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The Pop Reporter®

Volume 6, Number 43
30 October 2006

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Guest Editorials (free with every subscription)

When contraceptives change bleeding: How family planning providers and programs can help clients choose and use suitable methods


Author: Salem R | Setty V

rsalem@jhsph.edu, vsetty@jhsph.edu

Monthly bleeding changes are common with hormonal family planning methods and IUDs. They are rarely harmful, and they do not signify underlying or impending illness. These family planning methods also are the most effective reversible methods, and many women choose them for their effectiveness. Nonetheless, many women are concerned when a contraceptive method changes monthly bleeding. In fact, bleeding changes make up women’s most commonly reported method-related reason —- and sometimes the most common reason overall —- for discontinuing hormonal methods and IUDs. Addressing bleeding changes may be the most important way that family planning providers can help users of these methods choose and use suitable methods.

The latest issue of Population Reports (see below) can help family planning providers inform and counsel clients about possible bleeding changes with these methods so that they can choose methods that suit them and know what to expect. Being aware of bleeding changes ahead of time helps women avoid unnecessary worry and increases women’s satisfaction with their chosen method (1, 5). Also, evidence from diverse countries —- Bolivia, China, and Mexico -— suggests that in-depth explanatory counseling about bleeding changes and encouragement to return with any problems contributes to longer use of a method (2, 3, 4).

Bleeding changes with these contraceptive methods differ, depending on the method. Combined hormonal methods -— the pill, monthly injectables, the patch, and the vaginal ring -— tend to make monthly bleeding shorter and more predictable. Progestin-only methods such as long-acting injectables, implants, progestin-only oral contraceptives (“the minipill”), and the hormonal levonorgestrel-releasing IUD all can cause bleeding changes that range from breakthrough bleeding and spotting to no monthly bleeding. Copper IUDs do not change the length of menstrual cycles but do tend to cause somewhat heavier and longer monthly bleeding. Often, the same method can have different effects for different women or different effects over time for the same woman.

To help clients choose and use methods that fit their needs and their attitudes toward bleeding changes, family planning providers can take the following steps:

Help new clients decide whether to choose a family planning method that may change monthly bleeding:

• Describe the common bleeding changes in ways that clients understand, including how the changes may vary over time.

• Explain that such bleeding changes are normal with these contraceptives. They are not harmful, and they are not signs of illness.

• Help each client consider how she would feel and what she would do if these bleeding changes happened to her.

• Invite her to return any time that she has concerns.

Help continuing clients manage bleeding changes caused by a family planning method:

• In the first few months of use, explain that the changes probably will lessen with time.

• If the bleeding changes persist, or at any time a client asks, offer available treatments to relieve the bleeding.

• At any time a client finds bleeding changes unacceptable, help her choose a method that better suits her.

Additionally, providers can gain an understanding of cultural and social beliefs and behavior concerning menstruation. This knowledge can help providers be sensitive to their clients’ attitudes towards contraceptive-related bleeding changes. To answer common questions that clients have about menstruation and the menstrual cycle, providers can refer to the INFO Reports issue “Key Facts About the Menstrual Cycle” (see www.infoforhealth.org/inforeports/). This report presents information in a simple way, accompanied by illustrations that providers can use with clients. Good counseling about monthly bleeding changes with use of hormonal methods and IUDs is one way providers can help women who want a very effective contraceptive method to continue preventing unwanted pregnancies.

Based on Population Reports, “When Contraceptives Change Monthly Bleeding: How Family Planning Providers and Programs Can Help Clients Choose and Use Suitable Methods.” For printed copies of the report, send an e-mail message to orders@jhuccp.org or write to Orders Department, Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, MD 21202, USA. Or use our online order form.

References:

1. Backman, T., Huhtala, S., Luoto, R., Tuominen, J., Rauramo, I., and Koskenvuo, M. Advance information improves user satisfaction with the levonorgestrel intrauterine system. Obstetrics and Gynecology 99(4): 608-613. Apr. 2002.

2. Canto de Cetina, T.E., Canto, P., and Ordonez Luna, M. Effect of counseling to improve compliance in Mexican women receiving depot-medroxyprogesterone acetate. Contraception 63(3): 143-146. Mar. 2001.

3. Hubacher, D., Goco, N., Gonzalez, B., and Taylor, D. Factors affecting continuation rates of DMPA. Contraception 60(6): 345-351. Dec. 1999.

4. Lei, Z.W., Wu, S.C., Garceau, R.J., Jiang, S., Yang, Q.Z., Wang, W.L., and Vander Meulen, T.C. Effect of pretreatment counseling on discontinuation rates in Chinese women given depo-medroxyprogesterone acetate for contraception. Contraception 53(6): 357-361. Jun. 1996.

5. Tan, A., Mahdar, E., Djamal, F.R., Bachtiar, H., Tuladhar, J., and Hoesni, R.H. Improvements in knowledge of Norplant implants acceptors: An intervention study in West Sumatra and West Java, Indonesia. Final report. Bandung, Indonesia, Padjadjaran University, Study Group on Biomedical and Human Reproduction, Jun. 1995. 41 p.

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Improving the reproductive health of married and unmarried youth in India: Evidence of effectiveness and costs from community-based interventions, Final report of the Adolescent Reproductive Health Program in India
(Report; Asia)
(You need Adobe Acrobat Reader to access this document)
International Center for Research on Women, Washington, D.C., 2006.
Pande R | Kurz K | Walia S | MacQuarrie K | Jain S
Related News Article: Intervention needed to break 'silence' on reproductive health
There is "enormous silence" in India around adolescent sexual and reproductive health issues, and this can be overcome through involvement of parents, in-laws, spouses and elders, says a new report by the International Center for Research on Women (ICRW) and partners. More than half the population in India is younger than 25, and many adolescents, particularly unmarried girls, suffer serious reproductive health problems but face constraints in receiving care and treatment.



Oral contraceptives for functional ovarian cysts
(Abstract; subscription needed for full text; Global)
Cochrane Database of Systematic Reviews. 2006 Oct 18;4(CD006134)
Grimes DA | Jones LB | Lopez LM | Schulz KF
This review examined all randomized controlled trials that studied oral contraceptives as therapy for functional ovarian cysts. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true for cysts that occurred spontaneously as well as those that developed after ovulation induction. Although widely used for treating functional ovarian cysts, combined oral contraceptives appear to be of no benefit. Watchful waiting over several cycles is appropriate. Should cysts persist, surgical management is often indicated.



Improving reproductive health through community-based services: 25 years of Pathfinder International experience
(Report; Global)
Pathfinder International, Watertown, MA, 2006.
Burket M
This report describes Pathfinder's efforts at the grassroots level to expand access and knowledge, stimulate acceptance, and create awareness and ownership of reproductive health and family planning programs.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Afghans cling to old ways
(News Article; Asia)
24 Oct 2006
St. Louis Dispatch
Only 10 percent of married Afghan women aged 15 to 49 use any method of contraception, according to the Population Reference Bureau in Washington. For more than two years, the United States has paid for a birth control program in Afghanistan that distributes condoms and oral and injectable contraceptives.



Older mothers risk fertility of daughters
(News Article; Global)
25 Oct 2006
The Guardian Unlimited
Women who delay having children until later in life risk damaging the fertility of their daughters, researchers warn. The discovery is the first evidence that the steep decline in fertility seen in older women causes genetic damage that is passed on if they conceive, causing reduced fertility in female children.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Cayman Islands: Need for sex education programmes - Broadcaster
(News Article; Central America and the Caribbean)
25 Oct 2006
Cayman Net News
Discussions between Don Seymour, Managing Director of dms Management Ltd, and Minister of Communications, Works and Infrastructure, the Hon Arden McLean, have resulted in agreements on two issues, one of which is the airing of sex education on local radio in the Cayman Islands.

HIV/AIDS RESEARCH

Mother-to-child transmission of HIV-1: Timing and implications for prevention
(Abstract; subscription needed for full text; Asia | Sub-Saharan Africa)
The Lancet Infectious Diseases. 2006 Nov;6(11):726-732.
Kourtis AP | Lee FK | Abrams EJ | Jamieson DJ | Bulterys M
This article looks at clinical trial data to determine the timing of mother-to-child transmission of HIV-1. The authors' estimates predict that, for non-breastfeeding populations, 50% of HIV infections are transmitted to the infant at the very end of pregnancy, near to the time of labor. For breastfeeding populations, the postnatal period accounts for most of the HIV infections transmitted to the infant. This paper presents the hypothesis that the time when a fetus initially encounters the virus might not be when infection is established. The implications of this hypothesis are discussed.



Rapid HIV testing: A review of the literature and implications for the clinician
(Abstract; subscription needed for full text; Global)
Current HIV/AIDS Reports. 2006 Dec;3(4):159-165.
Wools-Kaloustian K
HIV counseling and testing services are critical for individuals to access HIV prevention and treatment. Unfortunately, standard HIV testing can take 1 week or longer. Therefore, innovative approaches are needed to reach the large number of individuals who are not aware that they are HIV-infected. Currently available rapid HIV tests are comparable to those of standard HIV testing. These rapid HIV tests are increasingly being used in various clinical scenarios to decrease the number of missed opportunities for detection of HIV-infection.

HIV/AIDS NEWS

S.Africa drafting revised AIDS battle plan
(News Article; Sub-Saharan Africa)
26 Oct 2006
Reuters AlertNet
South Africa's cabinet endorsed a revised version of its national blueprint to fight HIV/AIDS, which has come under increasing criticism as the epidemic cuts an ever deeper swath through the population.



South Africa: Johannesburg takes HIV testing to the people
(News Article; Sub-Saharan Africa)
20 Oct 2006
African News Dimension
Following the world AIDS conference earlier this year, Johannesburg, South Africa has set up an outreach program to take voluntary counseling and testing services to hostels and informal settlements.



Staging sex myths to save Zimbabwe's girls
(News Article; Sub-Saharan Africa)
24 Oct 2006
BBC News
Zimbabwe's most prominent organization fighting child sexual abuse is confronting traditional healers to take action over the myth that having sex with a virgin can cure AIDS -- one reason behind the rape of young girls.



Malawi: BLM selects 2 for TV show
(News Article; Sub-Saharan Africa)
20 Oct 2006
Sexual reproductive health organisation Banja La Mtsogolo (BLM) has finally selected two presenters for its upcoming television show, the organization’s marketing officer announced. The program will look at issues of HIV and AIDS and how they have affected Malawians and at how Malawi can respond to the situation.



Angola: ECOWAS workshop urges concerted action against HIV/AIDS
(News Article; Sub-Saharan Africa)
22 Oct 2006
Angola Press
A four-day workshop on developing a strategic plan of action on gender and the HIV/AIDS epidemic in the ECOWAS region has ended in Nigeria with the adoption of recommendations to stem the rising tide of the disease in the region. ECOWAS is the Economic Community Of West African States (ECOWAS). The workshop proposed the harmonization of laws and policies of ECOWAS countries relating to the empowerment of women and youth and recommended that governments of member states improve the roads to aid the flow of drugs in the region.



Nigeria: Does the breeze kill HIV?
(Feature Article; Sub-Saharan Africa)
23 Oct 2006
Political Cortex
Beth Fredrick, Executive Vice President of the International Women's Health Coalition, reports on an HIV/AIDS education session organized by the International Centre for Reproductive Health and Sexual Rights (INCRESE), a six-year-old Nigerian organization that works to protect and promote sexual and reproductive health.



South Africa: Health workers are 'making HIV testing difficult'
(News Article; Sub-Saharan Africa)
24 Oct 2006
SABC News
Francois Venter, president of the Southern African HIV Clinicians Society, says health care providers should begin to create a better atmosphere for voluntary HIV testing. He also suggested that HIV testing should be made mandatory in South Africa. He said companies have testing targets in the same way that they currently have black economic empowerment targets.



Africa's forgotten HIV children
(News Article; Sub-Saharan Africa)
25 Oct 2006
BBC News
Children with HIV and AIDS in the developing world are half as likely as adults to get life-saving drugs. This means fewer than 1 in 10 of over two million children infected get antiretroviral treatment. The BBC's Angus Crawford interviews three children living with the illness in Swaziland, which has the highest rate of infection in the world.



Ethiopian doctors learning to treat AIDS patients in Israeli clinic
(News Article; Sub-Saharan Africa)
26 Oct 2006
International Herald Tribune
Ethiopian doctors are learning to fight their country's massive AIDS epidemic in a clinic run by Israeli doctors, who have extensive experience treating HIV-infected Ethiopian immigrants. AIDS is a major health issue in Ethiopia, where up to 4 percent of Ethiopia's population is infected with HIV.

MATERNAL AND CHILD HEALTH RESEARCH

Anaemia and pregnancy outcomes in a South African rural population
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Obstetrics & Gynaecology. 2006 Oct;26(7):617-619.
Van Bogaert LJ
The purpose of this study was to evaluate whether booking hemoglobin (Hb), a marker for anemia, affected the mode of child delivery in a rural South African population. Moderate and severe anemia were defined, respectively, as an Hb of less than 10 and less than 8 g/dl. The overall prevalence of anemia was 19.7%. Women with a previous pregnancy who had vaginal delivery had a 22.5% prevalence of booking Hb less than 10 vs 14.2% in women in their first pregnancy. The prevalence of severe anemia was similar for all subgroups. Researchers concluded that anemia could predispose women to caesarean delivery.



Risk factors associated with congenital malaria in Enugu, South Eastern Nigeria
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Obstetrics & Gynaecology. 2006 Oct;26(7):612-616.
Okafor UH | Oguonu T | Onah HE
This study assessed the risk factors for congenital malaria in a population of neonates delivered in Enugu, South Eastern Nigeria. It was found that 57% of mothers and 33% of babies were smear positive for malaria. Some risk factors for congenital malaria were low socioeconomic class, low birth weight, malaria in the placenta, maternal malaria infection, and a higher number of children. The risk factors for congenital malaria identified in this study emphasize the need for effective preventive and curative treatment of malaria, not only during pregnancy but also during delivery in malaria endemic areas.



Community response to intermittent preventive treatment delivered to infants (IPTi) through the EPI system in Manhica, Mozambique
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Tropical Medicine & International Health. 2006 Nov;11(11):1670-1678.
Pool R | Munguambe K | Macete E | Aide P | Juma G | Alonso P | Menendez C
This research describes attitudes in Mozambique toward the Expanded Program on Immunization (EPI) and Intermittent Preventive Treatment in Infants (IPTi), a malaria prophylaxis regimen. IPTi was generally acceptable, in spite of initial resistance. Perceived negative aspects of IPTi did not affect perceptions of EPI, and IPTi was not misinterpreted as immunization against malaria. IPTi delivered together with EPI was generally accepted after initial rejection.



Child access to health services during the economic crisis: An Indonesian experience of the safety net program
(Abstract; subscription needed for full text; Asia)
Social Science and Medicine. 2006 Dec;63(11):2912-2925.
Suci E
This paper examines the extent to which the Social Safety Net in Health Sector program contributed to better health services for poor children in four Indonesian provinces. Two significant improvements occurred during the first year of the program: (1) more sick children visited outpatient facilities, and (2) more children lived in households possessing health cards. The program increased both "potential access," demonstrated by the significant increase in health card possession regardless of the visit, and "realized access," demonstrated by the significant increase in child outpatient visits regardless of health card possession.

MATERNAL AND CHILD HEALTH NEWS

Uganda: ADB loan to finance mental health services
(News Article; Sub-Saharan Africa)
21 Oct 2006
African News Dimension
Uganda's deprived mental and maternal health services may soon get a fresh look if Parliament approves a $32.7 million loan from the African Development Bank. The loan is planned to boost a five-year School Health Support Services Program (SHSSP), especially in areas of mental and reproductive health services.



Ghana: Integrated Child Health Campaign to start
(News Article; Sub-Saharan Africa)
25 Oct 2006
Ghana Web
An integrated child health campaign aimed at reducing under-five mortality rate by two-thirds by the year 2015 is expected to start in November 2006 in Ghana. A five-day campaign, combining measles and polio immunization, vitamin A, and free insecticide treated bednets for children under-two is expected to boost the survival of millions of children.



Ghana: Malnutrition cause of 50% infant mortality
(News Article; Sub-Saharan Africa)
27 Oct 2006
Accra Mail
About half of the total number of death in children under five years of age in Ghana can be traced to malnutrition. And over the last five years, infant mortality and under-five mortality rates in Ghana have not improved.



Kenya: Safe motherhood through traditional birth attendants
(Feature Article; Sub-Saharan Africa)
27 Oct 2006
East Africa Standard
Mothers in parts of Kenya's Western province are dying after opting to deliver at home for fear of going against traditional practices. Rather than be taken to a hospital after developing complications during childbirth at home, most mothers choose death. Surveys conducted by The Standard show that once a woman delivers, custom demands that she bury the placenta in a traditional ritual. But in health centers, the placenta is either thrown away or incinerated.

MEN'S HEALTH RESEARCH

Rape perpetration by young, rural South African men: Prevalence, patterns and risk factors
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Social Science and Medicine. 2006 Dec;63(11):2949-2961.
Jewkes R | Dunkle K | Koss MP | Levin JB | Nduna M | Jama N | Sikweyiya Y
Related News Article: One in five South African men has committed rape, study finds
This paper describes the prevalence, patterns, and factors associated with rape of an intimate partner or a woman who was not a partner by men in rural South Africa. Among men, 16.3% had raped a non-partner or participated in a form of gang rape; 8.4% had been sexually violent towards an intimate partner; and 79.1% had done neither. The mean age of first rape was 17 years. There was overlap between rape of a non-partner and partner, in that 44.3% of men who raped an intimate partner had also raped a non-partner.

MEN'S HEALTH NEWS

Beyond condoms: Male hormonal contraceptives may finally be on track
(News Article; Global)
16 Oct 2006
NewsDay
Forty years after the introduction of the female birth control pill —- and despite sluggish progress in recent years —- researchers are still optimistic about the ultimate feasibility of a male contraceptive. Drugs now in development use hormonal methods similar to those used in many female contraceptives. Small studies have found their delivery -— a combination of implants, injections, and gels -— to be generally safe, reversible, and effective in lowering sperm counts.

POPULATION RESEARCH

Moving young
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
UNFPA, New York, NY, 2006.
This report explores the lives of young women and young men who have ventured into new lands to chase their dreams or to escape oppression, war, poverty, or misfortune. It profiles the lives of young women and men from ten countries –- Burkina Faso, Colombia, India, Kenya, Liberia, Moldova, the Netherlands, the Philippines, Suriname and Zambia. Some have never migrated, but their lives are marked by the experiences of spouses or relatives who have moved abroad. They were interviewed in their countries of origin or destination.

POPULATION NEWS

Iran's president urges higher birth rate
(News Article; Middle East)
23 Oct 2006
Seattle Post Intelligencer
Iran's president is urging couples to have more children to boost the country's population. President Mahmoud Ahmadinejad said his administration would reduce the working hours of women to allow them to have more children.



Azerbaijan: "Echo": Children and poverty
(News Article; Asia)
25 Oct 2006
Democracy, Elections, and Human Rights in Azerbaijan
Child poverty in Azerbaijan is an urgent problem, according to Yusif Bekirov of the League for the Protection of Children's Rights (LPCR). In the 1990s the number of births in Azerbaijan was 180,000 children annually; now there are only 50,000 children born each year. Bekirov explained that although Azerbaijan is a nation that loves children, many couples are not having children because of the poverty in which they live.

WOMEN'S HEALTH RESEARCH

Beyond the shadows: Domestic spousal violence in a "democratizing" Egypt
(Abstract; subscription needed for full text; North Africa)
Trauma, Violence, & Abuse. 2006 Oct;7(4):244-259.
Ammar NH
Since the beginning of 2000, Egypt has witnessed legal, organizational, and political changes, both generally and concerning women. Some changes address the issue of spousal abuse directly, and others focus on empowering women in family and society. As a result, it is important to develop a baseline profile of spousal abuse for future research on and evaluation of the effects of such policies and legal changes. This will enable researchers to measure strategies that influence change and reduce violence against women. This article provides the first step in the baseline.



Customs, culture, and tradition -- What role do they play in a woman's sexuality?
(Abstract; subscription needed for full text; Global)
Journal of Sexual Medicine. 2006 Nov;3(6):954–959.
Fourcroy JL
This is a review of the available literature on the impact of culture on a woman's sexual satisfaction, with emphasis placed on information from cultures practicing female genital circumcision (FGC). The spectrum of FGC surgical excisions can alter well-being, obstetrical outcomes, and sexual responses. The psychologic aspects of a painful procedure in a young child may also impact future sexual responsiveness. There is a paucity of information on which to base conclusions and the effect of culture on a woman's sexual satisfaction.



Sexual dysfunction and related risk factors in a cohort of middle-aged Ecuadorian women
(Abstract; subscription needed for full text; South America)
Journal of Obstetrics & Gynaecology. 2006 Oct;26(7):682-686.
Yanez D | Castelo-Branco C | Hidalgo LA | Chedraui PA
Sexuality is a complex phenomena that can be affected by both psychological and physiological factors. This study assessed the incidence of sexual dysfunction and related risk factors in Ecuadorian women. Of the women surveyed, 53.5% had sexual intercourse at least four times per month. Masculine erectile dysfunction and premature ejaculation were also complicating factors. Female sexual dysfunction was present in 78.4% of women included in the study. Male sexual dysfunction, marital status, and antidepressant use were the most important predicting risk factors for sexual dysfunction among the women.

WOMEN'S HEALTH NEWS

U.N focuses on indigenous; Mothers' health at risk
(News Article; Global)
21 Oct 2006
Women's eNews
For the first time, the United Nations has formally addressed violence against indigenous women. The International Indigenous Women's Forum urged on Oct. 16 the adoption of the U.N.'s Declaration on the Rights of Indigenous Peoples, which includes an article to draw special attention to the needs of women. The forum, based in New York, issued the recommendation in a companion report to the Oct. 9 "Study on Violence Against Women" sent to the secretary-general, Kofi Annan.



United Kingdom: Parents fly in African village elders to circumcise their young daughters
(News Article; Europe)
23 Oct 2006
Times Online
British police and health authorities fear that 25,000 girls are at risk of genital mutilation. Young girls in Britain are suffering genital mutilation at the hands of women paid to come to Britain by their families. African immigrants are joining together to pay for practitioners to fly to Britain and circumcise their daughters in highly secretive rituals.



Facts on female genital mutilation
(News Article; Global)
25 Oct 2006
Atlanta Journal Constitution
No one knows how many sexually mutilated women and girls live in Atlanta, Georgia or in the United States. It is a hidden, private matter. The procedure is often called female circumcision and is mainly is performed on female children and adolescents between 4 and 14 years of age. In some countries, however, it is performed on infants under 1 year old.

YOUTH HEALTH RESEARCH

Correlates of sexual abstinence among adolescent virgins dating steady boyfriends in Taiwan
(Abstract; subscription needed for full text; Asia)
Journal of Nursing Scholarship. 2006 Sep;38(3):286-291.
Wang RH | Hsu HY
This research examined sexual abstinence behavior and identified the important explanatory factors for sexual abstinence among adolescent virgins who were dating steady boyfriends using the Stages of Change (SOC) model. Higher self-efficacy for sexual abstinence, higher decisional balance for sexual abstinence, and lower age increased the probability of being in earlier stages. This information about SOC for sexual abstinence can be used by health professionals for intervention strategies for adolescent girls who are dating steady boyfriends.

YOUTH HEALTH NEWS

Nigeria: Talking amongst ourselves
(News Article; Sub-Saharan Africa)
24 Oct 2006
This Day
UNICEF has tapped into the National Youth Service Corps network, in which graduates perform community service for one year, to spread the word on sexual health. UNICEF is training these volunteers to organize peer education programs to share information about HIV prevention and voluntary counseling and testing for HIV.



Guam: Birth rates unchanged
(News Article; Oceania)
23 Oct 2006
Pacific Daily News
While recent figures from the U.S. Centers for Disease Control and Prevention show that between 1991 and 2004 the teen birth rate declined by 33% in the United States, the same can't be said for Guam. In 1999, according to the National Campaign to Prevent Teen Pregnancy, the island's birth rate for 15-to-19-year-olds was 97 per 1,000, compared to 50 in the United States.



Vietnam’s sexual textbooks inadequate
(News Article; Asia)
22 Oct 2006
Vientnam Net Bridge
Sex education is not taught as a separate subject in Vietnamese schools. It is taught as part of other subjects such as science or biology. Knowledge about sex has been added to 5th grate textbooks, but it is still omitted from sixth and seventh grade textbooks and is only superficially mentioned in the 8th, 10th, and 11th grade textbooks.



Malawi: Speaking out for children
(Feature Article; Sub-Saharan Africa)
21 Oct 2006
Oxford Mail
An Oxford UK woman who has been working in Malawi has been speaking about conditions for children there. Joanna Watson travelled to Uganda and Malawi this year as part of her advocacy and communications work for Oxford-based charity Viva Network.



Jamaica: Students to discuss the 'value' of abstinence
(News Article; Central America and the Caribbean)
26 Oct 2006
Jamaica Observer
Students in Jamaica aged 11 to 15 years old will participate in an intensive discussion on the value of abstinence, when the National Family Planning Board (NFPB) hosts a rap session on the topic. Participants will be drawn from ten schools.

BOOKS/BOOK REVIEWS

World Bank book asks: What about men and gender?
(Review/Synthesis; Global)
25 Oct 2006
Reuters AlertNet
Improving the lives of women in the world's poorest countries has been the focus of development programs for more than three decades, but now a new World Bank book asks: What about the men? The book is titled "The Other Half of Gender." Its authors argue that resolving some of the most chronic social ills in the developing world requires helping men deal with problems unique to being men.

Calendar of Events

See All Events

November 13, 2006 - November 18, 2006
PSP-One On-Line Conference - Expanding Health Services, Quality, and Equity in Developing Countries: The Role of the Private Sector
This global on-line conference, sponsored by USAID and the World Bank, will include narrated Powerpoint presentations given by representatives from leading organizations (e.g., Center for Global Development, WHO, Bill and Melinda Gates Institute), filmed during the Global Health Council event in May 2006. These presentations review options to ensure quality of and access to private health services in the developing world. Expert presenters include: Dr. Ruth Levine, Dr. Amy Tsui, Dr. Alex Preker, Dr. Benjamin Loevinsohn, Dr. Claus-Peter Janisch, and many more. The conference is divided into three sessions, each composed of recorded presentations, followed by both recorded and live question and answer sessions. The three sessions are: (1)Strengths and Limitations of the Private Sector, (2)Public/Private Interface, and (3) Perspectives of the Private Sector: A Discussion with Leading Health Organizations. Participants in developing countries and elsewhere can access the conference online 24 hours a day.
E-Mail: info@psp-one.comEvent Location: On-line

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