1.  Peer Reviewed Title: Assessment of childhood immunisation coverage [letter] Author: Aaby P; Benn CS Source: Lancet. 2009 Apr 25;373(9673):1428. Abstract: Stephen Lim and colleagues scrutinise coverage with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) in 193 countries. With donor emphasis on DTP3 coverage, it is not surprising that the national estimates might be inflated. Still, there is little doubt that DTP3 coverage has increased in recent decades. But maybe we should be more concerned about the health implications of this trend than about the accuracy of the estimate. From a public health perspective, the fact that DTP3 coverage is now higher than measles vaccine coverage in most African countries is of questionable value. Numerous studies have shown that measles vaccine is beneficial for child survival, but there are conflicting data about the effect of DTP. DTP has frequently been associated with increased mortality in situations with herd immunity. Furthermore, as a result of the drive to increase the DTP3 coverage, more children receive DTP simultaneously with or after measles vaccine. We have found consistently that DTP given simultaneously with measles vaccine (table) or after it is associated with increased mortality compared with having measles vaccine alone as the most recent vaccine. In a study from Bangladesh, children who received DTP/BCG after the age of measles vaccine administration had around threefold higher mortality than unvaccinated children. These observations have not been contradicted. If they are true, the drive to boost the DTP3 coverage could lead to increased child mortality. Current policy is based on the assumption that receiving three DTP vaccines is associated with decreased child mortality. It should be a major priority to determine whether this assumption is correct. (full-text) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGIC METHODS | CHILDREN | IMMUNIZATION | PERTUSSIS | TETANUS | DIPHTHERIA | Comparative Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Bacterial and Fungal Diseases | Infections | Diseases Document Number: 341150 |
| 2. Title: Reproductive and hormonal factors, and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers: results from the International BRCA1/2 Carrier Cohort Study. Author: Antoniou AC; Rookus M; Andrieu N; Brohet R; Chang-Claude J Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Feb;18(2):601-10. Abstract: BACKGROUND: Several reproductive and hormonal factors are known to be associated with ovarian cancer risk in the general population, including parity and oral contraceptive (OC) use. However, their effect on ovarian cancer risk for BRCA1 and BRCA2 mutation carriers has only been investigated in a small number of studies. METHODS: We used data on 2,281 BRCA1 carriers and 1,038 BRCA2 carriers from the International BRCA1/2 Carrier Cohort Study to evaluate the effect of reproductive and hormonal factors on ovarian cancer risk for mutation carriers. Data were analyzed within a weighted Cox proportional hazards framework. RESULTS: There were no significant differences in the risk of ovarian cancer between parous and nulliparous carriers. For parous BRCA1 mutation carriers, the risk of ovarian cancer was reduced with each additional full-term pregnancy (P trend = 0.002). BRCA1 carriers who had ever used OC were at a significantly reduced risk of developing ovarian cancer (hazard ratio, 0.52; 95% confidence intervals, 0.37-0.73; P = 0.0002) and increasing duration of OC use was associated with a reduced ovarian cancer risk (P trend = 0.0004). The protective effect of OC use for BRCA1 mutation carriers seemed to be greater among more recent users. Tubal ligation was associated with a reduced risk of ovarian cancer for BRCA1 carriers (hazard ratio, 0.42; 95% confidence intervals, 0.22-0.80; P = 0.008). The number of ovarian cancer cases in BRCA2 mutation carriers was too small to draw definitive conclusions. CONCLUSIONS: The results provide further confirmation that OC use, number of full-term pregnancies, and tubal ligation are associated with ovarian cancer risk in BRCA1 carriers to a similar relative extent as in the general population. Language: English Keywords: DEVELOPED COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | CLINICAL RESEARCH | WOMEN | PREVALENCE | RISK ASSESSMENT | OVARIAN CANCER | CHROMOSOME ABNORMALITIES | PARITY | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | TUBAL LIGATION | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Measurement | Evaluation | Cancer | Neoplasms | Diseases | Neonatal Diseases and Abnormalities | Fertility Measurements | Fertility | Population Dynamics | Health | Contraceptive Safety | Safety | Public Health | Female Sterilization | Sterilization, Sexual | Family Planning Document Number: 331025 |
3.  Title: Condom use for preventing STI/HIV and unintended pregnancy among young men in sub-saharan Africa. Author: Bankhole A; Singh S; Hussain R; Oestreicher G Source: American Journal of Men's Health. 2009 Mar;3(1):60-78. Abstract: The condom is the only known method that provides simultaneous protection against unplanned pregnancy and some sexually transmitted infections (STIs), including HIV, among sexually active people. Using data from the Demographic and Health Surveys from 18 Sub-Saharan African countries, this study examined condom use and reasons for using the method at last intercourse among sexually active young men aged 15 to 29. Most young men were aware of the condom (73%-98%), but its use at last intercourse was quite variable, ranging from 6% in Madagascar to 74% in Namibia. In 10 countries, more young men reportedly used condoms for preventing STIs alone than they did for preventing pregnancy alone. In 6 countries, at least one third of the users used the method for both purposes. Use of the condom at last intercourse was associated with union status, education, residence, and exposure to television in at least two thirds of the countries. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | CROSS-CULTURAL COMPARISONS | YOUTH | MEN | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | PREGNANCY, UNPLANNED | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Comparative Studies | Age Factors | Population Characteristics | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Reproductive Behavior | Fertility | Sociocultural Factors | Contraceptive Usage | Contraception | Family Planning Document Number: 329249 |
| 4. Peer Reviewed Title: Behavioral mechanisms in HIV epidemiology and prevention: past, present, and future roles. Author: Bingenheimer JB; Geronimus AT Source: Studies in Family Planning. 2009 Sep;40(3):187-204. Abstract: In the 1980’s behavioral variations across geographically and socially defined populations were the central focus of AIDS research, and behavior change was seen as the primary means of controlling HIV epidemics. Today, biological mechanisms-especially other sexually transmitted infections, antiretroviral therapy, and male circumcision-predominate in HIV epidemiology and prevention. We describe several reasons for this shift in emphasis. Although the shift is understandable, we argue for a sustained focus on behavioral mechanisms in HIV research in order to realize the theoretical promise of interventions targeting the biological aspects of HIV risk. We also provide evidence to suggest that large reductions in HIV prevalence may be accomplished by small changes in behavior. Moreover, we contend that behavioral mechanisms will find their proper place in HIV epidemiology and prevention only when investigators adopt a conceptual model that treats prevalence as a determinant as well as an outcome of behavior and that explicitly recognizes the dynamic interdependence between behavior and other epidemiological and demographic parameters. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGY | BEHAVIOR CHANGE | HIV INFECTIONS | RISK REDUCTION BEHAVIOR | HIV PREVENTION | ANTIRETROVIRAL THERAPY | MALE CIRCUMCISION | Africa | Developing Countries | Comparative Studies | Studies | Research Methodology | Public Health | Health | Behavior | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 339701 |
| 5. Peer Reviewed Title: Potential acceptability of microbicides in HIV prevention in stable marital relationships in Malawi. Author: Bisika T Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):115-7. Abstract: BACKGROUND: The XVII International Conference on AIDS held in Mexico City in August 2008 emphasised the importance of dual prevention using both vaccines and microbicides in the fight against HIV and AIDS. Microbicides are important because they constitute one of the potentially important female-controlled methods of HIV and sexually transmitted infection prevention, especially in Malawi where the use of the female condom has not yet been fully embraced. METHODS: A qualitative study utilising focus group discussions was used to assess the acceptability of the microbicide nonoxynol-9 (N-9) as part of the ongoing Preparatory AIDS Vaccine Evaluation (PAVE) studies. RESULTS: The study observed that men oppose the use of N-9, and that although women consider themselves at risk for HIV they caution against the unintended consequence of altering the vaginal environment with the use of microbicides, which can interfere with the men's preference for dry sex. DISCUSSION AND CONCLUSIONS: Although N-9 did not produce the desired results, these can inform the development of other promising microbicide candidates. The study concludes that it is important to pay attention to how new microbicides are formulated rather than just concentrating solely on an individual product's effectiveness. Language: English Keywords: MALAWI | RESEARCH REPORT | FOCUS GROUPS | CURRENTLY MARRIED | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | MICROBICIDES | NONOXYNOL-9 | HUSBAND-WIFE COMPARISONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Marital Status | Nuptiality | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Spermicidal Contraceptive Agents | Contraceptive Agents | Contraception | Family Planning | Comparative Studies | Studies Document Number: 341651 |
| 6. Peer Reviewed Title: Assessment of insecticide-treated bednet use among children and pregnant women across 15 countries using standardized national surveys. Author: Eisele TP; Keating J; Littrell M; Larsen D; Macintyre K Source: American Journal of Tropical Medicine and Hygiene. 2009 Feb;80(2):209-14. Abstract: Impact of insecticide-treated bednets (ITNs) on preventing malaria may be minimized if they are not used by vulnerable populations. Among ITN-owning households from 15 standardized national surveys from 2003 to 2006, we identify factors associated with ITN use among children younger than 5 years of age and make comparisons of ITN use among children and pregnant women across countries. Within ITN-owning households, many children and pregnant women are still not using them. Between-country analysis with linear regression showed child ITN use increases as intra-household access to ITNs increases (P = 0.020, R2 = 0.404), after controlling for season and survey year. Results from within-country logistic regression analyses were consistent with between-country analysis showing intra-household access to ITNs is the strongest and most consistent determinant of use among children. The gaps in ITN use and possession will likely persist in the absence of achieving a ratio of no more than two people per ITN. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | STATISTICAL REGRESSION | CHILDREN | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PESTICIDES | BED NETS | MALARIA PREVENTION | CHILD SURVIVAL | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Ingredients and Chemicals | Parasite Control | Public Health | Health | Malaria | Parasitic Diseases | Diseases | Survivorship | Length of Life | Mortality | Population Dynamics Document Number: 330299 |
| 7. Peer Reviewed Title: Perinatal outcomes in a South Asian setting with high rates of low birth weight. Author: George K; Prasad J; Singh D; Minz S; Albert DS; Muliyil J; Joseph KS; Jayaraman J; Kramer MS Source: BMC Pregnancy and Childbirth. 2009;9:5. Abstract: BACKGROUND: It is unclear whether the high rates of low birth weight in South Asia are due to poor fetal growth or short pregnancy duration. Also, it is not known whether the traditional focus on preventing low birth weight has been successful. We addressed these and related issues by studying births in Kaniyambadi, South India, with births from Nova Scotia, Canada serving as a reference. METHODS: Population-based data for 1986 to 2005 were obtained from the birth database of the Community Health and Development program in Kaniyambadi and from the Nova Scotia Atlee Perinatal Database. Menstrual dates were used to obtain comparable information on gestational age. Small-for-gestational age (SGA) live births were identified using both a recent Canadian and an older Indian fetal growth standard. RESULTS: The low birth weight and preterm birth rates were 17.0% versus 5.5% and 12.3% versus 6.9% in Kaniyambadi and Nova Scotia, respectively. SGA rates were 46.9% in Kaniyambadi and 7.5% in Nova Scotia when the Canadian fetal growth standard was used to define SGA and 6.7% in Kaniyambadi and < 1% in Nova Scotia when the Indian standard was used. In Kaniyambadi, low birth weight, preterm birth and perinatal mortality rates did not decrease between 1990 and 2005. SGA rates in Kaniyambadi declined significantly when SGA was based on the Indian standard but not when it was based on the Canadian standard. Maternal mortality rates fell by 85% (95% confidence interval 57% to 95%) in Kaniyambadi between 1986-90 and 2001-05. Perinatal mortality rates were 11.7 and 2.6 per 1,000 total births and cesarean delivery rates were 6.0% and 20.9% among live births >or= 2,500 g in Kaniyambadi and Nova Scotia, respectively. CONCLUSION: High rates of fetal growth restriction and relatively high rates of preterm birth are responsible for the high rates of low birth weight in South Asia. Increased emphasis is required on health services that address the morbidity and mortality in all birth weight categories. Language: English Keywords: INDIA | CANADA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS-CULTURAL COMPARISONS | LONGITUDINAL STUDIES | INFANT | INFANT, PREMATURE | PREVALENCE | BIRTH WEIGHT | LOW BIRTH WEIGHT | GESTATIONAL AGE | PERINATAL MORTALITY | GROWTH | MATERNAL MORTALITY | Asia, Southern | Asia | Developing Countries | Developed Countries | North America, Northern | Americas | Research Methodology | Comparative Studies | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Body Weight | Physiology | Biology | Fetus | Pregnancy | Reproduction | Mortality | Population Dynamics | Child Development Document Number: 331227 |
| 8. Peer Reviewed Title: The role of controlling behaviour in intimate partner violence and its health effects: a population based study from rural Vietnam. Author: Krantz G; Nguyen Dang V Source: BMC Public Health. 2009 May 14;9(1):143. Abstract: ABSTRACT: BACKGROUND: It has been proposed that intimate partner violence is not a single phenomenon but consists of two distinct types of violence, defined conceptually in terms of the presence or absence of controlling behaviour in the violent member of the couple. Studies performed in high income countries support this hypothesis but no studies are available from a low income country. This study wanted to test this hypothesis in a low income setting focusing on men's use of physical/sexual violence with and without control tactics and resulting health effects in rural Vietnam. Of particular interest was whether men's controlling behaviour acted synergistically with physical/sexual violence to aggravate the health outcome. METHODS: In this cross sectional study data was collected among 883 married or partnered women aged 17-60. Structured interviews following a questionnaire developed for violence research were used. Control tactics were assessed by six items combined into a scale with Cronbach alfa of .80. Bi- and multivariate analyses were performed, including effect modification analyses. RESULTS: Of the participating women, 81 (9.2 per cent) had been exposed to physical and/or sexual violence in the past 12 months and of these, 26 had experienced one or more control tactics by their partner. Physical/sexual violence was highly associated with women's pain and discomfort (OR 3.40 (1.85-6.27) and with sadness and depression (OR 4.06 (2.40-6.88), while for suicidal thoughts control tactics were the strongest risk factor (OR 4.41; 1.95-10.02) when controlling for possible confounders. The combined effect of controlling behaviour and physical/sexual violence considerably elevated the risk of ill-health and synergy was present. Controlling men differed in terms of psychosocial characteristics and used more severe violence as compared to men not employing any control tactics. CONCLUSIONS: Physical and/or sexual violence is a serious threat to health in Vietnamese women, especially when combined with controlling behaviours. Health policy and programmes in Vietnam need to address the issue of violence as a most serious violation of gender equity ideas and as an unacceptable part of normal family life. Language: English Keywords: VIETNAM | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | CROSS SECTIONAL ANALYSIS | MULTIVARIATE ANALYSIS | RURAL POPULATION | CURRENTLY MARRIED | WOMEN IN DEVELOPMENT | DISEASES | HEALTH | DOMESTIC VIOLENCE | RISK FACTORS | Asia, Southeastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Data Analysis | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Economic Development | Economic Factors | Crime | Social Problems | Sociocultural Factors Document Number: 341485 |
| 9. Peer Reviewed Title: A multilevel analysis of condom use among adolescents in the European Union. Author: Lazarus JV; Moghaddassi M; Godeau E; Ross J; Vignes C; Ostergren PO; Liljestrand J Source: Public Health. 2009 Feb;123(2):138-144. Abstract: OBJECTIVES: This study examined which individual and national factors affect condom use among adolescents. STUDY DESIGN: Multilevel analysis. METHODS: This study reviewed the data on bullying, alcohol use and condom use provided by 18 European countries and subnational entities in the Health Behaviour in School-Aged Children survey. Another eight contextual variables were also analysed. Three multilevel logistic regression models were applied consecutively (analysing for crude geographical and school variance in condom use, adjusting for gender and adjusting all variables for one another). RESULTS: Among the 15-year-olds studied, 7.0% of the total variance in condom use was explained by school-related factors (intraschool-level correlation) and 5.8% by national/subnational factors. In the empty model, condom use was significantly associated with gender, alcohol consumption, predominant national religion and national prevalence of human immunodeficiency virus (HIV). In the full model, there was also a significant association with the Human Development Index ranking, gross domestic product, Gini coefficient and the Gender-related Development Index. CONCLUSIONS: This study suggests that while alcohol, gender, human development level, income, religion and HIV prevalence affect condom use in young Europeans, these factors do not explain all or even most of the variation. Nonetheless, since some of these factors are not traditionally associated with young people's sexual and reproductive health, these findings should enable more nuanced health policy programming. Language: English Keywords: EUROPEAN UNION | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | CROSS-CULTURAL COMPARISONS | STATISTICAL REGRESSION | ADOLESCENTS | CONDOM USE | CONTRACEPTIVE PREVALENCE | PSYCHOLOGICAL ABUSE | ALCOHOL USE AND ABUSE | SECONDARY SCHOOLS | SEX FACTORS | RELIGION | HIV INFECTIONS | PREVALENCE | Organizations | Political Factors | Sociocultural Factors | Family Planning Surveys | Family Planning | Comparative Studies | Studies | Research Methodology | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Contraceptive Usage | Contraception | Aggression | Schools | Education | Viral Diseases | Diseases | Measurement Document Number: 329662 |
| 10. Peer Reviewed Title: Gender norms in South Africa: implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution. Author: Mantell JE; Needham SL; Smit JA; Hoffman S; Cebekhulu Q Source: Culture, Health and Sexuality. 2009 Feb;11(2):139-157. Abstract: In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women's ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students, who are a relatively 'privileged' group, there is little information on gender norms that might shape responses to HIVprevention programmes. To elicit gender norms regarding women's and men's roles, condom and contraceptive use, sexual communication and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students in order to understand how norms might be used to buttress HIV- and pregnancy-prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women's rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women's freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women's protection against unintended pregnancy and HIV/STIs. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | FOCUS GROUPS | CROSS-CULTURAL COMPARISONS | WOMEN | ASIANS | ETHNIC GROUPS | STUDENTS | WOMEN IN DEVELOPMENT | UNIVERSITIES | VALUE ORIENTATION | GENDER RELATIONS | HIV PREVENTION | PREGNANCY | PREVENTION AND CONTROL | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Cultural Background | Population Characteristics | Education | Economic Development | Economic Factors | Schools | Psychological Factors | Behavior | Gender Issues | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Reproduction Document Number: 341087 |
| 11. Peer Reviewed Title: Trends in marriage and time spent single in sub-Saharan Africa: a comparative analysis of six population-based cohort studies and nine Demographic and Health Surveys. Author: Marston M; Slaymaker E; Cremin I; Floyd S; McGrath N; Kasamba I; Lutalo T; Nyirenda M; Ndyanabo A; Mupambireyi Z; Zaba B Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i64-i71. Abstract: The authors analyzed cohort data from Uganda, Tanzania, South Africa, Zimbabwe, and Malawi and Demographic and Health Survey (DHS) data from Uganda, Tanzania and Zimbabwe. Life table methods were used to calculate median age at first sex (AFS), age at first marriage (AFM), and time spent single. In each study, two surveys were chosen to compare marital status by age and identify changes over time. Median AFS, AFM, and time spent single vary considerably among these populations. These three measures are underlying determinants of sexual risk and HIV infection, and they may partially explain the variation in HIV prevalence levels among these populations. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | DEMOGRAPHIC AND HEALTH SURVEYS | UNMARRIED | MARRIAGE AGE | MARITAL STATUS | SEX FACTORS | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Nuptiality | Marriage Patterns | Marriage | Population Characteristics Document Number: 340109 |
| 12. Title: The role of partner reduction and faithfulness in HIV prevention in Sub-Saharan Africa: evidence from Cameroon, Rwanda, Uganda, and Zimbabwe. Author: Mishra V; Hong R; Assche SB; Barrere B Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. 31 p. (USAID Contract No. GPO-C-00-03-00002-00DHS Working Papers No. 61) Abstract: Objectives. We examine patterns of multiple sexual partnerships and partner faithfulness among men, women, and cohabiting couples in four countries in sub-Saharan Africa and assess the association between these behaviors and the risk of HIV infection. Methods. Our data are from nationally-representative surveys conducted during 2004-2006 in Cameroon, Rwanda, Uganda, and Zimbabwe that included HIV testing of adult men and women, using blood specimens analyzed with standard laboratory and quality control procedures. Men and women in a marital/cohabiting union who reported never having had sex with any person other than their current partner(s) are defined as lifetime faithful. Men and women in a marital/cohabiting union who ever had sex with a person other than current their partner(s) but not in the previous 12 months are defined as recently faithful. Lifetime and recent mutual faithfulness among cohabiting couples are similarly defined. Data are analyzed using descriptive and multivariate statistical methods after adjusting for potential confounding factors. Results. Multiple sexual partnerships are common in sub-Saharan Africa. In all four countries considered, the adjusted odds of being HIV-infected increase with the number of lifetime sexual partners and decrease with the level of spousal faithfulness. Similarly, in couples where the partners are not mutually faithful, either or both partners are more likely to be HIV-infected than in couples where both partners are lifetime faithful. Our study finds that men report having more lifetime partners and being less faithful to their spouse(s) than women report. Conclusions. Having fewer lifetime sexual partners and being faithful to spousal partner(s) are strongly associated with reduced risk of HIV infection. Thus, in addition to promoting abstinence until marriage and condom use, especially in higher-risk sex, HIV prevention programs should focus more on promoting partner reduction and partner faithfulness, especially for men. KEYWORDS: faithfulness, multiple sexual partnerships, partner reduction, HIV, AIDS, sub-Saharan Africa. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIPLE PARTNERS | SEXUAL PARTNERS | EXTRAMARITAL SEX BEHAVIOR | SAFER SEX | HIV PREVENTION | SEX BEHAVIOR | RISK ASSESSMENT | RISK BEHAVIOR | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Behavior | HIV Infections | Viral Diseases | Diseases | Evaluation Document Number: 329991 |
| 13. Peer Reviewed Title: Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. Author: Park BJ; Wannemuehler KA; Marston BJ; Govender N; Pappas PG; Chiller TM Source: AIDS. 2009 Feb 20;23(4):525-30. Abstract: OBJECTIVE: Cryptococcal meningitis is one of the most important HIV-related opportunistic infections, especially in the developing world. In order to help develop global strategies and priorities for prevention and treatment, it is important to estimate the burden of cryptococcal meningitis. DESIGN: Global burden of disease estimation using published studies. METHODS: We used the median incidence rate of available studies in a geographic region to estimate the region-specific cryptococcal meningitis incidence; this was multiplied by the 2007 United Nations Programme on HIV/AIDS HIV population estimate for each region to estimate cryptococcal meningitis cases. To estimate deaths, we assumed a 9% 3-month case-fatality rate among high-income regions, a 55% rate among low-income and middle-income regions, and a 70% rate in sub-Saharan Africa, based on studies published in these areas and expert opinion. RESULTS: Published incidence ranged from 0.04 to 12% per year among persons with HIV. Sub-Saharan Africa had the highest yearly burden estimate (median incidence 3.2%, 720 000 cases; range, 144 000-1.3 million). Median incidence was lowest in Western and Central Europe and Oceania (Language: English Keywords: GLOBAL | AFRICA, SUB SAHARAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | ESTIMATION TECHNIQUES | CROSS-CULTURAL COMPARISONS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | CENTRAL NERVOUS SYSTEM EFFECTS | MENINGITIS | COMPLICATIONS | HUMAN GEOGRAPHY | DEATH RATE | ECONOMIC DEVELOPMENT | Africa | Developing Countries | Research Methodology | Comparative Studies | Studies | HIV Infections | Viral Diseases | Diseases | Measurement | Central Nervous System | Physiology | Biology | Geography | Social Sciences | Science | Sociocultural Factors | Mortality | Population Dynamics | Demographic Factors | Population | Economic Factors Document Number: 341165 |
| 14. Title: User Satisfaction with the Combined Oral Contraceptive Drospirenone 3 mg/Ethinylestradiol 20 mug (Yasminelle(R)) in Clinical Practice: A Multi-Country, Questionnaire-Based Study. Author: Short M Source: Clinical Drug Investigation. 2009;29(3):153-9. Abstract: To assess women's perception of a combined oral contraceptive (COC) containing drospirenone 3 mg/ethinylestradiol (EE) 20 mug administered in the conventional 21/7 regimen (drospirenone 3 mg/EE 20 mug 21/7 regimen [Yasminelle(R)]) in clinical practice. This questionnaire-based study was performed in 12 European countries and included women who had been taking the drospirenone 3 mg/EE 20 mug 21/7 regimen COC for >/=3 months. Of 16 461 completed questionnaires, 12 277 were from women who had been using the drospirenone 3 mg/EE 20 mug 21/7 regimen COC for >/=3 months - 34% of women were new users of COCs and 65% had switched from alternative contraceptive brands. The mean age of these respondents was approximately 27 years. Seventy percent of women who indicated that they had skin problems before taking the drospirenone 3 mg/EE 20 mug 21/7 regimen COC responded that their skin had improved with treatment (3030/4305). Sixty-nine percent of women who had switched to the drospirenone 3 mg/EE 20 mug 21/7regimen COC because of weight problems with their previous method of contraception responded that they had experienced weight loss (1205/1745). Approximately 95% of respondents said they were satisfied with the drospirenone 3 mg/EE 20 mug 21/7 regimen COC. Moreover, 83% of respondents said they would recommend this COC to a friend. There were high levels of perceived satisfaction with the drospirenone 3 mg/EE 20 mug 21/7 regimen COC. The reported effects on weight loss (due to decreased water retention) and skin problems are consistent with the antimineralocorticoid and antiandrogenic benefits of drospirenone-containing COCs. Language: English Keywords: EUROPE | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | WOMEN | SATISFACTION | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | PERCEPTION | CONTRACEPTIVE METHOD SWITCHING | BODY WEIGHT | FLUID BALANCE | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Demographic Factors | Population | Psychological Factors | Behavior | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Usage | Physiology | Biology | Homeostasis Document Number: 330423 |
| 15. Peer Reviewed Title: A community perspective on young people's knowledge of HIV/AIDS in three African countries. Author: Stephenson R Source: AIDS Care. 2009 Mar;21(3):378-383. Abstract: Individual, household and community-level influences on young people's (15-24) knowledge of HIV/AIDS in three African countries (Burkina Faso, Ghana and Zambia) are explored. The focus of the analysis is on the roles of demographic, economic and behavioral dimensions of the community environment in shaping knowledge of HIV/AIDS. Data from Demographic and Health Surveys, collected independently for males and females in each of the countries, are analyzed. There are clear pathways through which the community environment shapes knowledge, and the community influences on knowledge vary greatly by country and gender. For young women, residences in communities with demographic and behavioral patterns that are indicative of greater opportunities are associated with increased knowledge of HIV/AIDS. The results highlight community-level factors that can be harnessed in the development of community-based interventions to improve knowledge of HIV/AIDS among young people, and reinforce the need to focus on the community environment in designing behavioral change interventions. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | DEMOGRAPHIC AND HEALTH SURVEYS | COMMUNITY | HOUSEHOLDS | YOUTH | HIV TRANSMISSION | DEMOGRAPHIC FACTORS | SOCIOECONOMIC FACTORS | SEX BEHAVIOR | RISK BEHAVIOR | SEX FACTORS | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Demographic Surveys | Population Dynamics | Population | Residence Characteristics | Population Distribution | Geographic Factors | Family and Household | Sociocultural Factors | Age Factors | Population Characteristics | HIV Infections | Viral Diseases | Diseases | Economic Factors | Behavior Document Number: 325333 |
| 16. Title: The Transnational study of oral contraceptive cardiovascular safety: history and science. Author: Suissa S Source: Journal of Clinical Epidemiology. 2009;62:588-593. Abstract: This study, in which Kuhl et al. reported elevated ethinyl estradiol (EE) levels in women receiving the gestodene/EE combination oral contraceptives (OCs) compared with desogestrel-containing combination OCs, by its implication that such differences could be associated with increased cardiovascular risks, had attracted much publicity and created great concern in Germany. The working group found sufficient methodological deficiencies in the Kuhl study to question the validity of its findings of significant differences in effects between the various OCs. Besides a large number of studies mostly irrelevant to the issue of cardiovascular risk, Schering had conducted a large postmarketing phase IV study in over 100,000 women. Joe Fleiss, who was the primary reviewer of that report, presented the shortest review I had ever witnessed: he raised the thick report in the air and simply tossed it on the floor. It was clear to all that the data were simply unreliable and unusable to address this safety concern. The working group thus recommended that the only way to address the safety issue regarding gestodene was to conduct epidemiological studies on the safety of all newer low-dose OCs and saw it as an international priority, particularly in view of the number of newer OCs that had been brought to market and the scarcity of recent published studies. Schering agreed in principle to fund such research, and Walter coordinated the writing of protocols for a research program that included three studies. The Trinational study, a field case-control study conducted in three European countries was the only one retained. The Value Added Medical Products (VAMP), the predecessor of the General Practice Research Database (GPRD), historical cohort study was rejected for political (no data on German women) and scientific reasons, such as the absence of important confounder data and insufficient OC history. The Saskatchewan study was rejected because gestodene was not available in Saskatchewan, and other low-dose COCs, by themselves, were not relevant to the sponsors. (excerpt) Language: English Keywords: EUROPE, WESTERN | CONFERENCES AND CONGRESSES | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CROSS-CULTURAL COMPARISONS | WOMEN | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES | CARDIOVASCULAR EFFECTS | GESTODENE | ORAL CONTRACEPTIVES, COMBINED | DESOGESTREL | ORAL CONTRACEPTIVES, LOW-DOSE | LOW-DOSE PROGESTINS | NORTH AMERICA, NORTHERN | Europe | Developed Countries | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Safety | Public Health | Health | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Americas Document Number: 331005 |
| 17. Peer Reviewed Title: Reported number of sexual partners: comparison of data from four African longitudinal studies. Author: Todd J; Cremin I; McGrath N; Bwanika JB; Wringe A; Marston M; Kasamba I; Mushati P; Lutalo T; Hosegood V; Zaba B Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i72-i80. Abstract: Objective: To compare reported numbers of sexual partners in Eastern and Southern Africa. Methods: Sexual partnership data from four longitudinal population-based surveys (1998-2007) in Zimbabwe, Uganda and South Africa were aggregated and overall proportions reporting more than one lifetime sexual partner calculated. A lexis-style table was used to illustrate the average lifetime sexual partners by site, sex, age group and birth cohort. The male-to-female ratio of mean number of partnerships in the last 12 months was calculated by site and survey. For each single year of age, the proportion sexually active in the past year, the mean number of partners in the past year and the proportion with more than one partner in the past year were calculated. Results: Over 90% of men and women between 25 and 45 years of age reported being sexually active during the past 12 months, with most reporting at least one sexual partner. Overall, men reported higher numbers of lifetime sexual partners and partners in the last year than women. The male-to-female ratio of mean partnerships in the last year ranged from 1.41 to 1.86. In southern African cohorts, individuals in later birth cohorts reported fewer sexual partners and a lower proportion reported multiple partnerships compared with earlier birth cohorts, whereas these behavioural changes were not observed in the Ugandan cohorts. Across the four sites, reports of sexual partnerships followed a similar pattern for each sex. Conclusions: The longitudinal results show that reductions in the number of partnerships were more evident in southern Africa than in Uganda. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | SEXUAL PARTNERS | MULTIPLE PARTNERS | SEX FACTORS | AGE FACTORS | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Sex Behavior | Behavior | Population Characteristics | Demographic Factors | Population Document Number: 340110 |
| 18. Peer Reviewed Title: Improving maternal and child health in difficult environments: the case for "cross-border" health care. Author: Walraven G; Manaseki-Holland S; Hussain A; Tomaro JB Source: PLoS Medicine. 2009 Jan 13;6(1):e5. Abstract: Health indicators, including levels of maternal and infant mortality, are very different in adjacent geographical border areas of Afghanistan, Pakistan, and Tajikistan. These differences reflect the combined and complex interplay of elements within the different health systems, as well as political, economic, social, and cultural factors. Reducing maternal and child mortality requires focus and balance in all of these dimensions and can best be achieved through service interventions underpinned by general development. A policy promoting "cross-border" health programmes could immediately make available existing resources that could contribute to reducing maternal and child mortality in all three geographical locations. (excerpt) Language: English Keywords: ASIA | CRITIQUE | RECOMMENDATIONS | CROSS-CULTURAL COMPARISONS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | INFANT | BORDER CROSSING | MATERNAL-CHILD HEALTH SERVICES | CULTURE | ECONOMIC FACTORS | POLITICAL FACTORS | CHILD SURVIVAL | MATERNAL HEALTH | INTERNATIONAL COOPERATION | Developing Countries | Comparative Studies | Studies | Research Methodology | Economic Development | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | International Migration | Migration | Population Dynamics | Primary Health Care | Health Services | Delivery of Health Care | Health | Sociocultural Factors | Survivorship | Length of Life | Mortality Document Number: 330709 |
| 19. Peer Reviewed Title: A new way of perceiving the pandemic: the findings from a participatory research process on young Africans' stories about HIV/AIDS. Author: Winskell K; Enger D Source: Culture, Health and Sexuality. 2009 May;11(4):453-467. Abstract: This paper presents the findings, shares the methodology and outlines the benefits of a multi-country participatory research process on a unique data source: stories about HIV and AIDS written by young Africans. Between 1997 and 2005, more than 105,000 young people from 37 countries participated in competitions inviting them to think up storylines for short fiction films to educate their communities about HIV and AIDS as part of the 'Scenarios from Africa' communication process. The winning stories were selected by juries made up of: PLWH and other local specialists in prevention, treatment and care; former contest winners and other young people; and communication specialists, including the top African directors, who went on to transform the ideas into short films. In 2005, over 200 jurors selected 30 winners from the 22,894 stories submitted that year by 63,327 contest participants. After reading around 200 stories each and participating in the selection process, jurors compiled their observations and recommendations. The jurors' findings reveal notable persistent shortcomings in existing communication efforts and identify key emerging needs. In some areas, they show remarkable consistency across the continent. Jurors view this as a powerful needs assessment, networking and capacity building process that motivates action. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | METHODOLOGICAL STUDIES | CROSS-CULTURAL COMPARISONS | ACTION RESEARCH | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | PERCEPTION | HIV INFECTIONS | EPIDEMICS | FILM AND VIDEO | DRAMA AND THEATER | HEALTH EDUCATION | COMMUNITY HEALTH SERVICES | CONTESTS | Africa | Developing Countries | Studies | Research Methodology | Comparative Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Psychological Factors | Behavior | Mass Media | Communication | Culture | Sociocultural Factors | Education | Primary Health Care | Health Services | Delivery of Health Care | Health | Incentives | Policy | Political Factors Document Number: 341091 |
| 20. Peer Reviewed Title: Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes. Author: Zou J; Yamanaka Y; John M; Watt M; Ostermann J; Thielman N Source: BMC Public Health. 2009;9:75. Abstract: BACKGROUND: Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment. METHODS: A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. RESULTS: Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p < 0.01) or that people living with HIV/AIDS (PLWHA) have not followed the Word of God (p < 0.001). Most participants (84.2%) said that they would disclose their HIV status to their pastor or congregation if they became infected. Although the majority of respondents (80.8%) believed that prayer could cure HIV, almost all (93.7%) said that they would begin ARV treatment if they became HIV-infected. The multivariate analysis found that respondents' hypothetical willingness to begin ARV treatme was not significantly associated with the belief that prayer could cure HIV or with other religious factors. Refusal of ARV treatment was instead correlated with lack of secondary schooling and lack of knowledge about ARVs. CONCLUSION: The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups. Language: English Keywords: TANZANIA | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | MULTIVARIATE ANALYSIS | TARGET POPULATION | RELIGION | HIV INFECTIONS | STIGMA | PARTNER COMMUNICATION | TREATMENT | ATTITUDES | BELIEFS | ANTIRETROVIRAL THERAPY | INTERPERSONAL COMMUNICATION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Data Analysis | Program Design | Programs | Organization and Administration | Sociocultural Factors | Viral Diseases | Diseases | Social Problems | Interpersonal Relations | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Psychological Factors | Culture | HIV | Communication Document Number: 331080 |
| 21. Title: Fact Sheet: Comprehensive HIV prevention: condoms and contraceptive count. Source: Washington, D.C., Population Action International, 2008. 4 p. (No. 21) Abstract: This fact sheet presents key findings from the 'Comprehensive HIV Prevention: Condoms and Contraceptives Count' which details successful public health strategies and a comprehensive condom programming framework. Language: English Keywords: DEVELOPING COUNTRIES | RECOMMENDATIONS | CROSS-CULTURAL COMPARISONS | POLICYMAKERS | HIV PREVENTION | CONDOM USE | FEMALE CONDOMS | CONTRACEPTIVE AVAILABILITY | FOREIGN AID | FINANCIAL ACTIVITIES | LOGISTICS | INTEGRATED PROGRAMS | PREVALENCE | Comparative Studies | Studies | Research Methodology | Administrative Personnel | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Risk Reduction Behavior | Behavior | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Economic Factors | Management | Programs | Measurement Document Number: 329883 |
| 22. Title: Revitalizing lactational amenorrhea method (LAM) services in Burkina Faso and Mali. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [25] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: In 2006, the United States Agency for International Development (USAID) gave the Institute for Reproductive Health (IRH), Georgetown University the mandate to resume work in the Lactational Amenorrhea Method (LAM), which IRH had developed under a prior cooperation agreement, with an emphasis on revitalizing LAM in settings where the method previously had been introduced but was not reaching its potential. After considerable advocacy to overcome the initial skepticism of policymakers and other key gatekeepers in both countries, IRH began activities in late 2006. By working through local partners, IRH trained core groups of Ministry of Health (MOH) trainers, supervisors and selected providers, who then trained providers from selected areas in Burkina, where IRH worked in close collaboration with JHPIEGO, and in Mali. There has been a visible impact in areas where LAM services became available soon after these trainings. In Burkina over 600 women received LAM counseling; and there was also a noticeable increase of users of other family planning methods, particularly injectables and oral contraceptives, in the facilities where LAM service were available. Field information from Mali shows that significant numbers of women are choosing LAM and receiving counseling on it. Expansion of LAM services to other areas of Mali is already underway, with continued (TA) from IRH to the MOH, including TA to strengthen some support systems. Expansion to other areas of Burkina is contingent on availability of resources. The data and other information obtained from these two pilot projects can be the base for expansion of LAM services to other parts of Burkina and Mali. The information, together with the lessons learned here can also be presented to policymakers from other countries, cooperating agencies, international organizations, and others, as evidence that repositioning LAM as a gateway to other modern family planning methods is of interest to policy makers and that the proposed technical strategies are viable. (excerpt) Language: English Keywords: BURKINA FASO | MALI | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | PILOT PROJECTS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | FAMILY PLANNING PERSONNEL | LACTATIONAL AMENORRHEA METHOD | CONTRACEPTIVE EFFECTIVENESS | FAMILY PLANNING EDUCATION | TECHNICAL ASSISTANCE | USAID | CURRICULUM | TRAINING OF TRAINERS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Comparative Studies | Studies | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | Family Planning Programs | Family Planning | Family Planning, Behavioral Methods | Contraception | Education | Programs | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Training Programs Document Number: 327648 |
| 23. Title: Social marketing final report: three country overview. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Mar. [40] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: While unmet need is growing in sub-Saharan Africa, where contraceptive prevalence is lowest, unmet need remains even in countries where contraceptive prevalence is high, such as in Latin America. Due to rapid growth in the population and increase in the numbers of couples interested in planning and spacing births, reproductive health programs in developing countries face a major challenge: to provide a greater variety of products and services to a rapidly increasing number of users. This challenge must be met in the context of stagnant or decreasing donor funding for contraception. Thus, efforts to meet this unmet need must involve cost-effectively expanding options and access to couples. Social marketing concepts have been successfully applied to increase access and use of many modern contraceptives. The present study was conducted to research the potential of socially-marketing the Standard Days Method® (SDM) in three countries: Ecuador, Benin and the Democratic Republic of the Congo (DRC). The impact of mass media campaigns on knowledge, sales and distribution of the SDM, quality of information provided by pharmacists and providers, and correct use by pharmacy and clinic SDM users was assessed. The aim of the study was to answer the following research questions: What is the impact of a mass media campaign on knowledge, attitudes, sales and free distribution of the SDM?; Can pharmacists and health providers provide high quality information about the SDM?; How do characteristics of women who purchase the SDM from pharmacies compare with those obtain it at a lower or no cost from a clinic?; Can women who purchase the SDM from a pharmacy use the method correctly? (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | LATIN AMERICA | EVALUATION REPORT | CROSS-CULTURAL COMPARISONS | KAP SURVEYS | WOMEN IN DEVELOPMENT | SOCIAL MARKETING | FERTILITY AWARENESS | COST EFFECTIVENESS | MASS MEDIA | FAMILY PLANNING EDUCATION | PHARMACY DISTRIBUTION | CLINICAL DISTRIBUTION | CONTRACEPTIVE EFFECTIVENESS | Africa | Developing Countries | Americas | Evaluation | Comparative Studies | Studies | Research Methodology | Surveys | Sampling Studies | Economic Development | Economic Factors | Marketing | Family Planning | Evaluation Indexes | Quantitative Evaluation | Communication | Education | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception Document Number: 327650 |
| 24. Title: Paying the price. The economic cost of failing to educate girls. Author: Plan Source: Woking, United Kingdom, Plan, 2008. 11 p. Abstract: Perhaps it is impossible to quantify the difference it makes to individuals' confidence, well-being and life-chances. But there is increasing evidence that we can make a serious estimate of the cost to economies of failing to educate girls to the same standard as boys. This report presents a new analysis of the economic cost of failing to educate girls. Based on World Bank research and economic data and UNESCO education statistics, it estimates the economic cost to 65 low and middle income and transitional countries of failing to educate girls to the same standard as boys as a staggering US$92 billion each year. This is just less than the $103bn annual overseas development aid budget of the developed world. The message is clear: investment in girls' education will deliver real returns, not just for individuals but for the whole of society. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | PROGRESS REPORT | COST BENEFIT ANALYSIS | CROSS-CULTURAL COMPARISONS | CHILD, FEMALE | EDUCATION | MACROECONOMIC FACTORS | ECONOMIC DEVELOPMENT | COST EFFECTIVENESS | FOREIGN AID | INEQUALITIES | PROGRAM ACCESSIBILITY | WOMEN'S EMPOWERMENT | SEX DISCRIMINATION | SCHOOL ENROLLMENT | Quantitative Evaluation | Evaluation | Comparative Studies | Studies | Research Methodology | Child | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Factors | Evaluation Indexes | Financial Activities | Socioeconomic Factors | Program Evaluation | Programs | Organization and Administration | Women's Status | Social Discrimination | Social Problems | Sociocultural Factors | Educational Status | Socioeconomic Status Document Number: 326794 |
| 25. Title: State of the world's mothers 2008. Closing the survival gap for children under 5. Author: Save the Children Source: Westport, Connecticut, Save the Children, 2008. [56] p. Abstract: Worldwide, more than 200 million children under age 5 do not get the basic health care they need. This contributes to nearly 10 million children dying needlessly every year from highly preventable or treatable ailments such as diarrhea and pneumonia. A disproportionate number of the children without health care come from the poorest and most marginalized families in developing countries. While there has been significant progress in reducing the overall death toll among children under 5 in recent decades, death rates among the poorest of the poor have not improved nearly so well, and in some countries they have gotten worse. These widening health care inequities unfairly condemn millions of the world's poorest children to early death or a lifetime of ill health. This year's State of the World's Mothers report shows which countries are succeeding - and which are failing - to deliver basic health care to the mothers and children who need it most. It examines where the health care gaps between the poorest and best-off children are widest, and where they are smallest. It also looks at the survival gaps between the rich and poor children in developing countries, and shows how millions of children's lives could be saved by ensuring all children get essential, low-cost health care. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | PROGRESS REPORT | CROSS-CULTURAL COMPARISONS | STATISTICAL STUDIES | CHILDREN | WOMEN IN DEVELOPMENT | MATERNAL HEALTH | CHILD SURVIVAL | HEALTH STATUS INDEXES | POVERTY | INDUSTRIALIZATION | FUNDS | FOREIGN AID | CHILD HEALTH SERVICES | Comparative Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Health | Survivorship | Length of Life | Mortality | Population Dynamics | Socioeconomic Factors | Financial Activities | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care Document Number: 326320 |
| 26. Title: World contraceptive use 2007. [Wallchart]. Author: United Nations. Department of Economic and Social Affairs. Population Division Source: New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2008 Jan. [2] p. (ST/ESA/SER.A/273) Abstract: At the 2005 World Summit, Governments committed themselves to "achieving universal access to reproductive health by 2015, as set out at the International Conference on Population and Development" (A/RES/60/1). This wall chart presents the latest data available on key dimensions of reproductive health, including two of the indicators for the Millennium Development Goals, namely, contraceptive prevalence relative to the use of any method (indicator 5.3) and unmet need for family planning (indicator 5.6). The wall chart shows that universal access to reproductive health is still far from being attained since, at least in terms of unmet need for family planning, in at least 43 countries over 20 per cent of the women of reproductive age who are married or in union have not met their need for contraception. Nevertheless, contraceptive use continues to increase. At the world level, 63 per cent of women of reproductive age who are married or in union are currently using a contraceptive method for a total of 716 million worldwide. (excerpt) Language: English Keywords: GLOBAL | TABLES AND CHARTS | STATISTICAL STUDIES | CROSS-CULTURAL COMPARISONS | CONTRACEPTIVE PREVALENCE SURVEYS | POPULATION | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS CHOSEN | Studies | Research Methodology | Comparative Studies | Family Planning Surveys | Family Planning | Contraceptive Usage | Contraception Document Number: 326747 |
| 27. Peer Reviewed Title: Does an expansion in private sector contraceptive supply increase inequality in modern contraceptive use? Author: Agha S; Do M Source: Health Policy and Planning. 2008 Nov;23(6):465-75. Abstract: OBJECTIVE: To determine whether an expansion in private sector contraceptive supply is associated with increased socio-economic inequality in the modern contraceptive prevalence rate (MCPR inequality). METHODS: Multiple rounds of Demographic and Health Surveys data were analysed for five countries that experienced an increase in the private sector supply of contraceptives: Morocco, Indonesia, Kenya, Ghana and Bangladesh. Information on household assets and amenities was used to construct wealth quintiles. A concentration index, which calculates the degree of inequality in contraceptive use by wealth, was calculated for each survey round. RESULTS: Socio-economic inequality in the MCPR (MCPR inequality) declined in Morocco and Indonesia, where substantial expansion in private sector contraceptive supply occurred. In both countries, poor women continued to rely heavily on contraceptives supplied by the public sector even as they increased use of contraceptives obtained from the private sector. A marginally significant decline in MCPR inequality occurred in Bangladesh, where the increase in private sector supply was modest. There was no significant overall change in MCPR inequality in Kenya or Ghana. In Kenya, this lack of significant overall change disguised trends moving in opposite directions in urban and rural areas. In urban Kenya, MCPR inequality declined as low-income urban women increased use of contraceptives obtained primarily from the public sector. In rural Kenya, MCPR inequality increased. This increase was associated with a decline in the supply of contraceptives by the public sector and non-governmental organizations to the poorest, rural, women. CONCLUSIONS: The study found no support for the hypothesis that an increase in private sector contraceptive supply leads to higher MCPR inequality. The findings suggest that continued public sector supply of contraceptives to the poorest women protects against increased MCPR inequality. The study highlights the role of the public sector in building contraceptive markets for the private sector to exploit. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | EVALUATION INDEXES | CROSS-CULTURAL COMPARISONS | WOMEN | PRIVATE SECTOR | CONTRACEPTIVE AVAILABILITY | INEQUALITIES | SOCIOECONOMIC STATUS | CONTRACEPTIVE PREVALENCE | CONTRACEPTION TERMINATION | CONTRACEPTIVE USAGE DETERMINANTS | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Quantitative Evaluation | Evaluation | Comparative Studies | Studies | Research Methodology | Macroeconomic Factors | Economic Factors | Contraception | Family Planning | Socioeconomic Factors | Contraceptive Usage Document Number: 329173 |
| 28. Title: Wealth status and risky sexual behaviour in Ghana and Kenya. Author: Awusabo-Asare K; Annim SK Source: Applied Health Economics and Health Policy. 2008;6(1):27-39. Abstract: BACKGROUND: Emerging evidence seems to suggest that there is some association between individual socioeconomic status and sexual risk-taking behaviour in sub-Saharan Africa. A number of broad associations have emerged, among them, positive, neutral and negative relationships between wealth status and sexual risk-taking behaviour. Reduction in the number of sex partners as a behavioural change has been advocated as an important tool in HIV prevention, and affecting such a change requires an understanding of some of the factors that can influence social behaviour, interactions and activities of subpopulations. OBJECTIVES: To further explore the determinants of sexual risk-taking behaviour (individuals having multiple sex partners), especially the effects that variations in household wealth status, gender and different subpopulation groups have on this behaviour. METHODS: The relationship between wealth status and sexual risk-taking behaviour in the context of HIV/AIDS infection in Ghana and Kenya was assessed using raw data from the 2003 Demographic and Health Surveys of each country. Wealth quintiles were used as a proxy for economic status, while non-marital and non-cohabiting sexual partnerships were considered indicators for risky sexual behaviour. RESULTS: For females, there appears to be an increasing probability of sexual risk taking by wealth status in Kenya, while, in Ghana, an inverted J-shaped relationship is shown between wealth status and sexual risk taking. When controlled for other variables, the relationship between wealth status and sexual risk-taking behaviour disappears for females in the two countries. For males, there is no clearly discernable pattern between wealth status and sexual risk-taking behaviour in Ghana, while there is a general trend towards increasing sexual risk-taking behaviour by wealth status in Kenya. For Ghana, the highest probabilities are among the highest and the middle wealth quintiles; in Kenya, high probabilities were found for the two highest wealth quintiles. Controlling for the effects of other factors, the pattern for Ghana is further blurred (not statistically significant), but the relationship continues to show in the case of Kenya, and is significant for the highest quintile. In general, for both Ghana and Kenya, men in the highest wealth quintile were found to be more likely to have multiple sexual partners than the other groups. CONCLUSION: The changing phases of HIV infection indicate that it is no longer poverty that drives the epidemic. Rather, it is wealth and a number of other sociodemographic factors that explain sexual risk-taking behaviour that puts people at risk. Understanding local specific factors that predispose individuals towards sexual risk taking could help to expand the range of information and services needed to combat the HIV pandemic. Language: English Keywords: KENYA | GHANA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | CROSS-CULTURAL COMPARISONS | MULTIPLE PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | SOCIOECONOMIC STATUS | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Western | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Comparative Studies | Sexual Partners | Behavior | Socioeconomic Factors | Economic Factors | Population Characteristics Document Number: 329817 |
| 29. Title: Experiences of abortion in Nepal and menstrual regulation in Bangladesh: a gender analysis. Author: Bhandari A; Hom NM; Rashid S; Theobald S Source: Gender and Development. 2008 Jul;16(2):257-272. Abstract: The extent to which abortion and menstrual regulation services are safe, legal, and women-friendly is a strong proxy of gender equity. This article draws on women's voices from Nepal and Bangladesh to illustrate that even where services are provided legally, women can still face multiple barriers to access to services, and problematic quality of care. This is exacerbated by the stigma which surrounds these services. Stigma is directly related to gender inequality, and is constructed at both the community and provider level. It is imperative to overcome these barriers by promoting gender equality across the board, in all services and all contexts. (author's) Language: English Keywords: NEPAL | BANGLADESH | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MENSTRUAL REGULATION | GENDER ISSUES | ABORTION | ABORTION LAW | SEX DISCRIMINATION | INEQUALITIES | STIGMA | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | |