Volume 4, Number 43
25 October 2004

"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs INFO Project. 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

Access to Contraceptive Services among Unmarried Young People in the North-East of China (research abstract)
A community-based survey was conducted in September 2001 in Changchun city among 1,227 unmarried young people aged 15-24 years to assess risky sexual practices and the obstacles to accessing appropriate contraceptive and other services. Results showed that 16% of young people had experienced premarital sexual intercourse and, among them, only 48.2% used contraceptive methods during the first sexual intercourse; 29.9% used a condom. While data are sparse, findings suggest that the hostile and judgmental attitudes of providers, as well as the lack of counseling and privacy, were the key obstacles that unmarried youth encountered in their search for contraceptive services.

Provision of Female Sterilization in Ribeirão Preto, São Paulo, Brazil (research article)
This study examines physicians' perceptions and attitudes towards the current provision of female sterilization and its legal implications, as well as women's experience with obtaining and undergoing sterilization. The study design included: (1) an investigation of the hospitals and health professionals and (2) a survey of women sterilized in combination with cesarean delivery in 1998. Women with less schooling and lower socioeconomic status had more children and had begun childbearing and had been sterilized at younger ages than women with more schooling and higher socioeconomic status. Inequalities related to reproduction were strongly associated with teenage pregnancy and inadequate knowledge about contraceptives.

Uganda Family Planning Programs: Lessons from the Field: Partnering with Communities and District Health Teams (report)
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This case study focuses on the family planning (child spacing) efforts of two US private voluntary organizations (PVOs), each of which doubled modern contraceptive use in rural areas of Uganda. This study presents strategies, approaches, activities, and lessons learned as a learning model for other PVOs, government entities, and community members as they work to develop successful family planning projects in similar resource-poor environments.

Safe Sex Negotiation on TV: Gender Discourses among Female Community Health Workers Under the Family Health Program in Porto Alegre, Rio Grande do Sul, Brazil (research abstract)
This paper analyzes understanding among female community health workers in Brazil's Family Health Program of the notion of safe sex negotiation promoted by the Brazilian government in AIDS prevention campaigns targeting women. The study focused on TV advertisements used in campaigns by the Brazilian Ministry of Health from 1994 to 2000. The paper argues that knowledge and practices permeating the "safe sex negotiation" discourse incorporate, reproduce, and/or transmit hegemonic representations of masculinity and femininity and that these representations differentiate and highlight hierarchical positions of women in relation to men and/or women in relation to other women, producing and/or reinforcing prejudices and inequalities.

Village Birth Attendants in Papua New Guinea (research article)
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This paper describes the care delivered by village birth attendants in a remote area of Papua New Guinea. A qualitative study using semistructured interviews with 56 voluntary village birth attendants found that village birth attendants supervise and assist women with labour and delivery. Many have additional roles in their community. Most are motivated by a desire to help the women in their community. Common difficulties encountered include obstetric and logistical problems. The most common reason for ceasing work is family pressure or lack of support. Village birth attendants may be key to improvement in maternal morbidity and mortality in remote areas of Papua New Guinea.

A Nova Vida: The Commoditization of Reproduction in Central Mozambique (research abstract)
This paper examines the influence of commodification and female economic marginalization on virginity reviews, seduction fees, bride wealth payments, and childbirth assistance. Rather than disappearing, occult practices may be increasing in response to the new inequalities associated with "modernity." Life history and pregnancy case study data reveal how women facing growing inequality and increasing danger to reproductive health mobilize cultural resources in ways that, paradoxically, both reinforce and contest dominant relations of reproduction.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Birth Control Pill Is Safe, Says Federal Study (news article)
Related: news article: Pill Could Cut Cancer and Heart Disease Risk
An American nationwide study has told women that the birth control pill is safe. The study found that women on the pill have a lower risk of heart disease and stroke and of certain types of cancer, including ovarian and endometrial cancer. Risk of breast cancer is not increased as a result of being on the pill, says the study, which involved 162,000 women in the Women's Health Initiative. Researchers presented their findings at the American Society for Reproductive Medicine Conference in Philadelphia.

Philippines to Launch Family Planning Drive Door-to-Door (news article)
Starting in February 2005, the Philippine Department of Health is set to conduct a door-to-door campaign to promote the government's family planning program and provide information about available family planning methods.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

China: Beijing Maintains One-Child Policy (news article)
Officials from the Beijing Municipal Commission of Population and Family Planning said Wednesday the policy restricting couples to one child will not be changed in the short term, the China Daily reports. China's one-child policy forbids Beijing residents from having a second child except under a combination of rare circumstances: both parents must themselves be only children, and their first child must be verified to have some type of disability. China implemented its one-child policy 30 years ago as its population was approaching the 1 billion mark. The regulations are not evenly enforced, with urban residents being monitored more closely than those in the countryside.

HIV/AIDS RESEARCH

HIV/AIDS Prevalence among South African Health Workers (research abstract)
This study examines HIV prevalence among South African health workers. Based on a sample of 595 respondents, the study found that an estimated 15.7% of health workers employed in the public and private health facilities located in four South African provinces, were living with HIV/AIDS in 2002. Among younger health workers, the risk is much higher. These alarming rates call for the introduction of antiretroviral programs targeting health workers, coupled with vigorous human resource planning to replace the health workers likely to die from AIDS. Infection control procedures also need to be reviewed.

HIV Patients' Understanding of Information on Antiretroviral Therapy (research abstract)
To assess the understanding of information related to antiretroviral therapy among HIV-infected patients enrolled in public AIDS services in Brazil, interviews were conducted with patients after initial provision of antiretroviral drugs. The study evaluated the information on antiretroviral therapy provided by healthcare professionals and the patients' level of understanding in relation to prescription information. The level of understanding regarding the prescribed antiretroviral was obtained, and 26.3% of patients displayed insufficient understanding. The results show an important proportion of patients with misunderstanding of information regarding antiretroviral therapy, mainly those with limited schooling and low income.

Healthcare Worker Safety Is a Prerequisite for Injection Safety in Developing Countries (research abstract)
It is argued here that promoting the occupational safety of healthcare workers in developing countries is an essential and currently under-valued component of the response to the problem of unsafe injection practices. Protecting healthcare workers from occupational infection with blood-borne viruses has a range of potential benefits, including safer injection practices for patients and less discrimination against people with HIV/AIDS. There is an urgent need for organisational commitment to the occupational safety of healthcare workers in developing countries, along with the provision of training in injection safety and universal precautions, adequate supplies of personal protective equipment, and hepatitis B vaccination.

HIV/AIDS NEWS

U.N. Warns of AIDS Epidemic in Ecuador (news article)
The spread of AIDS in Ecuador's most populated province is reaching levels comparable to Africa and the Caribbean a decade ago and could mushroom into a national epidemic if left unchecked, United Nations officials recently warned.

Washington Post Examines Why Many HIV-Positive South Africans Prefer Traditional Therapies over Antiretroviral Drugs (news article)
Medical authorities in South Africa and other developing countries have discovered that many people in the advanced stages of AIDS are reluctant to take anti-retrovirals--or accept the treatment only when death is so near that the medication can no longer reverse the slide--and instead have more faith in traditional cures than Western medicine.

Zambia to Boost Free AIDS Treatment (news article)
Zambia will dramatically boost its distribution of free HIV/AIDS drugs next year to confront the disease that infects one in five Zambians and threatens the country's development, President Levy Mwanawasa recently stated.

The Philippines: Ingredients of AIDS Explosion Here (news article)
The international community warned that an anemic government effort may play a major factor in an impending epidemic of HIV/AIDS in the Philippines, even though transmission of the virus is now described as "low and slow." Low condom use among vulnerable individuals like sex-industry workers, young people engaged in risky sexual behavior, the high prevalence of sexually transmitted infections, and lack of knowledge about the disease among the high-risk population add to the potential for an HIV/AIDS explosion.

Botswana Winning AIDS Battle (news article)
Provision of antiretroviral therapy to people living with HIV/Aids in Botswana is progressing at a steady rate, resulting in fewer deaths, according to the World Health Organization.

UNAIDS Commends Viet Nam on Its National HIV Prevention Strategy (news article)
Viet Nam's national HIV prevention strategy, which targets prostitutes and addicts, should be replicated in other countries, a senior official with UNAIDS said. The country's Government has divided the work of AIDS prevention and treatment among several ministries, giving specific duties to each.

AIDS Spread in Papua Blamed on Poverty (news article)
Despite an extensive campaign against HIV/AIDS in Papua, the number of local people living with the deadly virus continues to increase, making the province one of the regions worst affected by the disease.

Zimbabwe: Few Rural Dwellers Visit VCT Centres (news article)
Few rural Zimbabweans are using the Voluntary Counselling and Testing centers, according to the latest Zimbabwe Human Development Report.

U.S. Firm Opens $15M Ugandan AIDS Clinic (news article)
The largest training center in Africa for health workers treating AIDS sufferers opened outside of Uganda's capital in what officials said was a major step toward dealing with the epidemic on the world's poorest continent. The $15 million Infectious Diseases Institute at the University of Makerere, funded by the US pharmaceutical firm, Pfizer Inc., will teach 250 health professionals a year how to train other medical workers in the most modern methods of treating HIV, the virus that causes AIDS.

MATERNAL AND CHILD HEALTH RESEARCH

Reducing Maternal Mortality from Unsafe Abortion among Adolescents in Africa (research abstract)
Unsafe abortion is a major cause of maternal mortality among adolescents in Africa. This article argues the importance of focusing on primary prevention including the provision of appropriate sexuality education and information as well as supportive services to allow adolescents to prevent unwanted pregnancy. Secondary prevention efforts should include prompt diagnosis and treatment of complications by ensuring that services are made more responsive to the needs of adolescents, and by improving access to and quality of care for them.

From Research to Practice: The Example of Antenatal Care in Thailand (research article)
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This WHO study reviews the implementation of a new model of antenatal care in Thailand. The model calls for the introduction of fewer antenatal visits in clinical practice. The focus is on methods of moving research findings into practice.

Retrospective Study of a Pioneer Antenatal Screening Program with 8,477 Pregnant Women in Brazil (PubMed abstract)
This study is a retrospective audit of the screening results of 8,477 pregnant women for 11 diseases in a statewide screening program begun in 2002 in Brazil. Primary screening with filter-paper blood samples was carried out with positives being resampled and sera appropriately tested. The most frequent diseases serodiagnosed were hepatitis B, syphilis, HIV, and Chagas' disease. The authors conclude that the diagnosis of 11 diseases of importance for mothers and their offspring must be matched by opportunities to elaborate new control strategies and improve health care during pregnancy.

MATERNAL AND CHILD HEALTH NEWS

Nigeria: Maternal Mortality Rate Alarming (news article)
With a maternal mortality rate of 1,500 per 100,000 births, Nigeria's rate of maternal death is one of the highest that has been recorded in any developing country in the world.

Maternal Mortality Rate Worries UNDP (news article)
The United Nations Development Program(UNDP) says there continues to be a marked increase in maternal mortality since 2000, despite high pre-natal care attendances.

MEN'S HEALTH RESEARCH

Body Mass Index in Relation to Semen Quality and Reproductive Hormones Among 1,558 Danish Men (research abstract)
Related: news article: Study: Body Mass Affects Sperm Quality
Men who weigh too much are more likely to have poor sperm quality, research on nearly 1,600 young Danish men has found. Being too thin is a problem, too. Sperm counts and sperm concentration were 28.1 percent and 36.4 percent lower respectively in underweight men. The same measures were 21.6 percent and 23.9 percent lower respectively in overweight men. Why this may be happening is unclear. "Low BMI can result from a 'healthy lifestyle' but may also be due to many chronic diseases," the authors write. The biological explanation or mechanism also may be different in underweight and overweight men, they note.

Condom Use with Sex Workers and Abstinence Behavior Among Men in Nigeria (research abstract)
This exploratory, community-based study assessed condom use among married men when with commercial sex workers (CSWs) and abstinence when their wives were unavailable for sex. Only 46% of those who last visited a CSW in the previous 6 months had used a condom. Young age (less than 30 years) was the only predictor of condom use when with CSWs. Predictors of abstinence behavior when the wife was unavailable for sex included primary and secondary education, young age of the wife, low occupational status, and monogamy.

POPULATION RESEARCH

China's Missing Children: The 2000 Census Underreporting Surprise (research abstract)
This study compares the age and sex structure of China's 2000 population census to an estimate of that structure derived from a projection from the 1990 census. Based on China's own official estimates of demographic change, this analysis indicates a shortfall in enumeration of more than a quarter of all children under age 5 and an eighth of those between 5 and 9, a total of nearly 37 million children missing in the 2000 census. The shortfall is primarily due to underreporting of children in the census.

Popular Perceptions of Emerging Influences on Mortality and Longevity in Bangladesh and West Bengal (research abstract)
Findings from individual interviews and focus-group discussions show that, while child mortality levels are perceived to have fallen dramatically in recent times, the health and survival prospects of the middle aged and the elderly are seen to have been better in the past. The perceived decline in adult health is attributed to environmental deterioration and lifestyle changes accompanying modernization. This paper explores people's reasons for this unexpected worldview.

Population Futures for the Next Three Hundred Years: Soft Landing or Surprises to Come? (research abstract)
The long-range population projections of the United Nations issued in 2003 span three centuries and are elaborated for all countries of the world according to the present-day political map. This note discusses the merits and limitations of this ambitious enterprise.

POPULATION NEWS

China Set for 1.5 Billion Population (news article)
China, the world's most populous nation, will see its population grow to nearly 1.5 billion over the next 20 to 30 years, according to the minister of the National Population and Planning Commission.

Sri Lanka: Population Growth Continues to Decline, Says Healthcare Minister (news article)
The rate of population growth in Sri Lanka has continued to decline, from 1.5% in the early 1990s to 1.1% today, Minister of Healthcare and Nutrition Nimal Siripala de Silva, told the UN General Assembly. Speaking on the 10th anniversary of the 1994 International Conference on Population and Development (ICPD), he said that life expectancy at birth for females and males is comparable to that of more advanced developed countries, with 75.4 and 70.7 years respectively.

U.N.: Ethiopia Still on Brink of Disaster (news article)
Ethiopia remains on the brink of disaster because it is failing to deal with spiraling population growth, slow economic growth, and environmental degradation fueling its near perpetual crises, a United Nations report said. The study, which examined a food crisis that took place in 2002-2003 in Ethiopia, said the country's population grows by 2 million a year, while its economy expands by just 3 percent. Agriculture accounts for nearly 40 percent of the gross domestic product, but unsustainable land policies are fueling ever-larger emergencies in the country.

WOMEN'S HEALTH RESEARCH

Women and AIDS: Gender Relations and Condom Use with Steady Partners (research article)
An educational project on sexuality, STDs, and AIDS was conducted for four years with some 500 women in Brazil. As a result, changes were observed in HIV-related knowledge and attitudes, but not in risk behaviors for infection. This led to a qualitative study to learn the reasons why women failed to incorporate HIV preventive behaviors into their daily lives. Six focus groups were conducted with women who had participated in the educational project. It was found that although women had information about AIDS, they did not use preventive measures in steady relationships because they did not wield decision-making power.

A Determination of the Prevalence of Gender-Based Violence among Conflict-Affected Populations in East Timor (research abstract)
The Reproductive Health Response in Conflict Consortium designed a standardized questionnaire to measure the prevalence of gender-based violence (GBV) in conflict-affected settings. A preliminary field test was undertaken July/August 2002 in one urban and one rural district in East Timor to assess the prevalence of GBV among women 18-49 years of age during and after conflict. Reported rates of physical assault by an intimate partner were not significantly different in the year preceding the survey.

WOMEN'S HEALTH NEWS

Gabon: Female Condoms Are Subsidised, but Not Widely Advertised (news article)
A sharp cut in the price of female condoms should promote their use in Gabon, one of the Central African countries most affected by HIV/AIDS, medical workers said. In September 2003 the Gabonese Movement for Family Welfare, a local non-governmental organization, began selling female condoms to women for just 100 CFA (20 US cents), a fraction of their price in commercial pharmacies. Sales of female condoms, which are subsidised by the UK-based International Planned Parenthood Federation, have picked up quickly and the NGO is now selling about 4,000 a month.

UNICEF Adviser Says Rape in Darfur, Sudan Continues with Impunity (news article)
Armed militias in Sudan’s strife-torn Darfur region are continuing to rape women and girls with impunity, an expert from the United Nations children’s agency said on her return from a mission to the region. Pamela Shifman, the UN Children’s Fund (UNICEF) adviser on violence and sexual exploitation, said she heard dozens of harrowing accounts of sexual assaults–-including numerous reports of gang-rapes–-when she visited internally displaced persons (IDPs) at one camp and another settlement in North Darfur last week.

Pains of Female Circumcision (news article)
This analysis of female circumcision considers the practice in East Africa, its history to the present day, its victims, and the legal steps countries have taken to outlaw it. Female circumcision refers to several practices that involve the cutting of female genitals. Over the past decade, the term female genital mutilation has been adopted by a wide range of women's health and human rights activists because it clearly indicates the harm caused by the practice.

YOUTH HEALTH RESEARCH

The Health of Young People in a Global Context (research abstract)
This paper examines the chief causes and influences of morbidity and mortality among young people throughout the world and concludes that changes in population, migration, age of marriage, and education have had profound impact on mortality and morbidity among adolescents.

Development of a Scale to Measure Adolescents' Beliefs and Attitudes About Postponing Sexual Initiation (research abstract)
This study sought to develop a scale to measure adolescent beliefs and attitudes about postponing sexual initiation (PSI). The beliefs about PSI rated as most important by both girls and boys were concern about pregnancy and STIs. A higher score was associated with female gender; age under 14 years; higher global and social self-esteem; more frequent attendance at religious services; less peer pressure to have sexual intercourse; nonuse of alcohol, illicit drugs, and cigarettes; and no intention to initiate sexual intercourse in the next year.

YOUTH HEALTH NEWS

South Africa: A Third of Under-10s Have Had Sex (news article)
By the age of 10, one out of every three South African schoolchildren have already had sex. In addition, many misguidedly believe that condoms do not prevent pregnancy and, even more startlingly, many say they would have unprotected sex even if they were HIV-positive. Joan van Niekerk, National Director of Childline, said the statistics indicated that the educational programmes for youth were not succeeding and that young people are becoming sexually active at an earlier age. She said 43% of all sexual crimes committed on children that are reported to Childline countrywide, are committed by children under 18 years. More than half - 51% - are committed by people under the age of 21.

US: FDA Weighs Morning After Pill Teen Access (news article)
Some see easy access to emergency contraception as a way to drastically reduce teen pregnancy, already on the decline since the early 1990s. Such access, they argue, would make it easier to get emergency contraception on evenings and weekends, allowing more women to take it in the recommended 72-hour window after unprotected sex. Others, including some young women, see it as a way for teens who don't want their parents to know they're having sex to help prevent unwanted pregnancy. Over-the-counter sales have received support from both the American College of Obstetricians and Gynecologists and American Medical Association.

Declining Youth Pregnancies Contribute to Dip in Jamaica's Fertility Rate (news article)
The family planning board in Jamaica reports that teenage pregnancies continue to decline, and that this factor is the most significant contributor to a fall in the fertility rate, as detected by the latest Reproductive Health Survey.

BOOKS/BOOK REVIEWS

Reproductive Health: Women and Men's Shared Responsibility (book)
In ten chapters scholars of health, sociology, anthropology, women's studies, and religion present an agenda for reproductive health reflecting the shared responsibilities of men and women, the value of community support, and the demands of human rights. Chapters discuss ethics, expectation and life paths, cultural scripts, family planing, adoption, infertility, infections, violence, and environmental and behavior threats.

New Frontiers in Contraceptive Research: A Blueprint for Action (book)
A new report from the Institute of Medicine of the National Academies, this book identifies priority areas for research to develop new contraceptives. The report highlights new technologies and approaches to biomedical research, including genomics and proteomics, which hold particular promise for developing new products. It also identifies impediments to drug development that must be addressed. Research sponsors, both public and private, will find topics of interest among the recommendations, which are diverse but interconnected and important for improving the range of contraceptive products, their efficacy, and their acceptability.

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Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 4, Number 4325 October 2004