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Title: Diarrheal disease: solutions to defeat a global killer.
Author: Program for Appropriate Technology in Health [PATH]
Source: Washington, D.C., PATH, 2009. 38 p.
Abstract: Today, the leading causes of death among children under the age of five, particularly in the developing world, are pneumonia and diarrhea. These illnesses are both preventable and treatable. The global health community possesses the interventions and knowledge to save millions of children's lives worldwide. We can do this by reprioritizing diarrheal disease on the global health agenda; educating, increasing awareness, and mobilizing health care providers, policymakers, and the larger global community around the burden of diarrheal disease and the lifesaving interventions that exist today; and by implementing these solutions with a coordinated approach. Proven, lifesaving, prevention and treatment methods [include]: safe water, improved sanitation and good hygiene; vaccines; exclusive breastfeeding and optimal complementary feeding; oral rehydration therapy (ORT) / oral rehydration solution (ORS); zinc treatment and other micronutrients. (Excerpts)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | LOW INCOME POPULATION | CHILDREN | DIARRHEA | MALNUTRITION | CHILD MORTALITY | ZINC | WATER QUALITY | CAUSES OF DEATH | SANITATION | TREATMENT | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Nutrition Disorders | Mortality | Population Dynamics | Metals | Vitamins and Minerals | Physiology | Biology | Water | Natural Resources | Environment | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 331382

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Peer Reviewed

Title: Effects of a rapid peer-based HIV/AIDS educational intervention on knowledge and attitudes of high school students in a high-income Arab country.
Author: Barss P; Grivna M; Ganczak M; Bernsen R; Al-Maskari F
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):86-98.
Abstract: INTRODUCTION: In response to low knowledge about HIV and intolerant attitudes toward persons living with HIV among Arab university students, a peer-based educational intervention was developed and impact evaluated on knowledge and attitudes of high school students in 2 of 4 main cities of United Arab Emirates. METHODS: Four small teams of final year medical students, 3 female and 1 male, were trained. Multistage random sampling selected 14 female and 5 male Arab schools, then 56 female and 14 male grade 12 classes in Al Ain and Abu Dhabi. The 90-minute intervention included a factual presentation and 3 attitude workshops. Baseline and postintervention knowledge and attitudes were assessed. Significance was tested by McNemar, Wilcoxon signed rank, and multilevel regression tests. RESULTS: Response was 99.6%, 1398 females and 505 males. Misconceptions about modes of transmission and intolerant attitudes were evident. Mean knowledge score improved from 65% to 82% and attitude 51% to 64%, that is, relative increase 26% (P < 0.0005). Females had slightly lower baseline knowledge than males but showed greater improvement in knowledge and attitudes (P < 0.0005) CONCLUSIONS: Grade 12 students' knowledge about HIV/AIDS was inadequate and attitudes stigmatizing. Peer-based knowledge workshops were effective, especially among females. Concise integrated teaching and workshops designed to address key knowledge and attitudinal deficiencies can be highly effective.
Language: English
Keywords:
MIDDLE EAST | RESEARCH REPORT | STUDENTS | SECONDARY SCHOOLS | HIGH INCOME POPULATION | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | SEX EDUCATION | HIV INFECTIONS | AIDS | INTERVENTIONS | STIGMA | ADOLESCENT HEALTH | PROMOTION | AIDS PREVENTION | HIV PREVENTION | EPIDEMIOLOGY | Education | Schools | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Psychological Factors | Behavior | Viral Diseases | Diseases | Programs | Organization and Administration | Social Problems | Health | Marketing | Public Health
Document Number: 342885

5.
Peer Reviewed

Title: Maternal healthcare financing: Gujarat's Chiranjeevi Scheme and its beneficiaries.
Author: Bhat R; Mavalankar DV; Singh PV; Singh N
Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):249-58.
Abstract: Maternal mortality is an important public-health issue in India, specifically in Gujarat. Contributing factors are the Government's inability to operationalize the First Referral Units and to provide an adequate level of skilled birth attendants, especially to the poor. In response, the Gujarat state has developed a unique public-private partnership called the Chiranjeevi Scheme. This scheme focuses on institutional delivery, specifically emergency obstetric care for the poor. The objective of the study was to explore the targeting of the scheme, its coverage, and socioeconomic profile of the beneficiaries and to assess financial protection offered by the scheme, if any, in Dahod, one of the initial pilot districts of Gujarat. A household-level survey of beneficiaries (n=262) and non-users (n=394) indicated that the scheme is well-targeted to the poor but many poor people do not use the services. The beneficiaries saved more than Rs 3000 (US$ 75) in delivery-related expenses and were generally satisfied with the scheme. The study provided insights on how to improve the scheme further. Such a financing scheme could be replicated in other states and countries to address the cost barrier, especially in areas where high numbers of private specialists are available.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PILOT PROJECTS | LOW INCOME POPULATION | MATERNAL HEALTH SERVICES | FINANCIAL ACTIVITIES | OBSTETRICS | EMERGENCY SERVICES | PROGRAM EVALUATION | MATERNAL MORTALITY | QUALITY OF HEALTH CARE | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Medicine | Programs | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Health Services Evaluation
Document Number: 341931

Peer Reviewed

Title: Putting mental health on the agenda for HIV+ women: a review of evidence from sub-Saharan Africa.
Author: Brandt R
Source: Women and Health. 2009 Mar-May;49(2-3):215-28.
Abstract: This article reviews the scientific literature regarding mental health services for poor HIV-infected women in sub-Saharan Africa and argues that they should constitute part of the healthcare agenda for these women. Key evidence points to the growing feminization of the HIV epidemic, as well as the differential social and economic impact of HIV on women. Further, HIV and poverty, both disproportionately affecting women, contribute independently and cumulatively to the risk for poor mental health. The limited empirical evidence regarding the mental health of this population is discussed. Multi-level psychosocial services, integrated within general health provision, are required to ensure long-term psychological benefits for HIV-infected women in the region.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | LOW INCOME POPULATION | PERSONS LIVING WITH HIV/AIDS | MENTAL HEALTH | HEALTH SERVICES | POVERTY | PROGRAM ACCESSIBILITY | Africa | Developing Countries | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases | Health | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration
Document Number: 342427

Title: Maternal mortality in low-income countries: what interventions have been evaluated and how should the evidence base be developed further?
Author: Burchett HE; Mayhew SH
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):78-81.
Abstract: OBJECTIVE: This article reviews the evidence for the effectiveness of non-clinical interventions to reduce maternal mortality in low-income settings and identifies the gaps in the evidence base. METHODS: A systematic search was conducted to identify reviews and evaluations of non-clinical interventions to reduce maternal mortality in lower-income countries with high maternal mortality published between 1997 and 2008. Studies were reviewed to identify the topic focus, study design, and outcomes measured. RESULTS: There were 109 intervention evaluations and 30 reviews identified. Studies had been conducted in less than half of the countries and were generally poor quality. More studies focused on tertiary prevention (i.e., preventing death) rather than secondary prevention (i.e., preventing complications). More interventions sought to address quality of care than delays in seeking or accessing care. CONCLUSIONS: While evidence partly reflects difficulties in evaluating complex public health interventions, more robust study designs are possible to evaluate interventions to reduce maternal mortality. In addition, better standardized outcome measures are needed. This overview identifies topic areas neglected by intervention research.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | INTERVENTIONS | LOW INCOME POPULATION | MATERNAL MORTALITY | EVALUATION | RESEARCH METHODOLOGY | Developed Countries | Europe, Western | Europe | Programs | Organization and Administration | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 341377

8.
Peer Reviewed

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

9.
Title: The impact of socioeconomic and demographic variables on poverty: a village study.
Author: Chaudhry IS; Malik S; ul Hassan A
Source: Lahore Journal of Economics. 2009 Summer;14(1):39-68.
Abstract: Poverty is a complex phenomenon based on a network of interlocking economic, social, political, and demographic factors. An understanding of the extent, nature, and determinants of rural poverty is a precondition for effective public policy to reduce poverty in rural Pakistan. The present study attempts to analyze the impact of socioeconomic and demographic characteristics of households on poverty, using primary data collected in the village ofBetti Nala in Tehsil Jatoi, district MuzaJfargarh in southern Punjab. We have used two distinct approaches: (i) a poverty profile, and (ii) an econometric approach in our empirical analysis. The results show that household size, dependency on household, participation, landholdings, and number oflivestock have a Significant impact on poverty incidence. Our final conclusion is that efforts should be made to improve socioeconomic foctors in general and demographic foctors in particular to alleviate rural poverty in remote areas of Pakistan, while land should beallotted to landless households.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | RURAL AREAS | RURAL POPULATION | LOW INCOME POPULATION | POVERTY | SOCIOECONOMIC FACTORS | INTERMEDIATE VARIABLES | NEEDS | IMPACT | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Population Characteristics | Demographic Factors | Social Class | Socioeconomic Status | Economic Factors | Population Dynamics | Communication
Document Number: 340236

10.

Peer Reviewed

Title: Estimating inequalities in ownership of insecticide treated nets: does the choice of socio-economic status measure matter?
Author: Chuma J; Molyneux C
Source: Health Policy and Planning. 2009 Mar;24(2):83-93.
Abstract: Research on the impact of socio-economic status (SES) on access to health care services and on health status is important for allocating resources and designing pro-poor policies. Socio-economic differences are increasingly assessed using asset indices as proxy measures for SES. For example, several studies use asset indices to estimate inequities in ownership and use of insecticide treated nets as a way of monitoring progress towards meeting the Abuja targets. The validity of different SES measures has only been tested in a limited number of settings, however, and there is little information on how choice of welfare measure influences study findings, conclusions and policy recommendations. In this paper, we demonstrate that household SES classification can depend on the SES measure selected. Using data from a household survey in coastal Kenya (n = 285 rural and 467 urban households), we first classify households into SES quintiles using both expenditure and asset data. Household SES classification is found to differ when separate rural and urban asset indices, or a combined asset index, are used. We then use data on bednet ownership to compare inequalities in ownership within each setting by the SES measure selected. Results show a weak correlation between asset index and monthly expenditure in both settings: wider inequalities in bednet ownership are observed in the rural sample when expenditure is used as the SES measure [Concentration Index (CI) = 0.1024 expenditure quintiles; 0.005 asset quintiles]; the opposite is observed in the urban sample (CI = 0.0518 expenditure quintiles; 0.126 asset quintiles). We conclude that the choice of SES measure does matter. Given the practical advantages of asset approaches, we recommend continued refinement of these approaches. In the meantime, careful selection of SES measure is required for every study, depending on the health policy issue of interest, the research context and, inevitably, pragmatic considerations.
Language: English
Keywords:
KENYA | RESEARCH REPORT | LOW INCOME POPULATION | SOCIOECONOMIC STATUS | EXPENDITURES | BED NETS | MALARIA PREVENTION | HEALTH STATUS INDEXES | HEALTH POLICY | HEALTH SERVICES | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Social Class | Socioeconomic Factors | Economic Factors | Financial Activities | Parasite Control | Public Health | Health | Malaria | Parasitic Diseases | Diseases | Policy | Political Factors | Sociocultural Factors | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration
Document Number: 331225

11.

Title: Problems to solve.
Author: Eichler R; Levine R
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :11-21.
Abstract: In the vast majority of low-income countries, health system performance is way off the mark. Many of the individuals who could benefit most from preventive and therapeutic health services do not receive them, and when they do, the quality of the services is low. The most obvious reason for the deficiencies is limited resources. On average, low-income countries -- those with a gross national income of less than $1,095 in 2009 dollars -- spend about 4.1 percent of gross domestic product from both public and private sources. At current levels of spending, even adjusting for differences in the cost of labor and other inputs across countries, it is impossible for basic services of acceptable quality to reach the majority of the population. Beyond this, a range of systemic shortcomings is evident: quality control and supervision are absent, supply chains are broken, the transfer and use of information are weak, managerial skills are in short supply in both public and private sectors, and the absolute number of health workers at virtually all levels is lower than optimal by technical standards. To solve a problem, one must identify it and understand its underlying causes. Here we highlight both a set of important problems and the reasons to believe -- at least on conceptual grounds -- that introducing financial and other material incentives can improve health sector performance. (Excerpts)
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW INCOME POPULATION | HEALTH SERVICES | PERFORMANCE IMPROVEMENT | INCENTIVES | PREVENTIVE HEALTH CARE | QUALITY OF HEALTH CARE | CHILD HEALTH | MANAGEMENT | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Delivery of Health Care | Health | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Health Services Evaluation | Program Evaluation | Programs
Document Number: 331461

12.

Title: Care-seeking behavior of women with reproductive health problems from low-income areas of Beirut.
Author: El-Kak F; Khawaja M; Salem M; Zurayk H
Source: International Journal of Gynaecology and Obstetrics. 2009 Jan;104(1):60-3.
Abstract: OBJECTIVE: To examine the patterns of care-seeking behavior and provider choice of women with self-reported reproductive health problems from 3 urban communities in Beirut. METHODS: The study was based on a sample of 1869 completed questionnaires from 2051 eligible women (married or had been married, and between 15 and 59 years) obtained during the Urban Health Survey. Associations between community of residence, other background characteristics, and two outcome measures (health care usage and choice of provider) were assessed using logistic regression. RESULTS: Of the 1869 women assessed, 439 (23.5%) reported reproductive health problems; of these, 273 (62%) women sought care for their problems, with the majority (52.5%) using private providers. Younger age, health insurance, and severity and duration of problems were associated with use. Women with higher parity and those with financial problems were significantly more likely to use public and subsidized services. CONCLUSION: The private health sector needs to be more involved in planning, implementing, and offering reproductive health care in low-income communities.
Language: English
Keywords:
LEBANON | RESEARCH REPORT | WOMEN | LOW INCOME POPULATION | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | BEHAVIOR | REPRODUCTIVE HEALTH | NEEDS ASSESSMENT | Middle East | Developing Countries | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Delivery of Health Care | Health | Evaluation
Document Number: 331193

13.

Title: Stillbirth and early neonatal mortality in rural Central Africa.
Author: Engmann C; Matendo R; Kinoshita R; Ditekemena J; Moore J; Goldenberg RL; Tshefu A; Carlo WA; McClure EM; Bose C; Wright LL
Source: International Journal of Gynaecology and Obstetrics. 2009 May;105(2):112-7.
Abstract: OBJECTIVE: To develop a prospective perinatal registry that characterizes all deliveries, differentiates between stillbirths and early neonatal deaths (ENDs), and determines the ratio of fresh to macerated stillbirths in the northwest Democratic Republic of Congo. METHOD: Birth outcomes were obtained from 4 rural health districts. RESULTS: A total of 8230 women consented, END rate was 32 deaths per 1000 live births, and stillbirth rate was 33 deaths per 1000 deliveries. The majority (75%) of ENDs and stillbirths occurred in neonates weighing 1500 g or more. Odds of stillbirth and END increased in mothers who were single or who did not receive prenatal care, and among premature, low birth weight, or male infants. The ratio of fresh to macerated stillbirths was 4:1. CONCLUSION: Neonates weighing 1500 g or more at birth represent a group with a high likelihood of survival in remote areas, making them potentially amenable to targeted intervention packages. The ratio of fresh to macerated stillbirths was approximately 10-fold higher than expected, suggesting a more prominent role for improved intrapartum obstetric interventions.
Language: English
Keywords:
AFRICA, CENTRAL | RESEARCH REPORT | LOW INCOME POPULATION | RURAL AREAS | NEONATAL MORTALITY | FETAL DEATH | Africa, Sub Saharan | Africa | Developing Countries | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Geographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Demographic Factors
Document Number: 341378

14.
Title: [A fixed dose anti-HIV combination for the poor? Triomune] Triom une: la tritherapie du pauvre ?
Author: Garcia MV; Mukeba-Tshialala D; Vaira D; Moutschen M
Source: Revue Medicale De Liege. 2009 Jan;64(1):32-6.
Abstract: Despite a relative global stabilization of its incidence, HIV infection remains a major threat for public health, principally in Africa where it concerns more than 22 million people and constitutes the first cause of death on the continent. To face the emergency of the HIV/AIDS epidemics on the African continent, the primary goal is to make available to all patients free and efficient antiretroviral medications. Such a goal cannot be dissociated from large scale prevention campaigns. In 2000, Triomune, one of the first fixed dose combinations of three antiretrovirals (stavudine, lamivudine & nevirapine) was launched by the Indian drug company Cipla, specialized in the production of low cost medications. Its convenient pill burden (one pill twice a day) and its very low cost (around 30 US $ per month) make Triomune an appealing solution for the treatment of HIV/AIDS in Africa. Unfortunately, Triomune presents several drawbacks (low genetic barrier, frequent side effects) and one of its constituents is not used in Europe anymore. Other first line treatments are urgently needed.
Language: French
Keywords:
AFRICA | RESEARCH REPORT | INCIDENCE | LOW INCOME POPULATION | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL DRUGS | HIV INFECTIONS | FEES | NEEDS ASSESSMENT | PREVENTION AND CONTROL | TREATMENT | PROGRAM ACCESSIBILITY | Developing Countries | Measurement | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Financial Activities | Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 341155

15.

Peer Reviewed

Title: Opportunity for natural selection among the Indian population: secular trend, covariates and implications.
Author: Gautam RK
Source: Journal of Biosocial Science. 2009 Jul 23;:1-41.
Abstract: Crow's index is widely used for indirect quantitative estimation of natural selection using birth and death rates. The present investigation is based on 179 studies among 144 different endogamous communities belonging to nineteen states and six geographical regions of India, categorized into six social groups. These studies appeared in 33 different years over six decades (1956 to 2007). The secular trend in Crow's index (It) and its mortality and fertility components (Im and If) shows a gradual decline in It and radical shift in the relative contributions of Im and If. Before 1990 the opportunity for natural selection was mainly determined by differential pre-reproductive mortality (Im), whereas after 1990 it has been determined by differential fertility (If). To find out the covariates of It, Im and If sixteen socio-demographic variables were considered, and nine were found to be significantly correlated with It: total dependency ratio, decadal growth rate 1991-2001, young age dependency ratio, crude death rate, total fertility rate, child mortality rate, under-5 mortality rate, old age dependency ratio and decadal growth rate 1981-1991. On the basis of multivariate stepwise regression analysis, female literacy emerged as one of the most important predictors of It. The declining trend of It, Im and If shows that the Indian population is passing through the demographic transition.
Language: English
Keywords:
INDIA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | DATA COLLECTION | STATISTICAL REGRESSION | TRIBES | MOTHERS | CASTE | POPULATION GENETICS | FERTILITY | MORTALITY | DEPENDENCY BURDEN | SOCIOCULTURAL FACTORS | DEMOGRAPHIC TRANSITION | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Data Analysis | Cultural Background | Population Characteristics | Demographic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Genetics | Biology | Population Dynamics | Microeconomic Factors
Document Number: 342293

16.

Title: Contraceptive attitudes among inner-city African American female adolescents: Barriers to effective hormonal contraceptive use.
Author: Gilliam ML; Davis SD; Neustadt AB; Levey EJ
Source: Journal of Pediatric and Adolescent Gynecology. 2009 Apr;22(2):97-104.
Abstract: STUDY OBJECTIVE: To better understand the contraceptive attitudes of low-income, inner-city African American female adolescents. DESIGN: We conducted four focus group sessions with African American female adolescents. SETTING: An urban, community health clinic serving low-income patients on Chicago's south side. PARTICIPANTS: African American female adolescents (n = 15) between 14 and 19 years of age. INTERVENTIONS: Focus group sessions lasting approximately 90 minutes in length were conducted using a pre-determined script with set probes and open-ended questions. MAIN OUTCOME MEASURES: Qualitative analysis was conducted to identify major themes related to adolescents' contraceptive attitudes. RESULTS: Six themes related to the contraceptive attitudes of these adolescents emerged: Concerns About Hormones, Concerns About Privacy, Concerns About Compliance, Limited Awareness of New Methods of Hormonal Contraception (HC), Preference for Condoms, and Acceptability of Emergency Contraception (EC). Overall, adolescents in these sessions expressed skepticism and unwillingness to use continuous methods of HC. For some adolescents, concerns about hormones, privacy, and compliance outweighed their concerns about pregnancy. CONCLUSION: Concerns about perceived side effects and long-term health risks associated HC and privacy in obtaining contraception and reproductive health care, as well as concerns about ability to comply with daily and weekly HC regimens are common among African American female adolescents and may deter consistent HC use. Although condoms and EC appear to be highly acceptable among this group, adolescents also report a number of barriers to their consistent use. Efforts to reduce early, unintended pregnancy among African American youth should focus on addressing adolescents' HC-related concerns, improving access to EC, and helping female adolescents effectively negotiate condom use.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | BLACKS | LOW INCOME POPULATION | ADOLESCENTS, FEMALE | URBAN POPULATION | ATTITUDES | CONTRACEPTIVE SAFETY | PRIVACY | CONTRACEPTION CONTINUATION | CONDOM USE | CONTRACEPTIVE METHODS | KNOWLEDGE | EMERGENCY CONTRACEPTION | Developed Countries | North America | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Adolescents | Youth | Age Factors | Psychological Factors | Behavior | Safety | Public Health | Health | Contraceptive Usage | Contraception | Family Planning | Risk Reduction Behavior | Sociocultural Factors
Document Number: 330953

17.

18.

Peer Reviewed

Title: Reproductive and family planning history, knowledge, and needs: A community survey of low-income women in Beijing, China.
Author: He H; Ostbye T; Daltveit AK
Source: BMC Women's Health. 2009 Aug 10;9(1):23.
Abstract: ABSTRACT: BACKGROUND: The reproductive health status of China's low-income urban women is believed to be poor. Therefore, understanding their reproductive history and needs and improving services provision is very important. However, few studies have been done to assess reproductive health status, knowledge and needs in this low-income population. The purpose of this study is to broadly assess reproductive and family planning history, knowledge and health needs among low income urban women with an aim to informing health services interventions. METHODS: 1642 low-income women age 18-49 from Haidian district, Beijing were selected. All were interviewed via a standardized questionnaire in 2006. RESULTS: Most women reported at least one pregnancy and delivery (97.7%, 98.3%). Deliveries in hospitals (97.3%) by medical personnel (98.5%) were commonplace, as was receipt of antenatal care (86.0%). Nearly half had at least one abortion, with most (56.0%) performed in district hospitals, by physicians (95.6%), and paid for out-of-pocket (64.4%). Almost all (97.4%) used contraception, typically IUDs or condoms. Reproductive knowledge was limited. Health needs emphasized by the participants included popularizing reproductive health information, being able to discuss their reproductive health concerns, free reproductive health insurance, examination and treatment. CONCLUSIONS: Among poor urban women in Beijing, antenatal care and contraceptive use were common. However, abortions were also common. Knowledge about reproductive health was limited. There is a need for better reproductive health education, free medical care and social support.
Language: English
Keywords:
CHINA | RESEARCH REPORT | SAMPLING STUDIES | FAMILY PLANNING SURVEYS | LOW INCOME POPULATION | URBAN POPULATION | WOMEN | REPRODUCTIVE HEALTH | PREGNANCY HISTORY | KNOWLEDGE | NEEDS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Family Planning | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | Health | Fertility Measurements | Fertility | Population Dynamics | Sociocultural Factors
Document Number: 342493

19.

Peer Reviewed

Title: Increasing uptake of HIV testing and counseling among the poorest in sub-Saharan countries through home-based service provision.
Author: Helleringer S; Kohler HP; Frimpong JA; Mkandawire J
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jun 1;51(2):185-93.
Abstract: BACKGROUND: Uptake of HIV testing and counseling (HTC) is lower among members of the poorest households in sub-Saharan countries, thereby creating significant inequalities in access to HTC and possibly antiretroviral treatment. OBJECTIVES: To measure uptake of home-based HTC and estimate HIV prevalence among members of the poorest households in a sub-Saharan population. METHODS: Residents of 6 villages of Likoma Island (Malawi) aged 18-35 and their spouses were offered home-based HTC services. Socioeconomic status, HIV testing history, and HIV risk factors were assessed. Differences in HTC uptake and HIV infection rates between members of households in the lowest income quartile and the rest of the population were estimated using logistic regression. RESULTS: Members of households in the lowest income quartile were significantly less likely to have ever used facility-based HTC services than the rest of the population (odds ratio = 0.60, 95% confidence interval (CI): 0.36 to 0.97). In contrast, they were significantly more likely to use home-based HTC services provided during the study (adjusted odds ratio = 1.70, 95% CI: 1.04 to 2.79). Socioeconomic differences in uptake of home-based HTC were not due to underlying differences in socioeconomic characteristics or HIV risk factors. The prevalence of HIV was significantly lower among members of the poorest households tested during home-based HTC than among the rest of the population (adjusted odds ratio = 0.37, 95% CI: 0.14 to 0.96). CONCLUSIONS: HTC uptake was high during a home-based HTC campaign on Likoma Island, particularly among the poorest. Home-based HTC has the potential to significantly reduce existing socioeconomic gradients in HTC uptake and help mitigate the impact of AIDS on the most vulnerable households.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | STATISTICAL REGRESSION | LOW INCOME POPULATION | COUNSELING | HIV TESTING | HOME VISITS | UTILIZATION OF HEALTH CARE | HIV INFECTIONS | PREVALENCE | ANTIRETROVIRAL THERAPY | INEQUALITIES | Africa | Developing Countries | Data Analysis | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Communication | Viral Diseases | Diseases | Measurement | HIV
Document Number: 341774

20.

Title: Premarital romantic partnerships: attitudes and sexual experiences of youth in Delhi, India.
Author: Hindin J; Hindin MJ
Source: International Perspectives on Sexual and Reproductive Health. 2009 Jun;35(2):97-104.
Abstract: Attitudes toward and behavior within romantic partnerships were examined using data collected in 2004 from unmarried youth (583 males and 475 females, ages 15�19) living in economically disadvantaged neighborhoods in Delhi, India. Associations between specific attitudes or behaviors and age, gender, and sexual experience were determined using Fisher's exact tests. Sixty-two percent of males and 53% of females reported that someone of the opposite sex had expressed an interest in them; 86% of males and 63% of females reported feeling good about it. In addition, 67% of males and 47% of females reported that they liked someone of the opposite sex. Compared with females, males were more likely to seek information about the person they were interested in (76% vs. 61%), and to engage in heterosexual premarital sex (32% vs. 6%). Females were less likely than males to report that it is okay to engage in premarital sex if the male and female love one another (14% vs. 33%). For both males and females, television and films were the most popular source of information on issues related to sexual health. Gender disparities in the formation of premarital romantic partnerships and in the experience of sexual relations make a strong case for sexuality education programs tailored differently for young men and for young women.
Language: English
Keywords:
INDIA | RESEARCH REPORT | SAMPLING STUDIES | YOUTH | LOW INCOME POPULATION | PREMARITAL SEX BEHAVIOR | ATTITUDES | SEX FACTORS | INFORMATION SOURCES | FILM AND VIDEO | TELEVISION | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sex Behavior | Behavior | Psychological Factors | Information | Mass Media | Communication | Broadcast Media | Data Collection
Document Number: 339892

21.

Title: Maternal weight and lean body mass may influence the lactation-related bone changes in young undernourished Indian women.
Author: Kulkarni B; Shatrugna V; Nagalla B; Ajeya Kumar P; Usha Rani K; Chandrakala Omkar A
Source: British Journal of Nutrition. 2009 May;101(10):1527-33.
Abstract: Lactation is known to be associated with a transient loss of bone mineral density (BMD) during 3-6 months post-partum. Bone changes during lactation in women consuming low dietary calcium are not sufficiently studied. The present longitudinal study examined the BMD changes during lactation in undernourished women and the relationship of bone changes to the nutritional status. Whole-body bone mineral content and BMD at hip, lumbar spine and forearm were assessed using dual-energy X-ray absorptiometry in thirty-six lactating women from the low socio-economic group at four time points -- within 1 month after delivery (baseline), and at 6, 12 and 18 months after delivery. Maternal body composition and biochemical parameters of bone metabolism were estimated at the same time. It was observed that femoral neck BMD reduced by 4.6 % at 6 months, but recovery to the baseline was incomplete at 18 months with a deficit of 2 %. Hip BMD reduction at 6 months was transient. Lumbar spine BMD did not show significant loss at 6 months and BMD increased by 3.6 and 6.3 % at 12 and 18 months, respectively. Regression analyses indicated that baseline lean mass was the most important determinant of bone preservation at femoral neck, hip as well as whole body, whereas baseline body weight was the most important determinant of per cent gain in lumbar spine. Maternal nutritional status as indicated by body weight and lean mass appears to influence the lactation-related BMD changes in undernourished women from the low socio-economic group in India.
Language: English
Keywords:
INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | LOW INCOME POPULATION | POSTPARTUM WOMEN | BODY WEIGHT | LACTATION | MALNUTRITION | DIET | SKELETAL EFFECTS | SERUM CALCIUM LEVEL | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Puerperium | Reproduction | Physiology | Biology | Maternal Physiology | Nutrition Disorders | Diseases | Nutrition | Health | Hemic System
Document Number: 342007

22.

Peer Reviewed

Title: Characteristics and determinants of sexual behavior among adolescents of migrant workers in Shangai (China).
Author: Li S; Huang H; Cai Y; Xu G; Huang F; Shen X
Source: BMC Public Health. 2009;9:195.
Abstract: BACKGROUND: China is facing a critical challenge of rapid and widespread human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) increase. Rural-to-urban migration plays a crucial role in shifting the HIV/sexual transmitted infection (STI) epidemic. The purpose of this study was to assess the prevalence of sexual behaviors and the correlates among the early adolescents of migrant workers in China. METHODS: A cross-sectional study was conducted in 10 junior high schools from April to June of 2008. A total of 2821 adolescents aged 14.06 +/- 0.93 years (8.9% of migrant workers vs. 91.1% of general residents) participated in the survey. A self-administrated questionnaire was used to collect information on knowledge, attitude, and behaviors associated with increased risk for HIV/STI. RESULTS: The percentage of adolescents who ever had sexual intercourse or had sexual intercourse in last three months was 7.2% and 4.3% in adolescents of migrant workers, respectively; in contrast, 4.5% and 1.8% in their peers of general residents, respectively. 47.3% adolescents of migrant workers and 34.3% of those adolescents of general residents reported no condom use in sexual intercourse during last three months. Multivariate logistic regression analyses found that migration was a independent risk factor for sexual intercourse in last three months in our sampled adolescents (odds ratio [OR] = 1.23, 95% confidence interval [CI]: 1.01-1.72). In adolescents of migrant workers, factors such as lower family income (OR: 2.22, CI: 1.09-3.05 for low level; OR:1.25, CI: 1.04-1.59 for medium level), younger age at first sexual intercourse (OR: 1.24, CI: 1.09-1.57), lower knowledge on HIV/AIDS (OR: 0.93, CI: 0.90-0.97), and fewer communication on HIV/AIDS related issues (OR: 0.79, CI: 0.90-0.97) were related to sexual intercourse in last three months. CONCLUSION: Based on these results, we advocated that heightened concerns targeting the adolescents of migrant workers be particularly necessary, given their higher level of sexual experience, lower socioeconomic status, restricted reproductive health information, and vulnerability to HIV/STI.
Language: English
Keywords:
CHINA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADOLESCENTS | MIGRANT WORKERS | SEX BEHAVIOR | LOW INCOME POPULATION | SOCIOECONOMIC STATUS | NEEDS | REPRODUCTIVE HEALTH | Asia, Eastern | Asia | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Labor Force | Human Resources | Economic Factors | Behavior | Social Class | Socioeconomic Factors | Health
Document Number: 342979

23.
Peer Reviewed

Title: Prevalence and risk factors for HIV, syphilis, hepatitis B, hepatitis C, and HTLV-I/II infection in low-income postpartum and pregnant women in Greater Metropolitan Vitoria, Espirito Santo State, Brazil.
Author: Lima LH; Viana MC
Source: Cadernos De Saude Publica. 2009 Mar;25(3):668-76.
Abstract: Sexually transmitted infections during pregnancy pose a major risk to the fetus due to vertical transmission. The study's objective was to determine the prevalence of HIV, syphilis, hepatitis B and C, and HTLV-I/II infection among low-income postpartum and pregnant women treated in Greater Metropolitan Vitoria, Espirito Santo State, Brazil, and the risk factors associated with these infections. A cross-sectional study was conducted from February to October 1999 assessing postpartum and pregnant women from the maternity ward of the Vitoria Mercy Hospital and the Carapina Outpatient Referral Unit in the Municipality of Serra, respectively. Patients were systematically interviewed and had blood samples drawn for serological tests (HIV 1&2, VDRL, HbsAg, anti-HCV, and HTLV-I/II). A total of 534 patients (332 postpartum and 202 pregnant women) were assessed. Seroprevalence rates for the target infections in postpartum and pregnant women and the overall sample were as follows, respectively: HIV 0.9%, 0%, and 0.6%; syphilis 2.1%, 3.6%, and 2.7%; HBV 1.2%, 1%, and 1.1%; HCV 1.8%, 0.6%, and 1.4%; and HTLV-I/II 1.7%, 0.6%, and 1.3%. Factors associated with the various infections are presented and analyzed in light of other research findings from the literature.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | PREGNANT WOMEN | POSTPARTUM WOMEN | LOW INCOME POPULATION | PREGNANCY | MOTHER-TO-CHILD TRANSMISSION | SEXUALLY TRANSMITTED DISEASES | INFECTIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Measurement | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Transmission | Diseases | Reproductive Tract Infections
Document Number: 342666

24.

Peer Reviewed

Title: Brazilian mothers' beliefs, attitudes and practices related to child weight status and early feeding within the context of nutrition transition.
Author: Lindsay AC; Machado MT; Sussner KM; Hardwick CK; Kerr LR; Peterson KE
Source: Journal of Biosocial Science. 2009 Jan;41(1):21-37.
Abstract: With the rapid pace of the nutrition transition worldwide, understanding influences of child feeding practices within a context characterized by the co-existence of overweight and undernutrition in the same population has increasing importance. This qualitative study describes Brazilian mothers' child feeding practices and their perceptions of their association with child weight status and explores the role of socioeconomic, cultural and organizational factors on these relationships. Forty-one women enrolled in the Family Health/Community Health Workers Programme were selected from rural, urban, coastal and indigenous areas in Ceara State, north-east Brazil, to participate in four focus group discussions. Content analysis identified fourteen emergent themes showing mothers' child feeding practices in this setting were influenced by economic resources, mothers' immediate social support networks (e.g. neighbours and family members) and participation in nutrition assistance programmes. Child malnutrition was the most common nutritional concern; nevertheless, mothers were aware of the negative health consequences of obesity but misunderstood its causes (e.g. foods filled with fat would make a person fat; others thought that birth control pills and stimulants given to children were causes of obesity); several reported their own struggles with overweight. Food assistance programmes emerged as an important influence on children's dietary adequacy, especially among mothers describing dire economic situations. The findings have implications for targeting food assistance as well as health and nutrition education strategies in low-income families undergoing the nutrition transition in north-east Brazil.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | DATA ANALYSIS | FOCUS GROUPS | LOW INCOME POPULATION | MOTHERS | INFANT | INFANT NUTRITION | BODY WEIGHT | PERCEPTION | BEHAVIOR | DIET | CALORIC INTAKE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Physiology | Biology | Psychological Factors
Document Number: 330517

25.

Peer Reviewed

Title: The burden of non-communicable diseases in South Africa.
Author: Mayosi BM; Flisher AJ; Lalloo UG; Sitas F; Tollman SM; Bradshaw D
Source: Lancet. 2009 Sep 12;374(9693):934-47.
Abstract: 15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urban areas, most prominently in poor people living in urban settings, and are resulting in increasing pressure on acute and chronic health-care services. Major factors include demographic change leading to a rise in the proportion of people older than 60 years, despite the negative effect of HIV/AIDS on life expectancy. The burden of these diseases will probably increase as the roll-out of antiretroviral therapy takes effect and reduces mortality from HIV/AIDS. The scale of the challenge posed by the combined and growing burden of HIV/AIDS and non-communicable diseases demands an extraordinary response that South Africa is well able to provide. Concerted action is needed to strengthen the district-based primary health-care system, to integrate the care of chronic diseases and management of risk factors, to develop a national surveillance system, and to apply interventions of proven cost-effectiveness in the primary and secondary prevention of such diseases within populations and health services. We urge the launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | RURAL AREAS | RURAL POPULATION | LOW INCOME POPULATION | PRIMARY HEALTH CARE | DISEASES | HEALTH SERVICES | QUALITY OF HEALTH CARE | DEMOGRAPHIC TRANSITION | DEMOGRAPHIC AGING | HIV PREVENTION | AIDS PREVENTION | INTEGRATED PROGRAMS | GOVERNMENT PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Population Characteristics | Demographic Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Population Dynamics | HIV Infections | Viral Diseases | AIDS
Document Number: 342869

27.

Peer Reviewed

Title: The effect of sympathy on discriminatory attitudes toward persons living with HIV/AIDS in Puerto Rico: a hierarchical analysis of women living in public housing.
Author: Norman LR; Abreu S; Candelaria E; Sala A
Source: AIDS Care. 2009 Feb;21(2):140-9.
Abstract: As the number of persons living with HIV/AIDS (PLWHA) continues to increase in Puerto Rico, it becomes increasingly important to address the issues of stigma and other discriminatory attitudes. Therefore, the objective of the present study is to examine the attitudes toward PLWHA of a large sample of women living in public housing in Puerto Rico, including sympathy and support for PLWHA in the workplace and in school. A total of 1138 women completed a self-administered 218-item survey made up of questions that measured HIV-related knowledge, attitudes and behaviors. Levels of sympathy varied depending upon the target group, with HIV-infected drug users receiving the least sympathy. Most women reported that HIV-positive teachers should be allowed to teach and that HIV-positive children should be allowed to attend school. However, a significantly lower percentage reported that HIV-infected nurses should be allowed to continue working. Women who were more sympathetic toward PLWHA were more tolerant of PLWHA in the workplace and school, while those with inaccurate knowledge concerning HIV transmission were less tolerant. Also, those who knew a PLWHA were more tolerant. Levels of discriminatory attitudes in Puerto Rico are high and warrant both individual- and societal-level interventions.
Language: English
Keywords:
PUERTO RICO | RESEARCH REPORT | DATA ANALYSIS | WOMEN | PERSONS LIVING WITH HIV/AIDS | LOW INCOME POPULATION | HIV INFECTIONS | AIDS | STIGMA | SOCIAL DISCRIMINATION | ATTITUDES | Caribbean | Americas | Developed Countries | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Social Problems | Sociocultural Factors | Psychological Factors | Behavior
Document Number: 330811

28.
Title: [The experience of the Mexican maternal health care program Arranque Parejo en la Vida] Participacion social en salud: la experiencia del programa de salud materna
Author: Orozco-Nunez E; Gonzalez-Block MA; Kageyama-Escobar LM; Hernandez-Prado B
Source: Salud Publica De Mexico. 2009 Mar-Apr;51(2):104-13.
Abstract: OBJECTIVE: To evaluate the implementation of its participative strategies and the creation of support networks for poor pregnant women. MATERIAL AND METHODS: A qualitative and comparative evaluation was carried on in four states. RESULTS: Coordination and community participation were relevant in relation with major resources allocation and availability, particularly housing and transportation. Governmental actors involvement and leadership favoured linking and coordination. Pregnant women used to valuate as the major support source the one provided by their kinship networks. CONCLUSIONS: To strengthen and to stimulate participative strategies is fundamental in zones with high maternal mortality rates. The wide appreciation of kinship networks, midwives and voluntaries' support to pregnant women in housing and transportation, suggests that these actors are a functional component of the support network; it is insufficient focusing the support network on health services and municipal authorities.
Language: Spanish
Keywords:
MEXICO | RESEARCH REPORT | QUALITATIVE RESEARCH | COMPARATIVE STUDIES | WOMEN | LOW INCOME POPULATION | PREGNANT WOMEN | COMMUNITY PARTICIPATION | MATERNAL HEALTH | KINSHIP NETWORKS | MIDWIVES AND MIDWIFERY | VOLUNTEERS AND VOLUNTARISM | LEADERSHIP | North America | Americas | Developing Countries | Research Methodology | Studies | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Organization and Administration | Health | Family and Household | Sociocultural Factors | Health Personnel | Delivery of Health Care
Document Number: 342075

29.

Peer Reviewed

Title: Partner- and partnership-related risk factors for preterm birth among low-income women in Lima, Peru.
Author: Paul K; Garcia PJ; Manhart LE; Holmes KK; Hitti JE
Source: Social Science and Medicine. 2009 Apr;68(8):1535-40.
Abstract: A woman's partner and the characteristics of their partnership can play an important role in the health of her pregnancy. Yet, with the notable exception of intimate partner violence, there has been little previous research addressing the associations between partner- or partnership-related factors and birth outcomes. This analysis tested the hypothesis that risk factors related specifically to partner or partnership characteristics increased the risk for preterm birth. Between 2003 and 2005, a total of 580 preterm cases (20-36 weeks gestational age at delivery) and 633 term controls (> or =37 weeks) were selected from women delivering at an obstetric hospital in Lima, Peru. Each woman completed a confidential, structured interview and provided biological specimens within 48 h after delivery. Multivariable logistic regression was used to assess associations between partner and partnership characteristics and preterm birth. After adjustment for behavioral, demographic, and obstetric risk factors, ever having had a partner with a history of drug use (aOR = 1.91, 95% CI 1.22-2.99), ever having had anal sex (aOR = 1.40, 95% CI 1.07-1.84), having a current partner with a history of visiting prostitutes (aOR = 1.69, 95% CI 1.22-2.33), and perceiving one's current partner as a "womanizer" (aOR = 1.34, 95% CI 1.02-1.77) were significantly associated with an elevated risk of preterm birth when tested in separate models. These four factors were then used to create a composite partnership risk score, which showed an increasing dose-response relationship with preterm birth risk (per additional partner risk factor: aOR = 1.31, 95% CI 1.16-1.49). These results highlight the importance of considering a broader set of risk factors for preterm birth, specifically those related to a woman's partner and partnership characteristics. Further research could clarify the specific mechanisms through which these partner and partnership characteristics may increase the risk of preterm birth.
Language: English
Keywords:
PERU | RESEARCH REPORT | CONTROL GROUPS | LOW INCOME POPULATION | WOMEN | SEXUAL PARTNERS | PREMATURE BIRTH | RISK FACTORS | SEX BEHAVIOR | DRUG USE AND ABUSE | INTERVIEWS | Developing Countries | South America, Western | South America | Latin America | Americas | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Demographic Factors | Population | Behavior | Pregnancy Outcomes | Pregnancy | Reproduction | Health | Data Collection
Document Number: 341690

30.

Peer Reviewed

Title: Providing infertility treatment in resource-poor countries.
Author: Pennings G; de Wert G; Shenfield F; Cohen J; Tarlatzis B; Devroey P
Author: ESHRE Task Force on Ethics and Law
Source: Human Reproduction. 2009 May;24(5):1008-11.
Abstract: Recently, several initiatives were started to introduce medically assisted reproduction in developing countries. Infertility is a major problem in these countries and causes extensive social and psychological suffering. This article analyses the main ethical arguments pro and contra the provision of infertility treatment in resource-poor countries. It is concluded that infertility treatment should be part of an integrated reproductive care programme including family planning and motherhood care. Education, empowerment of women and economic prosperity are the most effective solutions to most problems related to both population growth and infertility. Simultaneously, investments in low-cost interventions are justified.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | WOMEN | LOW INCOME POPULATION | INFERTILITY | REPRODUCTIVE HEALTH | TREATMENT | INTERVENTIONS | PREVENTION AND CONTROL | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Reproduction | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Programs | Organization and Administration | Diseases
Document Number: 342099


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