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Volume 3, Number 23
9 June 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Women's Networks and the Social World of Fertility Behavior 
(research article)
The authors used data from a study conducted in Mali in 1996-1997 to explore the social networks of Bamanan women and their impact on fertility decisions. Ordinary least-squares and logistic regression techniques were employed to examine the relationship between selected household and social network characteristics and two fertility measures: children ever born and ever-use of contraceptives. They found that Household characteristics did not have a significant effect on either outcome, but network attributes did. They suggest that programs should consider not only women's individual and household characteristics, but also their larger social networks. Additionally, programs should be designed for specific age-groups, given the different network effects on older and younger women.
The Influence of Presumed Influence (research abstract)
The authors tested a model of indirect influence, which they term "presumed influence," in a maternal health campaign in Nepal. A key aspect of the campaign was a serial radio drama directed at clinic health workers. Results showed, however, that many women in the general population also listened to the serial. The program had no direct positive influence on this population, but we found a significant indirect influence on their attitudes and reported behaviors when mediated by their perceptions of impact on the target population of clinic health workers.
Diagnosis and Treatment of Presumed STIs at Mexican Pharmacies: Survey Results from a Random Sample of Mexico City Pharmacy Attendants (research abstract)
Researchers interviewed the first available attendant in each of a 5% random sample of Mexico City's pharmacies, .inquiring training, age, and experience of the attendant and about the typical number of clients coming for treatment of suspected STIs. After considering three hypothetical case studies, attendants recommended diagnoses, treatments, and, sometimes, physician follow-up. They found that pharmacy personnel were unable to diagnose accurately or offer appropriate treatment advice when presented with classic, common STI symptoms.
Increasing Patient Participation in Reproductive Health Consultations: An Evaluation of "Smart Patient" Coaching in Indonesia (research abstract)
This study tested whether individual coaching can give family planning patients the confidence and communication skills to talk more openly and more vigorously with providers. Researchers found that coaching narrowed differentials in active communication by patient type, age, and assertiveness, but it widened differentials by patient education and socioeconomic class.
The Impact of Decentralisation on Sexual and Reproductive Health Services in Ghana (research abstract)
This paper analyses the impact of decentralisation on the political organisation, management and provision of sexual and reproductive health services in Ghana.
Modifying the Yuzpe Regimen of Emergency Contraception: A Multicenter Randomized Controlled Trial (research abstract)
Extending the Time Limit for Starting the Yuzpe Regimen of Emergency Contraception to 120 Hours (research abstract)
Related news article: New Options for 'Morning After' Pill
Women who use one type of the "morning-after pill" may have a larger window in which to take the treatment after unprotected sex than previously thought, new research suggests.
Knowledge and Perception of Emergency Contraception Among Female Nigerian Undergraduates (research article)
a randomly selected sample of female undergraduate students at the University of Benin, Nigeria, were surveyed about their demographic information, sexual history and contraceptive use, and their awareness and knowledge of emergency contraception. Of the 880 respondents, 58% of respondents reported knowing about emergency contraception. However, only 18% of respondents who reported knowing about emergency contraception knew the correct time frame in which emergency contraceptives must be used to be effective.
Why are Uneducated Women in India Using Contraception? A Multilevel Analysis (research abstract)
The authors used multilevel statistical procedures to investigate the variation in contraceptive use among uneducated women across India. Their analysis suggests that, while many of the expected socio-economic variables play their part, there are also considerable diffusion effects in progress, many of which operate at levels beyond the uneducated women's own individual circumstances. For example, they found significant relationships with others' use of contraception and others' education. Mass media exposure also emerges as an important diffusion channel.
Expanding Safer Sex Options: Introducing the Female Condom into National Programmes (research abstract)
Although the female condom has been introduced into more than 90 countries since 1997, it has only been accepted in sexual and reproductive health programmes as a mainstream method in a few. This paper describes introductory strategies developed by Ministries of Health and non-governmental organisations in Brazil, Ghana, Zimbabwe, and South Africa, supported by UNAIDS, and the manufacturers of the female condom, which have significantly expanded the number of female condoms being used.
The Link Between Quality of Care and Contraceptive Use (research article)
Researchers conducted interviews with 1,728 new family planning users who had sought services at 80 service delivery points in Davao del Norte and Compostela Valley, the Philippines, to assess the quality of care received from family planning services providers. They found that the quality of care received at the time a woman adopted a contraceptive method influenced her contraceptive use at follow-up, after adjustment for the effects of background characteristics.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
Muslims, Islam, and AIDS: Thoughts on the 2nd International Muslim Religious Leaders Consultation on HIV/AIDS (feature article)
This article presents a first-hand account of the Second International Muslim Religious Leaders Consultation on HIV/AIDS, held in Kuala Lumpur May 19-23, and the attention that followed after Amina Wadud's presentation "What is Vulnerability?" during which conference attendees walked out and others "hurled accusations of blasphemy".
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
The Philippines: Natural Birth Control Pushed (news article)
The Department of Health has admitted the administration's policy on population is geared towards natural family planning and has left the task of promoting artificial birth control methods to local government units.
Malawi: Church Leaders Object to Condom Distribution in Prisons (news article)
Leading clergy in Malawi have condemned proposals by some members of parliament that condoms be freely distributed to inmates around the country's prisons, to check the spread of HIV/AIDS, following rampant homosexual practices in the institutions.
Incorporating Sexual and Reproductive Health Care in the Medical Curriculum in Developing Countries (research abstract)
This paper outlines topics for inclusion in the curriculum and three strategies for incorporating core components of sexual and reproductive health in the curriculum by developing themes that can be integrated into the general curriculum in a multi-disciplinary fashion, adding free-standing modules as electives, and delegating cross-cutting issues such as gender issues and adolescent reproductive health to courses run by other departments.
Decentralisation and its Implications for Reproductive Health: The Philippines Experience (research abstract)
The author discusses The Philippines experience in decentralization and its positive and negative implications for delivery of reproductive health.
Using Accountability to Improve Reproductive Health Care (research abstract)
This paper focuses on accountability mechanisms in health care and how they mediate between service providers and communities and between different kinds of health personnel at the primary health care level.
Restructuring the Health System: Experiences of Advocates for Gender Equity in Bangladesh (research abstract)
This paper illustrates how advocates for gender equity succeeded in influencing the restructuring of the health system in Bangladesh in the mid-1990s but failed to influence its implementation.
HIV / AIDS RESEARCH
Predictors of Non-use of Condoms Among Drug Users in China: Implications for HIV Harm Reduction (research abstract)
Using a sample of 450 heroin users from a detoxification center in China, this short report documents and examines predictors of non-use of condoms. The results show that non-use of a condom is associated with unmarried males of low income. In addition, attitude factors are important; those who have heard of 'safer sex' and believe in the importance of condom use are more likely to use a condom in premarital and extramarital sex.
HIV Risk Reduction in the National Institute on Drug Abuse Cocaine Collaborative Treatment Study (research abstract)
Related news article: Drug Counseling Helps Reduce HIV Risk
New research indicates that people who are addicted to cocaine who undergo drug counseling reduce their cocaine use and significantly decrease their HIV risk.
Family Communication about HIV/AIDS and Sexual Behaviour among Senior Secondary School Students in Accra, Ghana (research abstract)
The author evaluated the relationship between family communications about HIV/AIDS and sexual activity and condom use among school-going adolescents in Accra, Ghana. 894 students (56.9% girls, 43.1% boys; mean age = 17.4) at two senior secondary schools in Accra completed a modified version of the Youth Risk Behavior Survey (YRBS) questionnaire. Twenty-five percent of the participants reported being sexually experienced, and 73.6% had talked about HIV/AIDS with parents or other family members. Of the sexually experienced students, 64.7% initiated first sexual intercourse by age 16; and 55.7% did not use a condom at last sexual intercourse. Bivariate analysis showed significant gender differences in sexual activity, condom use, and family communication about HIV/AIDS.
HIV / AIDS NEWS
Dirty Needles Misjudged in AIDS in Africa (news article)
The World Health Organization's long-held position that dirty needles cause 2.5 percent of African HIV exposures is too conservative, says a leading researcher at the UN agency, prompting questions about a congressional bill focused mainly on unsafe sex.
Head of Russian Academy of Medical Sciences: There May Be 1.5 million HIV-infected People in Russia (news article)
As of May 22, 3,303 people have died of AIDS in Russia. Another 241,266 people have been officially registered as HIV-infected, President of the Russian Academy of Medical Sciences Valentin Pokrovsky said at parliamentary hearings. Pokrovsky stressed that the estimated number of HIV-infected people was much larger and, some experts believe, might be 500,000 to 1.5 million.
Southern Africa: Poverty, Mobility, and HIV (feature article)
Mobility is often a sign of poverty, with people travelling out of their home areas looking for fresh opportunities. But in the struggle to make ends meet, mobility can also increase vulnerability to HIV/AIDS. This article looks at how poverty intertwines with highly mobile communities in towns along transport corridors in South Africa, Zimbabwe, and Mozambique.
MATERNAL AND CHILD HEALTH RESEARCH
Average Energy Intake among Pregnant Women Carrying a Boy Compared with a Girl (research article)
Related news article: Study: Women Pregnant With Boys Eat More
New research finds that women pregnant with boys tend to eat about 10% more calories a day than those carrying girls, but don't gain more weight.
Avoidable Stillbirths and Neonatal Deaths in Rural Tanzania (research abstract)
The objective of this study was to determine the causes of stillbirths and neonatal deaths in the community in rural Tanzania and to evaluate whether the deaths were avoidable under the prevailing circumstances. The authors conclude from their findings that prevention and adequate treatment of infections and asphyxia in the newborn should have high priority in low-income settings and that the relatively low proportion of avoidable stillbirths and neonatal deaths may be partly due to accessible emergency obstetric care in the area.
Making Safe Motherhood a Reality in West Africa (report)
This report documents UNFPA's efforts to address maternal mortality using a strategic and practical evidence-based approach in a region where data has been scarce,and where too many women have died. Increasing access to emergency obstetric care is central to this approach.
Do Unintended Pregnancies Carried to Term Lead to Adverse Outcomes for Mother and Child? An Assessment in Five Developing Countries (research abstract)
This paper investigates whether children later reported as having been unwanted or mistimed at conception will, when compared with children reported as wanted, show adverse effects when the following criteria are applied: receipt of antenatal care before the sixth month of gestation, supervised delivery, full vaccination of the child, and child growth (stunting). The study uses data from five recent Demographic and Health Survey enquiries in Bolivia, Egypt, Kenya, Peru, and the Philippines. In Peru, children unwanted at conception were found to have significantly worse outcomes than other children, but in the other countries, a systematic effect was found only for receipt of antenatal care.
Low Use of Rural Maternity Services in Uganda: Impact of Women's Status, Traditional Beliefs and Limited Resources (research abstract)
This paper reports a study conducted from November 2000 to October 2001 in Hoima, a rural district in western Uganda, whose aim was to enhance understanding of why, when faced with complications of pregnancy or delivery, women continue to choose high- risk options leading to severe morbidity and even their own deaths. The findings demonstrate that adherence to traditional birthing practices and beliefs that pregnancy is a test of endurance and maternal death a sad but normal event, are important factors.
MEN'S HEALTH RESEARCH
Male Circumcision: An Acceptable Strategy for HIV Prevention in Botswana (research abstract)
The authors conducted a cross sectional survey in nine geographically representative locations in Botswana to determine the acceptability of male circumcision in the country, as well as the preferred age and setting for male circumcision. Among 605 people surveyed, 408 (68%) responded that they would definitely or probably circumcise a male child if circumcision was offered free of charge in a hospital setting; this number increased to 542 (89%) after the informational session. Among 238 uncircumcised men, 145 (61%) stated that they would definitely or probably get circumcised themselves if it were offered free of charge in a hospital setting; this increased to 192 (81%) after the informational session. The authors state that circumcision might also be an acceptable option for adults and adolescents if its efficacy as an HIV prevention strategy among sexually active people is supported by clinical trials.
Increasing Relative Prevalence of HSV-2 Infection among Men with Genital Ulcers from a Mining Community in South Africa (research abstract)
Based on two cross sectional surveys, 4 years apart, researchers found that chancroid remained the leading cause of GUD in men who presented at the STD clinic with genital ulcers in the mining community of Carletonville, South Africa.
Effect of Male Age on Fertility: Evidence for the Decline in Male Fertility with Increasing Age (research abstract)
In this observational study, the authors found a fivefold increase in time to pregnancy (TTP) in men more than 45 years old. Relative to men <25 years old, those >45 years were 4.6-fold and 12.5-fold more likely to have had TTP of >1 or >2 years. Restricting the analysis to partners of young women revealed similar effects of increasing men's age.
MEN'S HEALTH NEWS
Male Rape in Zimbabwe (news article)
Men as young as 15 are being raped at youth-training centres across Zimbabwe in what the opposition claims is a concerted effort by the government of President Robert Mugabe to crush dissent.
POPULATION RESEARCH
Incorporating Heterogenous Intercourse Records into Time to Pregnancy Models (research abstract)
The author proposes Bayesian methods for joint modeling of intercourse behavior and biologic fecundability. The model accommodates a sterile subpopulation of couples, general covariate effects, and heterogeneity among fecund couples in menstrual cycle viability and in frequency of unprotected intercourse. Methods are described for incorporating cycles with varying amounts of intercourse information into a single analysis.
Cointegration Modeling of Fertility in the United States (research abstract)
This paper presents estimates of a multiple time series model of fertility, female labor force participation, women's wages, and the relative cohort size of younger to older adult males.
POPULATION NEWS
German Population to Slump (news article)
Germany's population is set to decline and get older - even with a large number of foreign immigrants. In a worst-case scenario, the German population could slump from its present 82 million to 67 million by 2050.
Nigeria's Population Disputed (news article)
The National Population Commission recently had to dispute the claim by the former Minister for Internal Affairs that the nation's population could be as high as 160 million. The NPC instead maintains that the nation's population as projected by the commission stands at 126 million based on the 1991 census figure of 88.9 million and a growth rate of 2.83% per annum.
Japan Says Its Population May Decline Sooner (news article)
Japan's population, under pressure from a low birth-rate and a rapidly ageing society, may start to decline sooner than forecast.
WOMEN'S HEALTH RESEARCH
Analysis of Racial Differences in Incidence, Survival, and Mortality for Malignant Tumors of the Uterine Corpus (research article)
Related news article: Black Women Face Worse Prognosis for All Types of Uterine Cancer than White Women
White women have a higher incidence of uterine corpus cancer than black women, but blacks have higher mortality. Two factors that may account for these data are that blacks have a higher incidence of rare, aggressive tumor types and that blacks suffer greater mortality for both prognostically favorable and unfavorable tumors.
Risk Factors Associated with Genital Warts in HIV-positive Brazilian Women (PubMed abstract)
A comparative cross-sectional evaluation was applied to 141 HIV-positive women to identify risk factors associated with the history of genital warts among this group. A history of genital warts presented associations with age at first sexual intercourse less than or equal to 17 years; history of genital warts in sex partners, especially with recurrent episodes; drug addiction, especially in crack users; cervical HPV infection; cervical infection caused by only one HPV type; perianal HPV infection, associated with negative results for undetermined risk HPV; and no antiretroviral therapy.
Female Genital Mutilation in the Sudan: Survey of the Attitude of Khartoum University Students Towards This Practice (research abstract)
This study was conducted in Sudan where FGM is a criminal offence and not a religious dictate. 414 anonymous questionnaires (82.8%) were returned from 192 (46%) female and 222 (54%) male university students. 109 (56.8%) of the female respondents were circumcised. 18.8% of the male students and 9.4% of the female students thought FGM was recommended by their religion. Only 90 (46.9%) female students compared with 133 (59.9%) male students thought FGM was illegal.
YOUTH HEALTH RESEARCH
Introduction of Sex Education into Nigerian Schools: The Parents', Teachers' and Students' Perspectives (research abstract)
A total of 1000 respondents (400 students, 400 parents and 200 teachers) completed questionnaires to assess knowledge of sex education and their level of acceptance of its introduction into the school curriculum in Nigeria. Most of the parents (92%), teachers (90%), and students (78%) supported its introduction into the school curriculum and believed that it would prevent unwanted pregnancies; enhance healthy relationships between the opposite sex; prevent transmission of HIV infections and STDs; provide knowledge of sexual interactions, consequences, and responsibilities; and educate the students on the basic processes of human reproduction. One hundred and fifty-four (15.4%) of the respondents opposed the introduction of sex education because they believed that it would corrupt the students, it might lead to experimentation, and that it should be the responsibility of the parents at home.
Opportunistic Screening for Chlamydia at a Community Based Contraceptive Service for Young People (research abstract)
The results of this study showed that a contraceptive service for young women is a highly acceptable location for effective Chlamydia screening.
Impact of a Course on Human Sexuality and Adolescence (PubMed abstract)
This study was conducted as part of a course on Human Sexuality and Adolescence for school children in India to ascertain the prior knowledge of children, source of their knowledge, and whether the course was a felt need of the children. Researchers found that in spite of chapters on reproduction in textbooks, children turn to peers or media to gather information on sexuality.
Meeting the Reproductive Health Care Needs of Adolescents: California's Family Planning Access, Care, and Treatment Program (research abstract)
This study examines the effects of the California Office of Family Planning's Family Access, Care, and Treatment Program (Family PACT), which was established in 1997 to provide comprehensive, reproductive health services for low-income adolescents and adults. Program evaluation was used to measure access to services, develop a profile of users, identify service utilization patterns, and assess the sensitivity of the health care system to the needs of adolescents.
Sex Education Sources and Attitudes toward Sexual Precautions across a Decade (PubMed abstract)
In this small study of 75 college students surveyed, the most commonly reported sources of sex education were peers, parents, and high school courses, respectively. Ratings of the most important of 10 potential sources of sex education included peers, high school courses, and religious institutions, respectively. None of these were significantly correlated with future condom use. Virgins reported more open communication with parents about sex.
YOUTH HEALTH NEWS
Kenya: Teenagers Turning to Contraceptives (feature article)
In Kenya, as in other parts of the world, parents face the same challenges in raising teens: peer pressure, media influences, and interpersonal communication.
PROFILES / SPECIAL REPORTS / RESOURCES
Developing Countries Journal Offer (resource)
Oxford University Press has set up a program wherein scholars from developing nations are eligible for free or greatly discounted electronic access to a large number of professional journals.
African Connectivity No Guarantee of Economic Upliftment (feature article)
Connectivity is generally assumed to be a passport to opportunity and economic upliftment, but the experience in Africa suggests the opposite may be true. This is according to African ICT delegates attending the recent Acacia Conference in South Africa. Riff Fullan of Bellanet, a non-profit organization funded in part by Canada's International Development Research Centre (IDRC), argued that ICT is, in fact "as likely to worsen poverty as to alleviate it."
UNESCO's Gender Mainstreaming Implementation Framework for 2003-2007 (report)
From the Introduction:
UNESCO's Medium Term Strategy for 2002-2007 provides the Organization with a new vision to achieve gender equality. Whereas the previous Medium-Term Strategy (1997-2001) considered "gender-mainstreaming" as one of the three approaches to achieve gender equality, the current strategy gives unprecedented value and visibility to "gender-mainstreaming" as the most effective approach to meet the "urgent needs of women" (31 C/4) and achieve gender equality. Given this new focus, the Section for Women and Gender Equality of the Bureau of Strategic Planning developed this Framework to provide UNESCO with a road map
and compass that will allow its staff to effectively integrate gender concerns throughout its programmes. As such, this Framework constitutes a common ground for future sectoral and regional policies.
WHO Seeks Brazil's Help in War Against AIDS (audio report)
(You will need Windows Media player or Real player to listen to his audio segment)
WHO Director-General J.W. Lee asks Brazil's AIDS director to help the UN health agency reach a goal of treating 3 million HIV-infected patients around the world by 2005. Brazil's generic AIDS drug program has led to a 50% decline in death rates due to AIDS.
Emergency Obstetric Care -- Checklist for Planners (resource)
Emergency obstetric care is the cornerstone of UNFPA's efforts to improve pregnancy outcomes. This six-panel checklist is designed to help programme planners and managers monitor elements that are critical to providing a high quality of emergency obstetric care.
It Takes 2: Partnering with Men in Reproductive and Sexual Health (resource)
Partnering with men is emerging as an important strategy for improving reproductive health. This new publication offers guidance on effective and gender-sensitive ways to engage men in the reproductive and sexual health of themselves and their partners. It includes examples of successful strategies and programming as well as lessons learned. A checklist summarizing key points makes this programme advisory note an especially useful tool for both designing and evaluating projects.
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