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Peer Reviewed

Title: A new agenda for children affected by HIV/AIDS [editorial]
Source: Lancet. 2009 Feb 14;373(9663):517.
Abstract: As is so often the case in the provision of health care and deciding research agendas, children have been sidelined in the fight against HIV/AIDS. According to the latest UNAIDS figures, nearly 2 million children live with HIV worldwide, two-thirds in sub-Saharan Africa. In addition, 12 million children in sub-Saharan Africa have lost one or two parents due to HIV/AIDS. Many more live with a parent or carer with HIV. A very small proportion of infected children receive antiretroviral treatment, and prevention of mother-to-child transmission is only given to a third of women. Diagnosis in infancy is difficult and therefore often delayed. Child-friendly medication is lacking. 60% of children in southern Africa live in poverty. Now that HIV/AIDS is evolving from an acute emergency into a chronic epidemic, the way to deliver treatment and achieve prevention needs to change radically from an individualistic approach to a broader strategic one. Children and families need to take centre stage. In an excellent report, based on 2 years of research and analyses, the Joint Learning Initiative on Children and HIV/AIDS-an independent alliance of researchers, implementers, activists, policy makers, and people living with HIV-has presented recommendations for such a change in direction. Home Truths: Facing the Facts on Children, AIDS, and Poverty, released on Feb 10, points out three broad policies that will make an immediate and long lasting difference to children: support children through immediate or extended families and deliver integrated family-centred services; strengthen community action to support families; and address family poverty through national social protection. Such policies are AIDS-sensitive but not AIDS-directed. The family is the most important support structure for children. The report argues that the way orphans have been defined (as having lost one or both parents) and have become the centre of attention for many HIV/AIDS policies has been unhelpful, if not damaging. 88% of children labelled as orphans have a surviving parent and overall 95% continue to live with extended families. Additionally, children who live with HIV-positive parents have needs long before their parents die. Children need to stay within a family or kinship structure. Infected children usually live with others who are infected with the virus. The whole family, not the individual, needs to become the unit for support and treatment. The report advocates home health visiting and early childhood development interventions together with strategies to encourage children's education. The use of schools as intervention platforms misses the opportunity to reach children early and to reach those who are not in education-the majority in some countries. Economic strengthening of families has to be the basis to allow many of these programmes to fully succeed. The best immediate support for families is given by com munity groups. International donors need to work with these groups in partnership to avoid duplication, confusion, and waste of time and money. The authors suggest that coordination could be strengthened with a district committee that maintains an active register of community activities and devises a system of accountability that is understood by all and serves the com munity. All activities should be delivered within a framework that is based on best practice. Communities also have a crucial role to act as a backstop when families break down or when children live in an abusive environment. Family poverty and undernutrition can be addressed through income-transfer programmes, such as Mexico's Oportunidades programme or South Africa's child support grants. These projects are efficient and simple, empower women, and can act as a springboard for other more complex schemes, such as microfinance loans. Such economic support increases school attendance, reduces illnesses, improves growth, and encourages uptake of health services. The largest portion of money is usually used to purchase food. Extreme poverty, rather than HIV infection, should be used as a criterion to avoid stigma and resentment. The report argues that "any developing country, no matter how poor, can afford social protection packages for children". The positive effect of this policy is now established beyond doubt and no further pilot studies are needed. To integrate all these strategies, governments need to take the lead with national plans and frameworks to scale-up programmes for children and families. With this approach, society as a whole will be strengthened with intergenerational effects that will go a long way towards, but also go well beyond, tackling the effects of HIV/AIDS. Putting children and families at the centre will show long-term vision with guaranteed future benefits. (fulll-text)
Language: English
Keywords:
AFRICA, SUB SAHARAN | SUMMARY REPORT | CHILDREN | HIV INFECTIONS | AIDS | POVERTY | MALNUTRITION | CHILD HEALTH | HEALTH SERVICES | DELIVERY OF HEALTH CARE | TREATMENT | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Socioeconomic Factors | Economic Factors | Nutrition Disorders | Health | Medical Procedures | Medicine
Document Number: 341049

Title: Family planning and the MDGs: Saving lives, saving resources.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Jun. 8 p.
Abstract: The USAID | Health Policy Initiative, Task Order 1, has completed and updated analyses for more than 30 countries that demonstrate the significant contribution of family planning (FP) to achievement of the Millennium Development Goals (MDGs). Family planning helps to improve health outcomes (e.g., fewer maternal and child deaths) and reduce costs for meeting the MDGs (by reducing the size of the target populations in need of services). This case study describes the FP-MDG analysis methodology and provides examples of how the findings have been used to support advocacy and policy change. Briefs on country-specific findings are also available online. The FP-MDG analyses and briefs are flexible, evidenced-based tools that help make the case that family planning is a strong complement to -- rather than a trade-off with -- other health, development, and poverty-reduction efforts. By showing the economic benefits of investing in family planning, the FP-MDG analyses and briefs can also reach diverse audiences that might not traditionally champion FP issues.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | WOMEN | FAMILY PLANNING | NEEDS | PREGNANCY, UNPLANNED | FAMILY SIZE, DESIRED | HEALTH SERVICES | POVERTY | MALARIA | DISEASE PREVENTION | Demographic Factors | Population | Economic Factors | Reproductive Behavior | Fertility | Population Dynamics | Family Size | Family Characteristics | Family and Household | Sociocultural Factors | Delivery of Health Care | Health | Socioeconomic Factors | Parasitic Diseases | Diseases | Prevention and Control
Document Number: 331540

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

Title: Expert Group Meeting to Assess the Progress in the Implementation of the Plan of Action on Population and Poverty Adopted at the Fifth Asian and Pacific Population Conference, 3-5 February 2009, Bangkok. Report.
Author: United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]; United Nations Population Fund [UNFPA]
Source: Bangkok, Thailand, ESCAP, 2009. 38 p.
Abstract: The Expert Group Meeting to Assess the Progress in the implementation of the Plan of Action on Population and Poverty adopted at the Fifth Asian and Pacific Population Conference was held at the United Nations Conference Centre, Bangkok from 3 to 5 February 2009. The Expert Group Meeting was organized by the Social Policy and Population Section, Social Development Division, ESCAP in collaboration with the UNFPA Asia and the Pacific Regional Office. The meeting benefited from background papers and country reports prepared by resource persons and representatives of governments.
Language: English
Keywords:
ASIA | OCEANIA | CONFERENCES AND CONGRESSES | ESCAP | POPULATION | SUSTAINABLE DEVELOPMENT | POVERTY | REPRODUCTIVE HEALTH | MATERNAL-CHILD HEALTH SERVICES | GENDER ISSUES | MIGRATION | HIV INFECTIONS | AIDS | IMPLEMENTATION | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Economic Development | Economic Factors | Socioeconomic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Population Dynamics | Demographic Factors | Viral Diseases | Diseases | Programs | Organization and Administration
Document Number: 331854

Title: Integrating gender into HIV / AIDS programmes in the health sector: Tool to improve responsiveness to women�s needs.
Author: World Health Organization [WHO]. Department of Gender, Women and Health
Source: Geneva, Switzerland, WHO, 2009. [130] p.
Abstract: This hands-on WHO tool helps programme managers and health-care providers in the public and private sectors integrate gender into HIV / AIDS programmes they wish to set up, implement and evaluate so they are more responsive to women's needs. In addition to describing basic steps in gender-responsive programming, which can be applied to all HIV / AIDS programmes, the tool suggests practical actions to address key gender issues in four service delivery areas: HIV testing and counseling; Prevention of mother-to-child transmission of HIV; HIV / AIDS treatment and care; Home-based care and support for people living with HIV. The tool also provides examples of gender-responsive interventions from the field, and resources such as: counseling role plays for risk reduction and HIV treatment adherence; examples of gender-sensitive communication messages; and protocols for addressing the risk of violence among women as a result of HIV status disclosure.
Language: English
Keywords:
GLOBAL | MANUAL | HIV PREVENTION | AIDS PREVENTION | WOMEN'S HEALTH | GENDER ISSUES | INEQUALITIES | NEEDS | PROGRAM DESIGN | PROGRAM ACCESSIBILITY | HIV TESTING | COUNSELING | ANTIRETROVIRAL THERAPY | HOME CARE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV Infections | Viral Diseases | Diseases | AIDS | Health | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Programs | Organization and Administration | Program Evaluation | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Clinic Activities | Program Activities | HIV | Care and Support | Disease Transmission Control | Prevention and Control
Document Number: 331798

Peer Reviewed

Title: Unmet need for contraception among HIV-positive women in Lesotho and implications for mother-to-child transmission.
Author: Adair T
Source: Journal of Biosocial Science. 2009 Mar;41(2):269-78.
Abstract: In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26.4%), low knowledge of HIV status and a total fertility rate of 3.5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15-49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIVARIATE ANALYSIS | URBAN POPULATION | WOMEN IN DEVELOPMENT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | KNOWLEDGE | CONTRACEPTION | NEEDS ASSESSMENT | BIRTH SPACING | POVERTY | ATTITUDES | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Population Characteristics | Economic Development | Economic Factors | Disease Transmission Control | Prevention and Control | Diseases | Sociocultural Factors | Family Planning | Evaluation | Socioeconomic Factors | Psychological Factors | Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 331114

Title: Maternal and perinatal outcome in teenage pregnancies in Sudan.
Author: Adam GK; Elhassan EM; Ahmed AM; Adam I
Source: International Journal of Gynaecology and Obstetrics. 2009 May;105(2):170-1.
Abstract: Pregnancy and childbirth in teenage women pose special risks for both mother and baby. As well as significant medical, nutritional, social, and economic risks, teenage pregnancy is associated with increased risks for adverse pregnancy outcomes, such as preterm birth, low birth weight, and death in the neonatal or postnatal periods. There is a paucity of literature regarding the maternal and perinatal outcome of teenage pregnancies in Sudan, Africa. The aim of the present study was to assess the risk of anemia, operative delivery, and perinatal complications (mainly low birth weight) among primiparous teenagers with a singleton delivery compared with a similar group of women aged 20-24 years. (excerpt)
Language: English
Keywords:
SUDAN | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | ADOLESCENT PREGNANCY | PREGNANCY OUTCOMES | ANEMIA | LOW BIRTH WEIGHT | MATERNAL AGE | EDUCATIONAL STATUS | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Pregnancy | Reproduction | Diseases | Birth Weight | Body Weight | Physiology | Biology | Parental Age | Age Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 341382

10.

Title: The economic burden of HIV and AIDS on households in Nigeria.
Author: Adedigba MA; Naidoo S; Abegunde A; Olagundoye O; Adejuyigbe E; Fakande I
Source: African Journal of AIDS Research. 2009 Apr;8(1):107-114.
Abstract: The study estimates the economic burden of HIV and AIDS on households in a Nigerian population. The data derive from a cross-sectional survey of households affected by HIV or AIDS in Ife-Ijesa Zone, Osun State, Nigeria. The sample consisted of 117 purposively selected, consenting adult HIV patients attending a general and teaching hospital. Participants were asked to self-report monetary expenses for HIV-related care, loss of savings, and funeral costs. The data show a significantly sharp drop in the participants' household income as a result of care for HIV-related illnesses, from the time of knowing one's HIV status to the time of illness, among three occupational categories (artisans, civil servants and unemployed; p = 0.02). Mean income among those in the unemployed category fell by 84.1%, income among artisans dropped by 72.6%, and income among civil servants decreased by 44.4%. The monetary loss during the course of HIV-related illnesses was heaviest for the artisan group, followed by the unemployed and the civil servants. Those who had lost a substantial part of their savings to HIV-related care were most numerous among the unemployed, followed by artisans and civil servants. Out of 16 households, 11 (42.3%) had received support from relatives during a funeral ceremony. There was a significant association between the occupational group and working for more hours after illness ( 2 = 9.28, df = 4; p = 0.05). Nearly all orphaned children were distributed to the extended family following the AIDS death of a parent. Among all the occupational groups, borrowing from a cooperative society during the course of HIV-related sickness was the commonest form. The findings add to data showing that despite the extended family support system, adult deaths due to AIDS continue to undermine the viability of sub-Saharan African households.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | AIDS | HIV INFECTIONS | ECONOMIC FACTORS | EXPENDITURES | INCOME | POVERTY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Financial Activities | Socioeconomic Factors
Document Number: 341292

11.
Title: Women's empowerment and the intention to continue the practice of female genital cutting in Egypt.
Author: Afifi M
Source: Archives of Iranian Medicine. 2009 Mar;12(2):154-60.
Abstract: BACKGROUND: The study aimed to (dis)prove the association of the level of women's empowerment with their future intention to perpetuate female genital cutting for their daughters. METHODS: In a national representative community-based sample of 14,393 currently-married women in Egypt, the level of empowerment, intention to continue the practice, and other socio- demographic variables were collected in the 2000 Egypt Demographic and Health Survey. Secondary in-depth analysis was conducted on data downloaded from MEASURE Demographic Health Surveys (MEASURE DHS) website.RESULTS: About 14% of the women intended to discontinue the practice. Twenty-six percent of the women were empowered in all household decisions. Levels of women's empowerment adjusted for age, residence, education, interaction between empowerment and education, work status, and female genital cutting status of currently-married women were entered in six logistic regression models in a sequential way.CONCLUSION: In the last model, those of high levels of empowerment and education were 8.06 times more likely not intending to perpetuate female genital cutting for their daughters than low- empowered low-educated women.
Language: English
Keywords:
EGYPT | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | STATISTICAL REGRESSION | CURRENTLY MARRIED | WOMEN | FEMALE GENITAL CUTTING | WOMEN'S EMPOWERMENT | DECISION MAKING | EDUCATIONAL STATUS | OCCUPATIONAL STATUS | ATTITUDES | AGE FACTORS | Developing Countries | Africa, North | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Research Methodology | Marital Status | Nuptiality | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors | Women's Status | Socioeconomic Factors | Economic Factors | Behavior | Socioeconomic Status | Employment Status | Psychological Factors | Population Characteristics
Document Number: 342003

12.

Title: The conceptions of care among family caregivers of persons living with HIV/AIDS in Addis Ababa, Ethiopia.
Author: Aga F; Kylma J; Nikkonen M
Source: Journal of Transcultural Nursing. 2009 Jan;20(1):37-50.
Abstract: This focused ethnographic study explores and describes the conceptions of care among family caregivers of people living with HIV/AIDS (PLWAs) in Addis Ababa, Ethiopia. Leininger's theory of culture care diversity and universality is the conceptual anchor of this ethnographic study. Using semistructured interviews and participant observation, 6 key informants and 12 general informants were interviewed in their home in Amharic language. Data were analyzed in Amharic using Leininger's phases of ethnonursing analysis for qualitative data and then translated to English. Four major themes representing family caregivers' conceptions of care were identified: nourishing the PLWA while struggling with poverty, maintenance of cleanliness and hygiene of the person and surroundings, comforting the PLWA, and sacrificing self to sustain the PLWA. Valuable data were gathered about the family caregivers' conceptions of care. Nurses can use this knowledge to design and provide culturally congruent care to family caregivers and PLWAs in the community.
Language: English
Keywords:
ETHIOPIA | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | AIDS | PERCEPTION | CARE AND SUPPORT | TREATMENT | HYGIENE | POVERTY | SANITATION | FAMILY AND HOUSEHOLD | HOME CARE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Psychological Factors | Behavior | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Public Health | Socioeconomic Factors | Economic Factors | Sociocultural Factors
Document Number: 330218

13.

Title: Eliminating world poverty: Building our common future.
Author: Akkerhuys Z; Allan T; Andreyeva R; Arthy B; Chalinder P
Source: Norwich, United Kingdom, The Stationery Office, 2009 Jul. 154 p.
Abstract: The White Paper represents a fundamental shift in the way the UK delivers development aid, refocusing resources onto fragile countries and for the first time treating security and justice as a basic service alongside health, education, water and sanitation. Fifty per cent of new bilateral funding will be committed to fragile countries. Key announcements in Building our Common Future include: A renewed commitment to 0.7 per cent of UK Gross National Income (GNI) for international development, meaning a contribution of �9bn per year by 2013; Measures to reduce maternal mortality rates and potentially save the lives of six million mothers and babies by 2015; Plans to support over eight million more children in Africa to go to school; Doubling of funding to �1bn for African infrastructure including transport, energy and trade in the region; A tripling of funding to support developing countries to recover stolen assets, and new resources to Interpol, as part of a major effort to stamp out corruption; Increased investment in the Central Emergency Response Fund for humanitarian aid at the UN.
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | POVERTY | ECONOMIC FACTORS | CHILD HEALTH | EDUCATION | Developed Countries | Europe, Western | Europe | Socioeconomic Factors | Health
Document Number: 331494

14.

15.

Title: The role of education level in the intergenerational pattern of adolescent pregnancy in Brazil.
Author: Almeida MC; Aquino EM
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):139-146.
Abstract: Adolescent pregnancy has been associated with the early childbearing experience of the mothers of adolescents, and young people's education level is believed to be an important factor in this phenomenon. In 2002, a representative household survey collected data from 3,050 young men and women ages 20�24 in three Brazilian cities. The main measures were mother's age at first birth, daughter's age at first pregnancy, and son's age when he first impregnated a partner. Ages were dichotomized as younger than 20 and 20 or older. The distribution of respondents, by both their own and their mothers' reproductive experience, was analyzed in relation to various characteristics, and logistic regressions assessed possible associations between these variables and pregnancy experience. Thirty percent of women reported getting pregnant before age 20, and 21% of men said they were younger than 20 when they first impregnated a partner. Of these groups, 34% of women and 31% of men reported that their mothers had first given birth at the same age. Both women and men were more likely to have had an early pregnancy experience if their mother had had a child before age 20. Among women, this positive association disappeared in the final model after adjusting for their education level, whereas among men the association remained after similar adjustment.
Spanish Abstract: Contexto: El embarazo durante la adolescencia se ha asociado con la experiencia de la maternidad temprana de las madres de los y las adolescentes; y se considera el nivel educativo de la gente joven como un factor importante en este fen�meno. M�todos: En 2002, una encuesta representativa de hogares recolect� datos de 3,050 hombres y mujeres j�venes de 20-24 a�os en tres ciudades brasile�as. Las principales medidas fueron la edad de la madre de los encuestados en el momento de su primer parto, la edad de la joven en el primer embarazo y la edad del joven al embarazar por primera vez a una pareja; los grupos de edad se dividieron en menores de 20 y de 20 a�os o mayores. La distribuci�n de las personas encuestadas (tanto por su propia experiencia reproductiva como la de su madre), se analiz� en relaci�n con varias caracter�sticas, y se valor� mediante regresiones log�sticas las posibles asociaciones entre estas variables y la experiencia del embarazo. Resultados: Treinta por ciento de las j�venes reportaron haberse embarazado antes de los 20 a�os; y 21% de los hombres dijeron que eran menores de 20 a�os cuando su pareja se embaraz�. De estos grupos, 34% de las mujeres y 31% de los hombres reportaron que sus madres hab�an dado a luz por primera vez a la misma edad. Tanto las mujeres como los hombres tuvieron mayor probabilidad de experimentar un embarazo temprano si su madre hab�a tenido un hijo antes de los 20 a�os (razones de momios, 2.0 y 2.3, respectivamente). En las mujeres, esta asociaci�n positiva desapareci� en el modelo final, despu�s de ajustar por nivel de educaci�n, mientras que entre los hombres la asociaci�n permaneci� despu�s de un ajuste similar (1.8). Conclusiones: El nivel de educaci�n de las hijas e hijos parece ser un factor importante en la repetici�n de la fecundidad adolescente a trav�s de las generaciones. Se necesita esfuerzos para aumentar el acceso a la educaci�n y para alentar a la gente joven a que permanezca en la escuela.
French Abstract: Contexte: Les grossesses d'adolescentes ont �t� associ�es � l'exp�rience de la maternit� pr�coce des m�res des adolescents concern�s et le niveau d'instruction des jeunes semble jouer un r�le important. M�thodes: En 2002, une enqu�te de m�nages repr�sentative a recueilli des donn�es aupr�s de 3.050 jeunes hommes et femmes de 20 � 24 ans dans trois villes du Br�sil. Les principales mesures ont port� sur l'�ge de la m�re � la premi�re naissance, l'�ge de la fille � la premi�re grossesse et l'�ge du fils au moment de la f�condation d'une partenaire. Les �ges ont �t� dichotomis�s entre moins de 20 ans et 20 ans ou plus. La distribution des r�pondants en fonction de leur propre exp�rience g�n�sique et de celle de leur m�re a �t� analys�e selon diff�rentes caract�ristiques, tandis que les associations possibles entre ces variables et l'exp�rience d'une grossesse �taient �valu�es par r�gressions logistiques. R�sultats: Trente pour cent des femmes ont d�clar� avoir �t� enceintes avant l'�ge de 20 ans, tandis que 21% des hommes d�claraient avoir eu moins de 20 ans au moment de la f�condation de leur partenaire. De ces groupes, 34% des femmes et 31% des hommes ont d�clar� que leur m�re avait accouch� pour la premi�re fois � ce m�me �ge. Tant les femmes que les hommes sont apparus plus susceptibles d'avoir connu une grossesse pr�coce si leur m�re avait eu un enfant avant l'�ge de 20 ans (rapports de probabilit�s, 2,0 et 2,3, respectivement). C�t� f�minin, cette association positive dispara�t dans le mod�le final apr�s correction du niveau d'instruction; c�t� masculin, elle se maintient apr�s correction similaire (1,8). Conclusions: Le niveau d'instruction des filles comme des fils semble jouer un r�le important dans la r�p�tition de la f�condit� adolescente d'une g�n�ration � l'autre. Des efforts sont n�cessaires pour accro�tre l'acc�s � l'�ducation et encourager les jeunes � poursuivre leur scolarisation.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | SURVEYS | MOTHERS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | AGE FACTORS | FIRST BIRTH | EDUCATIONAL STATUS | REPRODUCTIVE BEHAVIOR | FERTILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Population Dynamics | Pregnancy History | Fertility Measurements | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 343004

16.

Title: Socioeconomic determinants of age at first birth in rural areas of Bangladesh.
Author: Aminul Haque M; Sayem AM
Source: Asia-Pacific Journal of Public Health. 2009 Jan;21(1):104-11.
Abstract: The age at first birth is very low under existing rural sociocultural settings in Bangladesh. This study examined the socioeconomic and cultural determinants of age at first birth. The study subjects were married women aged 15 to 29 years in 2 rural areas that were identified through a multistage sampling technique. To collect the relevant information, a semistructured interviewer schedule was applied to the eligible women. This study found that 72.8% women gave first birth at <20 years of age with mean age at first birth 18.74 years. Simple linear regression model explained 30.9% of variance in age at first live birth. Among socioeconomic and cultural determinants, family pressure explained the most significant variance. It is really difficult to reduce fertility in complex sociocultural settings in rural Bangladesh. However, the findings of this study may provide an answer to increase the age at first birth and hence to reduce the high fertility among these group of women.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | RURAL AREAS | WOMEN | YOUTH | FIRST BIRTH | AGE FACTORS | SOCIOECONOMIC STATUS | CULTURE | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Demographic Factors | Population Characteristics | Pregnancy History | Fertility Measurements | Fertility | Population Dynamics | Socioeconomic Factors | Economic Factors | Sociocultural Factors
Document Number: 330710

17.

Peer Reviewed

Title: Examining the geographical heterogeneity associated with risk of mistimed and unwanted pregnancy in Ghana.
Author: Amoako Johnson F; Madise NJ
Source: Journal of Biosocial Science. 2009 Mar;41(2):249-67.
Abstract: After a decade of fertility decline, Ghana's fertility and the level of unmet need for contraception stalled in mid-transition in the late 1990s. Although the literature acknowledges this, the geographical patterns in unmet need have not been adequately documented. Spatial analysis of unmet need can reveal differences in usage and provision of contraceptive commodities, thereby pointing to geographical areas where contraceptive programmes should be strengthened. This study examines the geographical variation of the risk of mistimed and unwanted pregnancies between rural communities and also between urban communities of the three ecological zones of Ghana. The study also investigates if geographical differences in the risks of mistimed and unwanted pregnancies changed during the period when unmet need stalled at the national level. A multilevel regression model was applied to pooled data from the 1998 and 2003 Ghana Demographic and Health Surveys to examine the determinants of the risk of unintended pregnancies, while controlling for clustering of outcomes within communities. The results show that between the two surveys, there was no significant change in the levels of risk of mistimed and unwanted pregnancy. However, geographical heterogeneity in the risk of mistimed and unwanted pregnancy was observed, after controlling for relevant predictors. This showed concentration of mistimed pregnancies in some rural communities relative to others, and variation in the risk of unwanted pregnancies between urban communities. The results give a clear indication that bridging the inequality gap in contraceptive use requires programmes that are area-specific.
Language: English
Keywords:
GHANA | RESEARCH REPORT | NEEDS | HETEROGENEITY | FERTILITY DECLINE | GEOGRAPHIC FACTORS | PREGNANCY, UNPLANNED | CONTRACEPTIVE USAGE | INEQUALITIES | NEEDS ASSESSMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Economic Factors | Population Characteristics | Demographic Factors | Population | Fertility Changes | Fertility | Population Dynamics | Reproductive Behavior | Contraception | Family Planning | Socioeconomic Factors | Evaluation
Document Number: 331181

18.

Peer Reviewed

Title: Sexual risk behaviour of the first cohort undergoing screening for enrollment into Phase I/II HIV vaccine trials in South Africa.
Author: Andersson KM; Van Niekerk RM; Niccolai LM; Mlungwana ON; Holdsworth IM; Bogoshi M; McIntyre JA; Gray GE; Vardas E
Source: International Journal of STD and AIDS. 2009 Feb;20(2):95-101.
Abstract: We assessed risk behaviour in a heterosexual cohort undergoing prescreening for the first Phase I/II HIV vaccine trials in Soweto. We developed a survey and collected self-reported data from HIV-negative potential volunteers. Of 488 participants, most were single and approximately half were from households with incomes below the poverty level. Males reported higher rates of heavy alcohol use (P < 0.001), marijuana use (P < 0.001) and other recreational drug use (P < 0.01). Males reported more sex partners than females in the previous six months (P < 0.001), as well as more casual/anonymous partners (P < 0.001) and one-night stands (P < 0.001). Multivariate analyses revealed substance use and male gender predicted higher risk behaviours, including <100% condom use with known/suspected HIV-positive partners, having casual/anonymous partners and having more than two partners. For this population, male volunteers may need increased risk-reduction counselling during Phase I/II trials and additional recruitment methods may be necessary to identify high-risk female volunteers for Phase III efficacy trials.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | CLINICAL TRIALS | MULTIVARIATE ANALYSIS | HETEROSEXUALS | SEXUAL PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | VACCINES | ALCOHOL USE AND ABUSE | SCREENING | POVERTY | DRUG USE AND ABUSE | SEX FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Clinical Research | Data Analysis | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population
Document Number: 331093

19.

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

20.

Title: Collective violence and attitudes of women toward intimate partner violence: evidence from the Niger Delta.
Author: Antai D; Antai J
Source: BMC International Health and Human Rights. 2009 Jun 9;9(12):10 p.
Abstract: Background: The Niger Delta region of Nigeria has been undergoing collective violence for over 25 years, which has constituted a major public health problem. The objectives of this study were to investigate the predictors of women's attitudes toward intimate partner violence in the Niger Delta in comparison to that of women in other parts of Nigeria. Methods: The 2003 Nigeria Demographic and Health Survey was used for this study. Respondents were selected using a stratified two-stage cluster sampling procedure through which 3725 women were selected and interviewed. These women contributed 6029 live born children born to the survey. Internal consistency of the measure of the women's attitudes towards intimate partner violence against a woman was assessed using Cronbach's alpha (a). Percentage distributions of the relevant characteristics of the respondents were carried out, and multivariable logistic regression analysis was used to measure the magnitude and direction of the relationship between the outcome and predictor variables were expressed as odds ratios (OR) and statistical significance was determined at the 95 percent confident interval level (CI). Results: Tolerance for intimate partner violence among the women in the Niger delta (47 percent) was higher than that of women from the rest of the country (42 percent). Rural residence, lower household wealth, lower status occupations, and media access (newspaper and radio) were associated with lower risk of justifying IPV among the women in the Niger Delta. In contrast full or partial autonomy in household decisions regarding food to be cooked, and access to television were associated with a lower risk of justifying violence. Conclusion: The increased justification of intimate partner violence among the women in the Niger Delta could be explained by a combination of factors, among which are cognitive dissonance theory (attitudes that do not fit with other opinions they hold as a means of coping with their situation), ecological theory (behaviour or attitudes being shaped by current factors in their neighbourhood, community or family), and gender-role attitudes. Further in-depth studies are required to fully understand women's attitudes toward violence in areas of conflict.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | SAMPLING STUDIES | WOMEN | SEXUAL PARTNERS | DOMESTIC VIOLENCE | ATTITUDES | WAR | VIOLENCE | SOCIOECONOMIC STATUS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Sex Behavior | Behavior | Crime | Social Problems | Sociocultural Factors | Psychological Factors | Political Factors | Socioeconomic Factors | Economic Factors
Document Number: 341880

21.

Peer Reviewed

Title: Impact of the Family Health Project on infant mortality in Brazilian municipalities.
Author: Aquino R; de Oliveira NF; Barreto ML
Source: American Journal of Public Health. 2009 Jan;99(1):87-93.
Abstract: The authors evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. They collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. They performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. The authors observed a statistically significant negative association between FHP coverage and infant mortality rate. After controlling for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MATHEMATICAL MODEL | EVALUATION INDEXES | INFANT | URBAN POPULATION | INFANT MORTALITY | AGE SPECIFIC DEATH RATE | PRIMARY HEALTH CARE | HEALTH STATUS INDEXES | INEQUALITIES | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Theoretical Models | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Death Rate | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors
Document Number: 328585

22.

Peer Reviewed

Title: Education gender gaps in Pakistan: Is the labor market to blame?
Author: Aslam M
Source: Economic Development and Cultural Change. 2009 Jul;57(4):747-784.
Abstract: Differential labor market returns to male and female education are one potential explanation for large gender gaps in education in Pakistan. We empirically test this explanation by estimating private returns to education separately for male and female wage earners. This article contributes to the literature by using a variety of methodologies (ordinary least squares, Heckman correction, two-stage least squares, and household fixed effects) in order to estimate economic returns to education. The latest nationally representative data-the Pakistan Integrated Household Survey (2002)-are used. Earnings function estimates consistently reveal a sizable gender asymmetry in economic returns to education, with returns to women's education being substantially and statistically significantly higher than men's. The return to an additional year of schooling ranges between 7% and 11% for men and between 13% and 18% for women. There are also large, direct returns to women's education at low levels of schooling, and the education-earnings profile is more convex for women than for men. However, a decomposition of the gender wage gap (into the component "explained" by differing male and female endowments and the residual component) suggests that there is highly differentiated treatment by employers. We conclude that the total labor market returns are much higher for men, despite returns to education being higher for women. This suggests that parents may have an investment motive in allocating more resources to boys than to girls within households.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | STATISTICAL REGRESSION | MULTIVARIATE ANALYSIS | MATHEMATICAL MODEL | LABOR FORCE | SPOUSE | EDUCATIONAL STATUS | GENDER ISSUES | SEX FACTORS | INEQUALITIES | INCOME | PARENTAL INVOLVEMENT | Developing Countries | Asia, Southern | Asia | Data Analysis | Research Methodology | Theoretical Models | Human Resources | Economic Factors | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior
Document Number: 341095

23.

Title: Philani program: a case study of an integrative approach of empowerment and social and economic development.
Author: Austin SA; Mbewu N
Source: Social Work In Public Health. 2009 Jan-Apr;24(1-2):148-60.
Abstract: This article reports a case study of a South African nongovernmental organization's role in implementing maternal and child health care services for families in Khayelitsha, an informal township in the Western Cape. The township is an extremely poor community with high unemployment and many other social indicators of high need. The case study explores how services were enhanced to respond to the service needs of children and families. The role of economic development as a means of empowering the mothers is examined within the context of nongovernmental organization services. The implications of developing services that integrate social and economic development are discussed as a model for social work practice in the United States.
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | CASE STUDIES | NONGOVERNMENTAL ORGANIZATIONS | MATERNAL-CHILD HEALTH SERVICES | NEEDS | POVERTY | ECONOMIC DEVELOPMENT | SOCIAL DEVELOPMENT | WOMEN'S EMPOWERMENT | INTEGRATED PROGRAMS | SOCIAL POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Organizations | Political Factors | Sociocultural Factors | Primary Health Care | Health Services | Delivery of Health Care | Health | Economic Factors | Socioeconomic Factors | Women's Status | Programs | Organization and Administration | Policy
Document Number: 341952

24.

Peer Reviewed

Title: Domestic violence against women in eastern India: a population-based study on prevalence and related issues.
Author: Babu BV; Kar SK
Source: BMC Public Health. 2009;9:129.
Abstract: BACKGROUND: Violence against women is now widely recognised as an important public health problem, owing to its health consequences. Violence against women among many Indian communities on a regularly basis goes unreported. The objective of this study is to report the prevalence and other related issues of various forms of domestic violence against women from the eastern zone of India. METHODS: It is a population-based study covering both married women (n = 1718) and men (n = 1715) from three of the four states of Eastern India selected through a systematic multistage sampling strategy. Interviews were conducted using separate pre-piloted structured questionnaires for women (victimization) and men (perpetration). Women were asked whether their husband or any other family members committed violent acts against them. And men were asked whether they had ever perpetrated violent acts against their wives. Three principle domestic violence outcome variables (physical, psychological and sexual violence) were determined by response to a set of questions for each variable. In addition, data on socio-economic characteristics were collected. Descriptive statistics, bi- and multivariate analyses were done. RESULTS: The overall prevalence of physical, psychological, sexual and any form of violence among women of Eastern India were 16%, 52%, 25% and 56% respectively. These rates reported by men were 22%, 59%, 17% and 59.5% respectively. Men reported higher prevalence of all forms of violence apart from sexual violence. Husbands were mostly responsible for violence in majority of cases and some women reported the involvement of husbands' parents. It is found that various acts of violence were continuing among majority of women who reported violence. Some socio-economic characteristics of women have significant association with the occurrence of domestic violence. Urban residence, older age, lower education and lower family income are associated with occurrence of domestic violence. Multivariate logistic regressions revealed that the physical violence has significant association with state, residence (rural or urban), age and occupation of women, and monthly family income. Similar associations are found for psychological violence (with residence, age, education and occupation of the women and monthly family income) and sexual violence (with residence, age and educational level of women). CONCLUSION: The prevalence of domestic violence in Eastern India is relatively high compared to majority of information available from India and confirms that domestic violence is a universal phenomenon. The primary healthcare institutions in India should institutionalise the routine screening and treatment for violence related injuries and trauma. Also, these results provide vital information to assess the situation to develop public health interventions, and to sensitise the concerned agencies to implement the laws related to violence against women.
Language: English
Keywords:
INDIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | DOMESTIC VIOLENCE | PREVALENCE | PHYSICAL ABUSE | PSYCHOLOGICAL ABUSE | SEXUAL ABUSE | SOCIOECONOMIC STATUS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | Crime | Social Problems | Measurement | Violence | Behavior | Aggression | Socioeconomic Factors | Economic Factors
Document Number: 341406

25.

Title: Demographic data for development in sub-Saharan Africa.
Author: Baldwin W; Diers J
Source: New York, New York, Population Council, 2009. 15 p. (Poverty, Gender, and Youth Working Paper No. 13)
Abstract: More demographic data are being collected throughout the developing world than ever before, but the effective use of that data to further development goals is often lacking. This paper summarizes case studies on the demand for data in four sub-Saharan African countries, namely Ethiopia, Ghana, Senegal, and Uganda. The project's objective was to create a detailed portrait of access and demand at the country level, and to determine whether policymakers are getting the data they need to develop sound policies. Common findings across the four countries include an increased external demand from international initiatives that has not necessarily translated into internal demand for data; a missing link between producers and users of data; and a need for data to be presented in user-friendly formats. One driver of internal demand for data is the decentralization and democratization process that is underway in all four countries; this demand highlighted the paucity of available data that can be disaggregated at the level to which policies were being devolved. Next steps are to support initiatives to establish data access as a right, encourage a culture of data-sharing among funders and producers of data, strengthen intermediaries between policymakers and data collectors, display data in accessible formats such as maps, and disaggregate available data to the most useful levels. (Author's abstract)
Language: English
Keywords:
ETHIOPIA | GHANA | SENEGAL | UGANDA | SUMMARY REPORT | DEMOGRAPHIC ANALYSIS | DATA COLLECTION | CASE STUDIES | DATA QUALITY | NEEDS | DECENTRALIZATION | DEMOCRACY | INFORMATION DISTRIBUTION | POVERTY | GENDER ISSUES | YOUTH | POLICY | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Western | Research Methodology | Studies | Data Analysis | Economic Factors | Political Factors | Sociocultural Factors | Political Systems | Communication | Socioeconomic Factors | Age Factors | Population Characteristics | Demographic Factors | Population | Program Evaluation | Programs | Organization and Administration
Document Number: 331433

26.

27.

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

28.

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

29.
Peer Reviewed

Title: Loss to care and death before antiretroviral therapy in Durban, South Africa.
Author: Bassett IV; Wang B; Chetty S; Mazibuko M; Bearnot B; Giddy J; Lu Z; Losina E; Walensky RP; Freedberg KA
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jun 1;51(2):135-9.
Abstract: OBJECTIVE: To examine the loss to care and mortality rates before starting antiretroviral therapy (ART) among ART eligible HIV-infected patients in Durban, South Africa. Design: Retrospective cohort study. METHODS: We reviewed data from ART eligible adults (> or = 18 years) at an urban HIV clinic that charges a monthly fee from July to December 2006. ART eligibility was based on CD4 count < or = 200 cells per microliter or clinical criteria and a psychosocial assessment. Patients who did not start ART and were lost within 3 months were phoned. Correlates of loss to care were evaluated using logistic regression. RESULTS: During the study period, 501 patients registered for ART training. Mean time from initial CD4 count to first ART training was 3.6 months (interquartile range 2.3-3.9 months). Four hundred eight patients (81.4%) were in care and on ART at 3-month follow-up, and 11 (2.2%) were in care but had not initiated ART. Eighty-two ART eligible patients (16.4%) were lost before ART initiation. Of these, 28 (34.1%) had died; two thirds of deaths occurred before or within 2 months after the first ART training. Despite multiple attempts, 32 patients (39%) were unreachable by phone. Lower baseline CD4 counts (< or = 100 cells/microL) and unemployment were independently associated with being lost. CONCLUSIONS: Loss to care and death occur frequently before starting ART at an HIV clinic in Durban, South Africa. This delay from CD4 count to ART training, even among those with the lowest CD4 counts, highlights the need for interventions that improve linkage to care and prioritize ART initiation for those with low baseline CD4 counts.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | CARE AND SUPPORT | PROGRAM ACCESSIBILITY | TIME FACTORS | MORTALITY | EMPLOYMENT STATUS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Health Services | Delivery of Health Care | Health | Program Evaluation | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 341755

30.

Title: Exposure to information and communication about HIV/AIDS and perceived credibility of information sources among young people in northern Tanzania.
Author: Bastien S; Leshabari MT; Klepp KI
Source: African Journal of AIDS Research. 2009;8(2):213-222.
Abstract: A structured face-to-face interview was completed by 993 young people out of school, between the ages of 13 and 18, in Kilimanjaro, Tanzania; additionally, the questionnaire was self-administered by 1,007 students attending either their last year of primary or first year of secondary school. Significant factors associated with the frequency of exposure to HIV/AIDS information and frequency of communication about HIV/AIDS included urban/rural location, sex, socio-economic status, and educational attainment. Both groups ranked the radio as the most frequent source of HIV/AIDS information. The in-school group reported significantly more frequent exposure to all sources of HIV/AIDS information, and they communicated more frequently about the topic than did the out-of-school group. The in-school group gave high credibility ratings to medical doctors, the radio, and parents as sources of information, whereas the out-of-school group attributed the most credibility to the mass media. Irrespective of school attendance, the young people ranked friends, parents, and doctors as preferred communicators of sexual and reproductive health information.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | COMPARATIVE STUDIES | OUT-OF-SCHOOL YOUTHS | STUDENTS | HIV INFECTIONS | INFORMATION SOURCES | INTERPERSONAL CO