1.  Title: Traveling child-sex offenders in South East Asia: a regional review. Author: Child Wise Source: South Melbourne, Australia, Child Wise, 2009 Mar. 39 p. Abstract: This is the third edition of this compendium of information about the sexual exploitation of children in tourism destinations throughout South East Asia. The report provides a regional overview of child sex tourism in South East Asia along with national reports from all 10 countries in the region. It also provides an update on the successful ASEAN Regional Education Campaign and a brief summary of the key findings from a situational analysis of hotline reporting numbers in the region. Language: English Keywords: ASIA, SOUTHEASTERN | SUMMARY REPORT | TRAVELERS | ORPHANS AND VULNERABLE CHILDREN | STREET KIDS | SEXUAL EXPLOITATION | TRAVEL AND TOURISM | CRIME | SEXUAL ABUSE | PREVENTION AND CONTROL | Asia | Developing Countries | Behavior | Family and Household | Sociocultural Factors | Homeless Persons | Residence Characteristics | Population Distribution | Geographic Factors | Population | Social Problems | Diseases Document Number: 342036 |
2.  Peer Reviewed Title: Factors affecting awareness of emergency contraception among college students in Kathmandu, Nepal. Author: Adhikari R Source: BMC Women's Health. 2009 Sep 17;9(1):27. Abstract: ABSTRACT: BACKGROUND: In Nepal, Emergency Contraception (EC) could play a critical role in reducing unintended pregnancies, but very few people aware about it. This paper aims to investigate the level of awareness and factors influencing awareness of EC among college students. METHODS: A cross-sectional study was carried out in April-May 2006. Structured self-administered questionnaires were administered to 1,137 college students (573 males and 564 females) in Kathmandu district. The association between awareness of EC and the explanatory variables were first assessed in bivariate analysis using the Chi-square test. The associations were further explored using a multivariate logistic analysis. RESULTS: Only about two-thirds of college students (68%) had ever heard about EC. Bivariate analysis shows that males were more aware (72%) of EC than were females (64%). Similarly, the awareness level was significantly higher among younger, unmarried youth who were from outside Kathmandu Valley, who lived with friends, and who had received reproductive health (RH) education in school/college. The study also found that students' sex, permanent place of residence (district), and RH education are significant predictors of awareness of EC. Males are 1.5 times more likely to be aware of EC compared to females. Furthermore, students who lived in Kathmandu Valley were 41% less likely to be aware of EC than were students from outside Kathmandu Valley. On the other hand, those students who received RH education in school/college were almost nine times more likely to be aware of EC compared to those who did not receive such education. CONCLUSIONS: Awareness of the EC is low among college students in Nepal. Health education initiatives should target students as they are more likely to be sexually active. There is a need to further educate students about EC which can help to reduce unintended pregnancies, many of which result in unsafe abortion and take a large toll on women's health. Language: English Keywords: NEPAL | RESEARCH REPORT | STUDENTS | EMERGENCY CONTRACEPTION | AWARENESS | QUESTIONNAIRES | LIVING ARRANGEMENTS | SEX FACTORS | AGE FACTORS | SEX EDUCATION | PREGNANCY, UNPLANNED | Developing Countries | Asia, Southern | Asia | Education | Contraception | Family Planning | Knowledge | Sociocultural Factors | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Reproductive Behavior | Fertility | Population Dynamics Document Number: 342836 |
| 3. Title: The use of home-based therapy with ready-to-use therapeutic food to treat malnutrition in a rural area during a food crisis. Author: Amthor RE; Cole SM; Manary MJ Source: Journal of the American Dietetic Association. 2009 Mar;109(3):464-7. Abstract: When the international community declared a famine in Malawi in January of 2006, emergency food aid reached only populations with pre-existing health care services. To treat the widespread childhood malnutrition in Machinga district, a rural area lacking health care facilities, in February 2006 five outpatient therapeutic programs were implemented that utilized home-based therapy and ready-to-use therapeutic food. Children with severe malnutrition, defined as the presence of edema and/or a weight-for-height less than 70% of the reference standard, were enrolled in the program. Two senior clinical nurses trained village health aides in each of the five communities. Children visited the health aides biweekly. During the visits, health aides collected demographic and anthropometric information and distributed a 2-week supply of ready-to-use therapeutic food, providing 175 kcal/kg/d. Treatment continued for 8 weeks; children were discharged before 8 weeks if they reached a weight-for-height more than 100% of the reference standard, or required admission to the hospital due to systemic infection or recurrence of edema. Of the 826 children enrolled, 775 (93.7%) recovered, 13 (1.8%) remained malnourished, 30 (3.6%) defaulted, and 8 (0.9%) died. Mean weight gained was 2.7+/-3.7 g/kg/d, height gained 0.3+/-0.9 mm/d, and mid-upper arm circumference gained 0.2+/-0.3 mm/d. Home-based therapy with ready-to-use therapeutic food administered by village health aides is an effective approach to treating malnutrition during food crises in areas lacking health services. Language: English Keywords: DEVELOPING COUNTRIES | MALAWI | RESEARCH REPORT | RURAL AREAS | COMMUNITY | CHILDREN | FAMINE | FOOD SECURITY | NUTRITION DISORDERS | ANTHROPOMETRY | BODY WEIGHT | BODY HEIGHT | MALNUTRITION | HOME CARE | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Residence Characteristics | Population Distribution | Youth | Age Factors | Population Characteristics | Demographic Factors | Food Supply | Natural Resources | Environment | Diseases | Measurement | Research Methodology | Physiology | Biology | Care and Support | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine Document Number: 330803 |
| 4. Title: Does where you live influence what you know? Community effects on health knowledge in Ghana. Author: Andrzejewski CS; Reed HE; White MJ Source: Health and Place. 2009 Mar;15(1):228-38. Abstract: This paper examines community effects on health knowledge in a developing country setting. We examine knowledge about the etiology and prevention of child illnesses using a unique 2002 representative survey of communities and households in Ghana. We find that community context matters appreciably, even after adjusting for the anticipated positive effects of an individual's education, literacy, media exposure and household socioeconomic status. The proportion of literate adults and the presence of a market in a community positively influence a person's health knowledge. In other words, even if a person herself is not literate, living in a community with high levels of literacy or a regular market can still positively affect her health knowledge. Our results suggest that social networks and diffusion play a key role in these community effects. In turn, these results offer policy implications for Ghana and sub-Saharan Africa. Language: English Keywords: GHANA | RESEARCH REPORT | KAP SURVEYS | COMMUNITY | CHILDREN | SOCIAL NETWORKS | KNOWLEDGE | LOCALE | CHILD HEALTH | DISEASE PREVENTION | EDUCATIONAL STATUS | LITERACY | MASS MEDIA | SOCIOECONOMIC STATUS | SOCIAL POLICY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Friends and Relatives | Family and Household | Sociocultural Factors | Health | Prevention and Control | Diseases | Socioeconomic Factors | Economic Factors | Communication | Policy | Political Factors Document Number: 330296 |
| 5. Title: Inadequate use of prenatal services among brazilian women: the role of maternal characteristics. Author: Bassani DG; Surkan PJ; Olinto MT Source: International Perspectives On Sexual and Reproductive Health. 2009 Mar;35(1):15-20. Abstract: CONTEXT: To improve the uptake of prenatal care, it is important to know how the use of prenatal care varies by maternal attitudes and social and demographic factors. METHODS: Information about social and demographic variables, prenatal care, parity, pregnancy planning, abortion attempts, satisfaction with pregnancy and satisfaction with the relationship with the child's father was collected from 611 postpartum women in Porto Alegre in southern Brazil. Multinomial logistic regression was used to evaluate associations between these variables and whether the women's use of prenatal care was adequate, partially inadequate or inadequate. RESULTS: About 40% of women had inadequate or partially inadequate prenatal care. After adjustment for other covariates, including satisfaction with the pregnancy, women having an unplanned pregnancy were significantly more likely to have had inadequate care than women who had planned their pregnancy (odds ratio, 2.0). Not living with the child's father (2.8) and dissatisfaction with pregnancy (2.1) were also associated with inadequate use of prenatal care. Women having their second or higher order birth were significantly more likely to report inadequate use of prenatal care than women having their first birth (3.9-9.0). Household income was inversely associated with inadequate use of care. CONCLUSIONS: The study suggests that maternal attitudes may be important for adequate prenatal care. Interventions should be created to encourage women with negative maternal attitudes to use prenatal care and to ensure that they have access to the care they need. Language: English Keywords: BRAZIL | RESEARCH REPORT | STATISTICAL REGRESSION | POSTPARTUM WOMEN | ANTENATAL CARE | UTILIZATION OF HEALTH CARE | ATTITUDES | SOCIOECONOMIC STATUS | PARITY | LIVING ARRANGEMENTS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Analysis | Research Methodology | Puerperium | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 341412 |
| 6. Peer Reviewed Title: Women's use of private and government health facilities for childbirth in Nairobi's informal settlements. Author: Bazant ES; Koening MA; Fotso JC; Mills S Source: Studies in Family Planning. 2009 Mar;40(1):39-50. Abstract: The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | REFUGEES | TRADITIONAL BIRTH ATTENDANTS | HOUSEHOLDS | CHILDBIRTH | REFUGEE CAMPS | UTILIZATION OF HEALTH CARE | PRIVATE SECTOR | GOVERNMENT PROGRAMS | HEALTH FACILITIES | DEMOGRAPHIC FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Population | Migrants | Migration | Population Dynamics | Health Personnel | Delivery of Health Care | Health | Family and Household | Sociocultural Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Residence Characteristics | Population Distribution | Geographic Factors | Health Services | Macroeconomic Factors | Programs | Organization and Administration Document Number: 341077 |
| 7. 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 |
| 8. Peer Reviewed Title: Marital and reproductive behavior in Italy after 1995: bridging the gap with Western Europe? Author: Castiglioni M; Dalla Zuanna G Source: European Journal of Population. 2009 Feb;25(1):1-26. Abstract: Despite a delay of 20-25 years, when it comes to cohabitation, Italy has now begun to resemble other Western countries. In addition, the increase in legal separations has accelerated since 1995, although their number still remains far from that observed in countries such as the USA, the UK, and France. Finally, Italy's fertility decline has come to a halt: the cohort of women born in the early 1970s will likely have the same TFR as those born in the mid-1960s (around 1.55). Moreover, in the Centre-North areas, period TFR rose from 1.1 in 1995 to 1.35 children per woman 10 years later. The territorial diffusion of cohabitation, legal separation, out-of-wedlock births, and fertility recovery overlaps closely with that of the decline in births during the first half of the twentieth century. A similar geographical pattern has been observed for the diffusion of school enrolment, industrialization, secularization, and (during the last 20 years) foreign immigration. Language: English Keywords: EUROPE | ITALY | RESEARCH REPORT | COUPLES | LIVING ARRANGEMENTS | SEPARATION | MARRIAGE | FERTILITY CHANGES | REPRODUCTIVE BEHAVIOR | Developed Countries | Europe, Southern | Family Characteristics | Family and Household | Sociocultural Factors | Residence Characteristics | Population Distribution | Geographic Factors | Population | Nuptiality | Demographic Factors | Fertility | Population Dynamics Document Number: 331294 |
| 9. Title: Individual- and community-level determinants of social acceptance of people living with HIV in Kenya: Results from a national population-based survey. Author: Chiao C; Mishra V; Sambisa W Source: Health and Place. 2009 Sep;15(3):742-750. Abstract: Using the 2003 Kenya Demographic and Health Survey, we investigated the influence of individual- and community-level factors on accepting attitudes toward people living with HIV (PLHIV) using three outcomes: (1) willingness to care for an infected household member, (2) willingness to buy vegetables from an infected vendor, and (3) willingness to allow an infected female teacher to continue teaching. In multilevel logistic regression models, we found that individuals who expressed greater acceptance of PLHIV were more likely to be male, older, more educated, high AIDS knowledge, and exposed to mass media. At the community level, differences in accepting attitudes were associated with community AIDS knowledge, community education, and community AIDS experience, but not for region, or place of residence. The findings suggest the important role of community factors in determining social acceptance of PLHIV. Programmatic strategies aimed at increasing these accepting attitudes should consider both individual- and community-level factors. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | COMMUNITY | TEACHERS | PERSONS LIVING WITH HIV/AIDS | SOCIAL DISCRIMINATION | STIGMA | HIV INFECTIONS | PSYCHOSOCIAL FACTORS | ATTITUDES | FAMILY RELATIONSHIPS | ACCEPTANCE PROCESS | FOOD AND BEVERAGE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Education | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Behavior | Psychological Factors | Family Characteristics | Family and Household | Decision Making | Nutrition | Health Document Number: 341072 |
| 10. Title: Guinea. Village health committees drive family planning uptake: communities play lead role in increased acceptability, availability. Author: Diakite O; Keita DR; Mwebesa W Source: Washington, D.C., Core Group, [2009]. 8 p. Abstract: This document highlights the Village Health Committee (VHC), a vital player in the child survival project and the integration of family planning work within Save the Children's portfolio in Guinea. The document briefly describes the committee's purpose, membership, and tasks. It focuses on a handful of the people and activities that exemplified the VHCs' unique role in ensuring that family planning was not only accessible but acceptable to the villagers they served. The document concludes with some outcomes of Save the Children's family planning component in Mandiana and Kouroussa. In effect, the VHCs' stellar success in building demand for contraception (when coupled with modest investments in existing health workers' ability to supply modern methods) resulted in a sustained increase in the use of contraception in the project zone. Language: English Keywords: GUINEA | PROGRESS REPORT | EVALUATION | COMMUNITY | RURAL POPULATION | USAID | COMMUNITY HEALTH SERVICES | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | PERFORMANCE IMPROVEMENT | RURAL HEALTH SERVICES | FAMILY PLANNING | HEALTH SERVICES EVALUATION | PROGRAM ACCEPTABILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Primary Health Care | Health Services | Health | Program Evaluation | Programs | Organization and Administration | Management Document Number: 325193 |
| 11. Peer Reviewed Title: Saving mother's lives: programs that work. Author: Fortney JA; Leong M Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):224-36. Abstract: Maternal mortality is a complex problem requiring complex responses. Nevertheless, every intervention must operate through one of 3 pathways: preventing pregnancy, preventing complications, or preventing death when obstetric complications occur. We describe interventions following each pathway and assess their evidence base. In general, the more specific the intervention (such as procedures) the stronger the evidence. Broad interventions ("programs" for example) have a weaker evidence base although evidence is accumulating. The potential for robust evidence for effective programs is limited by epidemiologic design-the logistic difficulties of randomization, blinding, and single impact variables. Language: English Keywords: GLOBAL | RECOMMENDATIONS | POLICYMAKERS | COMMUNITY | SAFE MOTHERHOOD | MATERNAL MORTALITY | INTERVENTIONS | PREGNANCY COMPLICATIONS | OBSTETRICS | EMERGENCY SERVICES | MATERNAL HEALTH SERVICES | PROGRAM EFFECTIVENESS | FAMILY PLANNING PROGRAMS | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Population | Maternal Health | Health | Mortality | Population Dynamics | Demographic Factors | Programs | Diseases | Medicine | Health Services | Delivery of Health Care | Maternal-Child Health Services | Primary Health Care | Program Evaluation | Family Planning Document Number: 342175 |
| 12. Peer Reviewed Title: Community-based promotional campaign to improve uptake of intermittent preventive antimalarial treatment in pregnancy in Burkina Faso. Author: Gies S; Coulibaly SO; Ky C; Ouattara FT; Brabin BJ; D'Alessandro U Source: American Journal of Tropical Medicine and Hygiene. 2009 Mar;80(3):460-9. Abstract: Malaria preventive strategies in pregnancy were assessed in a health center randomized trial comparing intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) with and without community based promotional activities in rural Burkina Faso. The study involved 2,240 secundigravidae and secundigravidae and evaluated factors associated with antenatal clinic (ANC) attendance and uptake of IPTp-SP. With promotion, 64.2% completed > or = 3 ANC visits compared with 44.7% without (P = 0.05). Complete uptake of IPTp-SP was 71.8% with and 49.1% without promotion (P = 0.008). The IPTp-SP uptake was lowest in adolescents delivering during high malaria transmission with (29%) or without promotion (30%). Uptake of SP was higher during the low transmission season than in the high transmission season (adjusted odds ratio = 2.17, 95% confidence interval = 1.59-3.03). Community sensitization increased ANC attendance and IPTp-SP uptake. Adolescents were the most difficult to reach, particularly during the high malaria transmission period. The impact of IPTp-SP will be limited unless this high risk group is protected. Language: English Keywords: BURKINA FASO | RESEARCH REPORT | CASE CONTROL STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | COMMUNITY | ANTIMALARIAL DRUGS | PROMOTION | CAMPAIGNS | COMMUNITY HEALTH SERVICES | ANTENATAL CARE | PREVENTIVE MEDICINE | UTILIZATION OF HEALTH CARE | AGE FACTORS | SEASONAL VARIATION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Residence Characteristics | Population Distribution | Geographic Factors | Malaria | Parasitic Diseases | Diseases | Marketing | Communication Programs | Communication | Primary Health Care | Health Services | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Medicine | Population Dynamics Document Number: 331127 |
| 13. Title: HIV behavioural surveillance among refugees and surrounding host communities in Uganda, 2006. Author: Harrison KM; Claass J; Spiegel PB; Bamuturaki J; Patterson N; Muyonga M; Tatwebwa L Source: African Journal of AIDS Research. 2009 Apr;8(1):29-41. Abstract: We used a standardised behavioural surveillance survey (BSS), modified to be directly relevant to populations in conflict and post-conflict settings as well as to their surrounding host populations, to survey the populations of a refugee settlement in south-western Uganda and its surrounding area. Two-stage probability sampling was used to conduct 800 interviews in each population. The BSS questionnaire adapted for displaced populations was administered to adults aged 15-59 years. It collected information on HIV knowledge, attitudes and practices; issues before, during and after displacement; level of interaction and sexual exploitation among the refugees and host communities (i.e., nationals). Population parameters were compared and 95% confidence intervals were calculated for core HIV indicators. The demographic characteristics were similar (except for educational achievement), and HIV awareness was very high (>95%) in both populations. The refugees reported more-accepting attitudes towards persons with HIV than did nationals (19% versus 13%; p < 0.01). More refugees than nationals reported ever having had transactional sex (10% versus 6%; p < 0.01), which mostly occurred post-displacement. Five percent of females among both the refugees and nationals reported experiencing forced sex, which mostly occurred post-displacement and after the arrival of refugees, respectively. Nationals reported more frequent travel to refugee settlements than reported by refugees to national villages (22% versus 11%; p < 0.01). The high mobility and frequent interactions of these two populations suggest that integrated HIV programmes should be developed and would be an efficient use of resources. Evidence suggesting that female refugees may be at elevated risk for HIV infection, due to forced sex, transactional sex and other vulnerabilities, warrants further examination through qualitative research. The findings indicate a need for additional, focused HIV-prevention programmes, such as youth education, for both refugees and Ugandan nationals. Language: English Keywords: UGANDA | REFUGEE CAMPS | RESEARCH REPORT | SAMPLING STUDIES | REFUGEES | HIV PREVENTION | AIDS PREVENTION | ATTITUDES | KNOWLEDGE | SEXUAL EXPLOITATION | SEX BEHAVIOR | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Residence Characteristics | Population Distribution | Geographic Factors | Population | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Psychological Factors | Behavior | Sociocultural Factors Document Number: 341285 |
| 14. Peer Reviewed Title: South African teachers' reflections on the impact of culture on their teaching of sexuality and HIV/AIDS. Author: Helleve A; Flisher AJ; Onya H; Mukoma W; Klepp KI Source: Culture, Health and Sexuality. 2009 Feb;11(2):189-204. Abstract: The authors investigated how teachers respond to perceived cultural differences between the local community and the content of their teaching. Data were collected through interviews with teachers who taught students in grades 8 or 9 in public high schools. The teachers expressed differing viewpoints on the rationale for teaching about HIV/AIDS and sexuality. Many teachers saw teaching these topics as a response to declining moral standards, while others suggested that they were teaching issues that parents failed to address. The teachers were more concerned about young people's sexual behavior than about preventing HIV/AIDS. They perceived that cultural contradictions between what was taught and local cultural values were an issue to which they needed to respond, although they differed in terms of how to respond. Some took an adaptive approach to try to avoid conflicts, while others claimed the moral neutrality of their teaching. Teaching about sexuality was perceived to be challenging in terms of language and communication norms. Teaching about HIV/AIDS was perceived as challenging because teachers often needed to convince students about the reality of AIDS. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | TEACHERS | COMMUNITY | CULTURE | SEX EDUCATION | SEXUALITY | HIV TRANSMISSION | HIV PREVENTION | PERCEPTION | MOTIVATION | VALUE ORIENTATION | LANGUAGE | INTERPERSONAL COMMUNICATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Education | Residence Characteristics | Population Distribution | Geographic Factors | Population | Sociocultural Factors | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Diseases | Communication Document Number: 341086 |
| 15. Peer Reviewed Title: Traces of the second demographic transition in four selected countries in Central and Eastern Europe: union formation as a demographic manifestation. Author: Hoem JM; Kostova D; Jasilioniene A; Muresan C Source: European Journal of Population. 2009 Aug;25(3):239-255. Abstract: Using data from the first round of the national Gender and Generations Surveys of Russia, Romania, and Bulgaria, and from a similar survey of Hungary, which were all collected in recent years, we study rates of entry into marital and non-marital unions. We have used elements from the narrative of the Second Demographic Transition (SDT) as a vehicle to give our analysis of the data from the four countries some coherence, and find what can be traces of the SDT in these countries. The details vary by country; in particular, latter-day developments in union formation patterns did not start at the same time in all countries, but in our assessment it began everywhere before communism fell, that is, before the societal transition to a market economy got underway in 1990. Language: English Keywords: RUSSIA | EUROPE | ROMANIA | HUNGARY | BULGARIA | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | DATA ANALYSIS | MARRIAGE | LIVING ARRANGEMENTS | MARRIAGE AGE | Developing Countries | Asia, Northern | Asia | Developed Countries | Europe, Southeastern | Europe, Central | Population Dynamics | Demographic Factors | Population | Research Methodology | Nuptiality | Residence Characteristics | Population Distribution | Geographic Factors | Marriage Patterns Document Number: 339896 |
| 16. Peer Reviewed Title: Stopping HIV/AIDS - can China succeed? [letter] Author: Horng CT; Agoramoorthy G Source: International Journal of STD and AIDS. 2009 Jan;20(1):72. Abstract: Language: English Keywords: CHINA | RECOMMENDATIONS | EVALUATION | INTERDISCIPLINARY STUDIES | PEER EDUCATORS | CELEBRITIES | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | RESIDENTIAL MOBILITY | SEX EDUCATION | MASS MEDIA | BILLBOARDS AND SIGNS | COUNSELING | CAMPAIGNS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Education | Influentials | Knowledge Sources | Communication | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Residence Characteristics | Population Distribution | Geographic Factors | Population | Clinic Activities | Program Activities | Programs | Organization and Administration | Communication Programs Document Number: 330711 |
| 17. Peer Reviewed Title: Exploring health stakeholders' perceptions on moving towards comprehensive primary health care to address childhood malnutrition in Iran: a qualitative study. Author: Javanparast S; Coveney J; Saikia U Source: BMC Health Services Research. 2009;9:36. Abstract: BACKGROUND: Due to the multifaceted aspect of child malnutrition, a comprehensive approach, taking social factors into account, has been frequently recommended in health literature. The Alma-Ata declaration explicitly outlined comprehensive primary health care as an approach that addresses the social, economic and political causes of poor health and nutrition. Iran as a signatory country to the Alma Ata Declaration has established primary health care since 1979 with significant progress on many health indicators during the last three decades. However, the primary health care system is still challenged to reduce inequity in conditions such as child malnutrition which trace back to social factors. This study aimed to explore the perceptions of the Iranian health stakeholders with respect to the Iranian primary health care performance and actions to move towards a comprehensive approach in addressing childhood malnutrition. Health stakeholders are defined as those who affect or can be affected by health system, for example health policy-makers, health providers or health service recipients. METHODS: Stakeholder analysis approach was undertaken using a qualitative research method. Different levels of stakeholders, including health policy-makers, health providers and community members were interviewed as either individuals or focus groups. Qualitative content analysis was used to interpret and compare/contrast the viewpoints of the study participants. RESULTS: The results demonstrated that fundamental differences exist in the perceptions of different health stakeholders in the understanding of comprehensive notion and action. Health policy-makers mainly believed in the need for a secure health management environment and the necessity for a whole of the government approach to enhance collaborative action. Community health workers, on the other hand, indicated that staff motivation, advocacy and involvement are the main challenges need to be addressed. Turning to community stakeholders, greater emphasis has been placed on community capabilities, informal link with other social sectors based on trust and local initiatives. CONCLUSION: This research provided a picture of the differences in the perceptions and values of different stakeholders with respect to primary health care concepts. The study suggests that a top-down approach, which still exists among health policy-makers, is a key obstacle that delays, and possibly worse, undermines the implementation of the comprehensive strategy codified by the Alma-Ata Declaration. A need to revitalize primary health care to use its full potential and to combine top-down and bottom-up approaches by narrowing the gap between perceptions of policy makers and those who provide and receive health-related services is crucial. Language: English Keywords: IRAN | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CHILDREN | POLICYMAKERS | COMMUNITY | COMMUNITY WORKERS | HEALTH PERSONNEL | PRIMARY HEALTH CARE | CHILD NUTRITION | MALNUTRITION | PERCEPTION | HEALTH POLICY | COMMUNITY HEALTH SERVICES | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Delivery of Health Care | Health | Health Services | Nutrition | Nutrition Disorders | Diseases | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 331083 |
| 18. Title: Sexual violence against women and children in Chinese societies. Author: Ko Ling Chan Source: Trauma, Violence and Abuse. 2009 Jan;10(1):69-85. Abstract: This article provides a comprehensive overview of the reported patterns of sexual violence against women and children in China. It reviews the prevalence of and risk factors for various types of sexual violence and discusses community knowledge and perceptions of these violent acts. It also critically examines three major problems of sexual violence research in China. First, the diversity of findings and study methods reported by surveys and criminal reports reflects the problems in obtaining accurate figures on the scope of the problem. Second, precautions must be taken in reading studies on Chinese culture-specific risk factors for domestic violence. Third, the study of culture-specific factors should not focus solely on cultural factors in a vacuum but rather, should examine traditional culture in the context of modern societies and consensus international standards of human rights. Recommendations for future research are also discussed. Language: English Keywords: CHINA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | KAP SURVEYS | WOMEN IN DEVELOPMENT | CHILDREN | COMMUNITY | CHILD ABUSE | SEXUAL ABUSE | VIOLENCE AGAINST WOMEN | PREVALENCE | RISK FACTORS | RAPE | DOMESTIC VIOLENCE | KNOWLEDGE | PERCEPTION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Crime | Social Problems | Sociocultural Factors | Measurement | Biology | Psychological Factors | Behavior Document Number: 330270 |
| 19. Peer Reviewed Title: High fertility in city suburbs: compositional or contextual effects? La fecondite elevee dans les banlieues urbaines: effets de composition ou de contexte? Author: Kulu H; Boyle PJ Source: European Journal of Population. 2009 May;25(2):157-174. Abstract: Fertility rates are known to be higher in city suburbs. One interpretation is that the suburban 'context' influences the behaviour of individuals who reside there while an alternative is that the 'composition' of the suburban population explains the higher fertility levels. Furthermore, suburban in-migrants who intend to have children may have a significant influence on suburban fertility rates. Using Finnish longitudinal register data we show that fertility rates are higher in the suburbs and rural areas and lower in the cities. Fertility variation across these residential contexts decreases significantly after controlling for women's demographic and socio-economic characteristics. However, it does not disappear entirely suggesting that the local context may have some influence on fertility. While movers to suburbs do display higher fertility levels than non-migrant residents, their overall impact is not great because they form a small share of the suburban population. Language: English Keywords: FINLAND | RESEARCH REPORT | EVENT HISTORY ANALYSIS | WOMEN | REPRODUCTIVE BEHAVIOR | FERTILITY DETERMINANTS | GEOGRAPHIC FACTORS | SOCIOECONOMIC STATUS | INTERNAL MIGRATION | RESIDENTIAL MOBILITY | RESIDENTIAL SELECTION | Developed Countries | Europe, Northern | Europe | Demographic Analysis | Research Methodology | Demographic Factors | Population | Fertility | Population Dynamics | Socioeconomic Factors | Economic Factors | Migration | Residence Characteristics | Population Distribution Document Number: 340173 |
| 20. Peer Reviewed Title: Emerging discourse: Islamic teaching in HIV prevention in Kenya. Author: Maulana AO; Krumeich A; Van Den Borne B Source: Culture, Health and Sexuality. 2009 May 12;:1. Abstract: Islamic values portraying sex outside of marriage as sinful are often believed to contribute to HIV transmission as they reject safe-sex practices. Moreover, stigma associated with sinful behaviour is frequently assumed to interfere with access to care for those infected. In contrast, adherence to religious values such as abstinence is viewed as an explanation for the relatively low incidence of HIV infection in Islamic populations. Inspired by this debate, a study was conducted into the possibilities of using Islamic texts as a starting point for health promotion addressing HIV infection and HIV/AIDS-related stigma in Lamu, a Muslim community in Kenya. The study also explored the potential role of Lamu's Islamic leaders in the delivery of that health promotion. In collaboration with Islamic leaders, texts were identified that applied to sexual conduct, health, stigma and the responsibilities of Islamic leaders towards their congregations. In spite of the association of HIV with improper sexual behaviour, Islamic texts offer a starting point for tackling HIV transmission and HIV/AIDS-related stigma. Under particular conditions, the identified Islamic texts may even justify the promotion of safer-sex methods, including condom use. Language: English Keywords: KENYA | RESEARCH REPORT | EVALUATION | COMMUNITY | HIV PREVENTION | ISLAM | EXTRAMARITAL SEX BEHAVIOR | STIGMA | UTILIZATION OF HEALTH CARE | VALUE ORIENTATION | ABSTINENCE | LEADERSHIP | SEX BEHAVIOR | RISK BEHAVIOR | SAFER SEX | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Residence Characteristics | Population Distribution | Geographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Religion | Sociocultural Factors | Behavior | Social Problems | Health Services | Delivery of Health Care | Health | Psychological Factors | Family Planning, Behavioral Methods | Family Planning | Organization and Administration Document Number: 341496 |
| 21. Title: Concurrent sexual partnerships and HIV infection: Evidence from national population-based surveys. Author: Mishra V; Bignami-Van Assche S Source: Calverton, Maryland, Macro International, Demographic and Health Research Division, MEASURE DHS, 2009 Mar. 129 p. (DHS Working Papers No. 62USAID Contract No. CPO-C-00-03-00002-00) Abstract: Knowing the prevalence and correlates of multiple and concurrent sexual partnerships is important for understanding the dynamics of HIV transmission, and thus for developing effective prevention interventions. Although at least a few theoretical models of multiple and concurrent partnerships have been developed, there is little agreement about how to derive empirical measures and how to assess the relationship of multiple and concurrent sexual partnerships with HIV infection. This study takes advantage of self-reported data on sexual partnerships and biomarker data on HIV serostatus that have been collected in recent years from adult women and men (age 15-49) by nationally representative Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS). Using information on up to three of the respondents' most recent sexual partners, we evaluate and compare the prevalence of concurrent sexual partnerships across countries-defining concurrent partnerships as having two or more sexual partners that overlapped in time in the year preceding the survey. We also examine key characteristics of respondents reporting concurrent partnerships in pooled samples for sub-Saharan Africa, and we evaluate the association between concurrency and HIV serostatus at the individual level, after controlling for educational level, wealth status, condom use, male circumcision, and other factors. Finally, we assess the relationship between prevalence of concurrency and HIV prevalence at the community and country levels. We find that men are much more likely than women to have concurrent partners. Our analysis also shows that many reported multiple partnerships in the 12 months preceding the survey interview were not concurrent ones. Finally, very few men had overlapping partners for one year or longer. In the pooled samples for sub-Saharan Africa, we find that urban, more-educated, and wealthier women and men are more likely to have concurrent partnerships than their rural, less-educated, and poorer counterparts. Circumcised men are also more likely to have concurrent partners than uncircumcised men. Those who had concurrent partners are more likely to report using condoms than those who did not have concurrent partners; yet only one-fifth of women and less than one-tenth of men with concurrent partners reported using condoms at last sex. In most countries, at the individual level women and men who had concurrent sexual partners in the previous 12 months were more likely to be HIV-positive than those who had only one lifetime partner, or those who had multiple lifetime partners but no overlapping partners in the previous 12 months. Yet the duration of overlap in concurrent sexual relationships does not seem correlated with the likelihood of HIV infection. At the individual level, in the pooled samples for sub-Saharan Africa, a positive and significant relationship between concurrent sexual partnerships and HIV-positive status is observed for both women (aOR=3.32; 95%CI: 2.22-4.97) and men (aOR=2.87; 95%CI: 1.85-4.45), after adjusting for other factors such as educational level, wealth status, urban/rural residence, and condom use. Among men, controlling for male circumcision has virtually no effect on the adjusted association between sexual concurrency and HIV serostatus (aOR=2.85; 95%CI: 1.84-4.42). In multivariate models, associating one's concurrency behavior with his/her HIV serostatus reveals that the likelihood of HIV infection is only slightly greater among individuals with concurrent partnerships in the previous 12 months (aOR=3.32 for women; aOR=2.87 for men) than among those with multiple lifetime partnerships that were not concurrent in the previous 12 months (but could have been previously) (aOR=2.86 for women; aOR=2.63 for men). This is to be expected because having concurrent partners increases the risk of transmitting HIV infection to the partners, not necessarily one's own risk of infection above the risk of having multiple serial partners. One's own risk may be greater only to the extent his/her concurrency behavior is a proxy for partners' concurrency behavior or belonging to a higher-risk sexual network. The prevalence of sexual concurrency does not seem correlated with HIV prevalence at the community level or at the country level, neither among women nor among men. The associations are even weaker when the prevalence of HIV among women is correlated with the prevalence of concurrency among men, and when the prevalence of HIV among men is correlated with the prevalence of concurrency among women. The lack of a relationship between the prevalence of concurrency and HIV prevalence among men at the community level does not seem due to varying prevalence levels of male circumcision. However, at the country level a stronger association between prevalence of concurrency among men and HIV prevalence emerges in countries with lower prevalence of male circumcision. The study identifies a number of measurement issues and data constraints that limited the scope of our analysis and that should be kept in mind when interpreting the findings and planning future studies. Some of the major limitations of the study include the cross-sectional and self-reported nature of the survey data, the lack of data on complete sexual histories, and the lack of data on sexual networks. Some of these data limitations have already been addressed in more recent DHS and AIS surveys by systematically including questions about the number of the respondent's lifetime sexual partners, and about consistent condom use with all partners (up to three) in the previous 12 months. The measurement of concurrency could be further improved by collecting information on the duration of the sexual relationship with each of the respondent's sexual partners in the previous 12 months, including his/her spousal partners, and by collecting information on the frequency of sexual intercourse during each relationship. Despite the limitations inherent to the measurement of concurrency using self-reported data from cross-sectional population-based surveys, the findings of this study shed new light on the prevalence and correlates of concurrency, as well as on the association between concurrency and HIV. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | EPIDEMIOLOGIC METHODS | MULTIPLE PARTNERS | PERSONS LIVING WITH HIV/AIDS | COMMUNITY | HIV INFECTIONS | PREVALENCE | POLYGAMY | TIME FACTORS | CONDOM USE | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Sexual Partners | Sex Behavior | Behavior | Viral Diseases | Diseases | Residence Characteristics | Population Distribution | Geographic Factors | Measurement | Marriage Patterns | Marriage | Nuptiality | Risk Reduction Behavior Document Number: 341092 |
| 22. Peer Reviewed Title: Comparison of T-SPOT.TB assay and tuberculin skin test for the evaluation of young children at high risk for tuberculosis in a community setting. Author: Nicol MP; Davies MA; Wood K; Hatherill M; Workman L; Hawkridge A Source: Pediatrics. 2009 Jan;123(1):38-43. Abstract: OBJECTIVE: We wished to compare the sensitivity of an enzyme-linked immunospot assay (T-SPOT.TB; Oxford Immunotec, Oxford, United Kingdom) and the tuberculin skin test for the detection of tuberculosis infection in very young children being evaluated for active tuberculosis in a rural community setting. METHODS: Children with a history of exposure to tuberculosis and children presenting to a local clinic or hospital with symptoms suggesting tuberculosis were admitted to a dedicated case verification ward. T-SPOT.TB testing was performed, and children were evaluated with a clinical examination, a tuberculin skin test, chest radiographs, and cultures of induced sputum and gastric lavage specimens. The diagnosis was determined by using a clinical algorithm. RESULTS: A total of 243 children (median age: 18 months) were recruited, of whom 214 (88%) had interpretable T-SPOT.TB results. Children > or =12 months of age were more likely than younger children to have positive T-SPOT.TB results, whereas tuberculin skin test results were unaffected by age. The sensitivity of the T-SPOT.TB was no better than that of the tuberculin skin test for culture-confirmed tuberculosis (50% and 80%, respectively) and was poorer for the combined group of culture-confirmed and clinically probable tuberculosis (40% and 52%, respectively). For the 50 children clinically categorized as not having tuberculosis, the specificity of both the T-SPOT.TB and the tuberculin skin test was 84%. CONCLUSIONS: For young children presenting in a community setting after exposure to tuberculosis or with symptoms suggesting tuberculosis, T-SPOT.TB cannot be used to exclude active disease. The sensitivity of this assay may be impaired for very young children. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | COMPARATIVE STUDIES | CHILDREN | COMMUNITY | TUBERCULOSIS | TESTING | COMMUNITY HEALTH SERVICES | LABORATORY EXAMINATIONS AND DIAGNOSES | DERMATOLOGICAL EFFECTS | PHYSICAL EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Infections | Diseases | Measurement | Primary Health Care | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Physiology | Biology Document Number: 328039 |
| 23. Title: Gender differences in intention to remain a virgin until marriage among school pupils in rural northern Tanzania. Author: Njau B; Mtweve S; Manongi R; Jalipa H Source: African Journal of AIDS Research. 2009;8(2):157-166. Abstract: This study was conducted in 10 districts in northern Tanzania in July 2005. Out of 65 villages, four were randomly selected. In total, 953 primary school pupils, ages 10 to 14 years, participated in an interview and questionnaire: about 54% were girls and 41% were ages 12 to 13. Thirty-four percent of boys and 28.5% of girls said they had the intention to remain a virgin until marriage. Among the male respondents, having the intention to remain a virgin until marriage was associated with sharing a bedroom with a brother under age 18 years and with saying that girls have the right to say no to sex. Among the female respondents, having the intention to remain a virgin until marriage was associated with living with both parents and saying that they had the confidence to refuse sex with someone who has authority or power. Language: English Keywords: TANZANIA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | ABSTINENCE | VIRGINITY | ATTITUDES | SEX FACTORS | PRIMARY SCHOOLS | INTERVIEWS | LIVING ARRANGEMENTS | PSYCHOSOCIAL FACTORS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Studies | Research Methodology | Education | Family Planning, Behavioral Methods | Family Planning | Sex Behavior | Behavior | Psychological Factors | Population Characteristics | Demographic Factors | Schools | Data Collection | Residence Characteristics | Population Distribution Document Number: 339890 |
| 24. Peer Reviewed Title: Age patterns of severe paediatric malaria and their relationship to Plasmodium falciparum transmission intensity. Author: Okiro EA; Al-Taiar A; Reyburn H; Idro R; Berkley JA; Snow RW Source: Malaria Journal. 2009;8:4. Abstract: BACKGROUND: The understanding of the epidemiology of severe malaria in African children remains incomplete across the spectrum of Plasmodium falciparum transmission intensities through which communities might expect to transition, as intervention coverage expands. METHODS: Paediatric admission data were assembled from 13 hospitals serving 17 communities between 1990 and 2007. Estimates of Plasmodium falciparum transmission intensity in these communities were assembled to be spatially and temporally congruent to the clinical admission data. The analysis focused on the relationships between community derived parasite prevalence and the age and clinical presentation of paediatric malaria in children aged 0-9 years admitted to hospital. RESULTS: As transmission intensity declined a greater proportion of malaria admissions were in older children. There was a strong linear relationship between increasing transmission intensity and the proportion of paediatric malaria admissions that were infants (R2 = 0.73, p < 0.001). Cerebral malaria was reported among 4% and severe malaria anaemia among 17% of all malaria admissions. At higher transmission intensity cerebral malaria was a less common presentation compared to lower transmission sites. There was no obvious relationship between the proportions of children with severe malaria anaemia and transmission intensity. CONCLUSION: As the intensity of malaria transmission declines in Africa through the scaling up of insecticide-treated nets and other vector control measures a focus of disease prevention among very young children becomes less appropriate. The understanding of the relationship between parasite exposure and patterns of disease risk should be used to adapt malaria control strategies in different epidemiological settings. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | COMMUNITY | PREVALENCE | AGE FACTORS | MALARIA | HUMAN GEOGRAPHY | TIME FACTORS | LOCALE | CENTRAL NERVOUS SYSTEM EFFECTS | ANEMIA | INFECTION TRANSMISSION | Africa | Developing Countries | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Measurement | Parasitic Diseases | Diseases | Geography | Social Sciences | Science | Sociocultural Factors | Population Dynamics | Central Nervous System | Physiology | Biology | Infections Document Number: 330371 |
| 25. Peer Reviewed Title: Reasons for ineffective contraceptive use antedating adolescent pregnancies part 1: an indicator of gaps in family planning services. Author: Sheeder J; Tocce K; Stevens-Simon C Source: Maternal and Child Health Journal. 2009 May;13(3):295-305. Abstract: PURPOSE: Identify new ways to increase the impact of pregnancy prevention interventions on the number of children born to adolescents. METHODS: The study participants, a racially/ethnically diverse group of 1,568, pregnant 13-18 year olds, reported why they had not used contraception at the time of conception. Their explanations were sorted into categories. The frequency with which each category was endorsed, the stability of these endorsements (Kappa statistic), and differences between adolescents who endorsed each category (stepwise logistic regression) were examined at two points in gestation. RESULTS: "Not ready to prevent pregnancy" was the most frequently endorsed category; it was often the only category endorsed. Logistical barriers and misperceptions about the need for contraception were the least frequently endorsed categories. The reasons individual patients gave for not using contraception changed (K < or = 0.4) during gestation. Yet, adolescents who were not ready to prevent conception consistently differed from those who were; they were more apt to be Hispanic, to live in non-chaotic environments with an adult father of the child rather than their parents, and to have goals compatible with adolescent childbearing. CONCLUSIONS: The most expedient way to strengthen the impact of pregnancy prevention programs on adolescent childbearing is to shift the focus of intervention from overcoming logistical barriers and misperceptions about the need for contraception, to helping young women develop goals that make adolescent childbearing a threat to what they want in life. This means intervening actively enough to ensure that goal setting translates into an internal desire to postpone childbearing beyond adolescence. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SAMPLING STUDIES | ADOLESCENTS, FEMALE | SOCIAL NETWORKS | ADOLESCENT PREGNANCY | PREGNANCY, UNPLANNED | CONTRACEPTIVE USAGE DETERMINANTS | PSYCHOLOGICAL FACTORS | LIVING ARRANGEMENTS | SEXUALLY TRANSMITTED DISEASES | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Friends and Relatives | Family and Household | Sociocultural Factors | Reproductive Behavior | Fertility | Population Dynamics | Contraceptive Usage | Contraception | Family Planning | Behavior | Residence Characteristics | Population Distribution | Geographic Factors | Reproductive Tract Infections | Infections | Diseases Document Number: 342485 |
| 26. Peer Reviewed Title: Reasons for ineffective contraceptive use antedating adolescent pregnancies: part 2: a proxy for childbearing intentions. Author: Sheeder J; Tocce K; Stevens-Simon C Source: Maternal and Child Health Journal. 2009 May;13(3):306-17. Abstract: PURPOSE: Compare the relationship between childbearing intentions, maternal behaviors, and pregnancy outcomes in a group of early/middle adolescents versus a group of late adolescents (specifically high school seniors, high school graduates, and GED certificate recipients). METHODS: The reasons given by a racially/ethnically diverse group of 1,568 pregnant 13-18 year olds for not using contraception were used to classify their pregnancies as intended or unintended. Proportion comparison tests and stepwise logistic regression analyses were used to study the relationship between childbearing intentions, maternal behaviors, and pregnancy outcomes. RESULTS: Regardless of age, adolescents who intended to become pregnant conceived in an objectively more hospitable and supportive childbearing milieu than those who conceived unintentionally. This is evidenced by their greater likelihood of having goals compatible with adolescent childbearing, cohabitation with the father of the child, and living in a non-chaotic environment. However, pregnancy planning was not associated with improved compliance with preventive health care recommendations during gestation nor with infant outcomes. As such, the consequences among adolescents with intended pregnancies were negative, as evidenced by a higher rate of smoking, STDs late in gestation, school dropout, and repeat conception. CONCLUSIONS: Like adults, adolescents with intended pregnancies conceived in an objectively more supportive environment than their counterparts with unintended pregnancies. However, this advantage did not translate into better support, healthier maternal behavior during gestation, or improved pregnancy outcomes. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SAMPLING STUDIES | ADOLESCENTS, FEMALE | SOCIAL NETWORKS | ADOLESCENT PREGNANCY | PREGNANCY, UNPLANNED | CONTRACEPTIVE USAGE | PREGNANCY OUTCOMES | LIVING ARRANGEMENTS | TOBACCO USE | SEXUALLY TRANSMITTED DISEASES | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Friends and Relatives | Family and Household | Sociocultural Factors | Reproductive Behavior | Fertility | Population Dynamics | Contraception | Family Planning | Pregnancy | Reproduction | Residence Characteristics | Population Distribution | Geographic Factors | Behavior | Reproductive Tract Infections | Infections | Diseases Document Number: 342484 |
| 27. Title: Towards a sustainable community database: taking advantage of the Road-to-Health cards to monitor and evaluate health interventions targeting under fives. Author: Simba DO Source: Tanzania Journal of Health Research. 2009 Jan;11(1):46-50. Abstract: The Road-to-Health (RTH) card has served as a tool for monitoring nutrition and vaccination status individual child for several decades. The card has the potential to serve as a community database for research if kept by the caretaker for a considerable period. This study aimed to assess whether the magnitude of possession and retention of RTH cards is adequate to serve as a community database for monitoring and evaluating health interventions targeting under fives. This cross-sectional study was conducted among under fives in Korogwe town and its suburbs in Tanzania. Six wards and four villages were randomly selected and all under fives found were included. Using a structured questionnaire, demographic information was obtained from the parent/guardian of the child. Information was collected on the presence of RTH card from which the date of birth was recorded. A total of 4899 households were involved and information obtained for 6364 under fives. The overall card possession rate was 74.3%. Possession of RTH cards was found to be highest among the last born under fives (78.3%) than the third-from-last born under fives (45.1%). Caretakers who were married and educated had higher card possession rate. In conclusion the possession of RTH cards was adequate to serve as a community database for monitoring health status and evaluating health interventions targeting the under fives. However, the low retention rate poses a limitation for the cards to serve as a permanent community database. This paper discusses some of the strategies to increase retention of the cards by caretakers. Language: English Keywords: TANZANIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | COMMUNITY | HOUSEHOLDS | CHILD HEALTH | PERSONAL IDENTIFICATION SYSTEMS | INFORMATION RETRIEVAL SYSTEMS | MONITORING | INTERVENTIONS | PROGRAM EVALUATION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Family and Household | Sociocultural Factors | Health | Records | Information Processing | Information | Data Storage and Retrieval | Evaluation | Programs | Organization and Administration Document Number: 341671 |
| 28. Peer Reviewed Title: The impact of HIV/AIDS on the living arrangements and well-being of elderly caregivers in rural Uganda. Author: Ssengonzi R Source: AIDS Care. 2009 Mar;21(3):309-14. Abstract: As the HIV/AIDS epidemic continues to devastate the sub-Saharan Africa region, the demand for care and support services to persons infected and affected by the disease is proliferating. Currently providing the bulk of this much-needed care and support are elderly persons. However, limited work has been done to examine how such care and support impacts the well-being of elderly caregivers. Using qualitative data from elderly respondents in two Ugandan districts, Kamuli and Luwero, this article examines changes in the household structure and living arrangements of older persons (50 years and above) after they take on caregiving responsibilities for persons suffering from AIDS-related illnesses and orphans and vulnerable children (OVC) affected by HIV/AIDS. The findings show that elderly caregivers face drastic disruptions of living arrangements, including prolonged travels and absences from their homes to care for the sick. There is also a sharp increase in their household size as they take on more OVC. The implications of such changes on the older persons' health and well-being are discussed. Language: English Keywords: UGANDA | RURAL AREAS | RESEARCH REPORT | OLDER ADULTS | PERSONS LIVING WITH HIV/AIDS | ORPHANS AND VULNERABLE CHILDREN | FAMILY AND HOUSEHOLD | CARE AND SUPPORT | LIVING ARRANGEMENTS | INTERVIEWS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Adults | Age Factors | Population Characteristics | Demographic Factors | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Health Services | Delivery of Health Care | Health | Residence Characteristics | Population Distribution | |