1.  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 |
2.  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 |
| 3. 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 |
| 4. Title: Evidence-based, alternative cervical cancer screening approaches in low-resource settings. Author: Almeida MC; Aquino EM Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):147-154. Abstract: Cervical cancer kills approximately 270,000 women worldwide each year, with nearly 85% of those deaths occurring in resource-poor settings.1 Use of the Pap smear for routine screening of women has resulted in a dramatic decline in cervical cancer deaths over the past four decades in wealthier countries. A key reason for continuing high mortality in the developing world is the shortage of efficient, high-quality screening programs in those regions. Language: English Keywords: AFRICA | ASIA | LATIN AMERICA | SUMMARY REPORT | SCREENING | WOMEN | AGE FACTORS | CERVICAL CANCER | HPV | PREVENTION AND CONTROL | LOW INCOME POPULATION | TESTING | TREATMENT | PROGRAM EFFECTIVENESS | Developing Countries | Americas | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Population Characteristics | Cancer | Neoplasms | Diseases | Viral Diseases | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Measurement | Research Methodology | Program Evaluation | Programs | Organization and Administration Document Number: 343005 |
| 5. 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 fenómeno. Métodos: En 2002, una encuesta representativa de hogares recolectó datos de 3,050 hombres y mujeres jóvenes de 20-24 años en tres ciudades brasileñas. 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 años o mayores. La distribución de las personas encuestadas (tanto por su propia experiencia reproductiva como la de su madre), se analizó en relación con varias características, y se valoró mediante regresiones logísticas las posibles asociaciones entre estas variables y la experiencia del embarazo. Resultados: Treinta por ciento de las jóvenes reportaron haberse embarazado antes de los 20 años; y 21% de los hombres dijeron que eran menores de 20 años cuando su pareja se embarazó. De estos grupos, 34% de las mujeres y 31% de los hombres reportaron que sus madres habían 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 había tenido un hijo antes de los 20 años (razones de momios, 2.0 y 2.3, respectivamente). En las mujeres, esta asociación positiva desapareció en el modelo final, después de ajustar por nivel de educación, mientras que entre los hombres la asociación permaneció después de un ajuste similar (1.8). Conclusiones: El nivel de educación de las hijas e hijos parece ser un factor importante en la repetición de la fecundidad adolescente a través de las generaciones. Se necesita esfuerzos para aumentar el acceso a la educación y para alentar a la gente joven a que permanezca en la escuela. French Abstract: Contexte: Les grossesses d'adolescentes ont été associées à l'expérience de la maternité précoce des mères des adolescents concernés et le niveau d'instruction des jeunes semble jouer un rôle important. Méthodes: En 2002, une enquête de ménages représentative a recueilli des données auprès de 3.050 jeunes hommes et femmes de 20 à 24 ans dans trois villes du Brésil. Les principales mesures ont porté sur l'âge de la mère à la première naissance, l'âge de la fille à la première grossesse et l'âge du fils au moment de la fécondation d'une partenaire. Les âges ont été dichotomisés entre moins de 20 ans et 20 ans ou plus. La distribution des répondants en fonction de leur propre expérience génésique et de celle de leur mère a été analysée selon différentes caractéristiques, tandis que les associations possibles entre ces variables et l'expérience d'une grossesse étaient évaluées par régressions logistiques. Résultats: Trente pour cent des femmes ont déclaré avoir été enceintes avant l'âge de 20 ans, tandis que 21% des hommes déclaraient avoir eu moins de 20 ans au moment de la fécondation de leur partenaire. De ces groupes, 34% des femmes et 31% des hommes ont déclaré que leur mère avait accouché pour la première fois à ce même âge. Tant les femmes que les hommes sont apparus plus susceptibles d'avoir connu une grossesse précoce si leur mère avait eu un enfant avant l'âge de 20 ans (rapports de probabilités, 2,0 et 2,3, respectivement). Côté féminin, cette association positive disparaît dans le modèle final après correction du niveau d'instruction; côté masculin, elle se maintient après correction similaire (1,8). Conclusions: Le niveau d'instruction des filles comme des fils semble jouer un rôle important dans la répétition de la fécondité adolescente d'une génération à l'autre. Des efforts sont nécessaires pour accroître l'accès à l'éducation et encourager les jeunes à 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 |
| 6. 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 |
| 8. 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 |
| 9. 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 |
| 10. 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 |
| 11. Peer Reviewed Title: Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe? Author: Birdthistle I; Floyd S; Nyagadza A; Mudziwapasi N; Gregson S; Glynn JR Source: Social Science and Medicine. 2009 May;68(10):1810-1818. Abstract: This study explored the role of education in explaining the excess sexual risk previously documented among unmarried female orphans in urban Zimbabwe. School attendance and attainment were assessed by type of orphanhood, and for their association with markers of sexual risk (HIV and/or HSV-2 infection) among 743 participants drawn from a random sample of 15- to 19-year-old girls identified in a cross-sectional survey in Highfield, Harare in 2004. Multivariable logistic regression was used to assess the role of educational status in explaining the higher prevalence of adverse sexual outcomes among unmarried orphans compared to non-orphans, adjusting for possible confounders. Double orphans had significantly lower educational attendance and attainment than non-orphans. Maternal orphans had higher odds of school drop-out, although this association disappeared when adjusted for recent mobility. Educational status was strongly associated with HIV/HSV-2 risk, but explained only a small part of double orphans' sexual risk and did not explain the HIV/HSV-2 risk of maternal and paternal orphans. High overall levels of secondary school participation and school fee assistance provided to vulnerable families may have reduced the schooling disparities between orphans and non-orphans in Highfield. However, further efforts are needed to rectify the schooling inequities that persist, while additional research is needed to identify other socioeconomic and emotional factors driving orphans' sexual risk so that prevention and support programs can meet the needs of this growing population. Language: English Keywords: ZIMBABWE | URBAN AREAS | RESEARCH REPORT | SAMPLING STUDIES | ADOLESCENTS, FEMALE | ORPHANS AND VULNERABLE CHILDREN | HIV INFECTIONS | HERPES GENITALIS | EDUCATIONAL STATUS | SEX BEHAVIOR | RISK FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior | Health Document Number: 341411 |
| 12. Title: [Assessment of factors associated with patients' comprehension of treatment at the start of antiretroviral therapy] Evaluacion de factores asociados a la comprension del tratamiento en pacientes Author: Braga Ceccato MG; Acurcio Fde A; Vallano A; Comini Cesar C; Crosland Guimaraes MD Source: Enfermedades Infecciosas Y Microbiologia Clinica. 2009 Jan;27(1):7-13. Abstract: OBJECTIVE: The aim of this study was to evaluate factors associated with patients' comprehension of antiretroviral therapy (ART). METHOD: Cross-sectional analysis in which patients at 2 HIV/AIDS public referral centers (Belo Horizonte, Brazil) were interviewed after initiating ART. Information was recorded on variables related to the patient's characteristics, the treatment prescribed, and the healthcare professional involved. A score indicating the patients' level of comprehension regarding the medications prescribed was obtained using a latent trait model estimated by the item response theory. RESULTS: A total of 406 patients were interviewed. Mean (SD) age was 35 (10) years, 227 were men (56%), 302 of Afro-American ethnicity (77%), and 213 had <8 years of education (53%). The regression model determined that 52.25% of the variability of comprehension was explained by the individual's characteristics. Variables associated (P<0.05) with poorest understanding about ART were lower education (<8 years), lack of knowledge about treatment duration and clinical severity, inadequate information provided by physicians, inability to understand pharmaceutical information, daily number of tablets, and the ART regimen prescribed. CONCLUSION: Comprehension of information about the ART regimen prescribed varies considerably between individuals. Nonetheless, several factors were found to be associated with the level of understanding: characteristics of the patient (education, clinical severity), characteristics of treatment (daily number of tablets, ART regimen prescribed), and contribution of healthcare professionals (information from physicians and pharmacists). Strategies to reinforce information about ART should be a priority for patients with a low level of understanding. Language: Spanish Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INTERVIEWS | CLIENTS | ETHNIC GROUPS | PRESCRIPTIONS | EDUCATIONAL STATUS | KNOWLEDGE | TREATMENT | INFORMATION | PHYSICIAN-PATIENT RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Demographic Factors | Population | Distributional Activities | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior Document Number: 341238 |
| 13. 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 |
| 14. 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 |
| 15. Title: Evaluating the impact of community-based interventions on schooling outcomes among orphans and vulnerable children in Lusaka, Zambia. Author: Chatterji M; Hutchinson P; Murray N; Buek K; Mulenga Y Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Apr. 34 p. (MEASURE Evaluation Working Paper Series WP-09-110USAID Cooperative Agreement No. GPO-A-00-03-00003-00USAID Task Order GHS-I-00-07-00002-00) Abstract: This paper evaluates the impact of a community-based program implemented by a Zambian nongovernmental agency (NGO) on educational outcomes among orphans and vulnerable children (OVC) in Lusaka, Zambia. These outcomes included school enrollment and being at the correct age-for-grade. The study design included two rounds of post-intervention data collection, in 2003 and 2006. There were 2,302 children, ages 6-19, interviewed in 2003; and 3,105 children or young adults, ages 8-22, interviewed in 2006. A sub-sample of 2,922 orphans and vulnerable children, ages 8-19, was used. The effectiveness of Bwafwano Community Home-Based Care Organization, an NGO working in Lusaka, was evaluated, first using the individual cross-sectional samples and then using a differences-in-differences model on the pooled sample. Both cross-sectional analyses found positive and statistically significant effects of the intervention on school enrollment, with marginal effects of 0.104 and 0.168 respectively. The differences-in-differences estimates for school enrollment were positive, but small and not statistically significant. For the estimations of the effects of Bwafwano on the outcome of appropriate age-for-grade, only the difference-in-difference models showed positive program effect, with participation in the program being associated with a 15.7 percentage point increase in appropriate age-for-grade for intervention children, relative to control children. This study suggests that the Bwafwano program is a promising approach to improving educational outcomes among orphans and vulnerable children in urban Zambia. Language: English Keywords: ZAMBIA | RESEARCH REPORT | ORPHANS AND VULNERABLE CHILDREN | EDUCATIONAL STATUS | PRIMARY SCHOOLS | INTERVENTIONS | HIV PREVENTION | HOME CARE | PROGRAM EVALUATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Schools | Education | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Care and Support | Health Services | Delivery of Health Care | Health Document Number: 339995 |
| 16. 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 |
| 17. Title: Effects of female literacy on family size. Author: Chaudhry MA; Irshad S Source: Pakistan Journal of Medical Research. 2009 Jan-Mar;48(1):4-7. Abstract: Background: Education may indirectly lead to wider use of contraceptives and reduction in fertility. Female education reduces her vulnerability to unwanted pregnancies as a result of increased age at first marriage, being more aware of available contraceptive methods and by limiting family size. Objectives: To determine the effects of female literacy on family size and ascertain indirect effects of education on age at marriage, desired family size, use and knowledge of contraception and female autonomy. Methods: This cross-sectional study was carried out in 2005 and included 150 females from Outpatient Department of Combined Military Hospital and Military Hospital, Rawalpindi. The inclusion criteria was married females having children while educational status was an independent variable. Data was collected through convenience sampling using a questionnaire and was analysed using SPSS version II. Results: A total of 150 women were selected for the study, their marriage age ranged from 11-35 years. Forty two were uneducated and rest had some degree of education. Out of the total, 125 were using contraceptives. One hundred and thirty (87%) females desired small family and the fertility gap was higher in educated females. One hundred and thirty (87%) had knowledge of family planning with media being the strongest source of dissemination of information. One hundred and thirty-six (91%) females favored education of girl child. About 82% educated females had a small family with 3 or less children while only 18% had 4 or more children. Only 4 (10%) uneducated females had small family and rest 38 (90%) had a large family size. Conclusion: Educated women have fewer children, are more likely to use contraception and marry later. Improving educational status of women seems to be a cost effective intervention for controlling population growth in developing countries like Pakistan. Language: English Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | FAMILY SIZE | MARRIAGE AGE | LITERACY | KNOWLEDGE | CONTRACEPTIVE USAGE | FAMILY SIZE, DESIRED | Developing Countries | Asia, Southern | Asia | Research Methodology | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Marriage Patterns | Marriage | Nuptiality | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Contraception | Family Planning Document Number: 340190 |
| 18. Title: Mother's education and child health: is there a nurturing effect? Author: Chen Y; Li H Source: Journal of Health Economics. 2009 Mar;28(2):413-26. Abstract: In this paper, we examine the effect of maternal education on the health of young children by using a large sample of adopted children from China. As adopted children are genetically unrelated to the nurturing parents, the educational effect on them is most likely to be the nurturing effect. We find that the mother's education is an important determinant of the health of adopted children even after we control for income, the number of siblings, health environments, and other socioeconomic variables. Moreover, the effect of the mother's education on the adoptee sample is similar to that on the own birth sample, which suggests that the main effect of the mother's education on child health is in post-natal nurturing. We also find suggestive evidence that the effect is causal. Our work provides new evidence to the general literature that examines the determinants of health and that examines the intergenerational immobility of socioeconomic status. Language: English Keywords: CHINA | RESEARCH REPORT | CHILDREN | CHILD HEALTH | MATERNAL HEALTH | EDUCATION | EDUCATIONAL STATUS | IMPACT | Asia, Eastern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Communication Document Number: 341556 |
| 19. Peer Reviewed Title: Mental distress in the general population in Zambia: impact of HIV and social factors. Author: Chipimo PJ; Fylkesnes KM Source: BMC Public Health. 2009 Aug 18;9(1):298. Abstract: ABSTRACT: BACKGROUND: Population level data on mental health from Africa are limited, but available data indicate mental problems to represent a substantial public health problem. The negative impact of HIV on mental health suggests that this could particularly be the case in high prevalence populations. We examined the prevalence of mental distress, distribution patterns and the ways HIV might influence mental health among men and women in a general population. METHODS: The relationship between HIV infection and mental distress was explored using a sample of 4466 participants in a population-based HIV survey conducted in selected rural and urban communities in Zambia in 2003. The Self-reporting questionnaire-10 (SRQ-10) was used to assess global mental distress. Weights were assigned to the SRQ-10 responses based on DSM IV criteria for depression and a cut off point set at 7/20 for probable cases of mental distress. A structural equation modeling (SEM) was established to assess the structural relationship between HIV infection and mental distress in the model, with maximum likelihood ratio as the method of estimation. RESULTS: The HIV prevalence was 13.6% vs. 18% in the rural and urban populations, respectively. The prevalence of mental distress was substantially higher among women than men and among groups with low educational attainment vs. high. The results of the SEM showed a close fit with the data. The final model revealed that self-rated health and self perceived HIV risk and worry of being HIV infected were important mediators between underlying factors, HIV infection and mental distress. The effect of HIV infection on mental distress was both direct and indirect, but was particularly strong through the indirect effects of health ratings and self perceived risk and worry of HIV infection. CONCLUSION: These findings suggest a strong effect of HIV infection on mental distress. In this population where few knew their HIV status, this effect was mediated through self-perceptions of health status, found to capture changes in health perceptions related to HIV, and self-perceived risk and worry of actually being HIV infected. Language: English Keywords: ZAMBIA | RESEARCH REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | MENTAL HEALTH | HIV INFECTIONS | EDUCATIONAL STATUS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Viral Diseases | Diseases | Health | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 342549 |
| 20. Peer Reviewed Title: Causes of maternal mortality decline in Matlab, Bangladesh. Author: Chowdhury ME; Ahmed A; Kalim N; Koblinsky M Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):108-23. Abstract: Bangladesh is distinct among developing countries in achieving a low maternal mortality ratio (MMR) of 322 per 100,000 livebirths despite the very low use of skilled care at delivery (13% nationally). This variation has also been observed in Matlab, a rural area in Bangladesh, where longitudinal data on maternal mortality are available since the mid-1970s. The current study investigated the possible causes of the maternal mortality decline in Matlab. The study analyzed 769 maternal deaths and 215,779 pregnancy records from the Health and Demographic Surveillance System (HDSS) and other sources of safe motherhood data in the ICDDR,B and government service areas in Matlab during 1976-2005. The major interventions that took place in both the areas since the early 1980s were the family-planning programme plus safe menstrual regulation services and safe motherhood interventions (midwives for normal delivery in the ICDDR,B service area from the late 1980s and equal access to comprehensive emergency obstetric care [EmOC] in public facilities for women from both the areas). National programmes for social development and empowerment of women through education and microcredit programmes were implemented in both the areas. The quantitative findings were supplemented by a qualitative study by interviewing local community care providers for their change in practices for maternal healthcare over time. After the introduction of the safe motherhood programme, reduction in maternal mortality was higher in the ICDDR,B service area (68.6%) than in the government service area (50.4%) during 1986-1989 and 2001-2005. Reduction in the number of maternal deaths due to the fertility decline was higher in the government service area (30%) than in the ICDDR,B service area (23%) during 1979-2005. In each area, there has been substantial reduction in abortion-related mortality--86.7% and 78.3%--in the ICDDR,B and government service areas respectively. Education of women was a strong predictor of the maternal mortality decline in both the areas. Possible explanations for the maternal mortality decline in Matlab are: better access to comprehensive EmOC services, reduction in the total fertility rate, and improved education of women. To achieve the Millenium Development Goal 5 targets, policies that bring further improved comprehensive EmOC, strengthened family-planning services, and expanded education of females are essential. Language: English Keywords: BANGLADESH | RURAL AREAS | RESEARCH REPORT | MATERNAL MORTALITY | MORTALITY DECLINE | CAUSES OF DEATH | RISK FACTORS | SAFE MOTHERHOOD | OBSTETRICS | EMERGENCY SERVICES | PROGRAM ACCESSIBILITY | FERTILITY DECLINE | EDUCATIONAL STATUS | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Mortality | Population Dynamics | Demographic Factors | Health | Maternal Health | Medicine | Health Services | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration | Fertility Changes | Fertility | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 341939 |
| 21. Peer Reviewed Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population. Author: Deboosere P; Gadeyne S; Oyen HV Source: European Journal of Population. 2008 May;25(2):175-196. Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level. Language: English Keywords: BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics Document Number: 340174 |
| 22. Peer Reviewed Title: Determinants of nonadherence to a single-dose nevirapine regimen for the prevention of mother-to-child HIV transmission in Rwanda. Author: Delvaux T; Elul B; Ndagije F; Munyana E; Roberfroid D; Asiimwe A Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Feb 1;50(2):223-30. Abstract: OBJECTIVES: To describe experiences, and identify factors associated with nonadherence to a single-dose nevirapine (SD-NVP) regimen for the prevention of mother-to-child transmission (PMTCT) of HIV in Rwanda. METHODS: In April to May 2006, using a case-control design at 12 PMTCT sites, we interviewed HIV-infected women who did not adhere (n = 111) and who adhered (n = 125) to the PMTCT prophylaxis regimen. Nonadherence was defined as mother and/or infant not ingesting SD-NVP at the recommended time or not at all and adherence as mother-infant pairs who ingested it as recommended. RESULTS: Only 61% of nonadherent women had received SD-NVP during pregnancy or delivery. Among nonadherent women who received SD-NVP, 80% ingested it at the recommended time, representing 49% of all nonadherent women. Only 7% of their newborns ingested SD-NVP. Multivariate logistic regression showed that unmarried women, less educated women, women who made 2 or less antenatal care visits, and those offered HIV testing after their first antenatal care visit were more likely to be nonadherent to PMTCT prophylaxis. Not disclosing one's HIV status to someone aside from a partner was also associated with nonadherence in mother-infant pairs. CONCLUSIONS: Sociodemographic factors, health services delivery factors, and a lack of communication and social support contributed to nonadherence to PMTCT prophylaxis in Rwanda. Language: English Keywords: RWANDA | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | USER COMPLIANCE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | ADMINISTRATION AND DOSAGE | PREVALENCE | EDUCATIONAL STATUS | ANTENATAL CARE | PARTNER COMMUNICATION | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | HIV Infections | Viral Diseases | Diseases | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Behavior | Disease Transmission Control | Prevention and Control | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Socioeconomic Status | Socioeconomic Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Interpersonal Relations Document Number: 330370 |
| 23. 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 |
| 24. Title: Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use? Author: Ekabua JE; Ekabua KJ; Ekanem EI; Iklaki CU Source: Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):237-9. Abstract: The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status. Language: English Keywords: NIGERIA | CAMEROON | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | EXAMINATIONS AND DIAGNOSES | SCREENING | PSYCHOSOCIAL FACTORS | CONTRACEPTIVE USAGE | MULTIPARITY | SOCIAL CLASS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Contraception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors Document Number: 330945 |
| 25. 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 |
| 26. 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 |
| 27. Title: Domestic violence on pregnant women in Turkey. Author: Ergonen AT; Ozdemir MH; Can IO; Sonmez E; Salacin S; Berberoglu E; Demir N Source: Journal of Forensic and Legal Medicine. 2009 Apr;16(3):125-9. Abstract: OBJECTIVE: Domestic violence is accepted worldwide as an important health problem. Besides diagnosis and treatment process, there are difficulties when considering of medico-legal evaluation of pregnant women subjected to domestic violence. As a signatory of the ''Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW)'' Turkey has certain commitments regarding domestic violence and made regulations on national law. The purpose of the present study is to demonstrate the prevalence of domestic violence during pregnancy among the women who applied to obstetrics clinics and evaluating of the participants' knowledge level about the legal legislation concerning domestic violence. FINDINGS: Pregnant women attending for antenatal care to department of Gynecology and Obstetrics were interviewed using an anonymous and confidential questionnaire. The questionnaire used was a version of Abuse Assessment Screen with guidance of references. 28 (13.4%) women stated that they had been subjected to violence before pregnancy. Only 10 (4.67%) women had stated experience of violence during pregnancy. 148 (69.2%) of them had stated that they had no knowledge about any legislation concerning domestic violence in our country. CONCLUSION: We believe that society awareness should be increased and the health workers should be informed about their ethical and legal responsibilities concerning domestic violence during pregnancy. The knowledge and sensitivity of health care personnel in Prenatal Clinics and Family Planning Services should be increased and examination protocols should be provided about domestic violence against pregnant women. Language: English Keywords: TURKEY | RESEARCH REPORT | PREGNANT WOMEN | DOMESTIC VIOLENCE | PREVALENCE | LEGISLATION | KNOWLEDGE | EDUCATIONAL STATUS | QUESTIONNAIRES | TREATIES | ANTENATAL CARE | Europe, Southeastern | Europe | Developing Countries | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Measurement | Research Methodology | Political Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 342189 |
| 28. Title: Evaluation of berhane hewan: a program to delay child marriage in rural ethiopia. Author: Erulkar AS; Muthengi E Source: International Perspectives On Sexual and Reproductive Health. 2009 Mar;35(1):6-14. Abstract: CONTEXT: Early marriage limits girls' opportunities and compromises their health, yet in Sub-Saharan Africa many girls are married before the age of 18, and few programs have sought to increase the age at marriage on the continent. METHODS: Berhane Hewan was a two-year pilot project conducted in 2004-2006 that aimed to reduce the prevalence of child marriage in rural Ethiopia, through a combination of group formation, support for girls to remain in school and community awareness. A quasi-experimental research design with baseline and endline surveys was used to measure changes in social and educational participation, marriage age, reproductive health knowledge and contraceptive use. Chi-square tests, proportional hazards models and logistic regressions were conducted to assess changes associated with the project. RESULTS: The intervention was associated with considerable improvements in girls' school enrollment, age at marriage, reproductive health knowledge and contraceptive use. Particularly among girls aged 10-14, those exposed to the program were more likely than those in the control area to be in school at the endline survey (odds ratio, 3.0) and were less likely to have ever been married (0.1). However, among girls aged 15-19, those in the intervention area had an elevated likelihood of having gotten married by the endline (2.4). Sexually experienced girls exposed to the intervention had elevated odds at endline of having ever used contraceptives (2.9). CONCLUSIONS: The success of the Berhane Hewan program, one of the first rigorously evaluated interventions to delay marriage in Sub-Saharan Africa, suggests that well-designed and effectively implemented programs can delay the earliest marriages until later adolescence. Language: English Keywords: ETHIOPIA | RURAL AREAS | EVALUATION REPORT | PILOT PROJECTS | CHILD MARRIAGE | PREVALENCE | SCHOOL ENROLLMENT | CONTRACEPTIVE USAGE | MARRIAGE POSTPONEMENT | REPRODUCTIVE HEALTH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Evaluation | Studies | Research Methodology | Marriage Patterns | Marriage | Nuptiality | Demographic Factors | Measurement | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Contraception | Family Planning | Health Document Number: 341413 |
| 29. Peer Reviewed Title: Influence of wasting and stunting at the onset of the rainy season on subsequent malaria morbidity among rural preschool children in Senegal. Author: Fillol F; Cournil A; Boulanger D; Cisse B; Sokhna C; Targett G; Trape JF; Simondon F; Greenwood B; Simondon KB Source: American Journal of Tropical Medicine and Hygiene. 2009 Feb;80(2):202-8. Abstract: In sub-Saharan Africa, malaria and malnutrition are major causes of morbidity and mortality in children less than five years of age. To explore the impact of malnutrition on subsequent susceptibility to malaria, a cohort of 874 rural preschool children in Senegal was followed-up during one malaria transmission season from July through December. Data on nutritional status and Plasmodium falciparum parasitemia were collected at baseline. Malaria morbidity was monitored through weekly home visits. Wasted children (weight-for-height z-score < -2) were at lower risk of having at least one subsequent clinical malaria attack (odds ratio = 0.33; 95% confidence interval = 0.13-0.81, P = 0.02), whereas stunting (height-for-age z-score < -2) or being underweight (weight-for-age z-score < -2) was not associated with clinical malaria. Although non-biological explanations such as overprotection of wasted children by their mothers should be considered, immunomodulation according to nutritional status could explain the lower risk of malaria attack among wasted children. Language: English Keywords: IRAN | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | MOTHERS | CHILD CARE | KNOWLEDGE | ATTITUDES | BREASTFEEDING | DEMOGRAPHIC FACTORS | TIME FACTORS | BREASTFEEDING, EXCLUSIVE | SUPPLEMENTARY FEEDING | EDUCATIONAL STATUS | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Child Rearing | Behavior | Psychological Factors | Infant Nutrition | Nutrition | Health | Population | Population Dynamics | Socioeconomic Status | Socioeconomic Factors Document Number: 330300 |
| 30. Peer Reviewed Title: What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya. Author: Fotso J; Ezeh A; Madise N; Ziraba A; Ogollah R Source: Maternal and Child Health Journal. 2009 Jan;13(1):130-7. Abstract: Objectives: The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings. The objective of this paper is to identify the factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and "appropriate" health facilities. Methods: The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either "inappropriate" or "appropriate". Place of delivery is the dependent variable. Ordered logit models were used to quantify the effects of covariates on the choice of place of delivery, defined as a three-category ordinal variable. Results: Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy "wantedness", and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Conclusion: Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | SLUMS | URBAN POPULATION | WOMEN IN DEVELOPMENT | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | CHILDBIRTH | EDUCATIONAL STATUS | PROMOTION | ANTENATAL CARE | MULTIPARITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Economic Development | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Socioeconomic Status | Socioeconomic Factors | Marketing | Parity | Fertility Measurements | Fertility | Population Dynamics Document Number: 308031 |
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