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Criação e implementação de uma rede de jovens para a prevenção do VIH: Um estudo de caso do envolvimento significativo dos jovens no Zimbabué
Get PDFImproving acceptability, use, and continuation of IUD in Bangladesh
Get PDFAlthough the nonhormonal copper intra-uterine device (IUD) is the safest and cheapest long-acting contraceptive method, its use has been declining day-by-day in Bangladesh. Less than 1% of married women 15-49 years of age who currently use a contraceptive method use an IUD. Researchers conducted a quasi-experimental pre-post-test non-equivalent control group designed study to test a simple intervention intended to increase acceptance, use, and continuation of the IUD among married women of reproductive age (18 to 45 years) in Keraniganj, Savar, and Nawabganj Upazilas (sub-districts) in Bangladesh. The study was conducted in a real-life situation of Union Health and Family Welfare Centers from May 2021 to September 2023. This report summarizes the findings from the intervention study
Herpes simplex virus type 2 prevalence and association with inflammatory cytokines among sexual and gender minorities living with and without HIV-1 from Lagos, Nigeria
No full textHerpes simplex virus type 2 (HSV-2) is common globally and contributes significantly to the risk of acquiring HIV-1, yet these two sexually transmitted infections (STIs) have not been sufficiently characterized for sexual and gender minorities (SGM) across sub-Saharan Africa. To help fill this gap, we performed a retrospective study using plasma and serum samples from 183 SGM enrolled at the Lagos site of the TRUST/RV368 cohort in Nigeria, assayed them for HSV-2 antibodies with the Kalon ELISA and plasma cytokines and chemokines with Luminex, and correlated the findings with HIV-1 viral loads and CD4 counts. We found an overall HSV-2 prevalence of 36.6% (49.5% and 23.9% among SGM with and without HIV-1, respectively, p \u3c 0.001). Moreover, HSV-2 positive status was associated with high circulating concentrations of CCL11 among antiretroviral therapy (ART) treated (p = 0.031) and untreated (p = 0.015) participants, and with high concentrations of CCL2 in the untreated group (p = 0.004), independent of VL. Principal component analysis revealed a strong association of cytokines with HIV-1 viral load independent of HSV-2 status. In conclusion, our study finds that HSV-2 prevalence among SGM with HIV-1 is twice as high than HSV-2 prevalence among SGM without HIV-1 in Lagos and suggests that this is associated with higher levels of certain systemic cytokines. Additional work is needed to further characterize the relationship between HSV-2 and HIV-1 in SGM and help develop targeted therapies for co-infected individuals
Calling Attention to Experiences of Care for Hospitalized Newborns and Young Children to Improve Newborn and Child Survival
Get PDFSetting up the Girl Roster\u3csup\u3eTM\u3c/sup\u3e: Technical Guidance
No full textGirls—especially the most socially and economically marginalized—are often cited as key beneficiaries of health and development initiatives. However, unless they are subject to specific, intentional recruitment efforts, they are likely to receive a disproportionately low, even negligible, share of the benefits. Good intentions aside, some “youth”, “adolescent”, or “girls’” programs do not apply targeted, evidence-based practices and therefore reach fewer girls than they intended or could. Some programs, whether intentional or not, end up directing the majority of benefits to those who are better off and not to those most in need.
The Girl Roster was developed by the Population Council, in close collaboration with the Women’s Refugee Commission and other operational organizations of the Girls in Emergencies Collaborative. The tool is a user-friendly, efficient, and cost-effective way to collect program-relevant information about girls in the community using a mobile phone-based questionnaire (and where resources do not permit, paper and pencil). It enables its users to see a fuller view of girls’ lived realities in defined program areas, comprised of easily walkable or travelable communities. Within those boundaries, the identified girls are sorted into meaningful segments by age; school-going; marital, and childbearing status; and living-arrangements (living with two, one, or neither parents/guardian). The process of implementing the tool, as well as the information collected itself, helps local practitioners, with additional community dialogue and engagement, design prototype or modify existent programs serving different segments of girls.
This technical guidance will instruct you in how to: set up all platforms for the Girl Roster including your phones/tablets, Kobo Toolbox where your blank Girl Roster questionnaire and completed data are stored, and how to generate Girl Roster results in output tables
The salutogenic approach to childcare in sub-Saharan Africa: A focus on children who thrive in the face of adversity
No full textIn this chapter, the authors examine the potential of a salutogenic orientation to childcare in poor urban African settings. There is an, as of yet, limited but growing body of evidence on the application of the salutogenic model in research amongst children who experience adversity in Sub-Saharan Africa (SSA). The authors discuss the need for more childcare research in Africa, using a salutogenic lens. As most salutogenic research works with children have been conducted on other continents, the authors call for collaborations between African scholars and salutogenesis researchers in other parts of the world
Bad COVID public health messaging is blocking our path to a “new normal”
Get PDFIn this Scientific American opinion article, Thoai Ngo argues for critical long-term changes in how the United States disseminates public health information
Evaluation of a gender synchronized family planning intervention for married couples in rural India: The CHARM2 cluster randomized control trial
No full textBackground: Despite calls for gender transformative family planning interventions to increase male engagement and female reproductive agency, there is limited research involving rigorous evaluation of the integration of these approaches. CHARM2 (counseling Husbands and wives to Achieve Reproductive Health and Marital Equity) builds upon a prior three-session male engagement intervention by integrating female-focused sessions emphasizing women\u27s choice and agency (i.e., gender synchronization). We hypothesized that CHARM2 participants will be more likely to report marital contraceptive use and communication and women\u27s contraceptive agency, and less likely to report unintended pregnancy, relative to participants in the control condition. Methods: We conducted a two-armed cluster randomized controlled trial evaluating the effects of CHARM2 on marital contraceptive use, communication, decision-making; women\u27s contraceptive agency, and pregnancy among young married couples in rural Maharashtra, India (ClinicalTrials.gov #NCT03514914, complete). 40 geographic clusters, defined based on the catchment areas of subcenter health facilities (the most proximal level of community health care within India\u27s public health system) were randomized to control (n = 20) and intervention (n = 20). We assigned all participants within that geographic cluster to the corresponding cluster treatment condition; participants, investigators, and study staff were not masked to treatment assignment. Eligibility criteria included wife aged 18–29, couple residing together for at least six months with no plan for migration, and neither spouse sterilized or infertile. The CHARM2 intervention included five provider-delivered sessions on gender equity and family planning, two delivered in parallel to husbands and wives separately by gender-matched providers, and one final joint session, delivered within the four months subsequent to baseline survey. We conducted surveys and pregnancy testing at baseline and 9-month and 18-month follow-up. We used difference-in-differences multilevel mixed effects logistic regressions to assess CHARM2 effects on marital contraceptive use and communication, and women\u27s contraceptive agency; we used single time point mixed effects logistic regressions for pregnancy outcomes. All analyses used an intention-to-treat approach. Findings: 1201 couples were recruited between September 2018 and June 2019; 600 intervention and 601 control. All couples were included in outcome analyses. Full couple retention was 90·2% (n = 1083) at 9-month follow-up and 90·5% (n = 1087) at 18-month follow-up. Modern contraceptive use was higher among intervention participants at 9-month but not 18-month follow-up (9-month adjusted ratio of odds ratio [AROR] 1·5, 95% CI 1·03–2·3; 18-month AROR 0·8, 95% CI 0·4–1·4). Communication (9-month AROR 1·9, 95% CI 1·0–3·6; 18-month AROR 2·7, 95% CI 1·5–4·8) and agency (9-month AROR 5·1, 95% CI 1·2–22·4; 18-month AROR 8·1, 95% CI 1·4–48·2) both improved at both time points. There was no significant difference in pregnancy between groups over the 18-month period (AOR 0·8, 95% CI 0·7–1.1) However, for women who expressed fertility ambivalence at baseline, unintended pregnancy was marginally less likely among intervention participants (47% vs 19%) (p = 0·07). There were no reported adverse events. Interpretation: The CHARM2 intervention offers a scalable model to improve contraceptive use, communication, and agency and possibly decrease unplanned pregnancies for couples in rural India
Expressions of power in health care providers’ experiences and behavior
Get PDFThis brief describes a secondary cross-country qualitative analysis that investigated how power manifests and can be shifted to optimize provider behavior change (PBC) approaches across health areas and geographical contexts. Breakthrough RESEARCH explored how four interrelated domains of power are differentially experienced by health care providers (HCPs) based on one’s position and function within the health system in Kenya, Malawi, Madagascar, and Togo. The results are intended to help promote quality reproductive, maternal, and newborn care by offering insights for PBC programming. Key findings showed that HCPs’ power was often constrained by limited access to resources, opportunities for advancement, and supportive supervision and restrictive or shifting institutional policies, and that integrating power-enhancing, equity-promoting approaches in PBC programming can improve collaboration and feedback among HCPs and offer structural changes for quality. Further incorporation and investigation of power domains into implementation research design, intervention selection, and PBC outcomes—including shifting power dynamics among HCPs—is needed