6867 research outputs found
Sort by
Practice and development of male contraception: European Academy of Andrology and American Society of Andrology guidelines
No full textBackgrounds: Despite a wide spectrum of contraceptive methods for women, the unintended pregnancy rate remains high (45% in the US), with 50% resulting in abortion. Currently, 20% of global contraceptive use is male-directed, with a wide variation among countries due to limited availability and lack of efficacy. Worldwide studies indicate that \u3e50% of men would opt to use a reversible method, and 90% of women would rely on their partner to use a contraceptive. Additional reasons for novel male contraceptive methods to be available include the increased life expectancy, sharing the reproductive risks among partners, social issues, the lack of pharma industry involvement and the lack of opinion makers advocating for male contraception. Aim: The present guidelines aim to review the status regarding male contraception, the current state of the art to support the clinical practice, recommend minimal requirements for new male contraceptive development and provide and grade updated, evidence-based recommendations from the European Society of Andrology (EAA) and the American Society of Andrology (ASA). Methods: An expert panel of academicians appointed by the EAA and the ASA generated a consensus guideline according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system. Results: Sixty evidence-based and graded recommendations were produced on couple-centered communication, behaviors, barrier methods, semen analysis and contraceptive efficacy, physical agents, surgical methods, actions before initiating male contraception, hormonal methods, non-hormonal methods, vaccines, and social and ethical considerations. Conclusion: As gender roles transform and gender equity is established in relationships, the male contribution to family planning must be facilitated. Efficient and safe male-directed methods must be evaluated and introduced into clinical practice, preferably reversible, either hormonal or non-hormonal. From a future perspective, identifying new hormonal combinations, suitable testicular targets, and emerging vas occlusion methods will produce novel molecules and products for male contraception
Strengthening community midwives to tackle gender-based vulnerabilities during the 2022 floods in Pakistan—Lessons learned for future natural disasters
No full textSeveral countries across different continents experienced severe flooding in 2022, including Pakistan. Given the greater frequency and affliction of natural disasters like flooding in an increasing number of countries, we share lessons from the experience of Pakistan in helping the most vulnerable populations through community-based health workers
Changes in migration determinants along the urban hierarchy in China
No full textThis paper examines trends of internal migration in China across two decades, with a focus on changes in socio-demographic predictors of origin-destination patterns. We use four microdata samples of the China decennial census and minicensus. After introducing a description of overall internal migration trends and providing a discussion of the utility of the urban hierarchy framework, we proceed with a two-step statistical approach. We look first descriptively at interprovincial bilateral migration flows. We then turn to a multivariate analysis of outmigration and destination selection as a function of age, sex, educational attainment and hukou status. Our results reveal the differential attractiveness of origins (for retention) and destinations by demographic characteristics and position within the urban hierarchy, and also indicate shifts in the strength of predictors over time. Greater educational attainment and urban hukou strongly favour the selection of a destination within the top levels of the urban hierarchy. Over time, selectivity by gender weakens. Although urban hukou and schooling become slightly less powerful predictors of interprovincial migration, attractiveness of top-tier destinations increases once individual demographic characteristics are controlled
Prevalence and correlates of vitamin D deficiency among children and adolescents from a nationally representative survey in India
No full textObjective: To evaluate the prevalence of vitamin D deficiency (VDD) and its correlates among apparently healthy children and adolescents. Methods: We carried out a secondary analysis of data of Comprehensive National Nutrition Survey 2016–18 to analyze the prevalence and predictors of VDD among Indian children and adolescents. Results: The over-all prevalence of VDD in preschool children (1–4 years), school age (5–9 years) children, and adolescents (10–19 years) was 13.7%, 18.2%, and 23.9%, respectively. Age, living in urban area, and winter season were significantly associated with VDD. Vegetarian diet and high-income households were the main risk factors observed in 5–19 years age category. Female sex and less than three hours of physical activity/week were independent risk factors among adolescents. Conclusion: The prevalence and determinants of VDD across different age-groups are reported, and these should be interpreted and addressed to decrease the burden of VDD in India
Acceptance of the Advocacy Core Group approach in promoting integrated social and behaviour change for MNCH+N in Nigeria: A qualitative study
No full textObjective: This paper examines the acceptance of the Advocacy Core Group (ACG) programme, a social and behaviour change intervention addressing maternal, newborn, child health and nutrition (MNCH+N) in Bauchi and Sokoto states, with an additional focus on the perceived endorsement of health behaviours by social networks as a potential factor influencing acceptance. Design: This study used the qualitative social network analysis approach and used in-depth interviews to collect data from 36 participants across Bauchi and Sokoto states. Setting: This study was conducted in selected communities across Bauchi and Sokoto states. Participants: A purposive sample of 36 participants comprised of men and women aged 15-49 years who have been exposed to the ACG programme. Results: Programme beneficiaries actively engaged in various ACG-related activities, including health messaging delivered through religious houses, social gatherings, home visits, community meetings and the media. As a result, they reported a perceived change in behaviour regarding exclusive breast feeding, antenatal care visits, family planning and malaria prevention. Our findings indicated consistent discussions on health behaviours between programme beneficiaries and their network partners (NPs), with a perceived endorsement of these behaviours by the NPs. However, a potential negative factor emerged, whereby NPs exhibited perceived disapproval of key behaviours, which poses a threat to behaviour adoption and, consequently, the success of the ACG model. Conclusions: While findings suggest the successful implementation and acceptance of the model, it is important to address possible barriers and to further explore the socially determined acceptance of MNCH+N behaviours by NPs. Interventions such as the ACG model should mobilise the networks of programme participants, particularly those with decision-making power, to improve the uptake of health behaviours
Population Council Kenya Annual Report 2023: Amplifying the Impact of Evidence-Based Programs in Kenya and Eastern Africa
Get PDFA glass ceiling at the playhouse? Gender gaps in public and private preschool enrollment in India
No full textIndia has reduced male-biased gender gaps in primary school enrollment and progression rates in recent years. However, patterns of early childhood education enrollment, selection of preschool, and related gender gaps remain inadequately studied. This study uses data from India\u27s National Family Health Survey (2019–2021), which collected preschool information for children aged 2–4 years, to examine female-male gaps in preschool enrollment. An estimated 40% of children were enrolled in preschools, and among them, 28% were enrolled in private preschools, with substantial variation across states. State, district, and household fixed-effects regressions, which accounted for a wide range of background characteristics of children, show that while preschool enrollment rates were 3.6–4.1% higher among girls than boys, girls were 9.3–16.7% less likely to be enrolled in higher quality private preschools. Using a mother fixed-effects regression, we found that while there was no gender gap in siblings’ preschool enrolment rates, girls were 18.6% less likely to be enrolled in private preschool than their brothers. The relative bias towards males in private preschool enrollment decreased with standard of living and maternal schooling levels. The findings indicate gender discrimination in enrollment in higher quality private preschool against young girls
Lessons learnt from community referral and follow up of sick young infants with possible severe bacterial infection in Turkana County, Kenya
No full textIntroduction: Management of possible severe bacterial infections in young infants (0–59 days) requires timely identification of danger signs and prompt administration of efficacious antibiotic treatment. The Possible Severe Bacterial Infection guidelines underscore the importance of close follow up in an outpatient basis to ensure treatment adherence and early detection of illness-related complications. The purpose of this study was to strengthen the follow up and referral of sick young infants on day 4 and 8 by introducing community-led interventions that facilitated community health volunteers to identify sick young infants, conduct community reviews, link data with responsive facilities, and refer appropriately. Methods: Six health facilities were included in a longitudinal, descriptive, mixed methods approach weaved around an initial formative context assessment and three-monthly assessments between October 2019 to January 2020 with a endline assessment in August 2020. Quantitative data was extracted from facility registers to identify gaps in follow up and referral feasibility. Qualitative data was through focus group discussions with community health volunteers and key informant interviews with frontline providers. Results: Qualitative data provided insights into key barriers and facilitators of community follow up and referral. Barriers include community socio-cultural practices, competing tasks, dysfunctional community referral pathway, drivers of common infections, and unavailability of essential commodities. Key facilitators entail indication of competency in identification of danger signs in sick young infants, presence of older women, men, and community resource persons that can leveraged on in community engagement and sensitization, and mothers are the primary decision makers in care seeking. There was increased utilization of decision support tools and an increase in the number of sick young infants managed in dispensaries. The COVID-19 pandemic however negatively impacted community follow up and referral of sick young infants. Conclusion: Essential barriers and facilitators to follow up and community referral entwined with facility-based vulnerabilities were highlighted. A two-pronged intervention on improving communication, linkage and subsequent follow up of sick young infants was employed in the six participating facilities. The feasibility, adoption, and fidelity of strengthening community facility linkage through integrated communication strategies was documented, indicative of a successful community-facility linkage in dispensaries and health centers despite the effects of the COVID-19 pandemic
How can I tell my mom such a story? : Sexual violence against children in Kenya
No full textWorldwide, 120 million girls and a considerable (though lower) number of boys are estimated to have experienced sexual violence. Sexual violence against children (SVAC) is associated with a range of negative, long-term health effects, necessitating a better understanding of barriers and enablers associated with such violence. This chapter pieces together the socio-psychological context in which SVAC occurs in Kenya to help elucidate barriers and enablers specifically associated with the perpetration of SVAC, and with child survivor disclosure of SVAC. The chapter draws on qualitative data—a total of 222 descriptive fieldnotes recorded by trained psychologists in the course of screening for SVAC in two Nairobi primary schools—to explore, describe, and make sense of the socio-psychological context in which children experience sexual violence, and to provide pointers on effective intervention approaches
The role of social accountability in changing service users’ values, attitudes, and interactions with the health services: A pre-post study
No full textThis study evaluated the effects of community engagement through social accountability on service users’ values, attitudes and interactions. We conducted a pre–post study of the community and provider driven social accountability intervention (CaPSAI) over a 12-month period among 1,500 service users in 8 health facilites in Ghana and in Tanzania (n = 3,000). In both countries, there were significant improvements in women’s participation in household decision-making and in how service users’ perceive their treatment by health workers. In both settings, however, there was a decline in women’s knowledge of rights, perception of service quality, awareness of accountability mechanisms and collective efficacy in the community. Though CaPSAI intervention set out to change the values, attitudes, and interactions between community members and those providing contraceptive services, there were changes in different directions that require closer examination