delivery care and ensuring equity in access to both public and private health institutions. Language: English Keywords: GHANA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | CHILDBIRTH | HOME CARE | HOSPITALS | INEQUALITIES | DELIVERY OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Care and Support | Health Services | Health | Health Facilities | Socioeconomic Factors | Economic Factors | Primary Health Care Document Number: 340222 |
| 16. Title: Inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidities. Author: Knight M; Kurinczuk JJ; Spark P; Brocklehurst P Source: BMJ. 2009;338:b542. Abstract: OBJECTIVE: To describe on a national basis ethnic differences in severe maternal morbidity in the United Kingdom. DESIGN: National cohort study using the UK Obstetric Surveillance System (UKOSS). SETTING: All hospitals with consultant led maternity units in the UK. PARTICIPANTS: 686 women with severe maternal morbidity between February 2005 and February 2006. MAIN OUTCOME MEASURES: Rates, risk ratios, and odds ratios of severe maternal morbidity in different ethnic groups. RESULTS: 686 cases of severe maternal morbidity were reported in an estimated 775 186 maternities, representing an estimated incidence of 89 (95% confidence interval 82 to 95) cases per 100 000 maternities. 74% of women were white, and 26% were non-white. The estimated risk of severe maternal morbidity in white women was 80 cases per 100 000 maternities, and that in non-white women was 126 cases per 100,000 (risk difference 46 (27 to 66) cases per 100 000; risk ratio 1.58, 95% confidence interval 1.33 to 1.87). Black African women (risk difference 108 (18 to 197) cases per 100,000 maternities; risk ratio 2.35, 1.45 to 3.81) and black Caribbean women (risk difference 116 (59 to 172) cases per 100 000 maternities; risk ratio 2.45, 1.81 to 3.31) had the highest risk compared with white women. The risk in non-white women remained high after adjustment for differences in age, socioeconomic and smoking status, body mass index, and parity (odds ratio 1.50, 1.15 to 1.96). CONCLUSIONS: Severe maternal morbidity is significantly more common among non-white women than among white women in the UK, particularly in black African and Caribbean ethnic groups. This pattern is very similar to reported ethnic differences in maternal death rates. These differences may be due to the presence of pre-existing maternal medical factors or to factors related to care during pregnancy, labour, and birth; they are unlikely to be due to differences in age, socioeconomic or smoking status, body mass index, or parity. This highlights to clinicians and policy makers the importance of tailored maternity services and improved access to care for women from ethnic minorities. National information on the ethnicity of women giving birth in the UK is needed to enable ongoing accurate study of these inequalities. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | COHORT ANALYSIS | INCIDENCE | ETHNIC GROUPS | WOMEN | MORBIDITY | MATERNAL MORTALITY | INEQUALITIES | Developed Countries | Europe, Western | Europe | Research Methodology | Measurement | Cultural Background | Population Characteristics | Demographic Factors | Population | Diseases | Mortality | Population Dynamics | Socioeconomic Factors | Economic Factors Document Number: 330604 |
| 17. Peer Reviewed Title: Towards a common definition of global health. Author: Koplan JP; Bond TC; Merson MH; Reddy KS; Rodriguez MH Source: Lancet. 2009 Jun 6;373(9679):1993-5. Abstract: This commentary makes the argument for the necessity of a common definition of global health. Language: English Keywords: GLOBAL | CRITIQUE | TERMINOLOGY | PUBLIC HEALTH | GOALS | INEQUALITIES | INTERNATIONAL COOPERATION | DISEASE PREVENTION | Health | Planning | Organization and Administration | Socioeconomic Factors | Economic Factors | Political Factors | Sociocultural Factors | Prevention and Control | Diseases Document Number: 341669 |
| 18. Peer Reviewed Title: Conceptualising abortion stigma. Author: Kumar A; Hessini L; Mitchell EM Source: Culture, Health and Sexuality. 2009 May 12;:1. Abstract: Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor 'essential' and relies upon power disparities and inequalities for its formation. In this paper, we identify social and political processes that favour the emergence, perpetuation and normalisation of abortion stigma. We hypothesise that abortion transgresses three cherished 'feminine' ideals: perpetual fecundity; the inevitability of motherhood; and instinctive nurturing. We offer examples of how abortion stigma is generated through popular and medical discourses, government and political structures, institutions, communities and via personal interactions. Finally, we propose a research agenda to reveal, measure and map the diverse manifestations of abortion stigma and its impact on women's health. Language: English Keywords: CRITIQUE | KAP SURVEYS | POLICYMAKERS | ABORTION | STIGMA | SEX DISCRIMINATION | SOCIAL DISCRIMINATION | INEQUALITIES | POLITICAL FACTORS | SOCIAL PROBLEMS | FEMALE ROLE | PUBLIC OPINION | Surveys | Sampling Studies | Studies | Research Methodology | Administrative Personnel | Organization and Administration | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Social Behavior | Behavior | Attitudes | Psychological Factors Document Number: 341497 |
| 19. Title: Educational inequalities in the midst of persistent poverty: diversity across Africa in educational outcomes. Author: Lloyd CB; Hewett PC Source: New York, New York, Population Council, 2009. 27 p. (Poverty, Gender, and Youth Working Paper No. 14) Abstract: This paper explores inequalities in education across sub-Saharan Africa. Although we mainly focus on primary school completion rates, attention is also given to literacy as a more proximate indicator of human capital acquisition. Using data from the Demographic and Health Surveys and UNICEF's Multiple Indicator Cluster Surveys, we explore cross-country variations in primary school completion rates, gender and wealth gaps in education, and literacy rates in relation to one another and in relation to cross-country variations in national income per capita. While these data paint a picture of overall educational progress, particularly for girls, this general picture is juxtaposed against an extremely diverse landscape across Africa with respect to primary school completion rates and retained literacy. Although cross-country variation in primary school completion rates can be partially explained by variation in national per capita income, the same cannot be said for literacy rates. Even the poorest countries have significant variation in achieved literacy, suggesting that learning can occur even in resource-poor environments. At the same time, our findings are sobering: in many countries, international educational goals are unlikely to be reached by 2015, and poor learning outcomes are frequently widespread. (Author's abstract) Language: English Keywords: AFRICA | SUMMARY REPORT | INEQUALITIES | POVERTY | EDUCATION | EDUCATIONAL STATUS | PRIMARY SCHOOLS | SCHOOL ENROLLMENT | LITERACY | GOALS | INCOME | Developing Countries | Socioeconomic Factors | Economic Factors | Socioeconomic Status | Schools | Planning | Organization and Administration Document Number: 331434 |
| 20. Peer Reviewed Title: Women, economic hardship and the path of survival: HIV/AIDS risk behavior among women receiving HIV/AIDS treatment in Uganda. Author: MacLachlan E; Neema S; Luyirika E; Ssali F; Juncker M; Rwabukwali C; Harvey M; Duncan T Source: AIDS Care. 2009 Mar;21(3):355-67. Abstract: The results are presented from a 2005 survey of 377 women in four HIV/AIDS treatment programs in Uganda. The aim of the study was to explore women's economic hardships and the association with four sexual risk behaviors: whether a woman was sexually active in the last 12 months, whether a condom was used during the last sex act, whether she reported having had a sexual partner in the last six months who she suspected had multiple partners and report of forced, coercive or survival sex in the last six months. Few women were sexually active (34%), likely due to the high proportion of widows (49%). Married women were likely to report forced, coercive or survival sex (35%). Eighty-four percent of women reported condom used at last sex act. Forced, coercive or survival sex was associated with number of meals missed per week (AOR=1.125, 95% CI 1.11, 1.587, p<0.05). Sex with a partner in the last six months who a woman suspected had multiple partners was also associated with number of missed meals per week (AOR=2.080, 95% CI 1.084, 3.992). Currently women in Ugandan antiretroviral therapy programs are not likely to be sexually active, except for married women. Many women need to find food and other support, which may put them at risk of forced, coercive or survival sex due to dependency on men. Language: English Keywords: UGANDA | RESEARCH REPORT | WOMEN | PERSONS LIVING WITH HIV/AIDS | RISK BEHAVIOR | SEX BEHAVIOR | CONDOM USE | POVERTY | HIV PREVENTION | GENDER ISSUES | INEQUALITIES | INTERVIEWS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Behavior | Risk Reduction Behavior | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Data Collection | Research Methodology Document Number: 341829 |
| 21. Title: Blind optimism: Challenging the myths about private health care in poor countries. Author: Marriott A Source: Oxford, United Kingdom, Oxfam International, 2009 Feb. 55 p. (Oxfam Briefing Paper No. 125) Abstract: 'The realization of the right to health for millions of people in poor countries depends upon a massive increase in health services to achieve universal and equitable access. A growing number of international donors are promoting an expansion of private-sector health-care delivery to fulfil this goal. The private sector can play a role in health care. But this paper shows there is an urgent need to reassess the arguments used in favor of scaling-up private-sector provision in poor countries. The evidence shows that prioritizing this approach is extremely unlikely to deliver health for poor people. Governments and rich country donors must strengthen state capacities to regulate and focus on the rapid expansion of free publicly provided health care, a proven way to save millions of lives worldwide. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | EVALUATION | POPULATION | PRIVATE SECTOR | HEALTH SERVICES EVALUATION | PROGRAM ACCESSIBILITY | INEQUALITIES | CAPACITY BUILDING | WORLD BANK | GOVERNMENT PROGRAMS | QUALITY OF HEALTH CARE | DELIVERY OF HEALTH CARE | Macroeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration | Socioeconomic Factors | Program Sustainability | International Agencies | Organizations | Political Factors | Sociocultural Factors | Health Document Number: 331349 |
| 22. 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 |
| 23. Title: Mothers' community participation and child health. Author: Nobles J; Frankenberg E Source: Journal of Health and Social Behavior. 2009 Mar;50(1):16-30. Abstract: We use rich data from the Indonesia Family Life Survey to assess the relationship between mothers' access to social capital via participation in community activities and their children's health. We exploit the advantages of longitudinal data and community fixed effects to mitigate some of the concerns about spuriousness and reverse causality that predominate in this literature. We find that children from families with relatively low levels of human and financial capital fare better with respect to health status when their mothers are more active participants in community organizations. In fact, the association between maternal participation and child health is strong and positive only for children from relatively disadvantaged backgrounds, as measured by their mothers' educational and household economic resources. The results suggest that in poorer settings community involvement may benefit disadvantaged families, possibly by providing resources and information that would otherwise be inaccessible. Language: English Keywords: INDONESIA | RESEARCH REPORT | FAMILY LIFE SURVEYS | MOTHERS | COMMUNITY PARTICIPATION | HUMAN CAPITAL | CHILD HEALTH | INEQUALITIES | Developing Countries | Asia, Southeastern | Asia | Family Research | Family and Household | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Organization and Administration | Human Resources | Economic Factors | Health | Socioeconomic Factors Document Number: 341532 |
| 24. 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 |
| 25. 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 |
| 26. Title: Inequalities in maternal health [editorial] Author: Pollock W; King JF Source: BMJ. 2009;338:b357. Abstract: Language: English Keywords: DEVELOPING COUNTRIES | UNITED KINGDOM | CRITIQUE | MATERNAL HEALTH | WOMEN | INEQUALITIES | MATERNAL MORTALITY | MORBIDITY | DEATH RATE | Developed Countries | Europe, Western | Europe | Health | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Diseases Document Number: 330605 |
| 27. Title: Making family planning accessible in resource-poor settings. Author: Prata N Source: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 2009 Oct 27;364(1532):3093-9. Abstract: It is imperative to make family planning more accessible in low resource settings. The poorest couples have the highest fertility, the lowest contraceptive use and the highest unmet need for contraception. It is also in the low resource settings where maternal and child mortality is the highest. Family planning can contribute to improvements in maternal and child health, especially in low resource settings where overall access to health services is limited. Four critical steps should be taken to increase access to family planning in resource-poor settings: (i) increase knowledge about the safety of family planning methods; (ii) ensure contraception is genuinely affordable to the poorest families; (iii) ensure supply of contraceptives by making family planning a permanent line item in healthcare system's budgets and (iv) take immediate action to remove barriers hindering access to family planning methods. In Africa, there are more women with an unmet need for family planning than women currently using modern methods. Making family planning accessible in low resource settings will help decrease the existing inequities in achieving desired fertility at individual and country level. In addition, it could help slow population growth within a human rights framework. The United Nations Population Division projections for the year 2050 vary between a high of 10.6 and a low of 7.4 billion. Given that most of the growth is expected to come from today's resource-poor settings, easy access to family planning could make a difference of billions in the world in 2050. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | FAMILY PLANNING PROGRAMS | PROGRAM ACCESSIBILITY | NEEDS | OBSTACLES | POVERTY | INEQUALITIES | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE AVAILABILITY | POPULATION GROWTH | MATERNAL MORTALITY | Family Planning | Program Evaluation | Programs | Organization and Administration | Economic Factors | Socioeconomic Factors | Contraceptive Usage | Contraception | Population Dynamics | Demographic Factors | Population | Mortality Document Number: 342846 |
| 28. Title: Building international research partnerships to develop HIV programs for women of color in the context of social inequalities and human rights. Author: Sanders-Phillips K; Pretorius L; Reddy P Source: Social Work In Public Health. 2009 Jan-Apr;24(1-2):60-75. Abstract: This article examines relationships among social inequality, drug use, and HIV risk for women of color in the United States and South Africa. In the first section, social and cultural factors that may place women of color at risk for drug use and exposure to HIV are identified. In the second section, lessons learned while developing HIV prevention research protocols for women of color in South Africa are presented and discussed. Experience suggests that to effectively address women's risks of drug use and AIDS requires specific theoretical models and methodological approaches that acknowledge the critical interface that may exist among social inequality, drug use, and AIDS risk for women worldwide. Successful HIV prevention and intervention programs for women of color worldwide also require international research partnerships that are based on mutual respect between partners and attention to the needs and priorities of the target populations. Language: English Keywords: SOUTH AFRICA | UNITED STATES OF AMERICA | CRITIQUE | RESEARCH ACTIVITIES | WOMEN | BLACKS | INEQUALITIES | HUMAN RIGHTS | DRUG USE AND ABUSE | HIV INFECTIONS | AIDS | SOCIOCULTURAL FACTORS | PROGRAM DEVELOPMENT | INTERNATIONAL COOPERATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Socioeconomic Factors | Economic Factors | Political Factors | Behavior | Viral Diseases | Diseases | Programs | Organization and Administration Document Number: 341953 |
| 29. 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 |
| 30. Title: Access to sexual and reproductive health for young people: bridging the disconnect between rights and reality. Author: Shaw D Source: International Journal of Obstetrics and Gynaecology. 2009;106(2):132-136. Abstract: Of the 1.5 billion young people globally, 78% live in Asia and Africa, the poorest regions of the world. The majority of young people infected with HIV are female, and adolescent girls have a significant increased risk for maternal mortality and morbidity, such as fistula. Denial of young people's sexuality and rights by conservative and traditional forces has lethal consequences, especially for women and girls. Countries have committed to these rights through numerous international instruments and many are making progress, but challenges at the community level are significant. Language: English Keywords: GLOBAL | CRITIQUE | YOUTH | REPRODUCTIVE HEALTH | SEXUALITY | SEX EDUCATION | PROGRAM APPROPRIATENESS | PROGRAM ACCESSIBILITY | HUMAN RIGHTS | INEQUALITIES | NEEDS | CONSERVATISM | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Personality | Psychological Factors | Behavior | Education | Program Evaluation | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Socioeconomic Factors | Economic Factors Document Number: 339884 |
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