Volume 4, Number 40
4 October 2004

The USAID-funded Knowledge and Information for Optimal Health (INFO) Project of the Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP) announces the October 2004 launch of an electronic magazine for family planning and reproductive health care providers, policy-makers, and researchers in the Latin America region. The Pop Reporter en Español, a collaboration of the INFO Project and its Latin America-based joint programming partner, Bibliomed, Inc., is slated to deliver its first issue on Monday October 18, 2004. For more information and to sign up, go to http://www.infoforhealth.org/popreporter/spanishpressrelease.shtml

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

The Effects of Outreach on Perceived Quality of Care in Rural Areas of Bangladesh (research abstract)
This paper, based on data from Bangladesh, presents an illustrative analysis of how a family planning outreach program can be evaluated by the criterion set forth by the 1994 Cairo Conference. A scale for perceived service quality was developed from five indicators of desirable characteristics of services. Results show that increasing contact with outreach workers increases client satisfaction with the overall quality of the Bangladesh family planning program.

Designing a Reproductive Health Services Package in the Universal Health Insurance Scheme in Thailand: Match and Mismatch of Need, Demand and Supply (research abstract)
In October 2001 Thailand introduced universal healthcare coverage (UC) financed by general tax revenue. This paper assesses the design and content of the UC benefit package, focusing on the part of the package concerned with sexual and reproductive health.

Family Planning and Sexual Health Organizations: Management Lessons for Health System Reform (research abstract)
This article reviews the three typical means of service provision within the family planning and sexual health (FP&SH) sector since the mid-1990's: independent not-for-profit providers, vertical government programs, and social marketing programs. Each case is analyzed by service delivery mechanism evolved, the management techniques that characterize it, and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. Conclusions on the positive and negative FP&SH lessons in health management are offered.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Filipino Culture Makes Condom Use Hard (news article)
Health Secretary Manuel Dayrit said the Filipino culture makes promoting condom use difficult, and what worked in Thailand might not succeed in the Philippines. Dayrit invited Thai Sen. Mechai Viravaidya Mechai, known as Thailand's "Condom King," to a press conference on Wednesday, and the health chief said the senator's strategy would not work in a conservative country like the Philippines.

South Africa: Clerics Asked to Back Condoms (news article)
AIDS activists welcomed a proposed meeting between the health minister and religious leaders of Stouh Africa and urged the latter to support a pro-condom message.

Madagascar to Distribute 15 Million Free Condoms (news article)
Related: news article: Churches Hamper Condom Campaign in Madagascar
Impoverished Madagascar is to distribute 15 million free condoms next year to promote safe sex and halt the spread of HIV/AIDS.

South Africa: 'SA Condom Handouts Highest' (news article)
South Africa has the biggest female condom programme on the continent, Health Minister Manto Tshabalala-Msimang said. Her department had distributed about 4 million female condoms around the country in the past 5 years, she said in a written reply to a question in the National Assembly.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Sexual and Reproductive Health: Challenges for Priority-setting in Ghana's Health Reforms (research abstract)
This research sought to look at the sensitivity of the priority-setting tools and mechanisms used in the development of the health sector reforms in Ghana, to survey the needs and priorities of sexual and reproductive health (SRH) services, and to consider how priority-setting mechanisms could be improved. The study concludes that priority-setting tools in Ghana’s reform process were rudimentary, and SRH donors and advocates were little involved.

India: Government to Revamp AIDS Policy (news article)
In its endeavor to prevent the spread of AIDS in the country, the government may seek technical assistance from professional agencies across the globe for evaluating its policy on AIDS. A global bid is likely to be invited soon for engaging professional experts in evaluating the national AIDS policy of 1992.

Service Accountability and Community Participation in the Context of Health Sector Reforms in Asia: Implications for Sexual and Reproductive Health Services (research abstract)
This paper examines the concept and practice of community participation in World Bank-supported health sector reforms in Asia, and how far such participation has strengthened accountability with regard to provision of sexual and reproductive health (SRH) services. The authors assert that setting up of community health structures, decentralization, and community financing are three important strategies used for promoting participation and accountability within reforms.

Nigeria: Condom Advert Banned (news article)
Determined to ensure compliance with the Sharia practice in Bauchi, the state Sharia Consultative Council has placed an embargo on condom advertisements on the state-owned electronic media, saying they promote and encourage immorality and expose youth to unwholesome acts. The Council, in a statement signed by Alhaji Muhammadu B. Madugu, also urged the government to ban "immoral films" aired on the government-owned television station, arguing that such films apart from promoting promiscuity were against the tenets of the Sharia Legal System being operated in the state.

Health Sector Reform and Reproductive Health Services in Poor Rural China (research abstract)
This paper describes and analyses the major reforms and changes that have occurred in the rural health sector of China. The focus of this paper is what has actually been happening at the ground level, rather than what should have been happening as stated by rural health sector reform polices. It is argued that reproductive health is a missing component of the current health sector reform agenda.

South Korea: Condom Campaign to Begin Airing on TV (news article)
Public service announcements encouraging the use of condoms will be aired for the first time in Korea's history. The Korea Center for Disease Control and Prevention disclosed on Thursday that, with the Munhwa Broadcasting Corporation, it would air the announcements encouraging the use of condoms as the most efficient way to prevent the spread of AIDS, for one month beginning Oct. 1.

HIV/AIDS RESEARCH

HIV/AIDS, Sexual and Reproductive Health: Intersections and Implications for National Programmes (research abstract)
This paper argues that access to essential sexual and reproductive health care should be provided in HIV/AIDS prevention and care and treatment programs. The paper analyzes existing barriers to linking and integrating these services, e.g., at country level due to the traditional training of health workers to implement vertical programs, separate sources of funding for National AIDS Control Programs, and sexual and reproductive health services, and in international donor program and UN agency structures.

Distance Communication Transfer of HIV Prevention Interventions to Service Providers (research abstract)
HIV prevention organizations in 78 countries were randomized to receive either a control condition or a technology transfer condition with an interactive distance learning computer training curriculum and individualized distance consultation. Of 42 nongovernmental organizations in the technology transfer condition, 29 adopted the science-based program in their communities or trained other agencies to also use it. This paper shows that communication technologies can create a cost-effective infrastructure to disseminate new intervention models to service providers worldwide.

Effects of Combined Counseling and Case Management to Reduce HIV Risk Behaviors among Hispanic Drug Injectors in Puerto Rico: A Randomized Controlled Study (research abstract)
This study examined the effectiveness of a combined counseling and case management behavioral intervention, using motivational interviewing strategies, in engaging Hispanic injection drug users in treatment and reducing drug use and injection-related HIV risk behaviors. Subjects in the experimental arm were significantly less likely to continue drug injection independent of entering drug treatment and were also more likely to enter drug treatment. Subjects in both arms who entered drug treatment were less likely to continue drug injection. Among subjects who continued drug injection, those in the experimental arm were significantly less likely to share needles.

HIV/AIDS NEWS

South Africa: Cell Phones to Ease AID Treatment Monitoring (news article)
New mobile phone technology is helping South Africa's health workers monitor AIDS drug adherence and spot complications in HIV-positive patients.

Sierra Leone: NAS Applying the Rapid Result Initiative (news article)
As the war against HIV/AIDS continues, the National Aids Secretariat has recently formulated a new strategy called the rapid result initiative in order to focus and access the use of voluntary counseling and testing within a period of one hundred days.

Thailand to Provide Cheap Anti-AIDS Drugs (news article)
Thailand has vowed to provide locally-made cheap "copycat" anti-AIDS drugs to 300,000 HIV-positive people here and overseas within the next two years. The kingdom is one of the world's key production centres for inexpensive generic anti-retroviral drugs along with Brazil and India, and has already geared up production to supply 50,000 low-income Thais living with the virus.

China: Intervention Teams to Prevent AIDS Transmission (news article)
China will set up nationwide intervention teams to curb the transmission of HIV/AIDS, according to an official document released by the Chinese Health Ministry.

Swaziland: Clergy, Media Clash on Use of Condoms (news article)
Some Christian clergymen and journalists locked horns last week at a seminar in Swaziland over the use of condoms and masturbation as some of the safe practices in the fight against HIV and AIDS.

MATERNAL AND CHILD HEALTH RESEARCH

Lactation Ammenorrhoea in Well-Nourished Toba Women of Formosa, Argentina (research abstract)
This study sought to disentangle the relative impact that intense breast-feeding practices and maternal nutrition have on the regulation of ovarian function in nursing women. Duration of lactational amenorrhoea was not correlated with any of the nursing parameters under study or with static measures of maternal nutritional status. The results indicated that the pattern of resumption of postpartum fertility could be explained, at least partly, by differences in individual metabolic budgets.

Utilization of Maternal Care in Rural HeBei Province, The People's Republic of China: Individual and Structural Characteristics (research article)
Researchers studied the effect of individual's socio-economic characteristics and the structure of the health services in the village on utilization of maternal care in rural HeBei. They found that 54.8% of the women had at least one pre-natal care visit, 27.5% gave birth in a health care facility, and 18.1% had post-natal check-up. Utilization was inversely related to age and parity and positively to education, suggesting that health education programs are necessary.

Utilization of Well-Baby Care Visits Provided by Taiwan's National Health Insurance Program (research abstract)
This study, which investigated the utilization level of well-baby care visits provided by Taiwan's National Health Insurance Program, found that 36% of eligible children did not use any of the first four visits, 58% did not utilize the fifth, and 82% did not use the sixth in the late 1990s. Maternal awareness of and attitudes toward the services appeared to be the most important factors influencing utilization.

FIGO Save the Mothers Initiative: The Pakistan–UK Collaboration (research abstract)
The pilot study in Punjab, Pakistan was one of the five paired demonstration projects sponsored by FIGO in the "Save the Mothers" maternal mortality project. The goal of the project was to bring basic and comprehensive emergency obstetric care (EmOC) to a semiurban and rural area some 30 km from Lahore, where effectively there was none by using the existing facilities within the rural health system. This report indicates that availability and provision of EmOC coupled with changes in the attitude of the population resulted in marked improvement of process indicators.

Antenatal Screening for HIV; Are Those Who Refuse Testing at Higher Risk Than Those Who Accept Testing? (research abstract)
A retrospective audit of HIV screening uptake in women who were found to be infected with hepatitis B virus (HBV) and in those who were not infected with HBV was carried out in order to explore further the characteristics of "acceptors" and "refusers" of HIV screening. The prevalence of HBV infection was found to be twice as high (0.39%) in those who had refused an HIV test compared with those who had accepted a test (0.21%). There is good evidence that women refusing HIV antenatal screening have a higher prevalence of another blood-borne virus.

MATERNAL AND CHILD HEALTH NEWS

Stopping the Invisible Epidemic of Maternal Deaths (press release)
Related: resource material: Beyond the Numbers: Reviewing Maternal Deaths and Complications to Make Pregnancy Safer
Related: news article: WHO Calls on African Governments to Fight Maternal Deaths
Related: press release: UN Aims to Cut Toll of World's 500,000 Women Who Die in Childbirth Each Year
WHO and partners act to reduce the maternal death toll of half a million women each year.

Postponing Motherhood Halves Chance of Birth (news article)
Women who postpone starting a family until their 30s have only a 50% chance of giving birth to a first child, the Office for National Statistics (UK) revealed. It found that the problem is not just the ticking of the biological body clock that reduces fertility for women and men as the years go by. Lack of a partner wanting to share the raising of children and the economic pressures of the workplace are also powerful constraints.

MEN'S HEALTH RESEARCH

Reaching Men to Improve Reproductive Health for All (resource material)
The Implementation Guide captures the programmatic issues discussed at the Reaching Men to Improve Reproductive Health for All international conference held in Dulles, Virginia, September 15-18, 2003. The guide illustrates examples of how to develop, implement, and evaluate reproductive health programs that involve men in ways that promote gender equity and improve health outcomes for men and women. The primary audience for this guide is in-country reproductive health program managers and technical staff of implementing agencies, government, and non-governmental organizations. The guide has been produced for the Interagency Gender Working Group by the Health Communication Partnership based at the Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs.

MEN'S HEALTH NEWS

Seattle: Quest for "Male Pill" Brings Scientists of the World (news article)
Related: news article: Jagged Little Pill: Will Male Birth Control Ever Become a Reality?
As the 40-year quest for a new male contraceptive appears more promising, a groundbreaking international conference on the technology got under way on September 29th in Seattle.

POPULATION RESEARCH

Parental Perceptions of Costs and Benefits of Children as Correlates of Fertility in Kuwait (research abstract)
The sociocultural, economic, and political contexts that shape the mother's perceptions of the benefits and costs of children were analysed in this paper. It was concluded that the need for children as social and national capital is currently the most important driving force behind fertility desires and behavior.

The Risk of Child and Adolescent Mortality among Vulnerable Populations in Rio de Janeiro, Brazil (research abstract)
This study investigated the importance of socioeconomic factors such as education, income, religion, family structure and residence in explaining the increased risk of mortality among vulnerable populations aged less than 20 years in Rio de Janeiro, Brazil. Significant determinants of mortality included residence in a favela (shantytown), families in which mothers were the head of the family, and a lower median level of income. Religion was not found to be as important a predictor of high mortality.

POPULATION NEWS

HIV/AIDS Won't Affect Zambia's Population Growth (news article)
United Nations Population Fund resident coordinator Margaret O'Callaghan has said that though the country was losing many people to AIDS, its population would continue to increase.

WOMEN'S HEALTH RESEARCH

Unintended Preganancy and Women's Psychological Well-Being in Indonesia (research abstract)
This paper examines the impact of unintended pregnancy on Indonesian women's psychological well-being. Unintended pregnancy was associated with lower levels of psychological well-being and contraceptive use was associated with higher levels of psychological well-being, while number of children was not associated with level of well-being.

Female Sterilization in Latin America: Cross-national Perspectives (research abstract)
This study examined choice of female sterilization in four Latin American countries: Brazil, Colombia, the Dominican Republic and Peru. Results revealed that the likelihood of a woman's having undergone contraceptive sterilization was increasing over time in Brazil and Peru, suggesting that the potential for future growth of this method remains strong. A consistent pattern of increased probability of sterilization with higher education was seen across all countries, seemingly dispelling certain controversial claims that the procedure may have been disproportionately performed on the poor.

Implant Contraception in Singaporean Women: One Decade of Experience in KK Women's and Children's Hospital (research article)
(You need Adobe Acrobat Reader to access this document)
The aim of this study was to assess user acceptability and effectiveness of implant contraception in Singaporean women. The continuation rate was 92.4% after 1 year,
80.8% after 2 years, 68.9% after 3 years and 58.5% after 4 years. The main reasons for early implant removal were sideeffects and desire for future pregnancy. Re-insertion
was carried out in 53.7% of users who had completed 5 years of Norplant contraception. This largest sub-dermal hormonal implant contraception study in multi-racial Singapore showed that Norplant contraception had a high degree of effectiveness with relatively high user satisfaction and continuation rate.

WOMEN'S HEALTH NEWS

Female-Condom Maker Courts China (news article)
The US company that makes the female condom said it is looking to launch its product in China, a country that experts say is facing a potential AIDS crisis.

Zambia: Sending Teenage Moms Back to School (news article)
A new school has brought hope to the impoverished township of Kapiri Mposhi, a railway town in central Zambia. Matilyo Basic School, which evolved out of a community school run by the local Catholic church, not only provides education to the township residents but has also helped girls in early marriages return to the classrooms.

Kenya: Girls Get Ill After Being Circumcised (news article)
Twenty girls who were recently circumcised have developed complications and need specialised treatment, increasing the urges of some for harsher government penalties.

YOUTH HEALTH RESEARCH

Adolescent Sexuality and the HIV Epidemic in Yaounde, Cameroon (research abstract)
Using data collected in Yaoundé, Cameroon, in 1997, the study analyzed risk exposure and HIV prevalence among 426 men and 510 women aged 15–24. Although risky behaviors seem to be more prevalent among young men, their HIV prevalence remains under 1%. In contrast, HIV prevalence is high among young women (7.5%), even those who report having had few sexual partners. This study highlights the necessity of reinforcing prevention campaigns among youth and fighting the obstacles that continue to impede the use of condoms in this population.

Reproductive Health Awareness of School-going, Unmarried, Rural Adolescents (PubMed abstract)
An Indian Task-Force Study gauged the awareness level of adolescents regarding various reproductive health issues and to identify gaps in knowledge, particularly in legal minimum age of marriage, number of children, male preference, contraceptive practices, about STIs/AIDS, etc. The multi-centered investigation showed a tremendous lack in awareness of all reproductive health matters in a sample of 8,453 adolescents aged 10-19.

Teens Speak Out about HIV/AIDS: Focus Group Discussions about Risk and Decision-making (research abstract)
The study aimed to better understand the factors teens consider when making decisions regarding sex and condom use. Twenty-one same-sex focus groups were conducted with a total of 92 male and female teens from a range of high school programs in Seattle, Washington. Researchers found that although teens acquire HIV/AIDS knowledge in school and are aware of positive and negative outcomes of engaging in sexual behavior, many times the information does not seem salient or personally relevant and thus is not used in making decisions related to having sex. Teens report being bored with AIDS education, but suggest needing information that is more relevant for them.

Emergency Contraception Use is Correlated with Increased Condom Use Among Adolescents: Results from Mexico (research abstract)
This paper studies the association between knowledge about, or experience with, emergency contraception (EC), and condom use among school-attending adolescents in the state of Morelos, Mexico. Overall, 61% (6384) of students had heard of EC, and 36% (1964) of girls and 39% (1997) of boys had correct knowledge about EC. It was shown that experience with emergency contraception has no adverse effects on condom use, but rather is associated with an increased probability of condom use and an increased perceived capacity to negotiate condom use.

YOUTH HEALTH NEWS

Latin American Students to be Trained in Producing HIV/AIDS Prevention Messages (news article)
Public schools in Argentina will participate in a series of 20 workshops on HIV/AIDS and communication as part of the project "Youth, Communication and HIV/AIDS Prevention," directed by the NGO "Other Voices: Communication for Democracy," located in Buenos Aires.

UK: One in Eight Teenage Girls has Chlamydia, Tests Show (news article)
One in eight teenage girls is infected with chlamydia, an STD that can cause infertility, according to the first results from the national screening program. The rate of infection among 16- to 19-year-old women is more than 40% higher than in those aged 20 to 24, indicating that girls starting sex are at highest risk. Among men, rates are highest in the 20 to 24 age group with one in five infected.

Problems and comments can be addressed to rjacoby@jhuccp.org. Archives available at http://www.infoforhealth.org/popreporter/. Subscribe at http://prds.infoforhealth.org/signup.php. Modify your account at http://prds.infoforhealth.org/modify.php. Have an item to contribute for consideration in The Pop Reporter? E-mail the URL and description to rjacoby@jhuccp.org. Forward this message to a friend who could benefit from INFO project activities! Sincerely, Robert Jacoby, rjacoby@jhuccp.org Editor, The Pop Reporter

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 4, Number 40 4 October 2004