6867 research outputs found
Sort by
Impacto multidimensional de la pandemia en las juventudes indígenas de Yucatán
No full textA pesar de que cada día se cuenta con más evidencia sobre el impacto de esta pandemia en las juventudes de México y el mundo, entender las múltiples dimensiones que afectan la vida de poblaciones específicas, como es la indígena, es prioritario para poder orientar y redirigir medidas y acciones institucionales para atender sus necesidades y garantizar sus derechos. Por ello, además de incorporar técnicas participativas con las juventudes indígenas, el estudio también incluye un mapeo de decisiones y medidas que el gobierno de Yucatán tomó durante 2021 para hacer frente a la emergencia sanitaria y reactivar la economía del estado. ¿Es relevante este apoyo y llega a las juventudes indígenas del estado?
---
Although evidence about the impact of COVID-19 on youth is rapidly increasing in Mexico and around the globe, there is insufficient evidence on the multiple ways the pandemic is affecting indigenous youth. In addition to incorporating participatory techniques with this population, the study includes a mapping of decisions and government measures undertaken by Yucatan State during 2021 to support them. The purpose of this report is to provide evidence to guide and redirect measures and institutional actions that target the needs of indigenous youth and guarantee their human rights
A research agenda to strengthen evidence generation and utilisation to accelerate the elimination of female genital mutilation
Get PDFThis ‘Global Research Agenda’, produced by UNFPA, UNICEF, WHO and Population Council–Kenya, outlines evidence gaps and research priorities that need to be addressed to eliminate FGM over the next five years and provides approaches to enable uptake and effective use of the evidence generated
Impacts of multisectoral cash plus programs on marriage and fertility after 4 years in pastoralist Kenya: A randomized trial
No full textPurpose: Early marriage has multiple drivers including cultural and social norms alongside lack of educational and economic opportunities. This complexity may explain why few programs have demonstrated marriage delays and suggests multisectoral interventions are necessary. This study examined a 2-year multisectoral program designed to delay marriage in a marginalized setting. Methods: The study used a prospective 80-cluster randomized trial following up 2,147 girls aged 11–14 years from 2015 to 2019. Interventions included community dialogs about inequitable gender norms (violence prevention), a conditional cash transfer (education), weekly group meetings with health and life skills training (health), and financial literacy training (wealth creation). Villages were randomized to one of four study arms: (1) violence prevention only (V-only); (2) violence prevention and education (VE); (3) VE and health (VEH); or (4) all four interventions (VEHW). We used analysis of covariance to estimate intent-to-treat impacts of each study arm with an education component, as well as a pooled study arm combining the VE, VEH, and VEHW arms, in reference to V-only, 2 years after the intervention ended, when girls were 15–18 years old. Results: There were small but insignificant reductions on primary outcomes in unadjusted analyses that were larger and significant in adjusted analyses. Effects were particularly large for girls not in school at baseline—the pooled study arm reduced marriage by 18.0 and pregnancy by 15.6 percentage points, a relative reduction of 34% and 43%, respectively. Discussion: The article demonstrates the potential for multisectoral interventions with education components to delay early marriage in an impoverished, socially conservative, pastoral setting
Prevalence of metabolic syndrome among adolescents in India: A population-based study
No full textBackground: In India, the prevalence of overweight among adolescents is on the rise, setting the stage for an increase in metabolic syndrome (MS). This paper presents the national prevalence of MS in adolescents in India. Methods: A nationally representative data of adolescents (10–19 years) from the Comprehensive National Nutrition Survey was used. MS was defined based on the NCEP–ATP III criteria for adolescents. Bivariate analysis was used to report socio-demographic differentials in prevalence and to assess interstate variability. Multivariate logistic regression model was constructed to measure the association between socio-demographic characteristics and prevalence of MS. Census data from 2011 was projected to 2017 to calculate burden. Results: The prevalence of MS was 5.2% among adolescents. 11.9%, 15.4%, 26.0%, 31.9% and 3.7% had central obesity, high blood pressure, hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, respectively. The prevalence was higher among males (5.7% vs. 4.7%, adjusted odds ratio (AOR): 1.3, 95% confidence interval [CI]: 1.0, 1.6), those residing in urban areas (7.9% vs 4.2%, AOR: 1.4, 95% CI: 1.1, 1.8), and from wealthier households as compared to their counterparts (8.3% vs. 2.4%, AOR: 3.4, 95% CI: 2.1, 5.5). There was wide interstate variability in the prevalence of MS (0.5% – 16.5%). In 2017, 14.2 million adolescents had MS in India. Conclusions: The prevalence of MS among adolescents in India is low and clustered in urban areas and richer households. Early prevention interventions promoting a healthy lifestyle, especially in high prevalence areas, are needed to keep MS from becoming a public health issue
Health worker perceptions of stigma towards Zambian adolescent girls and young women: A qualitative study
No full textBackground: The high prevalence of HIV among adolescent girls and young women aged 15–24 in Eastern and Southern Africa indicates a substantial need for accessible HIV prevention and treatment services in this population. Amidst this need, Zambia has yet to meet global testing and treatment targets among adolescent girls and young women living with HIV. Increasing access to timely, high-quality HIV services in this population requires addressing the intensified anticipated and experienced stigma that adolescent girls and young women often face when seeking HIV care, particularly stigma in the health facility setting. To better understand the multi-level drivers and manifestations of health facility stigma, we explored health workers’ perceptions of clinic- and community-level stigma against adolescent girls and young women seeking sexual and reproductive health, including HIV, services in Lusaka, Zambia. Methods: We conducted 18 in-depth interviews in August 2020 with clinical and non-clinical health workers across six health facilities in urban and peri-urban Lusaka. Data were coded in Dedoose and thematically analyzed. Results: Health workers reported observing manifestations of stigma driven by attitudes, awareness, and institutional environment. Clinic-level stigma often mirrored community-level stigma. Health workers clearly described the negative impacts of stigma for adolescent girls and young women and seemed to generally express a desire to avoid stigmatization. Despite this lack of intent to stigmatize, results suggest that community influence perpetuates a lingering presence of stigma, although often unrecognized and unintended, in health workers and clinics. Conclusions: These findings demonstrate the overlap in health workers’ clinic and community roles and suggest the need for multi-level stigma-reduction approaches that address the influence of community norms on health facility stigma. Stigma-reduction interventions should aim to move beyond fostering basic knowledge about stigma to encouraging critical thinking about internal beliefs and community influence and how these may manifest, often unconsciously, in service delivery to adolescent girls and young women
Challenges and measures to improve interviewers’ bias in large-scale demographic surveys in India: Some suggestions based on analysis of NFHS-4 data
No full textWith increasing demand for more data at local level, the health surveys have expanded both their coverage and areas of inquiry. To cater to this demand, the sample size in National Family Health Surveys (NFHS) increased significantly and thereby raised concerns regarding quality. The present paper attempts to investigate the presence of interviewers\u27 bias in the birth history data in 4th round of NFHS in four states—Haryana, Odisha, Tamil Nadu and Maharashtra. The paper suggests a practical procedure that can be used to promote judicious supervision to minimize the non-sampling errors in future rounds of NFHS or other large-scale demographic surveys. Findings show that the outlier-based approach adopted in the paper helps in detecting the presence of interviewers’ bias in the enumeration of total children ever born as well as those born during 5 years prior to the survey – two critical variables in demographic surveys. Among the four study states, the extent of the bias was highest in Tamil Nadu. In fact, in Haryana, the data was found to be free of any bias in the recording of the occurrence of births in 5 years preceding the survey. It is suggested that it should be feasible to employ the outlier-based approach early when fieldwork is in progress, along with usual practice of generating field check tables. This approach would have the potential to not only streamline the supervision but also help salvage the data from any biasing effects. The biasing effects, if any and found early during fieldwork can be rectified by suitably arranging the necessary revisits to the respondents
Building the Adolescent Indicators and Gender Gaps Dashboard
Get PDFThe Adolescent Atlas for Action (A3) is a suite of tools that summarizes the lives and needs of adolescents around the world to promote evidence-based decision-making. Through accessible and easy-to-grasp data just one click away, the A3 bridges the gap between decisionmakers and evidence to inform policies and programs. The Adolescent Indicators dashboard and Gender Gaps dashboard are two simple but dynamic dashboards that provide insights on the lives of adolescent girls and boys living in low- and middle income countries (LMICs) across 9 thematic domains of wellbeing. The Adolescent Indicators dashboard showcases how adolescent girls or boys are faring under each theme, globally and subnationally, as well as how the indicators across domains are interlinked. The Gender Gaps dashboard allows you to compare gaps by domain and indicator, both globally and subnationally. This brief elaborates on the methodology for developing both dashboards
Experience of care of hospitalized newborns and young children and their parents: A scoping review
No full textIntroduction: Several global initiatives put parent involvement at the forefront of enabling children\u27s well-being and development and to promote quality of care for newborns and hospitalized young children aged 0-24 months. Scanty evidence on mistreatment such as delays or neglect and poor pain management among newborns exists, with even less exploring the experience of their parents and their hospitalized young children. To address this gap, authors reviewed research on experience of care for hospitalized young children and their parents, and potential interventions that may promote positive experience of care. Methods: A scoping review of English language articles, guidelines, and reports that addressed the experiences of care for newborns and sick young children 0-24 months in health facilities was conducted. Multiple databases: PubMed, PROSPERO, COCHRANE Library and Google Scholar were included and yielded 7,784 articles. Documents published between 2009 and November 2020, in English and with evidence on interventions that addressed family involvement and partnership in care for their sick children were included. Results: The scoping review includes 68 documents across 31 countries after exclusion. Mistreatment of newborns comprises physical abuse, verbal abuse, stigma and discrimination, failure to meet professional standards, poor rapport between providers and patients, poor legal accountability, and poor bereavement and posthumous care. No literature was identified describing mistreatment of hospitalized children aged 60 days- 24 months. Key drivers of mistreatment include under-resourced health systems and poor provider attitudes. Positive experience of care was reported in contexts of good parent-provider communication. Three possible interventions on positive experience of care for hospitalized young children (0-24 months) emerged: 1) nurturing care; 2) family centered care and 3) provider and parental engagement. Communication and counseling, effective provider-parental engagement, and supportive work environments were associated with reduced anxiety and stress for parents and hospitalized young children. Few interventions focused on addressing providers\u27 underlying attitudes and biases that influence provider behaviors, and how they affect engaging with parents. Conclusion: Limited evidence on manifestations of mistreatment, lack of respectful care, drivers of poor experience and interventions that may mitigate poor experience of care for hospitalized young children 0-24 months especially in low resource settings exists. Design and testing appropriate models that enhance socio-behavioral dimensions of care experience and promote provider-family engagement in hospitals are required
Multisectoral, combination HIV prevention for adolescent girls and young women: A qualitative study of the DREAMS implementation trajectory in Zambia
No full textObjective: To identify solutions to the implementation challenges with the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women) Partnership in Zambia, this study examines the rollout and evolution of the DREAMS Partnership’s implementation. Methods: In September–October 2018, implementing partner (IP) staff (n=15) and adolescent girls and young women (AGYW) participating in DREAMS programming (n=32) completed in-depth interviews exploring early rollout and scale-up of DREAMS, experiences with program participation, and shifting service delivery approaches in response to emerging implementation challenges. Inductive and deductive thematic analysis of 47 interviews uncovered salient service delivery facilitators and barriers in the first 2 years of DREAMS implementation, which were subsequently mapped onto the following domains: reach, effectiveness, adoption, implementation, and maintenance. Results: Key implementation successes identified by IP staff included using standardized recruitment and risk assessment tools across IP organizations, using a mentor model for delivering program content to AGYW, and offering centralized service delivery at venues accessible to AGYW. Implementation challenges identified early in the DREAMS Partnership’s lifecycle were rectified through adaptive service delivery strategies. Monthly in-person coordination meetings were established to resolve IP staff jurisdictional disputes over recruitment and target setting. To address high participant attrition, IP staff adopted a cohort approach to sequentially recruit AGYW who enrolled together and provided social support to one another to sustain involvement in DREAMS programming. Prominent barriers to implementation fidelity included challenges recruiting the highest-risk AGYW (e.g., those out of school), limited resources to incentivize participation by young women, and inadequate planning to facilitate absorption of individual DREAMS interventions by the public sector upon project conclusion. Conclusions: Delivering multisectoral HIV prevention programs like DREAMS with fidelity requires a robust implementation infrastructure (e.g., adaptable workplans and harmonized record management systems), early coordination between IP organizations, and sustained financial commitments from donors
Impact of community and provider-driven social accountability interventions on contraceptive uptake in Ghana and Tanzania
No full textBackground: Social accountability, which is defined as a collective process for holding duty bearers and service providers to account for their actions, has shown positive outcomes in addressing the interrelated barriers to quality sexual and reproductive health services. The Community and Provider driven Social Accountability Intervention (CaPSAI) Project contributes to the evidence on the effects of social accountability processes in the context of a family planning and contraceptive programme. Methods: A quasi-experimental study utilizing an interrupted time series design with a control group (ITS-CG) was conducted to determine the actual number of new users of contraception amongst women 15–49 years old in eight intervention and eight control facilities per country in Ghana and Tanzania. A standardized facility audit questionnaire was used to collect facility data and completed every year in both intervention and control groups in each country from 2018–2020. Results: In Ghana, the two-segmented Poisson Generalized Estimating Equation (GEE) model demonstrated no statistically significant difference at post-intervention, between the intervention and control facilities, in the level of uptake of contraceptives (excess level) (p-value = 0.07) or in the rate of change (excess rate) in uptake (p-value = 0.07) after adjusting for baseline differences. Similarly, in Tanzania, there was no statistical difference between intervention and control facilities, in the level of uptake of contraceptives (excess level) (p-value = 0.20), with the rate of change in uptake (p-value = 0.05) after adjusting for the baseline differences. There was no statistical difference in the level of or rate of change in uptake in the two groups in a sensitivity analysis excluding new users recruited in outreach activities in Tanzania. Conclusions: The CAPSAI project intervention did not result in a statistically significant increase in uptake of contraceptives as measured by the number of or increase in new users. In evaluating the impact of the intervention on the intermediate outcomes such as self-efficacy among service users, trust and countervailing power among social groups/networks, and responsiveness of service providers, cases of change and process evaluation should be considered. Trial registration: The CaPSAI Project has been registered at the Australian New Zealand Clinical Trials Registry (ACTRN12619000378123, 11/03/2019)