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The Pop Reporter®

Volume 4, Number 11
15 March 2004

"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs INFO Project Get news and research headlines delivered to your website, every day, customized to topics of interest to your webiste visitors. The Pop Reporter Headline Sharing Program is a free service of The INFO Project, with funding from USAID. Complete the form at our sign up page and let us know which news and research topics you want to display on your website. We will contact you to discuss the specific requirements for displaying The Pop Reporter headline box on your website. When you click on any link below, your Internet browser will access a Web site not connected to "The Pop Reporter." Information accessed through these links and contained in this issue of "The Pop Reporter" does not necessarily state or reflect the views of the INFO Project, Johns Hopkins University, or the US Agency for International Development. All links were verified at the date of mailing. Your computer and/or network configuration regarding Java script, cookies, and other security issues may not allow you to view certain Web sites. Consult your computer technician if you are having problems.

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Condom Use Within Marriage: A Neglected HIV Intervention (research article)
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Related research article: Condom Use Within Marriage: A Neglected HIV Intervention (with Arabic summary)
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Researchers assessed, via a secondary analysis performed on nationally representative cross-sectional surveys of women in 16 developing countries, the contraceptive effectiveness of condoms versus oral contraceptive pills and estimate the reproductive consequences of a major shift from pill to condom use. The median percentage of married couples currently using condoms was 2%, compared with 13% for the pill. Condom users reported a higher 12-month failure and higher method-related discontinuation rates than pill users (9% and 44% vs 6% and 30%, respectively). Condom users were more likely to report subsequent abortion following failure (21% vs 14%), and also more likely to switch rapidly to another method (76% vs 58%). The reproductive consequences, in terms of abortion and unwanted births, of a hypothetical reversal of the relative prevalence of condom and pill were estimated to be minor. The main reason for this unexpected result is that most abortions and unwanted births arise from non-use of any contraceptive method.

Sperm Specific Proteins-Potential Candidate Molecules for Fertility Control (review article)
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This article reviews the development of a contraceptive vaccine based on sperm antigen, which represents a promising approach to contraception.

Non Effective Partner Notification System: A Missed Opportunity for the Reduction of Sexually Transmitted Infections in Sub-Saharan Africa (PubMed abstract)
This study, from the School of Public Health in Warsaw, Poland, assessed the adequacy and effectiveness of partner notification and treatment system of rapid plasma reagin (RPR) positive patients of antenatal clinics (ANC) in Swaziland. Data were collected prospectively from routine records of ANC attendees. The positive RPR test was established in 19% (n=2,034) screened patients; 38% of all RPR-positive patients were not informed of their RPR status. Typical syphilis treatment was given in 42% of all RPR-positive pregnant women, and only 5% of partners of the RPR-positive pregnant women were traced, checked, and correctly treated. The author concludes that the usual way of syphilis screening and partner notification in a country like Swaziland is not effective, and there is a need to develop other, African-specific methods of syphilis screening and partners' notification.

Observational Study on the Use of Emergency Contraception in Spain: Results of a National Survey (research abstract)
The authors conducted a national observational study including 4,390 cases of requests for the prescription of emergency contraception in Spain. The mean age of the women requesting emergency contraception was 23 years, with 35.1% of these being adolescents and 71% of them under the age of 24 years. The educational level of studies was medium or higher. Emergency contraception had previously been used by 19.8% of the women and, of these, 75% used it on a single occasion. The main reason put forward for requesting emergency contraception was condom breakage (68.7%), followed by the failure to use any contraceptive measures whatsoever (15.4%).

Impact of Varying Frequency and Magnitude of Price Increases for Clinical Reproductive Health Services (report)
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The study was conducted in Quito, Ecuador. The design was a repeated measures experiment. Three groups of five clinics were formed by matching on clinic volume, current service fees, and an index of client characteristics derived from an "ability-to-pay" survey. The three clinic groups were randomly assigned to one of three price change regimes: a small monthly increase, a larger trimester increase, and a still-larger semester increase. Due to unforeseen and uncontrollable circumstances, the study was terminated early. The author discusses the probelms encountered and lessons learned.

Embryo Development after Heterotopic Transplantation of Cryopreserved Ovarian Tissue (research abstract)
Related news article: New Technique Allows Women to Put Fertility On Hold
Scientists have achieved a breakthrough in a technique that could one day allow a woman to put her fertility on ice and possibly reverse menopause. In a world-first, US researchers succeeded in creating a human embryo using ovarian tissue that had been removed from a 30-year-old breast cancer patient, then frozen and stored for 6 years.

Postpartum Contraceptive Acceptance in León, Mexico: A Multivariate Analysis (research abstract)
This study identifies the reasons for the acceptance or rejection of contraceptive methods among postpartum women (n=1,025) at the Hospital of Obstetrics and Gynecology in León, Mexico. There were 513 patients who accepted contraceptives (50%) and 512 (50%) who refused. The main reasons for accepting contraceptives were definitive desire for no more children (17%) and satisfaction with previous contraceptive methods (21.5%). The main contraceptive methods chosen were IUD (67.7%) and tubal sterilization (28.5%). Reasons for contraceptive refusal were husband's rejection (33.2%) and delaying contraceptive use until after finishing the postpartum period (31.8%). Predictors of acceptance included previous deliveries, number of Cesarean sections, and women's level of education.

Contraceptive Practices and Intentions of Ukrainian Women (research abstract)
This study was undertaken to investigate contraceptive practices and factors behind contraceptive preferences among Ukrainian women attending for abortion (n=919) or gynecological health check-up (n=297). The average number of abortions per woman rose with age to 4.6 in the abortion group and 2.4 abortions in the non-pregnant group. No contraceptive use during the past year was reported by the abortion group (27%) and non-pregnant group (20%) and at the time of conception or during the preivous month by the abortion group (61%) and non-pregnant group (51%). Nevertheless, no intention to use contraception in the future was reported by 15% and 8% of women, respectively. A history of previous childbirth, at least two induced abortions, and sexual education obtained from literature were associated with preference to use modern contraceptives.

Protecting Against Both Pregnancy and Disease Predictors of Dual Method Use Among a Sample of Women (research abstract)
This study examined associations of dual method use with women's background characteristics, intrapersonal factors, and relationship characteristics. Data are from a random sample of women selected from a large managed care organization in the Pacific Northwest. The analytic sample contained 371 women who completed a telephone survey. Findings indicate that women who were younger, reported more than one sexual partner in the past year, and were highly motivated to avoid HIV/STDs were more likely to use dual methods rather than condoms only or an effective contraceptive method. Women confident about using condoms without feeling embarassed or breaking the sexual mood were more likely to use dual methods rather than a single effective method. Finally, women with confidence in their ability to use condoms correctly are more likely to rely solely on condoms.

Defining Infertility (feature article)
This introductory article explores the complex causes and consequences of infertility, which often involves both members of a couple. Although sexually transmitted infections are the primary preventable causes of infertility, postpartum and postabortion infections are also associated with this condition.

Linkages between Participation in Democratic Activities and Reproductive Health Behaviors : A Case Study of Plateau State, Nigeria (report)
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This case study of Plateau State, Nigeria, examines linkages between women’s participation in democracy and governance (DG) activities, women’s empowerment, and reproductive health (RH) behaviors. The underlying belief was that, by expanding women’s participation in politics and the democratic process, their power and control in other areas, including RH, would be improved. The study findings confirmed the authors' beliefs: participation in democratic activities, such as registration to vote and questioning of political candidates, does lead to a greater sense of independent thinking.

Preserving Fertility (feature article)
This article by Willard Cates, Jr., MD, MPH, president of FHI's Institute for Family Health, underscores the fact that the main preventable causes of infertility are STIs, primarily chlamydial infection and gonorrhea. Because these widespread and easily transmitted infections are often "silent" or asymptomatic, Dr. Cates argues, active screening of sexually active persons for these particular STIs is crucial. Otherwise, few women will realize that they have a fertility-threatening infection until they try to become pregnant and are unable to do so.

Ensuring Contraceptive Supply Security (review article)
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This article, produced by PATH, highlights the shortage of contraceptives currently being experienced by family planning programs in developing countries, and the threat this poses to the sexual and reproductive health of the populations concerned. It identifies the main cause of the shortage as the decline in funding from donors just as demand for condoms for HIV prevention has risen, and as contraceptive use is increasing; this problem is compounded by inadequate health sector capacity and poor logistics. The article also notes that health sector reform, particularly decentralisation, has affected the security of supplies, due to a range of problems including inefficient procurement, poor management, stockouts, price increases and price inequity across districts. Suggested methods for ensuring a reliable, equitable and adequate supply of contraceptives include: affordable pricing for contraceptives sold in the public sector, reducing the need for subsidies; targeting subsidised supplies to those most in need; increasing resources and using them more efficiently; and encouraging the growth of the commercial contraceptives market. The key role of governments, donors and program managers is stressed. The article also calls for more strategic planning focused on supplies and highlights the need for co-ordination at national and global levels, including collaboration between countries, to achieve more efficient use of resources.

Adults’ Knowledge and Behaviors Related to Human Papillomavirus Infection (research abstract)
The aim of this study was to assess adults’ knowledge, risk behaviors, and preference for information about human papillomavirus (HPV). A cross-sectional study using a self-administered questionnaire was given in three locations in the US (a university health service and two community family practice offices); 289 people completed the questionnaire. Knowledge about HPV was low, with an average knowledge score of 5.50 (possible scores ranged from 0 to 14). Knowledge scores were significantly higher in women and married adults. Knowledge scores were positively correlated with condom use but not significantly associated with other risk behaviors.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

US: Condom Warning Labels Mulled (news article)
The Bush administration is considering requiring warning labels on condom packages, noting that the contraceptive devices do not protect users from all STDs. Most recent studies indicate condoms do not safeguard against human papillomavirus, or HPV, a little-known but widespread sexually transmitted disease that, untreated, can cause genital warts or cervical cancer. The FDA has considered warning labels since 2000, when President Clinton directed the agency to re-examine whether information included in packages accurately reflected condom effectiveness in preventing all STDs, including HPV.

The Philippines: Muslim Religious Leaders Rule: Families May Now Plan Babies (news article)
Henceforth, Filipino Muslims will not be barred from discussing family planning and adopting both natural and artificial methods, under certain conditions, Islam's "house of jurisprudence" in Mindanao announced last week. A fatwah, or official ruling, on reproductive health and family planning was officially announced and launched among leading religious and clan leaders across Mindanao gathered here. The ruling was issued by the Darul Iftah, or Islam’s highest decision-making body, after two major conferences were held here last year among the ulama, or religious leaders, and muftis, Islam's highest religious officials. In a traditionally elaborate but highly technical presentation of the process leading to what would turn out to be a liberal ruling on population control, the muftis said the discussion of family-planning methods should no longer be taboo and that the adoption of even artificial birth-control practices and devices should not be proscribed.

US Says Herpes Cases Fall, Syphilis on the Rise (news article)
Fewer US teenagers and adults have the virus that causes genital herpes, but health experts said last week that they were troubled by the recent resurgence in syphilis, especially among gay and bisexual men. The findings, which were presented at the 2004 National STD Prevention Conference in Philadelphia, showed many Americans, especially gay and bisexual men and adolescents, were tuning out safe-sex messages.

US: Resistant Form of Gonorrhea Gains Foothold (news article)
A dangerous form of gonorrhea that can't be treated with standard antibiotics has swiftly established a foothold in Massachusetts, highlighting a resurgence of sexually transmitted illnesses across New England, disease trackers report.

Internet Blamed in Spread of Syphilis Among Gays (news article)
The Internet has played a significant role in the latest increase in cases of syphilis among gay men by introducing partners more likely to practice high-risk sex, according to a study released last week. About 22% of homosexual men diagnosed with early stage syphilis reported meeting one or more of their sexual partners through the Internet around the time they were infected, according to the study by the Los Angeles Health Department. Researchers at a national conference in Philadelphia on the prevention of STDs also said they found gays who used the Web to meet sex partners were almost four times as likely to have anonymous sex than non-Internet users. They were also more than twice as likely to use injected drugs as those who found partners more traditionally.

Philippine Business Leaders Spearhead Drive for Family Planning (feature article)
This article relates how business leaders in The Philippines are calling for a national campaign on family planning. The business leaders cite the need to check rapid growth of the Philippine population to stimulate further economic growth, create more jobs, reduce poverty, and improve health.

India: Morning after Pill Works, but Few Know (news article)
This article relates how, even after levonorgestrel tablets have been introduced in India for more than 2 years, few people know about them. A survey suggests that general awareness is a mere 1% to 6%; a poll among doctors show that only 40% are aware of it.

India: Mumbai Prostitutes Insist on Free Condoms (news article)
About 90 prostitutes organized a protest last week after being told that the state would stop supplying them free condoms.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

10 Years after ICPD - the Roles of Business and Philanthropy (commentary)
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This article explores ways in which business, foundations, and private citizens can help achieve the lofty population and development goals agreed to by more than 180 governments at Cairo in 1994.

Interim Policy on Collaborative TB/HIV Activities (WHO) (policy brief)
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This policy document, produced by the World Health Organization, provides guidance on implementing collaboration between TB and HIV program, aimed at reducing the burden of both diseases in patients. Rather than calling for a separate program, it recommends the continuation of existing services, enhanced by joint strategic planning, surveillance, monitoring and evaluation. The recommendations include the establishment of a joint national TB and HIV co-ordinating body to gather resources, build capacity and organise training; education of health workers to increase their awareness of the interaction between TB and HIV; use of HIV/AIDS testing and counselling to identify TB infection; establishing joint referral between TB and HIV/AIDS programs; use of joint treatments in patients with both diseases; integration of preventive measures, such as screening of patients at TB clinics for STIs, and use of therapy to prevent TB in patients with HIV.

Jamaica: HIV/AIDS Policy Ready for Distribution in Schools (news article)
The Ministry of Education, Youth and Culture's national policy for the management of HIV/AIDS in the island's educational institutions is ready for dissemination throughout schools islandwide, where it is estimated that 500 teachers are carrying the disease. The policy is aimed at combating discrimination towards staff and students living with HIV/AIDS. It also focuses on protecting the right of the individual to be in an educational institution, and ensures that there is balance in protecting persons who might be at risk through contact.

Zambia Bans Distribution of Condoms in Schools to Prevent 'Immorality' (news article)
Zambia has banned the distribution of condoms in schools, started as part of a drive to combat the country's alarming HIV/AIDS problem, saying it was promoting immorality and pre-marital sex. Education Minister Andrew Mulenga said in a statement Monday that "the distribution of condoms to young boys and girls could, instead of protecting them from HIV/AIDS, encourage them to engage in premature sex."

UK: 'Pay Addicts Not to Have Children' (news article)
Women drug addicts should be paid to take contraception to stop them having children, according to a drugs expert. The professor has called for a system where women are paid to take long-term contraception to prevent pregnancies.

The Community Health Fund: Assessing Implementation of New Management Procedures in Hanang District, Tanzania (report)
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In August 2002, the Community Health Fund in Hanang district in Tanzania introduced new management procedures that helped it to exercise control over revenue collection and reporting and provide management with sufficient information to assess the Fund’s performance. This report looks at the implementation of the new management procedures, identifies successes and shortcomings in fulfilling record keeping and reporting requirements in particular, and recommends steps to improve record keeping at health care facilities, reporting of data to the district level, and use of the new data by the district.

HIV/AIDS RESEARCH

Mapping HIV Vulnerability along Kampong Thom, Siem Reap, Odor Meanchey, and Preah Vihear, Cambodia (report)
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This report is based on a mapping of HIV vulnerability along selected sections of secondary and tertiary feeder roads along National Road Number Six. This mapping was done as part of the preparatory phase of the World Bank Provincial and Rural Infrastructure Project (PRIP). This project aims at reducing rural poverty through economic and social development, thus facilitating the reintegration of the four target provinces into mainstream national development. The development objective of the PRIP is to provide sustainable and safe access to markets and essential services for people located in rural areas of Kampong Thom, Siem Reap, Odor Meanchey, and Preah Vihear.

Prevalence of, and Factors Associated with, HIV/AIDS-related Stigma and Discriminatory Attitudes in Botswana (research article)
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This study examined survey data on the prevalence of, and factors associated with, stigma and discrimination in Botswana. While most respondents showed discriminatory attitudes towards a teacher or a shopkeeper with HIV/AIDS, only 11% of 4,147 respondents reported unwillingness to
care for a family member with HIV/AIDS. The more tolerant attitudes towards a family member with HIV/AIDS appeared to be promoted by the fact that family members have been and continue to care for their sick members through a government project called Community Home-based Care aimed at relieving public hospitals of HIV/AIDS patients. Since the burden of caring for sick relatives rests on the shoulders of women, they portrayed more tolerant attitudes towards HIV/AIDS patients.

Traditions in Transition: Young People's Risk for HIV in Chiang Mai, Thailand (research abstract)
The author investigated young people's perspectives on sexual behavior and sexual networking, the continued acceptance of premarital sex with commercial sex workers, and perception of risk for HIV in Chiang Mai, Thailand. Findings in this study suggest that a changing social environment and the response to the AIDS epidemic have resulted in new patterns of sexual behavior that might trigger the dissemination of HIV into a broader network.

HIV/AIDS Care and Treatment in sub-Saharan Africa (research abstract)
Researchers review the considerable experience of ARV treatment acquired largely in the Americas and Europe, and the fledgling clinical trials and observational studies in Africa. They write that the implementation of safe, effective, and equitable access to ARVs in Africa should be cognizant of the guidelines for ARV treatment in the Northern countries. Careful observation and operational research to accrue more African data, and evaluate regional and local solutions to this daunting challenge, will identify new approaches to scaling-up of ARV treatment.

HIV/AIDS NEWS

China Province Hubei Admits Extent of AIDS Cases from Tainted Blood (news article)
The central Chinese province of Hubei has revealed the extent of its HIV/AIDS cases from tainted blood as it prepares to send government employees to live in affected areas to tackle the problem.

Rwanda to Join African Trials for AIDS Vaccine (news article)
Rwanda, where around 1 in 10 people are infected with the HIV virus that causes AIDS, will join African medical trials in March for a vaccine, a government minister said last week. Kenya, Uganda, Botswana, and South Africa are involved in similar trials designed to find a vaccine to fight the epidemic in sub-Saharan Africa.

Latin America Must Do More to Fight AIDS -WHO (news article)
The World Heath Organization has urged Latin American governments to step up their response to AIDS and make treatment more affordable while increasing HIV testing. Some 16 million people in Latin America and the Caribbean are affected with HIV/AIDS and the disease is spreading, but the number of people who have access to anti-AIDS drugs is "negligible," WHO director-general Lee Jong-wook told a news conference.

Uzbekistan: Drug-related HIV/AIDS Cases on the Rise in South (news article)
Injecting drug use, fuelled by illicit drug trafficking, is increasing the number of HIV/AIDS cases in southern Uzbekistan, particularly in areas bordering Tajikistan, health officials say.

China's Blood Donor AIDS Victims Turn to Suicide (news article)
This article relates the despair many feel in the central province of Henan, where some are turning to suicide over their HIV infection. Experts say up to 3 million people in Henan alone sold their blood to unsanitary clinics, many of them state-sponsored, throughout the 1990s in what they call the worst medically caused HIV epidemic in the world.

Good Health: HIV And the Prisons Systems in Nigeria (commentary)
In this commentary, the writer states that while the Nigerian authorities, NGOs, and development partners fight to contain the spread of the HIV epidemic, there is no policy to take care of infected prison inmates. As efforts are daily intensified in Nigeria to curb the spread in a populaton of about 130 million, prisoners are becoming more vulnerable.

MATERNAL AND CHILD HEALTH RESEARCH

Igniting Change! Accelerating Collective Action for Reproductive Health and Safe Motherhood (report)
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This report documents the experience of two global USAID-funded initiatives and describes how social mobilization has effectively been applied to the field of reproductive health and safe motherhood. The report describes how mulitsectoral coalitions or alliances use a social mobilization approach to foster local capacity and ownership, shared commitment and mutual accountability for health.

Are WHO/UNAIDS/UNICEF-recommended Replacement Milks for Infants of HIV-infected Mothers Appropriate in the South African Context? (research article)
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From the Bulletin of the World Health Organization, this article explored the suitability of the 2001 WHO/UNAIDS/UNICEF feeding recommendations for infants of HIV-infected mothers for a rural region in KwaZulu Natal, South Africa. Researchers found that no home-prepared replacement milks in South Africa met all estimated micronutrient and essential fatty acid requirements of infants less than 6 months old. Commercial infant formula is the only replacement milk that meets all nutritional needs. The authors conclude that revisions of WHO/UNAIDS/UNICEF HIV and infant feeding course replacement milk options are needed.

Feeding Practices and Growth of Infants from Birth to 12 Months in the Central Region of the Limpopo Province of South Africa (research abstract)
A total of 219 women who gave birth at the local hospital and their infants were followed from birth to 12 months. Data collected included infant feeding practices and anthropometry at 1, 3, 6, 9 and 12 months. At birth, 8.8% of infants had a low birth weight, 9.6% were stunted, 48.9% were underweight, and 7.3% were wasted. Mothers in this study breastfed their infants for long periods, with more than 80% still breastfeeding by the ninth month. However, exclusive breastfeeding during the first 3 months was uncommon as mothers tended to introduce supplementary feeds at an early age, with 56% of the infants receiving some form of supplement by the end of the first month. By the first month, 30% of infants were stunted. Twelve percent of infants were overweight by the twelfth month.

Factors Influencing the Use of Maternal Healthcare Services in Ethiopia (research article)
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This study examined the factors that influence the use of maternal healthcare services in Ethiopia and particularly assessed the use of antenatal and delivery-care services. Data for the study were drawn from the 2000 Ethiopia Demographic and Health Survey. Results of the study showed that the coverage of maternity-care services was very low in Ethiopia, ie, about 27% and 6% of women, respectively,
received professionally assisted antenatal and delivery-care services in the 5 years preceding the survey. The study also revealed that demographic and sociocultural factors were the most important aspects that influenced the use of maternal healthcare services in Ethiopia. The independent factors influencing the use of maternal healthcare services included education of mothers, marital status, place of residence, parity, and religion.

Impact of a Community-based Comprehensive Primary Healthcare Programme on Infant and Child Mortality in Bolivia (research article)
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This study examined the impact of a community-based comprehensive primary healthcare programme on child survival in Bolivia. Mortality rates from two intervention areas where Andean Rural Health Care (ARHC) had been conducting child-survival activities for 5 to 9 years were compared with those from two geographically adjacent comparison areas that lacked such activities and that were virtually identical to the intervention areas in socioeconomic characteristics. In the comparison areas, limited services were available that reached only a small percentage of the population, while in the intervention areas, prenatal care, immunizations, growth monitoring, nutrition rehabilitation, and acute curative services were readily available to the entire population. The annual rates of mortality of children, aged less than 5 years, were 205.5 per 1,000 and 98.5 per 1,000 in the comparison and intervention areas, respectively. The absolute difference in mortality of 107 deaths per 1,000 represented 52.1% lower mortality of children aged less than 5 years in the intervention areas compared to the control communities. The authors write that these results suggest that the provision of community-based, integrated health services can significantly improve child survival in poor countries.

Improving the Health of Newborns in Indonesia: Final Report (report)
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This report, produced by PATH, follows the implementation of a USAID-funded program to improve the health and survival of newborn babies and infants in Indonesia. Entitled Awal A Sehat Untuk Hidup Sehat or ASUH, meaning "A Healthy Start for a Healthy Life", it ran from November 2000 to September 2003 and cost $4.7 million. Key stages in implementation were building capacity of village midwives; increasing knowledge of good care in relation to newborn babies, both at delivery and during the first few weeks after birth; improving rates of breastfeeding; improving the nutritional status of mothers; empowering families and communities to work alongside local health management teams; and enabling district health offices to access health problems more effectively, find local solutions, and monitor and evaluate their activities. Key successes of ASUH include a significant increase in first visits after birth and of vital Hepatitis B vaccinations of newborn babies, as well as overall improvements in health services and behaviors. The program has left a legacy of strong relationships and flexible participatory approaches, enabling communities to work with health systems at village, district and government level to meet their own needs.

Insights for Implementers: Improving Access to Maternal Health Care (report)
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This article, produced by Partners for Health Reformplus, focuses on health insurance as a vital tool for improving access to care and increasing usage of maternal health services, as part of a broader package of health financing reform. Two case studies are described: a national insurance plan for mothers and children in Bolivia; and pilot-testing prepayment schemes (PPS) in Rwanda. Key findings include the following: Good design is essential to ensure sustainability and equity of access for all target groups; a participatory approach is recommended, with local planning and management, including a forum for the poor to express their health needs and negotiate benefits and improvements; ongoing support should be provided to communities, enabling them to learn the necessary technical skills to run the schemes themselves; monitoring and evaluation of the performance of providers is essential to ensure that schemes continue to reflect the health needs of the insured; where resources are limited, subsidies should be targeted effectively so that they reach the poorest people.

MEN'S HEALTH RESEARCH

Determinants of Condom Use among Monogamous Men in Ondo State, Nigeria (research article)
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This study examined the factors that influence condom use among monogamous men in Ondo State, Nigeria. Analysis was restricted to 394 men who were in their first union and reported a monogamous marriage at the time of interview. Findings showed that 30% of monogamous men had ever used a condom, while about 15% of men were currently using the method. Findings also showed that prevention of pregnancy was a concern among monogamous men, much more than prevention of STIs, including HIV/AIDS. Logistic regression models indicated that ever-use of a condom was associated with age, education, and having been counselled on family planning, while place of residence, frequency of television-watching, and exposure to family-planning counselling were factors associated with motivation for condom use.

Knowledge, Attitude, Behaviour and Practices (KABP) Survey of Male Reproductive and Sexual Health among Truckers and Cleaners/helpers in Three Cities of Jharkhand (report)
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Of the total sample of 299 truckers, cleaners and helpers in this study, 99 respondents each were from Bokaro and Ranchi, while 101 respondents were from Jamshedpur. Overall, most respondents travelled long distances of over 500 kms away from home. Only about 12% of the respondents travelled less than 500 kms per trip. More than four in five respondents had heard of HIV/AIDS. However, just over half of the respondents knew that AIDS could be prevented, and only one in five were aware that HIV/AIDS is incurable. Overall, 14% of the target respondents knew someone who was infected with HIV. Knowledge of prevention through sexual abstinence was higher among respondents (74%) than of other modes of prevention, such as consistent condom use (64%) or having one faithful uninfected sexual partner (59%).

Men Contribute to and Suffer from Infertility (feature article)
In about half of all cases of infertility, men are either the single cause of, or contribute to, the couple's infertility. This article, from Family Health International, describes the causes of male infertility but emphasizes the importance of men protecting their partners from fertility-threatening STIs by practicing abstinence, being faithful to one partner, or using condoms. Cultural and social norms that encourage men to behave in ways that put them at greater risk of acquiring and transmitting STIs, as well as the stigmatization that men may suffer if they cannot have children, are described. The article contains recommendations for reproductive health programs and clinics.

MEN'S HEALTH NEWS

Fathers are 'Ignored', Says Study (news article)
Institutional sexism is damaging the educational prospects and social development of youngsters, according to research from a children's charity. The study, by Newcastle-based Children North East, says subconscious practices disregard the needs of men and fail to recognise the role of fathers. In other cases, conscious discrimination labels men as "dangerous oppressors" or "perpetrators".

POPULATION RESEARCH

Population Ageing in Lebanon: Current Status, Future Prospects and Implications for Policy (research article)
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Related research article: Population Ageing in Lebanon: Current Status, Future Prospects and Implications for Policy (with Arabic summary)
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This article, from the Bulletin of the World Health Organization, provides an overview of two population surveys carried out in Lebanon. Demographic indicators of population ageing derived from two scenarios of fertility change are provides. Variations in population ageing by persons and place within the country at the governorate level are also presented.

POPULATION NEWS

Lack of Women Threatens Stability in China (news article)
More boys than girls are being born in China, and if that continues it could lead to serious social problems, the Chinese government says. An official report released last week, during the Chinese People's Political Consultative Conference in Beijing, blamed the practice of aborting girl babies for the growing disparity between male and female births. If it continues men in China will outnumber women by as many as 40 million by 2020.

U.S. Lone No at Chile Population Meeting (news article)
Related news article: Countries Commit to Population Control
Latin American and Caribbean nations last week overwhelmingly reaffirmed support for a 10-year-old international population and reproductive health action plan. The United States was the lone dissenter, being the only country to disagree with the declaration linking poverty eradication to greater access to services for family planning, safe motherhood, and HIV/AIDS prevention.

United Arab Emirates: It Pays to Have More Children! (news article)
In a bid to encourage UAE nationals to have more children and give a boost to declining birth rate in the country, nationals having extraordinary number of children will be rewarded at a ceremony. Some of those who will be honored and rewarded include a national with 63 children, another national with 57 children, and a young groom who offered two dirhams (about US$0.50) in dowry to his bride.

WOMEN'S HEALTH NEWS

Kenya: Boost for Anti-FGM Efforts as 200 Circumcisers Quit (news article)
Following various seminars conducted by NGOs to mark the 8 March International Women's Day, 200 female circumcisers from Kenya's Rift Valley Province have abandoned their tools of trade and vowed to fight the deeply rooted custom. Habil Oloo, a program officer at the Kenya National Focal Point for FGM, which coordinates nationwide activities against the practice, said the development was the fruit of years of struggle by Kenyan NGOs against entrenched traditional attitudes among communities.

YOUTH HEALTH RESEARCH

YouthLens: Abstinence, Fewer Partners, Condom Use Are Complementary Messages (feature article)
The first phase of a major six-country study suggests that promotion of abstinence from sex to prevent HIV infection contributed to an approximately one-year delay of sexual initiation among youth in two countries — Uganda and Zambia — where HIV prevalence declined throughout the 1990s. In both countries, delayed sexual initiation among youth, abstinence, having fewer partners, and condom use with nonregular partners all contributed to declines in HIV prevalence. Thus, the "ABC strategy" (abstinence, be faithful to one partner or reduce number of partners, or — if "A" or "B" cannot be achieved — use condoms consistently and correctly) continues to be an appropriate general recommendation. And messages to delay sexual initiation or to begin practicing abstinence even after having been sexually active need to be an integral part of programs to prevent HIV, other STIs, and pregnancy among unmarried youth.

Adolescent Health Determinants for Pregnancy and Child Health Outcomes among the Urban Poor (research article)
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This special review article from the journal Indian Pediatrics provides an overview adolescent health and its determinants, and its impact on pregnancy and its outcomes. The paper is divided into sections on the nutritional, biological, and social determinants of adolescent health, which contribute to poor pregnancy outcomes both for the young mother, a child herself, and her infant. The authors present data specific to urban slums, from varied sources, wherever available.

Reproductive Health: Knowledge and Opinions of University Students in Erzurum, Turkey (research abstract)
This study assessed knowledge of reproductive health (RH) and the opinions of university students towards reproductive health education and family planning services. A questionnaire about RH knowledge and the opinions of students was submitted to 673 randomly selected students at Ataturk University. Researchers found that the level of RH knowledge was below the theoretical mean value. An association was noted between gender, residential area, parents' education, and sibling number with the RH knowledge score. Most of the students approved of formal RH education (88.4%). Approval of family planning services was lower than that of RH education (71.6%). The percentage of men who support family planning services and RH education was lower than that of women. Students who had graduated from Islamic religious schools had more negative opinions towards family planning services.

TeenWeb Nairobi: Results of a Web-based Project to Survey and Educate Students about Health (report)
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This report concerns TeenWeb, an innovative, school-based Internet study that involved over 1,000 youth in five public secondary schools in Nairobi.

YOUTH HEALTH NEWS

UK: Teen Pregnancies Increase after Sex Education Classes (news article)
Teenage pregnancies have risen fastest in areas of the UK where the government has specifically targeted resources to reduce them, a new survey has revealed. The report says that the explicit sex education leaflets and free condoms provided to under-age girls have simply encouraged them to have sex.

Teens Who Pledge 'No Sex' are Still Getting STDs, Study Says (news article)
Teens who make a one-time pledge to remain virgins until marriage catch STDs about as often as those who don't pledge abstinence, according to a study of the sex lives of 12,000 adolescents. Those who make a public pledge to delay sex also wind up having fewer sex partners and get married earlier, the research shows. But the two groups' STD rates were statistically similar. One of the problems, researchers found, is that virginity "pledgers" are less likely to use condoms.

Adolescent Reproductive Sexual Health: March News Update (feature article)
The March news posted to the Adolescent Reproductive Sexual Health website of the UNESCO Asia and Pacific Regional Bureau for Education includes the following stories:

o Young Cambodian actively shared knowledge on RH and HIV/STIs at the EU/UNFPA/USAID 4th Annual Youth Camp
o Touching young lives: a success story of Butuan Youth Center (Philippines)
o Youth Empowerment Skills! (YES)! Quetta project – Pakistan
o "You and Me" - Condom Café for affordable food, information and advice, run by Friends’ students (Cambodia)
o Moving to standard quality of services at Friend Corners (Thailand)

SPECIAL REPORTS/PROFILES/RESOURCES

Advocacy: Building Skills for NGO Leaders (training manual)
This resource is a three-day, six-session curriculum designed as a companion piece to Cairo, Beijing, and Beyond: A Handbook on Advocacy for Women Leaders. This manual uses participatory methodologies and is based on CEDPA’s experience in building the skills of NGO leaders to advocate for change in the reproductive health arena. While the background information and role play scenarios deal directly with reproductive health issues, a trainer can adapt the sessions for other contexts. This manual is available in English, Spanish, and French.

Adolescent Sexual and Reproductive Health: A Training Manual for Program Managers (training manual)
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Related report: Spanish language version
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As part of the CATALYST Consortium south-to-south program, PROFAMILIA/Colombia and CEDPA collaborated to produce a manual for managers of adolescent sexual and reproductive health programs. This 224-page manual builds the capacity of youth-serving program managers and coordinators from the public and private sectors, with limited experience managing youth programs, to design programs that respond to the sexual and reproductive health (SRH) needs and rights of young people (10-24 years of age), and helps youth develop life skills and adopt healthy behaviors.

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