Volume 7, Number 41
29 October 2007

Pop Reporter Tip: Your publications count! Many Pop Reporter subscribers let us know about their published research on global health and population. Just provide us with the link (we need the URL) to your recently published report, working paper, or article, and we’ll consider it for posting in an issue of The Pop Reporter.

ADOLESCENT HEALTH NEWS

Only 20 per cent of Thai teens know about AIDS
(News Article; Asia)
24 Oct 2007
The Nation (Thailand)

Uganda: One in five adolescents believe AIDS can be cured - survey
(News Article; Sub-Saharan Africa)
21 Oct 2007
Ouma F, New Vision (Kampala)

Uganda: Youths to be sensitised on HIV/Aids
(News Article; Sub-Saharan Africa)
22 Oct 2007
Nalugo M, Daily Monitor

Ghana: New district faces teenage pregnancy epidemic
(News Article; Sub-Saharan Africa)
19 Oct 2007
Zakaria M, Public Agenda (Accra)

ADOLESCENT HEALTH RESEARCH

How to end child marriage: Action strategies for prevention and protection
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
Washington, D.C., ICRW, 2007.
International Center for Research on Women
Child marriage perpetuates an unrelenting cycle of gender inequality, sickness and poverty. Its consequences ripple through the world's poorest regions devastating the lives of girls, their families and their communities. Despite nearly universal condemnation, this harmful tradition thrives: 51 million girls are married. If nothing changes, another 100 million girls will be married within the decade. This policy brief outlines what we can and should be doing to end child marriage: changing harmful cultural norms, supporting community programs, maximizing foreign assistance, increasing access to girls' education, providing young women with economic opportunities, addressing the unique needs of child brides and evaluating programs to determine what works.

A measure of success: Building monitoring and evaluation capacity in small, community-based programs. Lessons learned from three youth reproductive health programs in India
(Report; Asia)
(You need Adobe Acrobat Reader to access this document)
Washington, D.C., ICRW, 2007. 16 p.
International Center for Research on Women
Youth reproductive and sexual health has become a priority for policy makers, researchers and programmers in many developing countries. While numerous nongovernmental organizations (NGOs) are working -- often successfully -- to address youth's health needs, few have the data they need to show these programs are making a difference. Their limited financial and human capacity hinders systematic monitoring and evaluation (M&E) of their programs.

Program scan matrix on child marriage: A web-based search of interventions addressing child marriage
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
Washington, D.C., ICRW, 2007.
International Center for Research on Women
The international community and U.S. government are increasingly concerned about the prevalence of child marriage and its toll on girls in developing countries. One in seven girls in the developing world marries before 15. Nearly half of the 331 million girls in developing countries are expected to marry by their 20th birthday. At this rate, 100 million more girls -- or 25,000 more girls every day -- will become child brides in the next decade. Current literature on child marriage has primarily examined the prevalence, consequences and reported reasons for early marriage. Much less has been analyzed about the risk and protective factors that may be associated with child marriage. Also, little is known about the range of existing programs addressing child marriage, and what does and does not work in preventing early marriage. The work presented here investigates two key questions: What factors are associated with risk of or protection against child marriage, and ultimately could be the focus of prevention efforts? What are the current programmatic approaches to prevent child marriage in developing countries, and are these programs effective?

FAMILY PLANNING NEWS

South Africa: Further setback as more condoms recalled
(News Article; Sub-Saharan Africa)
23 Oct 2007
Thom A, Health-e (Cape Town)

Yemen: Family planning ups chances for happy married life
(News Article; Middle East)
23 Oct 2007
Ghaleb T, Yemen Observer

India: Check 'we two, our two', think nutrition
(News Article; Asia)
24 Oct 2007
Bagriya A, CNN-IBN

FAMILY PLANNING RESEARCH

Contraception among HIV concordant and discordant couples in Zambia: A randomized controlled trial
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Women's Health. 2007 Oct;16(8):1200-1210.
Mark KE | Meinzen-Derr J | Stephenson R | Haworth A | Ahmed Y
This study examines the impact of an intervention to promote dual-method contraceptive use among HIV concordant and discordant couples already using condoms for HIV prevention. A three-armed randomized, controlled trial was conducted at a voluntary HIV testing and counseling clinic in Lusaka, Zambia; 251 couples were randomized. Control couples received family planning education and referral to an outside clinic for nonbarrier contraceptives, intervention 1 couple received education and offer of contraceptives at the research clinic, and intervention 2 couples received intervention 1 plus a presentation designed to reduce outside pressures to conceive. There was a 3-fold higher contraceptive initiation rate in both intervention arms compared with the control arm. The interventions had no impact on incident pregnancy, largely due to high levels of contraceptive discontinuation and user failure. HIV-positive women who initially selected injectable contraception were less likely to abandon the method and significantly less likely to conceive than other study participants. Improving access to nonbarrier contraceptives among couples already using condoms for HIV prevention increased dual-method use. Selection of longer-acting injectable contraception was associated with lower pregnancy rates among HIV-positive women. Further research is needed to identify ways to help couples in this population continue to correctly use nonbarrier contraceptives.

Implants: The next generation
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
Population Reports. Series K: Injectables and Implants. 2007 Oct;(7):1-19.
Ramchandran D | Upadhyay UD
Related Tool: Implants: Tools for Providers
(You need Adobe Acrobat Reader to access this document)
Family planning programs around the world are introducing the new one- or two-rod implant systems Implanon(r), Jadelle(r), and in some countries Sino-Implant (II)(r). By 2008 Norplant(r), the six-capsule implant system, first introduced in mid-1980s, will no longer be available. Like Norplant, the new implants are highly effective, and like Norplant, they alter bleeding patterns. Their most important improvement over Norplant is easier and quicker insertion and removal. Sino-Implant (II) may also cost much less than other implants. The new implants are recommended for as much as three to five years of use, depending on the make. Thus they are particularly suitable for women who want to space births. Indeed, for many women implants are a convenient method. Once inserted into a woman's arm, the implants do not require any action by the user. Since implants do not contain estrogen, they do not decrease production of breast milk and thus are suitable for breastfeeding women. They are also a good choice for women who do not want more children but are not ready to opt for sterilization, which is permanent. With new implants making the method easier to provide, more programs may want to begin offering implants. Programs currently offering Norplant will need to consider how to make the transition to the newer implants and to meet possibly greater demand.

Long-term efficacy and tolerability of flutamide combined with oral contraception in moderate to severe hirsutism: A 12-month, double-blind, parallel clinical trial
(Abstract; subscription needed for full text; Europe)
Journal of Clinical Endocrinology and Metabolism. 2007;92(9):3446-3452.
Calaf J | Lopez E | Millet A | Alcaniz J | Fortuny A
Our objective was to test the efficacy and tolerability of three doses of flutamide (125, 250, and 375 mg) combined with a triphasic oral contraceptive (ethynylestradiol/levonorgestrel) during 12 months to treat moderate to severe hirsutism in patients with polycystic ovary syndrome or idiopathic hirsutism. We conducted a randomized, double-blind, placebo-controlled, parallel clinical trial. A total of 131 premenopausal women, suffering from moderate to severe hirsutism, were randomized to placebo or 125, 250, or 375 mg flutamide daily associated with a triphasic oral contraceptive pill. Hirsutism (Ferriman-Gallwey), acne and seborrhea (Cremoncini), and hormone serum levels were monitored at baseline and at 3 (except hormone serum levels), 6, and 12 months. Side effects and biochemical, hematological, and hepatic parameters were assessed. We used three-way ANOVA (subject, dose, and visit) with Scheffe´ adjustment for multiple comparisons or nonparametrical Friedman test and least-squares mean (paired data) and Kruskall-Wallis test for unpaired data analyses. We used x/2 or Fisher's test for categorical data. A total of 119 patients were included in the intention-to-treat analysis. All flutamide doses induced a significant decrease in hirsutism, acne, and seborrhea scores after 12 months compared with placebo without differences among dose levels. Similar related side effects were observed with placebo and 125 mg flutamide (12.5%), and slightly higher with 250 mg (17.3%) and 375 mg (21.2%). No statistically significant differences were observed either among doses or compared with placebo. Flutamide at 125 mg daily during 12 months was the minimum effective dose to diminish hirsutism in patients with polycystic ovary syndrome or with idiopathic hirsutism.

Silence, condoms, and masculinity: Heterosexual Japanese males negotiating contraception
(Abstract; subscription needed for full text; Asia)
Men and Masculinities. 2007 Oct;10(2):153-177.
Castro-Vazquez G | Kishi I
To investigate how some Japanese graduate students understand their masculine identity and negotiate sexual encounters and condom use, the authors interviewed sixty twenty-four-year-old to twenty-six-year-old heterosexual men during the summer of 1997. They used a set of three interviews covering three areas: home, school and/or job, and sexual life. In talking about sexual encounters and decision making about contraception, they found that male's responsibility and protection are considered the main reasons for keeping decisions under their control. Allusions to sexuality as an act closely related to reproduction make condoms to be regarded as a barrier, which negates the pleasure of sex and interferes with arousal. The authors did not find any reference to "safer sex." Inaccurate information and ignorance about methods of contraception seemed to be constant. The association of condoms with contraception seemed to deny the possibilities of condoms as protection against sexually transmitted infections (STIs).

GENDER and HEALTH NEWS

Congo-Kinshasa: Ituri - Ongoing sexual violence and brutality
(News Article; Sub-Saharan Africa)
24 Oct 2007
Medecins Sans Frontieres

Rwanda: Gender balance should be more emphasised in the rural areas
(News Article; Sub-Saharan Africa)
23 Oct 2007
Gahene A, New Times

Nigeria: Traditional birth attendants advocate ending harmful practices
(News Article; Sub-Saharan Africa)
23 Oct 2007
This Day

Botswana: Double edged sword for women migrants
(News Article; Sub-Saharan Africa)
23 Oct 2007
Kennedy B, The Voice

GENDER and HEALTH RESEARCH

Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland
(Research Article; Sub-Saharan Africa)
PLoS Medicine. 2007 Oct 23;4(10):e260.
Weiser SD | Leiter K | Bangsberg DR | Butler LM | Korte FP | Hlanze Z | Phaladze N | Iacopino V | Heisler M
Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27-2.36), sex exchange (AOR 1.84, 95% CI 1.74-1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03-2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24-2.28). Associations between food insufficiency and risky sex were much attenuated among men. Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women.

Leisure and religious activity participation and mental health: Gender analysis of older adults in Nepal
(Research Article; Asia)
BMC Public Health. 2007 Oct 22;7(1):299-332.
Gautam R | Saito T | Kai I
Involvement in activities has been found beneficial for improving the quality of life and successful aging for older adults. Little is known about the involvement in activities and depression of older adults in Asian developing countries, however. This study explores whether participation in leisure social and religious activities are related to depression and satisfaction with life in older adults of Nepal. Gender differences are also explored. The study sample was derived from a survey which aimed to determine the intergenerational relationships between older adults and their married son. A cross-sectional quantitative study of older adults sixty years and over in Nepal was conducted with face-to-face interviews using structured instruments. A convenience sample of 489 community dwelling older adults, 247 men and 242 women, were included in the study. The dependent variables, depression and satisfaction with life, were measured by the Geriatric Depression Scale (GDS) and Satisfaction With Life Scale (SWLS) respectively. Age, gender, marital status, education, perceived health, financial satisfaction, social support received and provided by older adults, and social activity were independent variables in the study. Saying prayers (B=-2.75; p less than 0.005), watching television and listening to the radio (B=-1.88; p less than 0.05), and participating in physical activity (B=-1.05; p less than 0.05) correlated to lower depression for older men, but only watching television and listening to the radio (B=-2.68; p less than 0.005) related to lower rates of depression for women. Socializing with others (B=1.22; p less than 0.05) was related to higher satisfaction with life for men, but for women visiting friends (B=1.29; p less than 0.05), socializing with others (B=1.45; p less than 0.005), and watching television and listening to the radio (B=0.92; p less than 0.05) related to improved satisfaction with life. Activity engagement significantly improved mental health of older adults. Specific activity participation was a significant correlate of lower levels of depression and higher levels of satisfaction with life among the older adults in Nepal. The findings explore the need for further research on activity participation in developing countries so that it can be useful for health care practioners and those involved in activities of aged population in developing countries.

HIV/AIDS and STIs NEWS

South Africa: Aids-vaccine trial volunteers warned of HIV-infection risk
(News Article; Sub-Saharan Africa)
24 Oct 2007
Kahn T, Business Day (Johannesburg)

Uganda: New anti-Aids policy
(News Article; Sub-Saharan Africa)
23 Oct 2007
Kiwawulo C, New Vision (Kampala)

Botswana: New drug to fight HIV resistance
(News Article; Sub-Saharan Africa)
23 Oct 2007
Chwaane T, Mmegi/The Reporter (Gaborone)

Botswana: MPs conclude HIV/Aids mission
(News Article; Sub-Saharan Africa)
23 Oct 2007
Kajevu Z, The Voice (Francistown)

Ghana: Pawa takes HIV/Aids campaign to schools
(News Article; Sub-Saharan Africa)
22 Oct 2007
Public Agenda (Accra)

HIV/AIDS and STIs RESEARCH

Challenges to pediatric HIV care and treatment in South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Infectious Diseases. 2007 Dec 1;196 Suppl 3:S474-S481.
Meyers T | Moultrie H | Naidoo K | Cotton M | Eley B
It is estimated that almost 300,000 children in South Africa have human immunodeficiency virus (HIV) infection. The disease is responsible for reversing decreases in child mortality. Few data exist evaluating the outcomes of the prevention of mother-to-child transmission of HIV (PMTCT) program, although PMTCT coverage appears to be low. Hospitals are still witnessing large numbers of admissions of HIV-infected children. Postnatal transmission of HIV is high, reflecting poor education of and support for women in their infant feeding choices. Too few infants and children are entering care through early diagnosis, which should be widely available. Cotrimoxazole prophylaxis coverage is inadequate, contributing to high morbidity and mortality in infants. The number of children receiving antiretroviral therapy (ART) is increasing steadily. However, significant inequalities in access to ART exist between and within provinces. Challenges for pediatric ART include a lack of sufficiently trained health care personnel and inadequate facilities, as well as the complexity of drug regimens and formulations. The compartmentalization of the ART rollout program hinders PMTCT and makes it difficult for children to be identified and referred into appropriate services. This article delineates the challenges to pediatric HIV care in South Africa and provides some practical recommendations to improve it.

Bacterial vaginosis and human immunodeficiency virus infection
(Abstract; subscription needed for full text; Global)
AIDS Research and Therapy. 2007 Oct 22;4(1):25.
Spear GT | St. John EP | Zariffard MR
Epidemiologic studies indicate that bacterial vaginosis (BV), a common alteration of lower genital tract flora in women, is associated with increased susceptibility to HIV infection. Other recent studies show that HIV is detected more frequently and at higher levels in the lower genital tract of HIV-seropositive women with BV. In vitro studies show that genital tract secretions from women with BV or flora associated with BV induce HIV expression in infected cells. The increased HIV expression appears to be due at least in part to activation through Toll-like receptors (TLR), specifically TLR2. Further research is needed to elucidate how BV contributes to HIV acquisition and transmission.

Caring for the caregivers: Models of HIV/AIDS care and treatment provision for health care workers in southern Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Infectious Diseases. 2007 Dec 1;196 Suppl 3:S500-S504.
Uebel KE | Nash J | Avalos A
Rollout of antiretroviral therapy (ART) has been successfully initiated in many countries, but concerns have been raised about the ability to meet treatment needs in areas where there is a high prevalence of human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) and where there are severe deficits in human-resource capacity. Many health care workers in resource-poor areas are experiencing burnout, struggling with external and internal stigma, failing to access HIV testing and treatment early, and subsequently becoming sick and dying of AIDS. Although the human-resource deficit is a well-recognized problem, little has been written about the programs that have been established to provide treatment for HIV-infected health care workers. In the present article, we describe staff care programs at McCord Hospital in Durban, South Africa; Mseleni Hospital in northern KwaZulu-Natal, South Africa; and the Tshedisa Institute in Gaborone, Botswana. These programs provide convenient, confidential, and holistic care for HIV-infected health care workers and health care workers affected by caring for HIV-infected patients. All 3 programs have noted that, among health care workers, there is increasing acceptance of counseling, testing, and treatment. We propose that there is an urgent need for the development of HIV/AIDS care and treatment programs for health care workers that remove barriers to access, provide confidentiality in testing, are conveniently located, and are integrated with tuberculosis programs and other treatment services.

Expanding access to voluntary HIV counselling and testing in sub-Saharan Africa: Alternative approaches for improving uptake, 2001 -- 2007
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Tropical Medicine and International Health. 2007 Nov;12(11):1-8.
Matovu JK | Makumbi FE
The changing face of the HIV/AIDS epidemic has resulted in new opportunities to increase access to voluntary HIV counselling and testing (VCT), especially during the past 7 years (2001-2007). As access to HIV treatment becomes more widely available in sub-Saharan Africa, the need for enhanced access to VCT would become even greater. When given the opportunity, many more adults in sub-Saharan African would accept VCT, and many clearly express the desire to learn their HIV sero-status. However, in most parts of sub-Saharan Africa, fewer than one in 10 people know their HIV status. Stigma, fear of receiving an HIV-positive status, lack of confidentiality, long distances to VCT sites, and long delays in returning HIV test results limit people's access to traditional VCT systems. Alternative VCT delivery models, such as mobile VCT, routine offer of VCT and home-based VCT increase access to and uptake of VCT. We recommend that these alternative models be implemented in more settings and on a much larger scale in sub-Saharan Africa, where VCT uptake rates remain low.

MATERNAL AND CHILD HEALTH NEWS

Mozambique: Most neonatal deaths preventable
(News Article; Sub-Saharan Africa)
23 Oct 2007
Agencia de Informacao de Mocambique

Malawi: Role of traditional birth attendants to change
(News Article; Sub-Saharan Africa)
19 Oct 2007
Integrated Regional Information Networks (IRIN)

Mozambique: Minister calls for change of mentality about maternal health
(News Article; Sub-Saharan Africa)
20 Oct 2007
Agencia de Informacao de Mocambique

Nigeria: Maternal deaths - need for emergency?
(News Article; Sub-Saharan Africa)
18 Oct 2007
This Day

London's maternal conference ends on hopeful note
(News Article; Global)
20 Oct 2007
Maphosa T, Voice of America

MATERNAL AND CHILD HEALTH RESEARCH

Comparison of the therapeutic efficacy of chloroquine and sulphadoxine-pyremethamine in children and pregnant women
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Tropical Medicine and International Health. 2007 Nov;12(11):1-10.
Tagbor H | Bruce J | Ord R | Randall A | Browne E
The objective was to compare the parasitological failure rates of under-fives and pregnant women with parasitaemia treated with chloroquine (CQ) or sulphadoxine-pyrimethamine (SP). During a clinical trial of CQ, SP, amodiaquine (AQ) and SP plus AQ combination for malaria treatment in pregnant women in Ghana, a parallel study of treatment of children below 5 years of age with symptomatic malaria with CQ and SP was undertaken. Four hundred and fifty pregnant women with malaria parasitaemia and 203 children with malaria parasitaemia were randomized to receive CQ or SP. They were followed up and parasitological failure by days 14 and 28 after the start of treatment was assessed. Polymerase chain reaction (PCR)-uncorrected parasitological failure rates by day 28 after the start of treatment with CQ were 58.5% (55/94), 38.5% (45/117), 31% (13/42) and 8.2% (4/49) in children, primigravidae, secundigravidae and multigravidae, respectively. For those treated with SP the rates by day 28 were 36.4% (32/88), 27.1% (29/107), 6.1% (3/49) and 3.8% (2/52) in children, primigravidae, secundigravidae and multigravidae, respectively. In both CQ and SP treatment arms, children were twice as likely to experience recrudescence as pregnant women (RR 2.1 [95% CI 1.6-2.6] P less than 0.0001) by day 28 after the start of treatment. Parasitological failure rates were significantly lower in asymptomatic pregnant women, particularly in multigravidae, compared with symptomatic children. Reliance on drug sensitivity results observed in children only to decide on antimalarial regimes for pregnant women may not be appropriate.

Baseline data from the Nyando integrated child health and education project -- Kenya, 2007
(Research Article; Sub-Saharan Africa)
MMWR. Morbidity and Mortality Weekly Report. 2007 Oct 22;56:1-4.
Approximately 10 million children aged less than 5 years die each year in developing countries. The leading infectious causes of these deaths include acute respiratory infections, diarrhea, measles, and malaria; malnutrition contributes to approximately 50% of these deaths. To address multiple conditions that contribute to mortality, child-survival programs require effective interventions and implementation strategies. To assess the effectiveness of multiple interventions, CDC has joined with partners to create the Nyando Integrated Child Health and Education (NICHE) project to combine several proven approaches to child survival in an impoverished rural district of western Kenya. During March-April 2007, CDC began the NICHE project with a baseline survey. This report summarizes preliminary data from that survey, which determined that 1) 86.1% of surveyed households were in the poorest Kenya socioeconomic quintile and 2) among children aged 6-35 months, 21.5% had experienced an acute respiratory infection and 9.1% had experienced diarrhea in the preceding 24 hours, 28.0% had chronic malnutrition, 66.2% had anemia, and 19.8% had a positive malaria smear. Comprehensive interventions will be needed to improve living conditions and reduce the risk for death before age 5 years among children in this population.

The CORONIS trial. International study of caesarean section surgical techniques: A randomised factorial trial
(Research Article; Global)
BMC Pregnancy and Childbirth. 2007 Oct 22;7:24.
Caesarean section is one of the most commonly performed operations on women throughout the world. Rates have increased in recent years - about 20-25% in many developed countries. Rates in other parts of the world vary widely. A variety of surgical techniques for all elements of the caesarean section operation are in use. Many have not yet been rigorously evaluated in randomised controlled trials, and it is not known whether any are associated with better outcomes for women and babies. Because huge numbers of women undergo caesarean section, even small differences in post-operative morbidity rates between techniques could translate into improved health for substantial numbers of women, and significant cost savings. CORONIS is a multicentre, fractional factorial randomised controlled trial and will be conducted in centres in Argentina, Ghana, India, Kenya, Pakistan and Sudan. Women are eligible if they are undergoing their first or second caesarean section through a transverse abdominal incision. Five comparisons will be carried out in one trial, using a 2x2x2x2x2 fractional factorial design. This design has rarely been used, but is appropriate for the evaluation of several procedures which will be used together in clinical practice. The interventions are: Blunt versus sharp abdominal entry; Exteriorisation of the uterus for repair versus intra-abdominal repair; Single versus double layer closure of the uterus; Closure versus non-closure of the peritoneum (pelvic and parietal); Chromic catgut versus Polyglactin-910 for uterine repair The primary outcome is: death or maternal infectious morbidity (one or more of the following: antibiotic use for maternal febrile morbidity during postnatal hospital stay, antibiotic use for endometritis, wound infection or peritonitis) or further operative procedures; or blood transfusion. The sample size required is 15,000 women in total; at least 7,586 women in each comparison. Improvements in health from optimising caesarean section techniques are likely to be more significant in developing countries, because the rates of postoperative morbidity in these countries tend to be higher. More women could therefore benefit from improvements in techniques.

POPULATION/FERTILITY/DEMOGRAPHY NEWS

Migrants set to boost Beijing population to 20 million by 2020
(News Article; Asia)
22 Oct 2007
China View

Boys pulling away from girls in Vietnam
(News Article; Asia)
18 Oct 2007
VietnamNetBridge

India: First, policy planning
(Editorial; Asia)
24 Oct 2007
Hindustan Times

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

Fertility, age structure and demographic transition in the former Soviet Republics: The Central Asian Republics in focus
(Abstract; subscription needed for full text; Global | Asia)
Population, Space and Place. 2007 Nov-Dec;13(6):433-454.
Gentile M
Synthesising data from Soviet and post-Soviet statistical sources, this paper provides a general overview of some of the major population trends of the Former Soviet Union with a special focus on the Central Asian Republics. The paper investigates the characteristics of the countries' vital statistics, paths of demographic transition and age structure as they have developed during the past 50-60 years. Particular emphasis is placed upon data and methodological problems encountered when doing population research on the region.

Population change due to geographic mobility in Albania, 1989 -- 2001, and the repercussions of internal migration for the enlargement of Tirana
(Abstract; subscription needed for full text; Europe)
Population, Space and Place. 2007 Nov-Dec;13(6):471-481.
Agorastakis M | Sidiropoulos G
Being a country in transition, Albania has sustained vast political and socio-economic changes over the past 15 years, mostly due to its engagement in democratisation and transformation to an open market economy. The pathway to transition has involved economic hardship and political unrest and has been accompanied by intense, large-scale, geographical mobility. This paper describes population change due to internal and international migration, 1989-2001, using Census data at district level. Its contribution is a technical one in applying a method that allows new estimates to be made of the scale of internal migration in Albania. Descriptive analysis of population changes in 36 Albanian districts, based on the last two censuses, lead to the identification of poles of attraction of internal migrants. Limited data concerning the 1989 Census and the 12 years between the censuses resulted in the creation of various indices that characterise internal migration, such as the Attraction and Expulsion Index stemming from the Origin-Destination Matrix of the districts. In addition an Index of Conservation of the population and an Index of External Migration were also derived at the district level. By considering internal and international migration as two separate phenomena, we emphasise their uniqueness in affecting population change in Albania. The District of Tirana, capital of Albania, absorbed the majority of the inflow of internal migrants. The latter part of the paper focuses on the population of Tirana as the county's major migration destination.

Caribbean transnational migration behaviour: Reconceptualising its 'strategic flexibility'
(Abstract; subscription needed for full text; Global | Central America and the Caribbean)
Population, Space and Place. 2007 Nov-Dec;13(6):415-431.
Conway D
Building on a considerable body of extant literature, and critically assessing its strong and weak (or overlooked) conceptual explanations and observations, this reconceptualisation of Caribbean transnational migrant behaviour updates the theoretical account of what is now an increasingly prevalent mobility process in the region. Utilising a structuration construct in which a key conceptual base is a behavioural (agency) notion of strategic flexibility, transnational migrants operating within Caribbean family networks are situated in their multi-local transnational social fields and resultant distant-but-linked community structures. A 'moorings' construct (first offered by Moon in 1995) further enables the portrayal of transnational migrants' personal interactions and migration behaviours in multicultural contexts. It allows the examination of their aggregate outcomes in relation to the micro- and mesostructural contexts of institutional/familial/communal decision-making and action as they play themselves out in continuous time. 'Homes' and 'homes away from home' provide the microgeographical 'roots' of migrants' transnational existence, of their experiences, identities, and degrees of national and transnational consciousness.

"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs/INFO Project. When you click on any link, 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.

Problems and comments can be addressed to mdadamo@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.

Forward this message to a friend who could benefit from INFO project activities!

The Pop Reporter--Delivering thought-provoking global health news to your desktop.

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 7, Number 4129 October 2007