Volume 6, Number 50
18 December 2006

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FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Identifying appropriate IUD candidates in areas with high prevalence of sexually transmitted infections
(Abstract; subscription needed for full text; Global)
Contraception. Online access December 14, 2006.
Morrison CS | Murphy L | Kwok C | Weiner DH
This paper describes a simple algorithm to identify women at low risk of current sexually transmitted infection (STI) who are appropriate IUD candidates in regions with moderate or high STI prevalence. A simple unweighted algorithm based on age, living with partner, education, bleeding between periods, and a behavioral risk score was the most useful. Women categorized as low risk by the algorithm can be referred for IUD insertion while women categorized as high risk should not receive an IUD without further testing or treatment. Women in the moderate-risk group should be triaged based on the STI prevalence of the overall clinic population.

Evaluation of a continuous regimen of levonorgestrel/ethinyl estradiol: Phase 3 study results
(Abstract; subscription needed for full text; Global)
Contraception. 2006 Dec;13 Dec 2006 74(6):439-445.
Archer DF | Jensen JT | Johnson JV | Borisute H | Grubb GS | Constantine GD
Related News Article: New oral contraceptive may end periods
This study evaluated the safety and efficacy of a continuous daily regimen of levonorgestrel (LNG) 90 microg/ethinyl estradiol (EE) 20 microg (continuous LNG/EE). 58.7% of subjects reported amenorrhea and 79.0% reported absence of bleeding. Overall, the number of bleeding and spotting days per pill pack declined progressively. Adverse events were comparable to those reported for cyclic oral contraceptive regimens, except for higher rates in those related to uterine bleeding. The regimen continuously inhibited menses, increased the incidence of amenorrhea over time, and decreased the number of bleeding and spotting days.

Temperature and pH sensitive hydrogels: An approach towards smart semen-triggered vaginal microbicidal vehicles
(News Article; Global)
Journal of Pharmaceutical Sciences. Online access December 11, 2006.
Gupta KM | Barnes SR | Tangaro RA | Roberts MC | Owen DH | Katz DF | Kiser PF
Related News Article: The incredible melting condom
Related News Article: Gel condom fights AIDS
This research studied a drug delivery system made with a dual pH sensitive and thermosensitive smart polymer gel that could be used as a vaginal microbicide. The system was engineered to coat vaginal tissue with a stable gel layer and to release microbicides in response to semen. Negligible erosion of the gel in the presence of vaginal fluid simulant suggests prolonged retention. Burst release of molecular and macromolecular model compounds was observed when the system's pH changed from the vaginal pH to the pH of semen.

Audio computer-assisted self-interviewing in reproductive health research: Reliability assessment among women in Harare, Zimbabwe
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Contraception. 2007 Jan;75(1):59-65.
Minnis AM | Muchini A | Shiboski S | Mwale M | Morrison C | Chipato T | Padiana NS
This paper examines how audio computer-assisted self-interviewing (ACASI) influenced reports of hormonal contraceptive use and pregnancy among 655 Zimbabwean women. Compared to face-to-face interviews, reports of hormonal contraceptive use were lower in ACASI, and reports of pregnancy were higher. Both modes of self-report differed from records on contraceptive method disbursement. Although ACASI yielded higher reports of several reproductive health behaviors, discrepancies between self-reports and clinical data on method disbursement highlight persistent measurement challenges.

Sexual and reproductive health of asylum-seeking and refugee women in Europe: Entitlements and access to health services
(Abstract; subscription needed for full text; Europe)
Journal of Global Ethics. 2006 Dec;2(2):183-196.
Janssens K | Bosmans M | Leye E | Temmerman M
Asylum-seeking and refugee women (ASRW) are population groups characterized by diverse health needs. Their backgrounds of forced migration have a profound impact on their sexual and reproductive health (SRH). In the context of refugee health, it is important to distinguish between asylum seekers and statutory refugees, as asylum seekers have distinct needs and often limited rights in their host country. Yet both groups face many barriers in accessing national health services. This article highlights the range of difficulties of asylum-seeking and refugee women in accessing health services.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Condoms 'too big' for Indian men
(News Article; Asia)
8 Dec 2006
BBC
A survey of more than 1,000 men in India has concluded that condoms made according to international sizes are too large for a majority of Indian men. The study found that more than half of the men measured had penises that were shorter than international standards for condoms. It has led to a call for condoms of mixed sizes to be made more widely available in India.

Fight over morning-after pill splits Chile
(Feature Article; South America)
17 Dec 2006
Seattle Times
President Michelle Bachelet of Chile is a feminist and physician who used to practice pediatric medicine at public clinics in poor neighborhoods. So it was hardly surprising that her government liberalized contraception policy by making the so-called morning-after pill available free at state-run hospitals. But since Chile is perhaps the most socially conservative country in South America, the measure has generated complaints and challenges not only on the right, but even from some of her allies.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Vatican refuses to sign convention over right of disabled unborn to life
(News Article; Europe)
14 Dec 2006
Catholic Online
The Vatican has refused to sign the just-adopted United Nations landmark treaty to promote and protect the rights of the world’s 650 million disabled people over a clause that may be used to allow abortion.

HIV/AIDS RESEARCH

The demographic impact of HIV/AIDS in South Africa. National and provincial indications for 2006
(Report; Sub-Saharan Africa)
(You need Adobe Acrobat Reader to access this document)
Cape Town, South Africa, Center for Actuarial Research, South African Medical Research Council and Actuarial Society of South Africa, 2006.
Related News Article: South Africa: SA lifespan down to 51
The survey found that life expectancy for 2006 in South Africa was estimated to be 49 years for males and 53 years for females. Without antiretroviral medicines, that figure could drop to 48 years by 2015. Life expectancy in South Africa was on average 64 years in 1990 and dropped by 13 years to 51 in 2006. Additionally, 11% of all people in South Africa are living with HIV, while 11% of those have AIDS. [Note: Large file to download: 541k]

Gender, migration, risky sex, and HIV infection in China
(Abstract; subscription needed for full text; Asia)
Studies in Family Planning. 2006 Dec;37(4):241-250.
Yang X | Xia G
This study examined differences in sexual behavior that make female migrants more vulnerable to acquiring HIV infection. The prevalence rates of casual and commercial sex for female temporary migrants are found to be 14 and 80 times those for female nonmigrants, respectively. Female temporary migrants' higher unemployment rate and concentration in the service and entertainment sectors are keys to understanding the prevalence of casual and commercial sex in this population. Promoting equal access to employment is needed to improve their economic well-being and to reduce their risky sexual behavior.

Adoption of safer infant feeding and postpartum sexual practices and their relationship to maternal HIV status and risk of acquiring HIV in Zimbabwe
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Tropical Medicine & International Health. Online access December 13, 2006.
Tavengwa NV | Piwoz EG | Iliff PJ | Moulton LH | Zunguza CD | Nathoo KJ | Hargrove JW | Humphrey JH
This research examined the relationships between maternal knowledge and concern about HIV status, adoption of preventive practices, and risk of acquiring HIV in Zimbabwe. 20% of mothers reported practicing safer sex and 11% of mothers reported modifying their feeding behavior because of HIV. Fear of transmitting HIV (50.4%) and protecting the baby's health (30.9%) were the most frequently cited reasons for behavior change. Greater emphasis should be given to safer sex practices among women who test negative in mother-to-child HIV prevention programs.

The necessary contradictions of 'community-led' health promotion: A case study of HIV prevention in an Indian red light district
(Abstract; subscription needed for full text; Asia)
Social Science and Medicine. 2007 Jan;64(2):496-507.
Cornish F | Ghosh R
This research examined how the Sonagachi Project, a sex-worker-led HIV prevention project in India, has worked within a community. The analysis shows that the project is deeply shaped by its relationships with non-sex-worker interest groups. Therefore, the 'community' that leads this project is much wider than a local grouping of marginalized sex workers. The authors argue that engagement with other interest groups was necessary to the project's success. Moreover, sex workers' interests and leadership have increased. Rather than denying such power relationships, projects should plan for them.

HIV/AIDS NEWS

Adult male circumcision significantly reduces risk of acquiring HIV
(Press Release; Sub-Saharan Africa)
13 Dec 2006
National Institutes of Health
Related News Article: 'Research was the easy part'
The National Institutes of Health announced an early end to two clinical trials of adult male circumcision because an interim review of trial data revealed that medically performed circumcision significantly reduces a man's risk of acquiring HIV through heterosexual intercourse. The trial in Kisumu, Kenya, of 2,784 HIV-negative men showed a 53 percent reduction of HIV acquisition in circumcised men relative to uncircumcised men, while a trial of 4,996 HIV-negative men in Rakai, Uganda, showed that HIV acquisition was reduced by 48 percent in circumcised men.

South Africa: African minister ends decade of denial on AIDS
(News Article; Sub-Saharan Africa)
11 Dec 2006
The Telegraph
Nozizwe Madlala-Routledge, a plain-speaking 55-year-old deputy health minister, is being feted as a heroine by health campaigners, AIDS sufferers, and much of South Africa's media, for daring to end a decade of denial on the disease. In the space of a few weeks she has helped turn government policy on its head. She has publicly admitted for the first time that the government has been in "denial at the very highest level" over AIDS. She is also helping to draw up a five-year plan to triple the number of patients receiving life-saving antiretroviral drugs and halve the rate of new infections.

S. Africa uproar over call for president AIDS test
(News Article; Sub-Saharan Africa)
12 Dec 2006
Reteurs AlertNet
South Africa's deputy health minister denied calling upon President Thabo Mbeki to take a public AIDS test, but repeated that she believed it was important for national leaders to be tested.

Uganda: Young people still vulnerable to HIV/AIDS
(Feature Article; Sub-Saharan Africa)
12 Dec 2006
Daily Monitor
The Minister for the Presidency made a call for the need of a breakthrough in adolescent sexual behavior in Uganda. “As policy makers and key stakeholders, we should be guided by this wealth of information in our day to day fight against the pandemic,” Dr. Beatrice Wabudeya said. This was during the launch of a report on Adolescent Sexual and Reproductive Health in Uganda. Wabudeya said that young people aged 10-24 years comprise 33 percent of the total population but nearly 50 percent of the country’s HIV/AIDS cases.

Zambia: An AIDS crisis rooted in tradition
(Feature Article; Sub-Saharan Africa)
11 Dec 2006
Financial Times
Many risks associated with HIV infection are rooted in tradition, such as the practice of a widowed woman having unprotected sex with a male relative of her dead husband. Others -- such as the notion that a man can rid himself of HIV by having sex with a virgin -- are self-evidently opportunistic in origin. These traditions hint at how the huge task of curbing the AIDS crisis in Zambia is made even harder by questions of economics, culture, and religion.

Nigeria: AIDS: Holes in the campaign
(News Article; Sub-Saharan Africa)
14 Dec 2006
Daily Trust
In Nigeria, the prevalence of HIV/AIDS infection rose from its reported emergence in the country in 1986 to 5.8% of the entire population in 2001, dropping to 5.0% in 2003 and 4.4% in 2005. According to the National Action Committee on AIDS (NACA), over two million Nigerians have died of AIDS in the last 15 years, while 3 million are currently infected. These statistics exist despite widespread media campaigns on the importance of preventing HIV/AIDS, suggesting a need to determine ways to improve the prevention message.

Help the fight against HIV/AIDS with the touch of a button
(News Article; Sub-Saharan Africa)
13 Dec 2006
Bizcommunity
Two of South Africa’s leading AIDS organizations, Cotlands and the Topsy Foundation, have joined forces to offer South Africans an opportunity to show their support for the fight against HIV/AIDS. The campaign is essentially an SMS fundraising campaign -- with a difference. The innovative mobile billing solution supplied by Exactmobile incorporates a subscription billing system; i.e., those who participate in the campaign will have R10 automatically deducted from their account each month, regardless of whether the person is a prepaid or contract subscriber.

MATERNAL AND CHILD HEALTH RESEARCH

Why are infant and child mortality rates lower in the MCH-FP area of Matlab, Bangladesh?
(Abstract; subscription needed for full text; Asia)
Studies in Family Planning. 2006 Dec;37(4):281-292.
Hale L | DaVanzo J | Razzaque A | Rahman M
Infant and child mortality rates are significantly lower in the Maternal and Child Health-Family Planning (MCH-FP) area of Matlab, Bangladesh, than in a comparison area. The two areas are similar in terms of socioeconomic characteristics, but the MCH-FP area provides better maternal and child health and family planning services, leading to lower fertility rates and longer intervals between pregnancies. Differences in reproductive patterns account for about 20% of the variation in the rates between the MCH-FP and comparison areas, suggesting that most of the difference is due to the quality of MCH services.

Newborn care practices at home: Effect of a hospital-based intervention in Sri Lanka
(Abstract; subscription needed for full text; Asia)
Journal of Tropical Pediatrics. Online access December 14, 2006.
Senaratha U | Fernando DN | Rodrigo I
This study evaluated the effect of an essential newborn care (ENC) training program for maternity ward staff in Sri Lanka. The intervention was aimed at increasing knowledge and skills of ENC among health care providers. Three months after the intervention, 150 mother–newborn pairs were interviewed at home. There was a significant improvement in umbilical cord care practices at home following the intervention. Pre-intervention breastfeeding rates were high, and there was not any further improvement in the post-intervention. There was a 35% reduction in the proportion of newborns who developed any undesirable health events at home. Findings suggest that the implementation of a training program for maternity ward staff can significantly improve mothers' practices of newborn care and clinical outcomes of newborns.

Scaling up of facility-based neonatal care -- A district health system experience
(Abstract; subscription needed for full text; Asia)
Journal of Tropical Pediatrics. Online access December 13, 2006.
Baliga BS | Raghuveera K | Prabhu VB | Shenoy R | Rajeev A
The report presents data of a scaled-up neonatal facility in a District Government Headquarters hospital in Southern India. The special care neonatal unit (SCNU) was a public- private partnership worked out on the principles of private funding of public institutions and effective budgeting of the public health care system. After 5 years, neonatal admissions from the district increased by 14.65%. Hospital stillbirth, early neonatal, and perinatal mortality rates showed significant decline, along with other indicators of infant health. Within the financial constraints of the public health system, private funding, public–private cooperation, and effective budgeting may become significant.

MATERNAL AND CHILD HEALTH NEWS

Half of Indian kids malnourished
(News Article; Asia)
12 Dec 2006
Times of India
As India races towards superpower status, its children are struggling to keep up. Children, especially girls, are faced with lack of educational opportunities, malnourishment, infant mortality, and early marriages. According to the latest data collected by the National Family Health Survey 2005-06, 47% of children in India are malnourished and sources say the situation is unlikely to change much.

Afghan women saving mothers' lives
(Feature Article; Asia)
13 Dec 2006
Yahoo News
War-shattered Afghanistan is behind only Sierra Leone for the highest number of women to die in childbirth. The maternal mortality rate here is around 1,600 out of 100,000 live births, according to a recent UNICEF survey. This means that one in six women between the ages of 15 and 49 die giving birth. A USAID-funded 18-month course at the Community Midwife Education centre in the provincial capital Taloqan, trains midwives to return to their districts to improve the chances of women surviving birth.

Liberia’s infant mortality rises
(News Article; Sub-Saharan Africa)
12 Dec 2006
The Analyst
Infant mortality is reaching alarming proportions in Liberia. The Liberian government and health partners noted that tremendous progress has been made in combating childhood disease. However, there is an urgent need for the government and its international partners to train more health care workers to handle childhood illnesses.

POPULATION RESEARCH

Global economic prospects: Managing the next wave of globalization 2007
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
Washington, DC, World Bank, 2007.
Related News Article: Poorer countries to power global growth by 2030
The report explores the next wave of globalization. Demographic trends will be a major driver
of future events. The Earth’s current population of some 6.5 billion is expected to rise to 8.0 billion by 2030, an average increase of 60 million annually. More than 97 percent of this growth will take place in developing
countries.

POPULATION NEWS

Migrants 'shape globalised world'
(Feature Article; Global)
18 Dec 2006
BBC
Migrant laborers from many different developing countries are helping to fuel increased economic expansion and globalization. A full one-quarter of the migrant worker population come from just two countries: India and China.

South Korea: Population growth at world bottom
(News Article; Asia)
13 Dec 2006
The Korea Times
South Korea’s population growth is projected to stagnate over the next 10 years, ranking at the world’s bottom, because of its low birthrate and rapid population aging. The country’s low population growth is expected to have a negative impact on its national competitiveness as the number of economically active people decreases and workers have to support more senior citizens.

Pakistan: Now, contraceptives in mosque!
(News Article; Asia)
18 Dec 2006
Hindustan Times
Taking a cue from Bangladesh, Pakistan has decided to distribute contraceptives at mosques and also involve clerics in spreading family planning awareness. Pakistan Population Planning Minister Chaudhry Shahbaz Hussain said that currently Pakistan’s birth rate was 1.86 percent, which his ministry wanted to bring down to 1.3 percent by 2020.

World disasters report: Living and dying in the shadows
(News Article; Global)
15 Dec 2006
Jamaica Observer
In 2005 the world responded more generously to people's humanitarian needs than at any time in recent history. Emergency aid reached at least US$ 17 billion -- outstripping any other year on record. Yet millions still missed out on vital, potentially life-saving aid because funds were directed at high-profile disasters, while countless other crises were neglected, according to this year's annual World Disasters Report, launched December 2006 by the International Federation of Red Cross and Red Crescent Societies.

WOMEN'S HEALTH RESEARCH

The state of the world's children, 2007: Women and children, the double dividend of gender equity
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
New York, NY, UNICEF, 2006.
Related News Article: West Africa: Gender equality and child survival linked
Improving the rights of women can boost child survival, especially in West and Central Africa, which have the highest rates of child mortality in the world, says a report by the United Nations children's agency (UNICEF). This report recommends maximizing gender equality and empowering women through education, financing, legislation, legislative quotas, engaging men and boys, women empowering women, and improved research. [Note: Large file to download: 1.8MB]

Sexual violence in Lesotho
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Studies in Family Planning. 2006 Dec;37(4):269-280.
Brown L | Thurman T | Bloem J | Kendall C
This research studied the magnitude and characteristics of sexual violence in two urban areas of Lesotho. Twenty-five percent of women surveyed reported ever being physically forced to have sex; 13% reported that forced sex was attempted. Boyfriends were the most common perpetrators of actual and attempted forced sex. Married women and those with more education were less likely than others to report that sex was forced upon them. Women living in areas where a program raising awareness about sexual violence was ongoing were more likely to report a history of sexual violence. Given the prevalence of HIV in Lesotho, programs should address women's right to control their sexuality.

WOMEN'S HEALTH NEWS

Kenya: Will a fatwa on FGM work?
(Feature Article; Sub-Saharan Africa)
17 Dec 2006
The East African
"Eliminating the Violation of Women’s Bodies,” was the name of a conference attended by some of Islam’s most senior and influential scholars. Most of them spoke against the common practice of female genital mutilation. The main message was that "female genital mutilation was never mandated in Islam." Anti-circumcision activists say many parents actually believe the practice prevents their daughters from being unfaithful to their future husbands and draw links between Islam’s emphasis on chastity and their own cultural beliefs.

Cameroon: Female circumcision persists despite sensitisation
(Feature Article; Sub-Saharan Africa)
12 Dec 2006
Cameroon Tribune
Cameroon has brought practitioners of female circumcision together with women affected by the practice. The meeting is supposed to help facilitate an exchange of ideas and to look for alternative solutions to the practice. According to the minister presiding over the conference, "We must have the courage to say it even if they are traditional practices: we must see those that are good and those that are bad and find a compromise between the two."

Tanzania: The irony of saying 'No' to unsafe sex
(Feature Article; Sub-Saharan Africa)
15 Dec 2006
IPP Media
"Abstain, be faithful to one partner, and condom use" are capturing slogans in the battle against HIV/AIDS. The ABC message may be catchy, but it does not automatically protect married women. Tens of thousands of women in Africa have died from AIDS, the vast majority of them monogamous wives infected by husbands. Such husbands may forcibly demand their marital 'rights,' won’t countenance HIV testing and beat and 'rape' wives who ask that they use condoms.

YOUTH HEALTH RESEARCH

Adolescent sexual and reproductive health in Uganda: Results from the 2004 National Survey of Adolescents
(Report; Sub-Saharan Africa)
(You need Adobe Acrobat Reader to access this document)
New York, NY, Guttmacher Institute, 2006.
Related News Article: Young people still vulnerable to HIV/AIDS
This report provides an overview of the sexual and reproductive health of adolescents in Uganda. Specifically, the report assesses the current knowledge, attitudes, and behaviors among adolescents and factors that put them at risk for HIV transmission and unwanted pregnancy. It examines why some adolescents are at higher risk of HIV transmission and unwanted pregnancy than others. It documents barriers that prevent adolescents from seeking sexual and reproductive health services, and provides new information about what very young adolescents know and do with respect to sexual and reproductive health.

Reaching youth through franchise clinics: Assessment of Kenyan private sector involvement in youth services
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Adolescent Health. Online access December 14, 2006.
Decker M | Montagu D
This paper evaluates the ability of social franchise programs, which use private providers to offer reproductive health services, to provide services to youth in western Kenya. Although franchise clinics have rarely targeted youth, they appear to offer a viable alternative for providing reproductive health services to this age group.

Sexuality education in Europe
(Programming Guide; Europe)
(You need Adobe Acrobat Reader to access this document)
Brussels, Belgium, International Planned Parenthood Federation, 2006.
Related News Article: Health experts urge Europe to focus more on sex education
This guide provides information about sexuality education in 26 European countries, and reflects the reality that
policies and practices related to young people’s sexual and reproductive health vary from country to country. There are, however, similarities in the way many governments approach sexuality education, and in the challenges they face in implementing policies related to this topic. By providing information about the policies for, and challenges to, providing sexuality education in diverse cultural, social and political settings, this guide can be a helpful resource for policy makers.

YOUTH HEALTH NEWS

Angola: Witchcraft an excuse for child abuse
(Feature Article; Sub-Saharan Africa)
13 Dec 2006
IRIN News
Isolated instances of children accused of sorcery have been recorded in the past in Angola. But now there is a "significant and growing phenomenon of abused and abandoned children" being singled out, according to a recent study by the National Children's Institute (INAC), the government of Angola's child protection department, and the United Nations Children's Fund (UNICEF).

Continuous Identification of Research Evidence (CIRE) Related to Family Planning Guidance

Lubianca JN, Moreira LB, Gus M, and Fuchs FD. Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension. Journal of Human Hypertension. 2005 Jun;19(6):451-455
The association of combined oral contraceptives (OC) with higher blood pressure (BP) may be attenuated with pills with smaller doses of oestrogen. The effect of stopping OC on BP of patients with hypertension was not described to date. In a cohort study of patients with hypertension, the authors identified 72 women using OC among 2112 patients seen from 1989 to 2002. Stopping hormonal contraception was recommended to all. The main outcome measurement was BP change in women who stopped (n = 44) and who did not stop (n = 28) OC, adjusting for baseline BP and age. Odds ratio for having a reduction of at least 20 mmHg in systolic blood pressure (SBP) or 10 mmHg in diastolic blood pressure (DBP), adjusting for age, change in weight and prescription of BP-lowering drugs, were calculated. The mean follow-up time was 6.6 ± 7.5 months. Participants who stopped and did not stop OC had similar baseline characteristics. The deltas of SBP (adjusted) were 15.1 plus or minus 2.6 mmHg in patients who stopped and 2.8 plus or minus 3.2 mmHg in patients who did not stop OC (P = 0.004). The corresponding values for DBP were 10.4 plus or minus 1.8 and 2.7 plus or minus 2.2 mmHg (P = 0.008), respectively. The odds ratio (adjusted) for having a decrease of at least 20 mmHg in SBP or 10 mmHg in DBP was 0.28 (95% CI 0.08-0.90) in patients who stopped OC. Stopping OC is an effective antihypertensive intervention in a clinical setting.

Link to CIRE evidence: http://www.infoforhealth.org/cire/cire_pub.pl?cire_input=COC.HBP..2791.3750.Y

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Volume 6, Number 5018 December 2006