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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

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Title: Wealth Index association with gender issues and the reproductive health of Egyptian women.
Author: Afifi M
Source: Nursing and Health Sciences. 2009 Mar;11(1):29-36.
Abstract: This study investigated the association of the Wealth Index of married women in Egypt with a number of gender and reproductive health issues found in the 2005 Egypt Demographic Health Survey. The data from a subsample of 5249 currently married women from a total of 19,474 was examined using logistic regression analysis. The women's lowest wealth quintile predicted the intention to continue female genital cutting for their daughters, exposure to physical and sexual marital violence, not being empowered in household decisions, having a higher number of children, having an unintended last child, mothers' maltreatment of their children, the perception of a lack of health-care providers or drugs as an obstacle to receiving care, and not being covered by health insurance. The association of poverty with the aforementioned adverse health outcomes are discussed. Physicians should understand the effect of poverty on health and endeavour to influence policy-makers to reduce the poverty burden on health.
Language: English
Keywords:
EGYPT | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN | GENDER ISSUES | REPRODUCTIVE HEALTH | POVERTY | ANTENATAL CARE | SOCIOECONOMIC FACTORS | WOMEN'S HEALTH | HEALTH POLICY | Developing Countries | Africa, North | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Sociocultural Factors | Health | Economic Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Policy | Political Factors
Document Number: 342089

Peer Reviewed

Title: Socioeconomic and environmental factors important for acquiring non-severe malaria in children in Yemen: a case-control study.
Author: Al-Taiar A; Assabri A; Al-Habori M; Azazy A; Algabri A; Alganadi M; Whitty CJ; Jaffar S
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jan;103(1):72-8.
Abstract: Little is known about the relative importance of environmental and socioeconomic factors for acquiring malaria in Yemen. A case-control study was conducted to determine the importance of these factors for acquiring malaria among children in Yemen. Cases of non-severe malaria were recruited from health centres; community controls were from the neighbourhood of the cases. Data were collected by personal interview and direct inspection during home visits. In total, 320 cases and 308 controls were recruited. In the multivariate analysis, environmental factors (living near streams and freshwater marshes), earth roofs of houses and history of travel were all significantly and positively associated with the occurrence of malaria, whilst regular spraying with insecticides at home was a protective factor. There was no association with socioeconomic factors, including crowding, education and occupation of parents, and ownership of house assets. An index created based on a number of indicators of wealth showed a significant association with malaria in the univariate analysis but was not significant in the multivariate analysis. Control activities can be targeted on identifiable environmental factors such as stream and freshwater marshes, although this needs further investigation. Extra protective measures may be needed by all those who travel in Yemen.
Language: English
Keywords:
YEMEN | MIDDLE EAST | RESEARCH REPORT | CASE STUDIES | CHILDREN | MALARIA | SOCIOECONOMIC FACTORS | RISK FACTORS | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Economic Factors | Health
Document Number: 330835

Peer Reviewed

Title: Structural barriers and human rights related to HIV prevention and treatment in Zimbabwe.
Author: Amon JJ; Kasambala T
Source: Global Public Health. 2009 Mar 26;:1-17.
Abstract: There has long been recognition that individual risk factors can only partially explain vulnerability to HIV infection, and that a broader range of socioeconomic, cultural and political factors must be taken into account. More recently this understanding has been applied to addressing obstacles to accessing HIV treatment. Yet, while structural interventions aimed at contextual factors related to HIV prevention and treatment have been shown to be effective, they have not been widely implemented. Using the situation of Zimbabwe as an example, we will present an illustration of how contextual barriers can be understood in human rights terms, and how using a human rights analysis can specifically help define 'structural-rights' interventions and compel their implementation.
Language: English
Keywords:
ZIMBABWE | CRITIQUE | EVALUATION | PERSONS LIVING WITH HIV/AIDS | POLICYMAKERS | HUMAN RIGHTS | HIV PREVENTION | AIDS PREVENTION | SOCIOECONOMIC FACTORS | CULTURE | POLITICAL FACTORS | INTERVENTIONS | SOCIAL PROBLEMS | HEALTH POLICY | SOCIAL POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Administrative Personnel | Organization and Administration | Sociocultural Factors | AIDS | Economic Factors | Programs | Policy
Document Number: 341476

Peer Reviewed

Title: [Prevalence of intimate partner violence and associated factors: a population-based study in Lages, Santa Catarina State, Brazil, 2007] Prevalencia e fatores associados a violencia entre parceiros intimos: um estudo de base populacional em Lages, Santa Catarina, Brasil, 2007.
Author: Anacleto AJ; Njaine K; Longo GZ; Boing AF; Peres KG
Source: Cadernos�de Saude Publica. 2009 Apr;25(4):800-808.
Abstract: The aim of this study was to estimate the prevalence of intimate partner violence and associated factors in Lages, Santa Catarina State, Brazil. A population-based household study included 20-59-year-old women (n = 1,042) living in the urban area. The Conflict Tactics Scales - Form R was used to investigate verbal aggression, minor physical violence, and severe physical violence. A questionnaire covering socioeconomic and demographic variables was applied. Pearson qui-square and linear trend test were used to test associations. Prevalence rates for verbal aggression and minor and severe physical abuse within couples were 79.0%, 14.9%, and 9.3%, respectively. Couples under 30 years of age, with per capita income less than half the minimum wage (approximately U$90/month), and in households with more than two family members per bedroom were more likely to report all types of violence as compared to older couples, those with better incomes, and those living with less crowding, respectively. Preventive programs and qualitative studies could be effective strategies to shed further light on intimate partner violence.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | PREVALENCE | URBAN POPULATION | COUPLES | SEXUAL PARTNERS | WOMEN | AGE FACTORS | VIOLENCE | SOCIOECONOMIC FACTORS | INCOME | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Sex Behavior | Behavior | Economic Factors
Document Number: 341868

Peer Reviewed

Title: Improved sanitation and income are associated with decreased rates of hospitalization for diarrhoea in Brazilian infants.
Author: Andrade IG; Queiroz JW; Cabral AP; Lieberman JA; Jeronimo SM
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 May;103(5):506-11.
Abstract: Diarrhoeal diseases remain a major cause of morbidity and mortality in Brazilian children. However, from 1992 to 2001 there was a significant decline in hospitalizations for acute diarrhoea in children below 1 year of age in Brazil. A significant improvement in child health was also observed in the state of Rio Grande do Norte (RN), with a decrease in child mortality from 70 to 40 deaths per 1000. Using distributed lag analysis we analysed a number of factors possibly connected with decreased hospitalization in RN and found that hospitalization was correlated up to lag 3 with poverty (P<0.001) and inflation (P<0.001). Improvements in public health infrastructure such as better waste collection, presence of city water supply and increased sanitation, socio-economic variables such as education and literacy, and increased investment in health services were all important in reducing severe early childhood diarrhoeas and thus directly associated with the decrease in hospitalization. We also observed a positive seasonal correlation between rainfall and hospitalizations with an increased in rainfall impacting positively on hospitalization in all lags. The data suggests that increased buying power and reductions in poverty played a crucial role in reducing hospitalizations for acute diarrhoea in infants in RN.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | INFANT | DIARRHEA, INFANTILE | POVERTY | INFANT MORTALITY | SANITATION | HOSPITALS | PUBLIC HEALTH | SOCIOECONOMIC FACTORS | PREVENTION AND CONTROL | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diarrhea | Diseases | Economic Factors | Mortality | Population Dynamics | Health | Health Facilities | Delivery of Health Care
Document Number: 342512

7.
Title: Quality-of-life assessment of family adopters through user perspectives in the District of Karimnagar.
Author: Avasarala K
Source: Indian Journal of Community Medicine. 2009 Jan;34(1):24-28.
Abstract: Background: Small families adopting family planning are usually considered happy families. They are expected to lead a better qualitative life. Quality-of-life (QOL) is routinely assessed for knowing patients' health status. Recently, the QOL concept has become increasingly popular for evaluating the impact of public health interventions. Hitherto, QOL is usually assessed by means of program achievements or indicators, which may sometimes be misleading. Hence, the new culture of QOL assessment by means of user perspectives is now becoming popular. Research Questions: 1) Is the quality-of-life of family planning (FP) adopters better than that of non-FP adopters? 2) Are the user perspectives helpful in QOL assessment? Materials and Methods: A cross-sectional descriptive study was carried out among 50 FP adopting families and 50 non-FP adopting families from the village of Vutoor and the city of Karimnagar in Andhra Pradesh. Sampling Methods: Random sampling, Proportions and Chi square test. Results: Program perspectives revealed a better standard of living for FP adopters because they have amenities like housing, television, and vehicles and less mortality and morbidity (P < 0.001). However, they lack positive feelings towards life, general adaptation, personal relationships, and leisure opportunities. Finally, self-assessment by FP adopters themselves revealed no significant increase in their qualitative life after family planning (P = 0.05). Conclusions: While assessing the impact of a health program on quality-of-life, multiple methods of assessments including user perspectives are better than program indicators alone.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | FAMILY PLANNING | QUALITY OF LIFE | LIFE STYLE | SOCIOECONOMIC FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Social Welfare | Economic Factors | Behavior
Document Number: 328705

Title: Factors predicting BCG immunization status in northern Nigeria: a behavioral-ecological perspective.
Author: Babalola S; Lawan U
Source: Journal of Child Health Care. 2009 Mar;13(1):46-62.
Abstract: This study examines the predictors of Bacille Calmette-Guerin (BCG) immunization status among infants in northern Nigeria using a behavioral-ecological model. The findings show only 37.3 percent of the children had received BCG vaccine, and reveal that BCG immunization status in northern Nigeria is influenced by multiple layers of factors, including child's characteristics, parental or household factors, community characteristics, vaccine supply and the policy environment. At the child's level, place of birth and ownership of an immunization card are the two most significant predictors. The parental and household predictors of BCG immunization status include maternal use of antenatal care, maternal knowledge about immunization, maternal exposure to child health information, social influence and paternal approval of immunization. Both the regularity of vaccine supply to the health facility and the state of residence are associated independently with BCG immunization status. These findings stress the need for interventions at multiple levels in order to increase BCG immunization status.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | ACTION RESEARCH | INFANT | INFANT HEALTH | IMMUNIZATION | SOCIOECONOMIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Health | Health | Primary Health Care | Health Services | Delivery of Health Care | Economic Factors
Document Number: 341722

9.
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

10.

Peer Reviewed

Title: Project AID Khmer: addressing the health impact of HIV/AIDS on Cambodia through rural capacity building.
Author: Chang M; Kong NB; Phal V; Pugatch D; Allen S
Source: Global Public Health. 2009 May 27;:1-12.
Abstract: HIV/AIDS prevention efforts in Cambodia have largely focussed on urban populations. This focus, however, has diverted attention from the impact of the disease on rural communities, where poverty and a lack of basic infrastructure forced many to migrate to urban areas. Rural communities thus play a crucial part in the understanding of HIV/AIDS transmission dynamics in Cambodia. This paper will provide an analysis of socio-economic and health-related needs of rural communities in Cambodia, giving a different context for understanding the national burden of HIV/AIDS. These concepts will be illustrated with experiences from Project AID Khmer, a Cambodian non-governmental organisation that is working to improve Cambodian health through education programmes and community capacity building in rural Takeo province.
Language: English
Keywords:
CAMBODIA | RESEARCH REPORT | EVALUATION | RURAL POPULATION | NONGOVERNMENTAL ORGANIZATIONS | CAPACITY BUILDING | HIV PREVENTION | SOCIOECONOMIC FACTORS | PROGRAM EVALUATION | POVERTY | AGRICULTURE | LAND TENURE | RURAL-URBAN MIGRATION | HIV TRANSMISSION | RISK FACTORS | Developing Countries | Asia, Southeastern | Asia | Population Characteristics | Demographic Factors | Population | Organizations | Political Factors | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Economic Factors | Macroeconomic Factors | Migration | Population Dynamics | Health
Document Number: 341470

11.
Title: The impact of socioeconomic and demographic variables on poverty: a village study.
Author: Chaudhry IS; Malik S; ul Hassan A
Source: Lahore Journal of Economics. 2009 Summer;14(1):39-68.
Abstract: Poverty is a complex phenomenon based on a network of interlocking economic, social, political, and demographic factors. An understanding of the extent, nature, and determinants of rural poverty is a precondition for effective public policy to reduce poverty in rural Pakistan. The present study attempts to analyze the impact of socioeconomic and demographic characteristics of households on poverty, using primary data collected in the village ofBetti Nala in Tehsil Jatoi, district MuzaJfargarh in southern Punjab. We have used two distinct approaches: (i) a poverty profile, and (ii) an econometric approach in our empirical analysis. The results show that household size, dependency on household, participation, landholdings, and number oflivestock have a Significant impact on poverty incidence. Our final conclusion is that efforts should be made to improve socioeconomic foctors in general and demographic foctors in particular to alleviate rural poverty in remote areas of Pakistan, while land should beallotted to landless households.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | RURAL AREAS | RURAL POPULATION | LOW INCOME POPULATION | POVERTY | SOCIOECONOMIC FACTORS | INTERMEDIATE VARIABLES | NEEDS | IMPACT | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Population Characteristics | Demographic Factors | Social Class | Socioeconomic Status | Economic Factors | Population Dynamics | Communication
Document Number: 340236

12.

Title: [Trends in sex ratio at birth according to parental social positions: results from vital statistics birth, 1981-2004 in Korea]
Author: Chun H; Kim IH; Khang YH
Source: Journal of Preventive Medicine and Public Health. 2009 Mar;42(2):143-50.
Abstract: OBJECTIVES: South Korea has experienced unprecedented ups and downs in the sex ratio at birth (SRB), which has been a unique phenomenon in the last two decades. However, little is known about socioeconomic factors that influence the SRB. Employing the diffusion theory by Rogers, this study was undertaken to examine the trends in social variations in the SRB from 1981 to 2004 in Korea. METHODS: The data was taken from Vital Birth Statistics for the period from 1981-2004. We computed the annual male proportion of live births according to the parental education (university, middle/high school, primary) and occupation (non-manual, manual, others). Logistic regression analysis was employed to estimate the odds ratios of male birth according to social position for the equidistant three time periods (1981-1984, 1991-1994, and 2001-2004). RESULTS: An increased SRB was detected among parents with higher social position before the mid 1980s. Since then, however, a greater SRB was found for the less educated and manual jobholders. The inverse social gradient for the SRB was most prominent in early 1990s, but the gap has narrowed since the late 1990s. The mother's socioeconomic position could be a sensitive indicator of the social variations in the sex ratio at birth. CONCLUSIONS: Changes in the relationship of parental social position with the SRB were detected during the 1980-2004 in Korea. This Korean experience may well be explained by diffusion theory, suggesting there have been socioeconomic differences in the adoption and spread of sex-detection technology.
Language: Korean
Keywords:
DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA | RESEARCH REPORT | VITAL STATISTICS | SEX RATIO | SOCIOECONOMIC FACTORS | Developing Countries | Asia, Eastern | Asia | Population Statistics | Research Methodology | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Economic Factors
Document Number: 341819

13.

Title: Women's rights and women's health during HIV/AIDS epidemics: the experience of women in sub-Saharan Africa.
Author: Dugassa BF
Source: Health Care For Women International. 2009 Aug;30(8):690-706.
Abstract: Twenty-five years have passed since HIV/AIDS was recognized as a major public health problem. Although billions of dollars are spent in research and development, we still have no medical cure or vaccination. In the early days of the epidemic, public health slogans suggested that HIV/AIDS does not discriminate. Now it is becoming clear that HIV/AIDS spreads most rapidly among poor, marginalized, women, colonized, and disempowered groups of people more than others. The HIV/AIDS epidemic is exacerbated by the social, economic, political, and cultural conditions of societies such as gender, racial, class, and other forms of inequalities. Sub-Saharan African countries are severely hit by HIV/AIDS. For these countries the pandemic of HIV/AIDS demands the need to travel extra miles. My objective in this article is to promote the need to go beyond the biomedical model of "technical fixes" and the traditional public health education tools, and come up with innovative ideas and strategic thinking to contain the epidemic. In this article, I argue that containing the HIV/AIDS epidemic and improving family and community health requires giving appropriate attention to the social illnesses that are responsible for exacerbating biological disorders.
Language: English
Keywords:
AFRICA, SUB SAHARAN | CRITIQUE | HIV INFECTIONS | AIDS | EPIDEMICS | WOMEN'S HEALTH | WOMEN'S RIGHTS | PUBLIC HEALTH | SOCIOECONOMIC FACTORS | HIV TRANSMISSION | MALNUTRITION | SOCIOCULTURAL FACTORS | Africa | Developing Countries | Viral Diseases | Diseases | Health | Human Rights | Political Factors | Economic Factors | Nutrition Disorders
Document Number: 342818

14.

Peer Reviewed

Title: Toward replacement fertility in Egypt and Tunisia.
Author: Eltigani EE
Source: Studies in Family Planning. 2009 Sep;40(3):215-226.
Abstract: Egypt and Tunisia began their fertility transition at almost identical fertility levels and at roughly the same time period, yet the difference in the pace of decline has been such that the total fertility rate (TFR) in Tunisia reached replacement level by the year 2001, whereas the TFR in Egypt remains above three live births per woman. This article draws on the secondary literature and on several nationally representative surveys from the two countries between 1978 and 2005 to provide empirical evidence of the difference in the pace of fertility decline and to analyze the determinants of the differential. Findings include (a) variation across the two countries in the consistency of fertility decline among the segments of the population leading the transition; (b) that the success of each country�s family planning program was influenced by the role of political leaders and the extent of the program�s integration with socioeconomic development objectives; (c) that the impact of contraception on TFR decline became an important factor in the mid-1980s; and (d) that the greatest determinant of the discrepancy in the pace of fertility decline is the disparity in age at marriage, which rose more significantly in Tunisia than in Egypt. The latter finding indicates that reaching replacement fertility in Egypt hinges primarily on further declines in marital fertility, resulting from reduction of wanted fertility and from an expansion of family planning program coverage and improved efficiency of service delivery and use.
Language: English
Keywords:
EGYPT | TUNISIA | RESEARCH REPORT | LITERATURE REVIEW | BELOW REPLACEMENT FERTILITY | FERTILITY DECLINE | SOCIOECONOMIC FACTORS | MARITAL FERTILITY | FAMILY PLANNING PROGRAMS | HEALTH SERVICES | DELIVERY OF HEALTH CARE | Developing Countries | Africa, North | Africa | Population Decrease | Population Dynamics | Demographic Factors | Population | Fertility Changes | Fertility | Economic Factors | Family Planning | Health
Document Number: 339703

15.

16.

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

17.

Title: Poverty, bridging between injecting drug users and the general population, and "interiorization" may explain the spread of HIV in southern Brazil.
Author: Hacker MA; Leite I; Friedman SR; Carrijo RG; Bastos FI
Source: Health and Place. 2009 Jun;15(2):514-9.
Abstract: The aim of this paper is to study how structural determinants and the role of injecting drug users (IDUs) as a bridging population to the general population affected the AIDS subepidemic in southern Brazil during 1986-2000. Data from 288 southernmost Brazilian municipalities were analyzed. Using hierarchical modeling and inputs from a Geographic Information System, a multilevel model was constructed. The dependent variable was the logged AIDS standardized incidence rate (among the heterosexual population aged 15-69-years-old); independent variables included indicators for education, water provision, sewage, and garbage collection, per capita income, Gini coefficient (on income), Human Development Index, indicators of accessibility, and AIDS rate among IDUs. Significant predictors included AIDS rate among IDUs, distance from/to highways/railways, the Human Development Index and the ratio of residents who have access to sanitary installations. Poverty (as measured by socioeconomic indicators) and bridging from IDUs contribute to the spread of HIV/AIDS in Brazilian southern municipalities.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | MATHEMATICAL MODEL | EPIDEMIOLOGIC METHODS | IV DRUG USERS | HIV TRANSMISSION | POVERTY | HUMAN GEOGRAPHY | PREVALENCE | SOCIOECONOMIC FACTORS | PROGRAM ACCESSIBILITY | DISTANCE | SANITATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Theoretical Models | Drug Use and Abuse | Behavior | HIV Infections | Viral Diseases | Diseases | Economic Factors | Geography | Social Sciences | Science | Sociocultural Factors | Measurement | Program Evaluation | Programs | Organization and Administration | Geographic Factors | Population | Public Health | Health
Document Number: 330964

18.

Title: Childbearing and contraceptive decision making amongst Afghan men and women: a qualitative analysis.
Author: Haider S; Todd C; Ahmadzai M; Rahimi S; Azfar P; Morris JL; Miller S
Source: Health Care For Women International. 2009 Oct;30(10):935-53.
Abstract: Afghanistan has one of the highest maternal mortality ratios and lowest contraceptive prevalence rates globally. Limited information is known regarding Afghan men and women's attitudes toward childbearing, child spacing, and contraceptive use, which is essential for delivery of appropriate services. We conducted a qualitative study among postpartum couples enrolled at maternity hospitals in Kabul, Afghanistan. We identified important themes that highlight the complex inter-relationship between acknowledged risks of childbearing, desire for family planning, rationales for limited contraceptive use, and sociocultural barriers to contraceptive use. We offer practical recommendations for application of findings toward family planning and maternal mortality reduction programs.
Language: English
Keywords:
AFGHANISTAN | RESEARCH REPORT | QUALITATIVE RESEARCH | MEN | WOMEN | COUPLES | POSTPARTUM | DECISION MAKING | BIRTH SPACING | REPRODUCTIVE BEHAVIOR | CONTRACEPTIVE USAGE | SOCIOECONOMIC FACTORS | FAMILY PLANNING PROGRAMS | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Behavior | Family Planning | Fertility | Population Dynamics | Contraception | Economic Factors
Document Number: 342710

19.

Peer Reviewed

Title: Assessing HIV Risk in Workplaces for Prioritizing HIV Preventive Interventions in Karnataka State, India.
Author: Halli SS; Buzdugan R; Ramesh BM; Gurnani V; Sharma V; Moses S; Blanchard JF
Source: Sexually Transmitted Diseases. 2009 Jul 16;
Abstract: OBJECTIVE:: To develop a modelfor prioritizing economic sectors for HIV preventive intervention programs in the workplace. METHODS:: This study was undertaken in Karnataka state, India. A 3-stage survey process was undertaken. In the first stage, we reviewed secondary data available from various government departments, identified industries in the private sector with large workforces, and mapped their geographical distribution. In the second stage, an initial rapid risk assessment of industrial sectors was undertaken, using key-informant interviews conducted in relation to a number of enterprises, and in consultation with stakeholders. In the third stage, we used both quantitative (polling booth survey) and qualitative methods (key informant interviews, in-depth interviews, focus group discussions) to study high-risk sectors in-depth, and assessed the need and feasibility of HIV workplace intervention programs. RESULTS:: The highest risk sectors were found to be mining, garment/textile, sugar, construction/infrastructure, and fishing industries. Workers in all sectors had at best partial knowledge about HIV/AIDS, coupled with common misconceptions about HIV transmission. There were intersector and intrasector variations in risk and vulnerability across different geographical locations and across different categories of workers. This has implications for the design and implementation of workplace intervention programs. CONCLUSIONS:: There is tremendous scope for HIV preventive interventions in workplaces in India. Given the variation in HIV risk across economic sectors and limited available resources, there will be increased pressure to prioritize intervention efforts towards high-risk sectors. This study offers a model for rapidly assessing the risk level of economic sectors for HIV intervention programs.
Language: English
Keywords:
INDIA | RESEARCH REPORT | WORKERS | WORKPLACE | HIV PREVENTION | INTERVENTIONS | SOCIOECONOMIC FACTORS | PROGRAM EVALUATION | Asia, Southern | Asia | Developing Countries | Labor Force | Human Resources | Economic Factors | Employment | Macroeconomic Factors | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration
Document Number: 342228

21.

Title: Usefulness of highly active antiretroviral therapy on health-related quality of life of adult recipients in Tanzania.
Author: Magafu MG; Moji K; Igumbor EU; Hashizume M; Mizota T; Komazawa O; Cai G; Yamamoto T
Source: AIDS Patient Care and STDs. 2009 Jul;23(7):563-70.
Abstract: This study assessed health-related quality of life (HRQOL) of highly active antiretroviral therapy (HAART) recipients aged 18 or older and associated factors, 2 years after HAART administration had started in Kagera, Tanzania. Using the 36-Item Short Form Health Survey (SF-36), 329 HAART recipients were interviewed in May 2007. Questions on sociodemographic characteristics, chronic diseases (besides HIV/AIDS), HAART side effects and adherence to antiretroviral drugs were added. Treatment data, the first and latest available CD4 counts were retrieved from patients' records. Gender and age-adjusted mean scale scores of the sample were compared to those of the general Tanzanian population of the late 1990 s using t test. Logistic regression was used to explore the effect of sex, age, education level, income, chronic diseases, CD4 count, HAART side effects and adherence to antiretroviral drugs on recipients' physical functioning and mental health scale scores. The mean scale scores of HAART recipients were generally lower than those of the general population except for general health perceptions (p = 0.191) and mental health (p = 0.161). HAART recipients with chronic disease comorbidity were more likely to score below the general population's mean score for mental health (p = 0.007). While the effect of chronic disease comorbidity on physical functioning among those who recorded a CD4 count increase was negative (odds ratio [OR] = 13.6, 95% confidence interval [CI] = 3.7, 49.9), there was no effect on those who did not have such an increase. The control of chronic diseases among recipients should be given priority to improve their HRQOL.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | HEALTH SURVEYS | CLIENTS | SOCIOECONOMIC FACTORS | DISEASES | HIV INFECTIONS | AIDS | HIV | ANTIRETROVIRAL THERAPY | TREATMENT | QUALITY OF LIFE | PERCEPTION | MENTAL HEALTH | TESTING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Health | Program Activities | Programs | Organization and Administration | Economic Factors | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Social Welfare | Psychological Factors | Behavior | Measurement | Research Methodology
Document Number: 342980

22.

Title: Levels and spread of HIV seroprevalence and associated factors: evidence from national household surveys.
Author: Mishra V; Medley A; Hong R; Gu Y; Robey B
Source: Calverton, Maryland, Macro International, 2009 Feb. [153] p. (DHS Comparative Reports No. 22USAID Contract No. GPO-C-00-03-00002-00)
Abstract: This report summarizes HIV prevalence and the associations between HIV serostatus and key characteristics and behaviors of adult women and men in 22 developing countries, primarily in sub-Saharan Africa. Among other factors, the report examines youth who were under age 18 at their first sexual encounter and found they had higher rates of HIV prevalence than other youth age 15-24. With the exception of Lesotho, HIV prevalence is low among youth who have never had sex (primary abstinence) and also among youth who did not have sex in the 12 months preceding the survey (secondary abstinence).
Language: English
Keywords:
RESEARCH REPORT | EPIDEMIOLOGY | DATA ANALYSIS | PREVALENCE | HIV TESTING | SOCIOECONOMIC FACTORS | RISK BEHAVIOR | SEX BEHAVIOR | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | Public Health | Health | Research Methodology | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Economic Factors | Behavior | Viral Diseases | Diseases | Reproductive Tract Infections | Infections
Document Number: 339989

23.
Title: Causes for the decline in child under-nutrition in Brazil, 1996-2007.
Author: Monteiro CA; Benicio MH; Konno SC; Silva AC; Lima AL; Conde WL
Source: Revista De Saude Publica. 2009 Feb;43(1):35-43.
Abstract: OBJECTIVE: To describe the evolution of prevalence of under-nutrition among Brazilian underfives between 1996 and 2007, and to identify major factors responsible for this evolution. METHODS: Data analyzed are from two Demographic Health Surveys carried out in Brazil in 1996 and 2006/7 based on probabilistic samples of roughly 4 thousand children under five years of age. Identification of factors responsible for temporal variation in prevalence of under-nutrition (height-for-age below -2 Z-scores; WHO 2006 standard) took into account changes in the distribution of four potential determinants of nutritional status. Statistical modeling of the independent association between these determinants and risk of under-nutrition, and calculation of 'partial attributable fractions' were used to determine the relative importance of each factor in the evolution of infant under-nutrition. RESULTS: Prevalence of under-nutrition fell by approximately 50%, from 13.5% (95%CI: 12.1%; 14.8%) in 1996 to 6.8% (5.4%; 8.3%) in 2006/7. Two-thirds of this reduction could be attributed to favorable evolution in the four factors studied: 25.7% to increased maternal schooling; 21.7% to increased purchasing power of families; 11.6% to expansion of healthcare; and 4.3%to improvements in sanitation. CONCLUSIONS: The 6.3% annual rate of decline in the proportion of children with height-for-age deficits indicates that, in another ten years, child malnutrition in Brazil may no longer be a public health issue. Achieving this will depend on the maintenance of economic and social policies that have favored an increase in purchasing power among the poor, and on public investments aimed at completing the universalization of access to essential services such as education, health, and sanitation among the Brazilian population.
Language: EnglishPortuguese
Keywords:
BRAZIL | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | CHILD | MALNUTRITION | PREVALENCE | CHILD NUTRITION | NUTRITION DISORDERS | SOCIOECONOMIC FACTORS | EDUCATIONAL STATUS | HEALTH SERVICES | SANITATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Diseases | Measurement | Research Methodology | Nutrition | Health | Economic Factors | Socioeconomic Status | Delivery of Health Care | Public Health
Document Number: 341847

24.
Peer Reviewed

Title: STD/AIDS prevention in Portuguese-speaking Africa: a review of the recent literature in the social sciences and health.
Author: Monteiro S
Source: Cadernos De Saude Publica. 2009 Mar;25(3):680-6.
Abstract: The article reviews academic literature in the social sciences and health on the problems and challenges of STD/AIDS prevention in Portuguese-speaking African countries. Based on a bibliographic survey of the SciELO, PubMed, and Sociological Abstracts databases between 1997 and 2007, the research under review was organized into two groups, according to content. The first group of studies sought to understand STD/AIDS vulnerability among social groups by examining local cultural and socioeconomic factors as related to gender dynamics, sexuality, color/race, religion and health care. The second group encompassed critical assessments of shortcomings in the STD/AIDS educational messages delivered by governments and international agencies. Attention is called to the way in which the presence of traditional medicine systems and the occurrence of civil wars in the post-colonial period impact the STD/AIDS epidemic in the African countries under study.
Language: English
Keywords:
AFRICA | MOZAMBIQUE | ANGOLA | GUINEA-BISSAU | CAPE VERDE | SAO TOME AND PRINCIPE | RESEARCH REPORT | LITERATURE REVIEW | SOCIOECONOMIC FACTORS | SEXUALITY | ETHNIC GROUPS | RELIGION | HEALTH SERVICES | SEXUALLY TRANSMITTED DISEASE PREVENTION | AIDS PREVENTION | GENDER RELATIONS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa, Western | Economic Factors | Personality | Psychological Factors | Behavior | Cultural Background | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | AIDS | HIV Infections | Viral Diseases | Gender Issues
Document Number: 342665

25.
Title: [Epidemiology of women suffering from obstetric fistula in Niger] Parcours de la femme souffrant de fistule obstetricale au Niger.
Author: Ndiaye P; Amoul Kini G; Abdoulaye I; Diagne Camara M; Tal-Dia A
Source: Medecine Tropicale. 2009 Feb;69(1):61-5.
Abstract: OBJECTIVE: The purpose of this epidemiological study was to determine factors influencing management of obstetrical fistula (OF) by attempting to understand the itinerary followed by women suffering from OF in Niger. Study was carried out during the surgery session that took place at the Niamey National Hospital from April 18 to 29, 2006. Study variables were socioeconomic profile, obstetric/surgical history, support resources, and level of education. Four trained investigators using a specially designed questionnaire carried out patient interviews. Data were analyzed using the Epi Info 3.3.1 software package. A total of 91 patients with average age of 27.30 years (+/- 8.94) were interviewed. Most patients had no schooling (95%), came from the southwest region of the country (85%), and belonged to the Djerma ethnic group (52%). Most were married (76%) or divorced (19%). In the majority of cases the age at the time of marriage and first childbirth was under 18 years (76% and 55% respectively). The delivery that resulted in OF was the first in 59%, took place in a health care facility in 88%, lasted more than 24 hours in 97%, and took place by the vaginal route in 71%. The delay for the first medical visit was at least 3 months in most cases (66%) usually due to a lack of awareness of treatment availability, or to unavailability of transportation. Most patients had a history of surgery (63%) and were unaware of the probable date of the treatment (99%) with many waiting more than 3 months (44%). Prevention of gainful activity was 4.79 times more frequent after occurrence of OF. Management of OF requires not only qualified personnel but also and especially access to the quality obstetric care and greater awareness among the population. Education for girls is a crucial factor for a better health in Niger.
Language: French
Keywords:
NIGER | RESEARCH REPORT | EPIDEMIOLOGY | WOMEN | FISTULA | OBSTETRICAL SURGERY | SOCIOECONOMIC FACTORS | SOCIOECONOMIC STATUS | HEALTH EDUCATION | AWARENESS | TREATMENT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Public Health | Health | Demographic Factors | Population | Diseases | Surgery | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Economic Factors | Education | Knowledge | Sociocultural Factors
Document Number: 342501

26.

Peer Reviewed

Title: Frequency and risk factors for repeat abortions after surgical compared with medical termination of pregnancy.
Author: Niinimaki M; Pouta A; Bloigu A; Gissler M; Hemminki E; Suhonen S; Heikinheimo O
Source: Obstetrics and Gynecology. 2009 Apr;113(4):845-52.
Abstract: OBJECTIVE: To compare the frequency and risk factors for repeat abortions after surgical compared with medical termination of pregnancy. METHODS: Frequency of and risk factors for repeat abortions after medical (performed with mifepristone alone, or with a combination of mifepristone and misoprostol or other prostaglandins) compared with surgical (dilation and curettage, or vacuum aspiration) termination of pregnancy were studied using Finnish national health registries. The cohort consisted of 40,360 women undergoing termination of pregnancy between 2000 and 2005 (19,841 medical and 20,519 surgical abortions) with duration of gestation of 63 days or less. Univariable and multivariable association models were used in connection with various factors associated with repeat abortion. The mean (+/-standard deviation) follow-up times were 3.0 (+/-1.5) and 4.3 (+/-1.9) years, respectively. RESULTS: Women choosing surgical and medical abortion differed subtly, but significantly in several respects. The total number of repeat terminations was 37.9 per follow-up year per 1,000 after surgical termination of pregnancy and 40.4 after medical termination of pregnancy (P=.01). However, medical termination of pregnancy was not linked to an increased risk of another abortion when compared with surgical methods (hazard ratio [HR] 0.98, 95% confidence interval [CI] 0.93-1.04). In multivariable analysis, the risk factors for repeat abortion were parity (HR 1.99, 95% CI 1.85-2.14), previous abortion(s) (HR 1.70, 95% CI 1.60-1.82), low socioeconomic status (HR 1.22, 95% CI 1.06-1.39), and being unmarried but cohabiting (HR 1.14, 95% CI 1.03-1.25) or single (HR 1.25, 95% CI 1.15-1.36). The risk of repeat termination of pregnancy decreased with age, among women living in rural areas, and when intrauterine devices or sterilization were planned for future contraception. CONCLUSION: The risk of repeat abortion is associated with various sociodemographic characteristics. The method of abortion used is not a risk factor for repeat termination of pregnancy. LEVEL OF EVIDENCE: II.
Language: English
Keywords:
FINLAND | RESEARCH REPORT | ABORTION | PREGNANCY | RISK FACTORS | SOCIOECONOMIC FACTORS | Developed Countries | Europe, Northern | Europe | Fertility Control, Postconception | Family Planning | Reproduction | Health | Economic Factors
Document Number: 341228 Notification

27.
Title: [Impact of maternal antecedents on neonatal mortality in a regional perinatal hospital] Repercusion de los antecedentes maternos en la mortalidad neonatal de un hospital
Author: Osorno Covarrubias L; Watty Caceres C; Alonzo Vazquez F; Davila Velazquez J; Echeverria Eguiluz M
Source: Ginecologia Y Obstetricia De Mexico. 2009 Jan;77(1):3-12.
Abstract: OBJECTIVE: Determine the prevalence of maternal risk factors and evaluate their impact on neonatal mortality in a regional perinatal center. MATERIALS AND METHODS: A cohort of 25,365 live newborns was studied between January 1st 2000 and December 31st 2004. Maternal antecedents were registered in a data base: sociodemographic; medical history; obstetric antecedents of previous pregnancies; as well as evolution of current pregnancy and birth. Newborn birth weight, gestational age and condition at discharge were registered too. Neonates who died were considered cases and controls those discharged alive. Mortality was compared to the presence or absence of risk factors in maternal medical history. Prevalence, odds ratio (OR) with 95% confidence interval, and attributable fraction in the exposed and the population were calculated with the SPSS 8.0 and Epi Info 6.4 programs. RESULTS: The most notable maternal factors associated with newborn mortality were maternal age > or = 30 years OR 1.5 (1.37-2.0), less than 7 prenatal exams OR 2.17 (1.52-3.09) (53.5% attributable fraction in the exposed and 23.3% in population), eclampsia OR 4.66 (2.82-7.64), type-II diabetes OR 5.41 (2.11-12.99), urinary tract infection OR 1.98 (1.40-2.78), positive serology to human immunodeficiency virus OR 41.75 (5.77-230.9), membrane rupture > or = 48 hours OR 22.99 (13.10-40.2), polyhydramnios OR 31.53 (19.12-51.6) and abruptio placentae OR 42.18 (21.06-83.1). CONCLUSIONS: Transpartum risk factors had a larger impact on mortality than pregnancy or pregestational factors.
Language: Spanish
Keywords:
BRAZIL | RESEARCH REPORT | PREVALENCE | COHORT ANALYSIS | INFANT MORTALITY | RISK FACTORS | PREGNANCY HISTORY | BIRTH HISTORY | SOCIOECONOMIC FACTORS | AGE FACTORS | PREECLAMPSIA | DIABETES | HIV INFECTIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Health | Fertility Measurements | Fertility | Economic Factors | Population Characteristics | Pregnancy Complications | Diseases | Viral Diseases
Document Number: 341999

28.

Title: Factors associated with underweight and stunting among children in rural Terai of eastern Nepal.
Author: Pramod Singh GC; Nair M; Grubesic RB; Connell FA
Source: Asia-Pacific Journal of Public Health. 2009 Apr;21(2):144-52.
Abstract: Malnutrition continues to affect a large proportion of children in the developing world. The authors undertook this study to identify biologic, socioeconomic, and health care factors associated with underweight and stunting in young children in an the eastern Tarai (plains) district of Nepal. Data were collected via questionnaires from mothers of 443 children aged 6 to 36 months in Sunsari district. Multistage cluster sampling was used to select villages and children. Anthropometric measurements were made on both children and their mothers. Logistic regression was used to measure the independent (adjusted) effect of risk and protective factors on the odds of underweight or stunting. More than half (53.3%) of the children were found to be underweight (<2 standard deviations weight for age below reference median) and more than one third (36.6%) had stunting (<2 standard deviations height for age below reference median). Low maternal body mass index, child's age, higher birth order, and lower standard of living score were strong predictors of underweight, whereas mother's education >5 years and participation in vitamin A and nutritional programs were protective. Infant age, low maternal body mass index, and low standard of living score were significant risk factors for stunting, whereas mother's education >5 years was strongly protective. These results suggest that underweight and stunting are the result of a nexus of biological, socioeconomic, and health care factors.
Language: English
Keywords:
NEPAL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | RURAL POPULATION | PREVALENCE | DEFICIENCY DISEASES | BODY WEIGHT | BODY HEIGHT | RISK FACTORS | MALNUTRITION | CHILD NUTRITION | SOCIOECONOMIC FACTORS | QUALITY OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Nutrition Disorders | Diseases | Physiology | Biology | Health | Nutrition | Economic Factors | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 331248

29.

Title: Expanding contraceptive choice: five promising innovations.
Author: Ringheim K; Gribble J
Source: Washington, D.C., Population Reference Bureau, 2009 Jun. 4 p.
Abstract: This new policy brief from the Population Reference Bureau highlights five "next generation" contraceptives, each of which offers one or more advantages over similar earlier methods. These innovations are among those expected to enter the market within five years and can assist country programs to make contraception more accessible and attractive to women and couples.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | COUPLES | WOMEN | CONTRACEPTIVE METHODS | CONTRACEPTIVE METHODS CHOSEN | AGE FACTORS | REPRODUCTIVE RIGHTS | FAMILY PLANNING | SOCIOECONOMIC FACTORS | NEEDS | Family Characteristics | Family and Household | Sociocultural Factors | Demographic Factors | Population | Contraception | Contraceptive Usage | Population Characteristics | Human Rights | Political Factors | Economic Factors
Document Number: 328045

30.


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