Your search found 707 Results
Public expectations concerning confidentiality protection of adolescents’ sexual and reproductive health care in Lithuania: Findings of the surveys conducted in 2005 and 2012.
European Journal of Contraception and Reproductive Health Care. 2014 Apr; 19(2):102-107.OBJECTIVE: An adolescent's right to confidential healthcare is protected by international law and professional consensus. However, parental and social support for confidential sexual and reproductive health (SRH) services, in particular, varies greatly. This study documents Lithuanian residents' expectations with regard to confidentiality protection for adolescents in this domain, and explores the factors related to the diversity of these expectations. METHODS: Two national surveys of Lithuanian residents completed in 2005 and 2012 using anonymous questionnaires. Participants rated their expectations for confidentiality using a five-point Likert scale for eight types of SRH consultations. RESULTS: Public anticipation for confidentiality depended on whether issues related to sexual behaviour or to its consequences were addressed during adolescent consultation. Only younger respondents had higher expectations for confidentiality in both contexts. Public expectations regarding confidentiality were less demanding in 2012 than in 2005. CONCLUSIONS: The expectation of confidentiality protection was greater for topics related to sexual behaviour than for the consequences of sexual behaviour, such as pregnancy, abortion or a sexually transmitted infection. This implies a need for targeted information strategies for the general population and explicit guidance for physicians on when and for whom care should remain confidential.
Social Indicators Research. 2015 Jun 13;South Africa has one of the most liberal abortion laws in the world, emphasising the right to reproductive choice, in keeping with the country’s post-apartheid emphasis on human rights. Access to abortion may also be considered a public health consideration, due to the large number of complications associated with illegal abortions and the associated burden of care. Despite these justifications for a more permissive stance towards abortion, there remain large segments of South African society who are opposed to termination of pregnancy on request. This paper examines the status of reproductive rights in South Africa before looking more closely at public attitudes towards them in the country’s largest city-region. It uses survey data considering attitudes towards abortion as well as the interaction of these attitudes with the variables of race, gender, education level and age using multinomial logistic regression. The results indicate that the largest proportion of respondents oppose abortion absolutely, while a smaller proportion would be open to abortion if the mother’s life is in danger or if the pregnancy was a result of rape. Throughout, the smallest proportion of respondents was of the view that abortion on request is a human right. In terms of predictive value, educational attainment was a stronger predictor than age, race or gender, though there is a distinct lack of consistency in predictive validity of all factors, demonstrating the significant gap between the liberality of laws and the conservatism of public attitudes.
Global Public Health. 2015; 10(3):354-365.Nigeria views the HIV self-test (HIVST) as a possible mechanism to help increase HIV testing uptake and capture otherwise undiagnosed HIV cases. The purpose of this survey was to obtain perspectives of informed members of the Nigerian public on the use of the HIVST. A convenience sample of 1712 researchers, academics, journalists, community advocates, activists and HIV policy-makers and programmers including those working in the development sectors enlisted on the New HIV Vaccine and Microbicide Advocacy Society listserv were sent a brief survey. Respondents were asked to provide a ‘yes’ or ‘no’ response to an enquiry if they support the introduction of HIVST into Nigeria. Reasons for their response were also recorded. Information was collected anonymously with no identifiers. Only 157 (9.2%) provided a response. While the majority (54.8%) supported the introduction of HIVST, a significant number of respondents were concerned about possible risk associated with self-testing, especially suicide and partner violence. Others were concerned about poor linkages to care. Introduction of HIVST would need to be paired with intense media campaigns and education about its use. Once Nigeria commences HIVST, efforts should also focus on approaches to reach people in hard to reach areas of the country.
Global Public Health. 2014; 9(1-2):224-48.As a result of massive scale-up efforts in developing countries, millions of people living with HIV are now receiving antiretroviral therapy (ART). However, countries have been uneven in their scale-up efforts with ART coverage rates exceeding expectations in some places and lagging behind expectation in others. This paper develops a model that explains ART scale-up as a function of the responsiveness of political parties to their primary constituents. Specifically, the paper argues that, faced with a perilous 'threat to the nation', countries responded in one of two ways, both of which were designed to appeal to their primary constituents--either adopting a 'Geneva Consensus' response, or depicting the epidemic as a Western disease and adopting a 'pan-African' response. The article tests this theory using Afrobarometer data for eleven countries. The paper finds that HIV/AIDS is generally a non-partisan issue in most countries. However, the analysis does uncover some differences in partisan support for HIV/AIDS responses in both countries that have adopted Geneva Consensus and pan-African responses, though not in the direction hypothesised. The lack of congruence in policy preferences between the public and their governments suggests a democratic deficit in that these governments have acted independently of the preferences of core constituents.
Public opinion about abortion-related stigma among Mexican Catholics and implications for unsafe abortion.
International Journal of Gynaecology and Obstetrics. 2012 Sep; 118 Suppl 2:S160-6.A nationally representative survey was conducted among 3000 Catholics in Mexico during 2009 and 2010. Respondents were presented with a hypothetical situation about a young woman who decided to have an abortion and were asked their personal opinion of her. On the basis of a stigma index, it was found that the majority (61%) had stigmatizing attitudes about abortion; however, 81% believed that abortion should be legal in at least some circumstances. Respondents were significantly more likely to stigmatize abortion if they disagreed with the Mexico City law legalizing the procedure (odds ratio 1.66; 95% CI, 1.30-2.11) and believed that abortion should be prohibited in all cases (odds ratio 3.13; 95% CI, 2.28-4.30). Such stigma can lead women to seek unsafe abortions to avoid judgment by society. Copyright (c) 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Social Science and Medicine. 2012 Jan; 74(1):52-7.Based on data from Afrobarometer's 2008-2009 public opinion surveys in 20 sub-Saharan African states, this article examines the extent of support for government AIDS policies. While many international and nongovernmental organizations have criticized African governments for failing to implement comprehensive HIV/AIDS policies, survey data shows that citizens have generally positive assessments of their governments' responses. The findings demonstrate that support for a government's AIDS policies arises less from demographic characteristics and more from experiences with and perceptions of the government's capabilities. In particular, those in better economic circumstances and those who approve of the president's job performance show particularly strong support for their government's AIDS policies. This may suggest that leaders are exhibiting the political will necessary to implement holistic AIDS policies and receiving support for them, but it may also suggest respondents are not differentiating between support for the government as a whole and support for particular policy areas. Copyright (c) 2011 Elsevier Ltd. All rights reserved.
Public opinion as leadership disincentive: exploring a governance dilemma in the AIDS response in Africa.
Contemporary Politics. 2012 Jun; 18(2):174-185.There is increasing emphasis in global declaration on the need to get politics right in the response to AIDS, particularly in terms of strengthening accountable leadership. However, in the worst affected countries in sub-Saharan Africa, such governance prescriptions introduce political concerns that are not well understood. In a context of the neo-patrimonial governance that characterises African democracies, the paper analyses data from the Afrobarometer on public opinions on AIDS in 20 countries to identify and explore the governance dilemma that leaders face when they are expected to show strong leadership on an issue that is low on the public political agenda. By identifying country-level correlates and individual-level determinants of the strong opinion on AIDS that is held by a minority, the paper suggests how public opinion for an effective response can be mobilised in ways that are politically sustainable.
Menlo Park, California, Henry J. Kaiser Family Foundation, 2012 May.  p. (U.S. Global Health Policy)This survey is the fourth in a series by the Foundation that explores the American public's views and knowledge of U.S. efforts to improve health for people in developing countries.The survey examines perceptions about foreign aid in general and U.S. spending on global health specifically, including views on the potential impact of spending, perceptions of progress in improving health in developing countries, and the visibility of global health issues in the media.The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation. It was conducted February 2 through February 12, among a nationally representative random sample of 1,205 adults ages 18 and older. The margin of sampling error for the full sample is plus or minus 3 percentage points.
Studies In Family Planning. 2011 Sep; 42(3):175-82.This article presents findings from three opinion surveys conducted among representative samples of Mexico City residents: the first one immediately prior to the groundbreaking legalization of first-trimester abortion in April 2007, and one and two years after the reform. Bivariate and multivariate analyses were performed to assess changes in opinion concerning abortion and correlates of favorable opinion following reform. In 2009 a clear majority (74 percent) of respondents were in support of the Mexico City law allowing for elective first-trimester abortion, compared with 63 percent in 2008 and 38 percent in 2007. A significant increase in support for extending the law to the rest of Mexico was found: from 51 percent in 2007 to 70 percent in 2008 and 83 percent in 2009. In 2008 the significant independent correlates of support for the Mexico City law were education, infrequent religious service attendance, sex (being male), and political party affiliation; in 2009 they were education beyond high school, infrequent religious service attendance, and ever having been married.
Studies In Family Planning. 2011 Sep; 42(3):191-8.In opposition to Mexico City's legalization of first-trimester abortion, 17 Mexican states (53 percent) have introduced initiatives or reforms to ban abortion entirely, and other states have similar legislation pending. We conducted an opinion survey in eight states--four where constitutional amendments have already been approved and four with pending amendments. Using logistic regression analyses, we found that higher education, political party affiliation, and awareness of reforms/initiatives were significantly associated with support for the Mexico City law. Legal abortion was supported by a large proportion of respondents in cases of rape (45-70 percent), risk to a woman's life (55-71 percent), and risk to a woman's health (48-68 percent). A larger percentage of respondents favored the Mexico City law, which limits elective legal abortion to the first 12 weeks of gestation (32-54 percent), than elective abortion without regard to gestational limit (14-31 percent).
Gender and Society. 2010 Feb; 24(1):83-109.This article identifies the dominant public narrative of AIDS in Malawi through an analysis of qualitative interview data and policy and intervention materials. The public narrative creates distinctions between "risky" and "healthy" sex that organize HIV prevention efforts around moral categories, rather than relative risk. These distinctions oppose images of backward, ignorant villagers to the protective power of "love matches" (loving heterosexual relationships between equals). The analysis demonstrates that the public narrative and corresponding prevention efforts only make sense in connection with the patently false assumption that love, heterosexuality, and modernity effectively protect individuals from HIV. This research brings to light the unspoken assumptions of modernity in the (Western) "charmed circle" of heteronormativity, as well as the need to consider the workings of heteronormativity in studies of modernization and globalization. Furthermore, it highlights individualistic and oversimplified analytic models currently directing HIV prevention efforts and points to potentially more effective strategies.
Keep talking about it: HIV/AIDS-related communication and prior HIV testing in Tanzania, Zimbabwe, South Africa, and Thailand.
AIDS and Behavior. 2009 Dec; 13(6):1213-21.Informal, interpersonal communication within a community about HIV and AIDS, or lack of such communication, may influence community members' uptake of voluntary counseling and testing. Drawing from Noelle-Neumann's spiral of silence theory, this study examined the association between communication about HIV/AIDS and prior HIV testing in communities in Tanzania, Zimbabwe, South Africa, and Thailand. Participants (N = 14,818) in 48 communities across five sites throughout the four countries completed a behavioral survey assessing communication, prior voluntary counseling and testing (VCT) uptake, social norms, stigma, and sexual risk. Site-specific logistic regression models demonstrated that frequent conversations about HIV were significantly associated with prior HIV testing at every site. Odds ratios for each site ranged from 1.885 to 3.085, indicating a roughly doubled or tripled chance of past VCT uptake. Results indicate that verbal communication may be an important mechanism for increasing health behaviors and inclusion in future interventions should be considered.
Culture, Health and Sexuality. 2009 Jan; 11(1):1-16.Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicized as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them.
Sexually Transmitted Infections. 2009 Feb; 85(1):65-69.Objectives: To design and assess HIV and homosexuality related stigma scales in a developing world context. Methods: A respondent-driven sampling survey was conducted among 351 men who have sex with men (MSM) in Shenzhen, China. Exploratory and confirmatory factor analyses were used to examine and determine the latent factors of stigma subscales. Results: Factor analyses identified three subscales associated with homosexuality and HIV stigma: public homosexual stigma (10 items), self homosexual stigma (8 items) and public HIV stigma (7 items). There were no items with cross-loadings onto multiple factors, supporting the distinctness of the constructs that these scales were meant to measure. The fit indices in confirmatory factor analysis provide evidence for the hypothesised three-factor structure of associations (the x2/degree ratio=1.84, CFI=0.91, RMSEA=0.05 and SRMR=0.05). Reliability of the three scales was excellent (Cronbach's alpha: 0.78-0.85) and stable across split samples and for the data as a whole. Conclusions: The selection of three latent factors was supported by both psychometric properties and theories of stigmatisation. The scales are brief and suitable for use in developing countries where less time-consuming measurement is preferable.
Are country reputations for good and bad leadership on AIDS deserved? An exploratory quantitative analysis.
Journal of Public Health. 2008 Dec; 30(4):398-406.Some countries (e.g. Brazil) have good reputations on AIDS policy, whereas others, (notably South Africa) have been criticized for inadequate leadership. Cross-country regression analysis reveals that these 'poster children' for AIDS leadership have indeed performed better or worse than expected given their economic and institutional constraints and the demographic and health challenges facing them. Regressions were run on HAART coverage (number on highly active antiretroviral therapy as percentage of total need) and MTCTP coverage (pregnant HIV+ women accessing mother-to-child-transmission prevention services as percentage of total need). Brazil, Cambodia, Thailand and Uganda (all of whom have established reputations for good leadership on AIDS performed consistently better than expected-as did Burkina-Faso, Suriname, Paraguay Costa Rica, Mali and Namibia. South Africa, which has the worst reputation for AIDS leadership, performed significantly below expectations-as did Uruguay and Trinidad and Tobago. The paper thus confirms much of the conventional wisdom on AIDS leadership at country level and suggests new areas for research.
Social Science and Medicine. 2008 Dec; 67(12):2126-34.We examine responses to the roll-out of antiretroviral drugs (ARVs) in Zambia in 2004, focusing on material features of the drugs (colour, shape, size, origin), 'spoiling' (concern about toxicity, side effects of the drugs) and rumours ('talk' about the drugs). Data consists of interviews with 10 people living with HIV and 21 healthcare practitioners. We found that the colour symbolism of 'traditional medicine' has some influence on ideas about ARVs, suggesting possible 'meaning responses' that could affect treatment outcomes. Respondents also become concerned when colours, shapes and side effects differ from expectations. 'Talk' about ARVs concerns risks of medication, sustainability of treatment programmes and people's feelings of vulnerability within larger socio-economic contexts in which countries like Zambia are disadvantaged. Understanding the associations that pharmaceuticals evoke can improve treatment programmes by elucidating public and patient concerns and sensitising healthcare professionals to the historical and political circumstances that condition the 'meaning' of ARVs.
Indian Journal of Medical Ethics. 2009 Jan-Mar; 6(1):5-6.This editorial examines the issue of male circumcision (MC) in India and discusses doctor's challenges' with the question,"Doesn't the public have the right to know that male circumcision protects against HIV?" It describes the reluctance of the Government of India to disclose this information due to the controversy that may erupt between conservative Hindus and the Muslims in the country in which male circumcision is a marker of religious identity.
Pharmacovigilance of antimalarial treatment in Uganda: community perceptions and suggestions for reporting adverse events.
Tropical Medicine and International Health. 2008 Sep; 13(9):1143-52.OBJECTIVES: The deployment of new antimalarials in Africa provides an important opportunity to develop systems for pharmacovigilance. To inform strategies for reporting adverse events in Uganda, we investigated local perceptions and experiences with antimalarial treatment, and evaluated existing and potential systems for pharmacovigilance. METHODS: Focus group discussions (FGD) were conducted with community members and health workers from urban and rural Uganda exploring knowledge of fever/malaria, perceptions and expectations of treatment, understanding of adverse effects, and experiences with adverse events. Sessions were recorded, transcribed into English, and analysed using a coding scheme developed from pre-defined topics together with themes emerging from the data. RESULTS: Between April and July 2006, we conducted 25 FGDs; 16 with community members and nine with health workers. All respondents had extensive experience with malaria and its treatment. Community members commonly recognized adverse effects of antimalarial therapy. However, events were uncommonly reported, and certain events were often interpreted as signs of successful treatment. Community members often felt that the costs of reporting or seeking additional care outweighed the potential benefits. Health workers were unfamiliar with formal pathways for reporting, and were deterred by the additional work of reporting and fear of incrimination. Respondents provided suggestions for incentives and methods of reporting, emphasizing that pharmacovigilance should ideally encompass the public and private sector, and the community. CONCLUSIONS: To be successful, pharmacovigilance relying on voluntary reporting will require active participation of patients and health workers. Addressing the costs and benefits of reporting, and providing sensitization, training and feedback will be important.
Lancet. 2008 Oct 11; 372(9646):1287-90.Nigeria has had several setbacks in its bid to control poliomyelitis, including false rumours about vaccine safety. Now public anger over the failure of the ailing health system to deliver for its people threatens to derail the country's eradication campaign. Margaret Harris Cheng reports. Not only is Nigeria struggling to contain its poliomyelitis outbreak, it is now exporting the virus across its porous borders, and the disease is using the region's ancient trade routes to spread itself across Africa once more. (excerpt)
A community-based bacteriological study of quality of drinking-water and its feedback to a rural community in western Maharashtra, India.
Journal of Health, Population and Nutrition. 2008 Jun; 26(2):139-150.A longitudinal study of the bacteriological quality of rural water supplies was undertaken for a movement towards self-help against diseases, such as diarrhoea, and improved water management through increased community participation. Three hundred and thirteen water samples from different sources, such as well, tank, community standpost, handpumps, percolation lakes, and streams, and from households were collected from six villages in Maharashtra, India, over a one-year period. Overall, 49.8% of the 313 samples were polluted, whereas 45.9% of the samples from piped water supply were polluted. The quality of groundwater was generally good compared to open wells. Irregular and/or inadequate treatment of water, lack of drainage systems, and domestic washing near the wells led to deterioration in the quality of water. No major diarrhoeal epidemics were recorded during the study, although a few sporadic cases were noted during the rainy season. As a result of a continuous feedback of bacteriological findings to the community, perceptions of the people changed with time. An increased awareness was observed through active participation of the people cutting across age-groups and different socioeconomic strata of the society in village activities. (author's)
Journal of Family Planning and Reproductive Health Care. 2008 Jul; 34(3):199-201.Intrauterine contraception is underutilised largely due to its reputed association with infections. The Copper T-380A, one of the most cost-effective methods of contraception and the most widely used intrauterine contraceptive device in the world, is effective for at least 12 years and is also used for emergency contraception. The levonorgestrel-releasing intrauterine system (LNG IUS) is extremely useful for treating menorrhagia. A renaissance of intrauterine contraception is overdue and will necessitate community-wide information campaigns to stimulate demand generation, implementation of service guidelines that avoid restrictive eligibility criteria, and access to service providers with special training in counselling and clinical skills. (author's)
Global Public Health. 2008; 3(S2):39-57.This study is aimed at examining how subsequent Peruvian governments, since 1990, have addressed reproductive rights, HIV/AIDS prevention and treatment, and sexual diversity rights, as well as the drastic policy shifts and its many contradictions. Abortion and contraception consistently generated the deepest public controversies and debates, which made progress in reproductive rights difficult. HIV/AIDS was often portrayed as having the potential to affect everyone, which allowed advocates and activists to achieve some success in advancing HIV/AIDS-related rights. Sexual diversity rights, perceived as a demand made by "others", were generally trivialised and disdained by politicians, officials, and the general population. Positive changes occurred as long as the issue was given a low political and institutional profile. The analysis of policy-making and programme implementation in these three areas reveals that: (1) Weaknesses in national institutional frameworks concerning reproductive health made it possible for governments to adopt two very different (even contradictory) approaches to the issue within the past 15 years; (2) Policies were presented as rights-based in order to garner political legitimacy when, in fact, they evidenced a clear disregard for the rights of individual citizens; and (3) By favouring low-profile "public health" discourses, and marginalising "the sexual" in official policies related to sexuality, advocacy groups sometimes created opportunities for legal changes but failed to challenge conservative powers opposing the recognition of sexual and reproductive rights and the full citizenship of women and sexual minorities. (author's)
Demographic Research. 2008 Jul 1; 19(13):361-402.This chapter provides a detailed description of the fertility changes in Bulgaria during recent decades and discusses possible reasons and consequences. It also gives an overview of the steps that the government has undertaken to offset the considerable decline in fertility. Before the fall of communism, fertility trends in Bulgaria were stable and characterized by a nearly universal entry into parenthood, dominance of a two-child family model, an early start and early end of childbearing, stable mean ages at entry into childbearing and marriage, and low percentages of non-marital births. During the 1990s and in the first years of the new century, we observe a marked, rapid change in fertility behaviour. Together with the severe decline in overall fertility rates, demographic data reveal a significant postponement of entry into motherhood and marriage, a decline of the two-child family model, and an emergence of new family forms. Most research attributes these changes to the particular political and social situation in Bulgaria since 1989. (author's)
Fertility concern in Finland and Russia: Economic thinking and ideal family size in the rhetoric of population polices.
Finnish Yearbook of Population Research. 2008; 43:63-84.This article deals with fertility concern in Russian and Finnish population policies. The article points out that some commonly known discourses are persistently used as arguments in fertility-related population policies. In Finland, these include, for instance, discourses on "ageing nation" and "economic competitiveness". Russian policymakers use a "crisis discourse" that consists of three sub-discourses: "demographic crisis", "reproductive health in crisis" and "family crisis". The Russian government implements pronatalist population policies, whereas Finnish authorities hesitate to use the term "population policy" because of its emphasis on reproductive rights on the one hand, and the negative associations of population policy on the other. Russia has both population and family programs, as well as a new law with a specifically pronatalist emphasis. Conversely, Finland uses family policy as a tool of population policy. (author's)
Johannesburg, South Africa, Gender Links, 2008. 100 p.This report is part of Mirror on the Media series of monitoring reports coordinated by GL with the support of the Open Society Initiative of Southern Africa (OSISA) on gender and the media. Previous studies include: Gender and Advertising in Southern Africa; Who talks on radio talk shows and Who makes the news, an analysis of the 2005 Global Media Monitoring Project (GMMP) results in Southern Africa. The study focused on gender and tabloids in three Southern African countries with the highest density of tabloids, defined both in terms of size and content. It included monitoring of three newspapers in each country over the month of June 2007. The monitoring covered a total of 2546 news items: 859 in Mauritius; 1203 in South Africa and 484 in Tanzania (where tabloids are much fewer pages than in the other countries). Researchers also conducted desk top research; interviewed editors; gathered case material and administered an audience survey to 280 readers in the three countries. (excerpt)