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Nairobi, Kenya, Program for Appropriate Technology in Health [PATH], Scouting for Solutions, 2006 Oct.  p. (USAID Cooperative Agreement No. GPO-A-00-05-00009-00)Scouting for Solutions is a five-year project that aims to prevent the spread of HIV and AIDS by promoting health sexual behavior amongst Scouts in Kenya and Uganda, including the promotion of abstinence until marriage, fidelity in marriage, and monogamous relationships. The project, funded by the US Agency for International Development, is being implemented by the US-based nongovernmental organization PATH, in conjunction with national Scouts associations in Kenya and Uganda. By 2009, the project with reach as estimated 325,000 girls and boys aged 12-15 years with intensive and repeated HIV prevention strategies and health promotion activities. (excerpt)
Journal of Southern African Studies. 2006 Mar; 32(1):85-105.This article investigates the extent of women's participation in South African public debate during the Government of National Unity, a two-year period beginning with the country's first non-racial elections of 1994 and ending with the signing of the Constitution in 1996. The new democratic government established basic rights enabling all citizens, regardless of race or gender, to engage in public debate. Were women able to take advantage of this opportunity? What factors advanced or impeded their progress? The first section of the article draws upon analyses of deliberative democracy to construct a model for assessing women's participation in public debate. Part two evaluates the justness of South African debate in four arenas of civic performance, action and argument at three geographic levels. The article argues that the liberal moment in South African politics was dominated by a state that prompted significant institutional reform, dramatically opening the South African public sphere. Nevertheless, sexism, a lack of education, skills and resources minimised women's ability to take advantage of these changes. (author's)
Health Affairs. 2007 Mar-Apr; 26(2):345-354.A number of important health policy issues, such as the allocation of flu vaccines during a pandemic, require society to determine priorities across different age groups. Cost-effectiveness analysis (CEA) and related methods of economic evaluation are often useful for determining optimal resource allocations. Using the examples of recently evaluated vaccine interventions, we show that current methods of CEA are likely to undervalue health interventions for young people, relative to societal preferences inferred from research on age preferences and the value of health over time. These findings demonstrate important considerations regarding how society distributes health resources across age groups. (author's)
Re-opening closed questions: respondents' elaborations on categorical answers in standardized interviews.
Madison, Wisconsin, University of Wisconsin-Madison, Center for Demography and Ecology,1993 Aug. 13 p. (CDE Working Paper No. 93-24)The participants in a survey interview draw on an interactional substrate of conversational skills and practices to achieve each answer, much as other pairs of interactants involved in standardized, formatted question-and-answer activities (Maynard and Marlaire, 1992). In most cases this process occurs smoothly, in a familiar sequence of "question-answer-(receipt)-entry of answer", or, if necessary, "question-answer-probe-answer-(receipt)-entry". The participants reach an accountable answer, the interviewer records it, and they move on to the next question. Arriving at an answer to one question is required for proceeding to the next one. The focus of this study is a phenomenon occurring at a particular point in that sequence. The cases presented here are examples of a respondent producing talk that is one of the offered answer choices for the question at hand, and then proceeding to engage in further talk after that answer. What kinds of actions are these, and more importantly, what consequences do they have for the collection of the data in the interview? (excerpt)
Health Transition Review. 1997 Apr; 7(1):61-71.The World Development Report 1993 announced that global life expectancy was then 65. Experience in the developed world suggests that the World Health Organization’s dictum, ‘health is a state of complete physical, mental and social well-being’, is simply not attainable for the foreseeable future. As physical health has improved, mental problems have become more prominent and a sense of well-being has declined. Furthermore, as the population ages and medical technology improves, the cost of health care grows almost exponentially. Since the population of the developed world is continuing to age and aging is spreading rapidly throughout the developing world, knowledge is the principal way of dealing with this seemingly intractable problem: we must know, quantitatively, the age-specific causes of ill health, and we must know which means of prevention and treatment are effective. Finally, we must apply that knowledge rationally. (author's)
Asia-Pacific Population Journal. 2004 Dec; 19(4):3-5.The debate between the protagonists of the Condoms, Needles and Negotiating Skills (CNN) and the Abstinence, Be Faithful and Use Condoms (ABC) approaches could go on forever. It is time for the proponents on each side to put aside their differences and begin working together to address the HIV/AIDS pandemic. To claim that either approach is superior to the other is to fail to recognize the potential benefits that each approach can have for various individuals, communities and cultures. We must recognize that all individuals are different. It is therefore foolish to limit ourselves by this "either-or" way of thinking. (excerpt)
Patrifocal concerns in the lives of women in academic science: continuity of tradition and emerging challenges.
Indian Journal of Gender Studies. 2003 May-Aug; 10(2):279-305.This paper examines the social milieu of women academic scientists, parental influence in decision making in regard to the career of their daughters, parents’ expectations, importance of marriage and the criteria involved therein. The support of parents and spouse are vital for the success of women scientists. Nevertheless, the “dual burden” has an impact on professional work, and the consequent redefinition of “success” is clearly a product of patrifocal social structures and ideology. (author's)
The children's streets. An ethnographic study of street children in Ciudad Juarez, Mexico. Las calles de los niños. Estudio etnográfico de niños de la calle en Ciudad Juárez, México.
International Social Work. 1999 Apr; 42(2):189-199.The purpose of this study was to observe behaviors of street children in Ciudad Juárez in an effort to gain a better understanding of their condition. This study sought to bring the words and perceptions of street children, and those who work with the children, into a forum which sheds light on the factors which affect these children as they live and work on the streets. (excerpt)
In: Handbook of health communication, edited by Teresa L. Thompson, Alicia M. Dorsey, Katherine I. Miller, Roxanne Parrott. Mahwah, New Jersey, Lawrence Erlbaum Associates, 2003. 403-422.In this chapter we enter into the quagmire that is U.S. healthcare policymaking. In doing so, we have three goals in mind: (a) to summarize contemporary models of the policymaking process, including the role that organizational discourse plays in it; (b) to examine the distinctive complexities of healthcare policymaking; and (c) to briefly illustrate those processes and complexities in an analysis of the development of Medicare. In the process we argue that the fragmented and incoherent nature of U.S. healthcare policy is not "accidental," as Reagan's title suggests, but instead is inherent in a complex interaction between the structure and processes of policymaking, the ideological bases of health discourse, and the rhetoric of healthcare reform. (excerpt)
In: Constitution-making and democratisation in Africa, edited by Goran Hyden and Denis Venter. Pretoria, South Africa, Africa Institute of South Africa, 2001 Dec. 162-176. (African Century Publications Series)This chapter addresses some of the concerns of the public in the course of constitution-making process, both in support of and criticizing the exercise. It focuses on: popular perception of the motives behind the whole process; the relationship between the Uganda Constitutional Commission and the public; and the extent to which the Constituent Assembly helped to legitimize the exercise.
Health and Place. 2001 Dec; 7(4):261-271.This paper reviews the nature and explores the context of, and reactions to, reproductive health education in China by both the target population of adolescents at school and the wider public. The debate about reproductive health education and its content is taking place within the context of rapid behavioural and sociological changes in China which, in turn is, generating conflicting demands concerning the need for education by the population and the control of the population by the government. Foucault's theories on sexuality and discipline are found to be useful in exploring the subject of reproductive health education in China. (author's)
In: Framing the sexual subject: the politics of gender, sexuality, and power, edited by Richard Parker, Regina Maria Barbosa, and Peter Aggleton. Berkeley, California, University of California Press, 2000. 143-64.This paper describes the popular representations of sex and sexuality in relation to the emerging AIDS epidemic in the Philippines. The author analyzes the sexual and class ideologies reflected in broadsheets, which are large circulation daily newspapers that cater mainly to middle- and high-income groups. This paper also describes ways in which information campaigns become part of moral panic. It notes that the medical world itself creates the conditions for this moral panic, and that the moral panic draws on a medical police model.
International Migration/Migrations Internationales/Migraciones Internacionales. 2000; 38(6):103-33.South Africa prides itself on having one of the most progressive constitutions in the world. The Bill of Rights guarantees a host of basic political, cultural, and socioeconomic rights to all who are resident in the country. Yet there have been persistent reports that citizen intolerance of non-citizens, refugees, and migrants has escalated dramatically since 1994. This article documents this process through presentation of results of national public opinion surveyed by the Southern African Migration Project. The surveys show that intolerance is extremely pervasive and growing in intensity and seriousness. Abuse of migrants and refugees has intensified, and there is little support for the idea of migrant rights. Only one group of South Africans, a small minority with regular personal contact with non-citizens, is significantly more tolerant. These findings do not augur well for migrant and refugee rights in this newly democratic country, or early acceptance of the UN Convention on the protection of migrant workers. (author's)
International Family Planning Perspectives. 2001 Mar; 27(1):42-6.This article establishes the link between the media, public opinion and population assistance. It presents a synopsis of trends in global population assistance and examines the issue-attention cycle as a means of explaining how issues attract the notice of the media and the public, as well as why media reporting, public opinion and government responses to global population issues differ. Much of the evidence comes from the US, which has been the main source of leadership and resources for population assistance, and has well-documented democratic processes and global population concerns. Overall, it is noted that through their wavering interest in global population questions, the media have played an undervalued role in determining global funding trends for population assistance. The evidence suggests a strong link between donor governments' funding for population assistance and media coverage of global population issues in developed countries. Media focus on population matters influence public opinion, which in turn influence politicians in developed countries. Therefore, its not surprising that donor government support for population assistance increased in years of heightened media attention and public support.
In: Understanding the new politics of abortion, edited by Malcolm L. Goggin. Newbury Park, California, Sage Publications, 1993. 268-84.This document is the 15th chapter in a book which provides a framework for considering the "new politics" of abortion in the US (created when the Supreme Court gave states more leeway in regulating access to abortion) and the last in a section devoted to an examination of state abortion policy and politics. This chapter analyzes the impact of female state legislators on abortion legislation. The study hypothesizes that the presence of a significant number of female legislators, especially Democrats, will affect state abortion policy at the committee level (where bills can be blocked). This study concludes that parental consent regulations and public funding of abortion are distinct dimensions of state abortion policy and uses three measures of state opinion toward abortion (Roman Catholic membership, proportion of professional women in the adult female population, and membership in the National Abortion Rights Action League). A table illustrates a simple model of state public funding and parental notification policies which indicates that women legislators may make a difference in parental notification legislation but not in funding policies. This test confirms the validity of Thomas's 1991 hypothesis that the presence of a threshold number of women legislators is important in predicting state abortion policy outputs regarding parental notification and indicates that to have an effect, these women must be Democrats. The analysis then examines post-Webster bills to determine how women may have influenced their fate in committees (which would indicate that the presence of women on key committees is more important than the number of women legislators). It is concluded that states with the fewest women and those most likely to pass anti-abortion legislation have Democratic women on committees blocking this legislation. Using the scales developed in this study, it is predicted that most state policies will remain stable even if Roe were overturned.
In: Understanding the new politics of abortion, edited by Malcolm L. Goggin. Newbury Park, California, Sage Publications, 1993. 89-103.This chapter in a book which provides a framework for considering the "new" politics of abortion in the US (created when the Supreme Court gave states more leeway in regulating access to abortion) is the fifth and final chapter in a section dealing with conflict; in this case, conflicting values and attitudes among anti-abortion and pro-choice supporters presented with adoption as an alternative to abortion. It is hypothesized that it is relatively easy to have an opinion supporting adoption as an alternative for abortion but that this support lessens when it is linked to government financing for adoption. The analysis first examines the structure of support for adoption and public funding separately and then links the issues through a four-part typology showing support for adoption and public funding of it, rejection of both options, and support for one option but not the other. It is found that the most support for adoption as a solution to abortion comes from the socially conservative predisposed against abortion. The strongest predictor of adoption funding support is support for funding abortion (social welfare spending). Other predictors are opposition to abortion (positively related) and age (negatively related). While supporters of adoption as an alternative are generally opposed to public spending on social welfare, dedicated supporters of adoption appear willing to lessen their resistance to government spending to pursue their favored alternative to abortion. Abortion supporters generally already favor social welfare spending and have nothing to offer a compromise on financing. It is concluded that policy alternatives to abortion for unwanted pregnancy would be difficult to fashion and that potential compromise would more likely be successful if it were directed towards contraception.
YOUTH AND SOCIETY. 1996 Jun; 27(4):421-49.This study uses a pragmatic model of discourse theory to analyze more than 700 articles about adolescent mothers published in the Canadian printed media in 1980-92. The introduction notes that feminist research has challenged the view that adolescent motherhood is caused by and perpetrates poverty and that a strong social stigma is still associated with teen pregnancy. After describing the methodology and theoretical framework used in this analysis, academic research on adolescent mothers, welfare, and poverty is criticized for using teen motherhood as a conventional scapegoat which allows the structural causes of poverty to be ignored. Discourses about teenage mothers are then described as a "stigma contest." Thus, discussion centers on 1) the bureaucratic notion that the "wrong" girls are keeping their babies, 2) the conservative framework which holds that an unwed teenager who relies on welfare and refuses to give her baby up for adoption (having properly rejected abortion) serves as the epitome of a "wrong family," and 3) oppositional discourse which provides a "wrong society" framework and is articulated in the alternative media. A "stigma-is-wrong" framework is then provided by the self-interpretation of the teen mothers who hold that the right to choose is essential and that it is inappropriate to stigmatize any choice. The bureaucratic viewpoint is the most common winner in this media contest and helps to frame the public debate and public policy about teenage motherhood and, thus, profoundly influences the daily lives of young mothers and their children by perpetuating negative stereotypes.
In: Abortion in the new Europe: a comparative handbook, edited by Bill Rolsten and Anna Eggert. Westport, Connecticut, Greenwood Press, 1994. 173-86.The focus of this chapter (in a book that looks at abortion law, practice, politics, and possible future changes in 20 different European countries) is on the Netherlands. The chapter opens with a look at the 24-year struggle to replace the restrictive abortion law of 1886 with a liberal abortion law (which occurred in 1984). These efforts gained momentum when physicians began to become involved in family planning and to feel responsible for contraceptive failure, and when England liberalized its law in 1968 and allowed foreign women to receive abortions. Dutch abortion travel created political pressure to change the law. During the 1970s, Dutch physicians began to perform abortions justified by a broad interpretation of the "medical necessity" clause in the 1886 law. During this period, the Liberals and Social Democrats succeeded in preventing the Christian Democrats from interfering in the evolving practice of abortion services, and the Christian Democrats impeded creation of a liberal law. The 1984 law has widespread support and will likely continue unchanged. Meanwhile, in 1969, a private, nonprofit clinic was established to provide safe medical abortion services, and 14 clinics were operating by 1974. By 1975, 84,000 foreign women had abortions in Dutch clinics. The 1984 law constituted formal approval of the practice that had evolved since 1970-73 allowing women to have abortions up to about the 20th week of pregnancy with no more barriers than a five-day waiting period (which is not needed for menstrual regulation procedures). In practice, most abortions are performed very early and are free of charge. Abortion rates for Dutch women are very low. Most Dutch women want to have the option of abortion while avoiding the need for one.
[Unpublished] . , 25 p.The World Health Organization's Global Programme on AIDS has put together this inventory and review of AIDS-related knowledge, attitudes, beliefs, and risk behaviors (KABP) to provide updated information on research findings to researchers, IEC (information, education, and communication) planners, and national AIDS prevention and control staff. The studies in this inventory were all published between January 1, 1989 and March 1, 1989. Each of the inventory's six parts addresses a specific population group: adolescents and young people, the general public, health care workers, homosexual/bisexual population, intravenous drug users, and prostitutes (both male and female). In those cases where a published study has information on more than one of the groups, the inventory includes that study in each of the appropriate sections. In each section, the studies are in chronological order, according to the date the study was conducted. The first column lists the complete bibliographic reference to allow the reader to refer to the original publication. A code has been assigned to the first column for each study to designate what primary type of study it is. These codes denote a KABP study (or at least one of the elements), a study focusing on sexual practices, a methodological study, an epidemiological study, a counseling study, a health promotion study, and a qualitative study. The second column lists the date of the study. The third column provides the site of the study. Most of the sites are in the US. Other sites are in both developed and developing countries. The fourth and fifth columns list the population studied and the size of the sample, respectively. The method of data collection is revealed in the sixth column. The methods are interview, telephone interview, questionnaire, and medical (physical or laboratory examination). The last column provides a brief summary of the major findings.
Impacts of modernisation and urbanisation in Bangkok: an integrative ecological and biosocial study.
Nakhon Pathom, Thailand, Mahidol University, Institute for Population and Social Research [IPSR], 1992 Aug. , vi, 71 p.The findings in this impact report are preliminary. The research aim is to assess comprehensively the ecological and social impacts of modernization and urbanization in Bangkok, Thailand. Specific aims include 1) studying the human urban population and the biophysical environment through use of an integrative ecological and biosocial methodology (Boyden et al.); 2) examining the changing interrelationships between the biophysical environment, human population, societal activities, and societal arrangements; 3) developing an integrated and comprehensive framework; and 4) exploring social processes that lead to quality of life improvements. Data collection occurred during 1989-90. This first exploratory report provides a literature review and preliminary findings from the analysis of focus groups and other statistical background data in selected communities. Focus group discussions were conducted in Phaya Thai, Bangkok Noi, and Taling Chan districts from the inner, middle, and outer zones, respectively. The seven communities represented middle class groups, slum groups, an old housing group, a canal community of agriculturalists, and an agriculture-based community. Background descriptions are provided of the early settlement of Bangkok, the modernization process, the Bangkok economy, land use changes (changes from agriculture to human settlement, high-rise buildings, slums), environmental conditions (transportation, air pollution and noise, water quality, and solid waste and toxic substance disposal), and health and crime conditions. Community views are reported for transportation, pollution, land use, and social and economic problems. The combination of environmental and economic conditions is viewed by the public as impacting on housing, lifestyles, stresses, the means of adaptation, and health. The analysis revealed that environmental problems/solutions usually reflected the views of elites and inner city residents. Public participation in urban solutions is viewed as hampered by societal hierarchies, patronage, and the Buddhist-influenced relaxed acceptance. Economic conditions appeared to determine both the capacity of people to solve problems as well as to adapt to change. The Thai sense of fun and the Thai capacity for creativity and regeneration were successfully tapped in the family planning model and some other past programs.
POPULATION RESEARCH AND POLICY REVIEW. 1993; 12:189-224.After an introduction, a brief review of the history of attitudes toward immigration in the US, and comments on the continuing importance of undocumented migration, this paper reformulates extant research hypotheses from diverse literatures connecting US public opinion to immigration. The hypotheses considered include 1) that immigrants take jobs from citizens, 2) that cultural and ethnic ties to immigrants promote proimmigration attitudes, 3) that education plays a role in shaping attitudes towards immigration, 4) that fears about the economic costs to society of new immigrants engender negative attitudes, and 5) that public opinion arises from a commitment to enduring values about what it means to be an American (the symbolic politics theory). These hypotheses are tested using data from a June 1983 survey of public attitudes toward undocumented immigration conducted in the six urban counties of southern California, the region of the US with the largest number of illegal migrants. These data were submitted to ordered-probit regression analysis of responses to two general questions about the problem and effect of illegal migration. Respondents' attitudes were modeled toward the general implications of undocumented migration as a function of their own demographic and socioeconomic characteristics and their opinions about a series of more specific issues. Explanatory variables were introduced sequentially in groups, and all explanatory variables were also encoded as dummies. The findings were summarized in a table which includes all of the socioeconomic and demographic background variables and in a table illustrating a fully populated model. These data provide only weak support for the labor market competition hypothesis, greater support for cultural affinity, strong associations with educational attainment (more education equals more favorable attitudes), evidence that cost-benefit considerations influence attitudes, and evidence that illegal immigration elicits normative cultural attachments. Respondents over age 35 were also more pessimistic as were females. These findings have important implications for US immigration and immigrant policy and imply that more effort should be devoted to the economic and social integration of migrants who are resident in the US. By raising the level of education in the general public, the US can engender more liberal attitudes towards immigration.
MIDDLE EASTERN STUDIES. 1991 Jul; 27(3):477-86.Middle Eastern surveys n the 1970s were incompatible with the data reflected in this presentation of trends in polygyny in Istanbul between 1885-1926 from census forms. The trends for Istanbul indicate that 2.29% of all married men were married polygynously (2.51% in 1885 and 2.16% in 1906). These rates appear low when compared to 3.4% in Egypt in 1947 or 7.5% in Iraq in 1957. Islamic law permits up to 4 wives, but in Istanbul the usual practice is 2.08% wives or bigamy. Incidence as well as intensity of polygyny is low. The history of public opinion about this practice in Istanbul shows an increasingly disapproving trend. In 1917, the Family Law Act specified that any woman could forbid her husband from taking a second wife and was granted an automatic divorce if the husband took a second wife. In 1924-25, the draft of the Civil Code stipulated that polygynous marriages were granted only with special permission from the judge upon proof by the husband that he "needed" a second wife and that he would be fair to both wives. In 1926, polygyny was made illegal, and the rate was unaffected. After 1930, no official records were kept. An opinion poll was conducted by a newspaper in 1924, and published letters reported that polygyny should be forbidden and should be allowed in cases where the wife is sterile. Most correspondents were against using polygyny to increase the Turkish population. In polygynous marriages, the woman's mean age at marriage is similar to that in monogamous marriages, but the man's mean age is an average of 4.25 years older. Comparative tables of marriages by type show that men marry the second, younger, wife 8.5 years after the first marriage when the men are approximately 40 years old. Model life tables are constructed to show the relationship between mortality patterns and polygyny, so that polygyny looks more like overlapping monogamous marriages. Unmarried women are the typical second partner. Urban women tend to be less involved in polygyny. Men with a strong religious background or men in a high official rank were slightly more often involved in polygyny.
Trends in HIV / AIDS behavioural research among homosexual and bisexual men in the United States: 1981-1991.
AIDS CARE. 1991; 3(3):281-7.Reviewing the existing research, this article traces the behavioral change among homosexual and bisexual men in the US between 1981-91, and discusses behavioral research goals for the future. First detected in 1981, AIDS quickly became associated with the homosexual and bisexual male community. Between 1981 and 1984, the research community made remarkable advances in coming to understand the epidemic. Case-control studies pointed out the high AIDS risk associated with some of the sexual practices of homosexual and bisexual men: multiple sex partners, anonymous partners, and unprotected anal intercourse. With the aid of behavioral experts, the gay community began conducting an array of information and education programs. In 1983, the Center for Disease Control developed "safer sex" guidelines, which revolved around the use of condoms. From 1984-88, education efforts led to dramatic behavioral changes, which led some to believe that AIDS had been conquered among the homosexual and bisexual population. But the AIDS epidemic brought along with it discrimination against gays. Calls for HIV counseling and testing intensified. As the epidemic moves into its second decade, researchers have noticed a relapse into unsafe sexual practices. Researchers have also found that the incidence of HIV has not decreased among special subgroups of the homosexual and bisexual community: younger men who recently became sexually active, blacks and Hispanics, men of lower socioeconomic status, those who life outside large urban centers, and those who do not identify with the gay lifestyle. For this decade, behavioral research goals include maintaining the existing educational programs and revising them as new developments necessitate, and working towards long-term maintenance of behavioral change.
INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION. 1988-89; 9(2):111-24.This retrospective examination looks at the strengths and weaknesses of anti-sterilization abuse organizing in the US, and draws out lessons for other areas of work. It begins by exploring the problem of sterilization abuse and the history of the movement against it. Theoretical concepts of community organizing, such as, the concept of community and the concept of movement, are defined and discussed. Issue selection and strategy, 2 crucial aspects of any successful organizing effort, are examined as are organizational forms and coalition building. An evaluation indicates that the anti-abuse efforts were successful and rich with lessons for reproductive rights and other popular health struggles today. (Author's modified)
Beverly Hills, California, Sage Publications, 1980. 246 p. (Sage Library of Social Research Vol. 100)This book's objective is to describe the circumstances surrounding adolescent pregnancy, demonstrate the need for social support, and describe how these supports might be offered. It contains 2 basic thrusts. The early chapters describe the adolescent pregnancy problem and the parallels between the development of the adolescent pregnancy and the potential child maltreater. What follows from this description is the author's sense of methods which will help to reduce the risks generated by participation in either, or both, of these environments. The information presented in this volume suggests that the time for joint study of child maltreatment and adolescent pregnancy has arrived. The demand for correlational study of these 2 social situations is viable for 4 interrelated reasons: both child maltreatment and adolescent pregnancy are social phenomena which demonstrate a dramatic increase in reported incidence in the past 25 years; both child maltreaters and adolescents who have experienced pregnancy appear to share multiple demographic or situational variables, i.e., minority overrepresentation, low income, low education, and high unemployment; the development of the maltreating event and the adolescent pregnancy reveal an unusual similarity, and the intergenerational aspects of both problems could well be strongly related to the snowball effect that these problems have on each other; and if the problems of child maltreatment and adolescent pregnancy are found to be symbiotic in their support of each other, rather than independent responses to a uniform social context, the direction of prevention efforts in these 2 areas could produce beneficial reductions in the rates of both problems. The best hope for the provision of prevention services in adolescent pregnancy rests within an alteration in public fears and misconceptions related to welfare dependency, contraceptive use, sexual education and information, and possibly even a general view of the adolescent in society. There is no question that contraceptive programming for the adolescent can serve as a vital preventive measure. The cornerstone of this service returns the perspective to education. Preventive services must include education for contraception, education for appropriate decision making, and education for survival of a parent and child. The community-based multidisciplinary system for the adolescent pregnancy or parent has been demonstrated to be the most effective model for programming today. It is also the most difficult program to find or or develop. Services to adolescents must begin as soon as community standards will permit them to be initiated to prevent the occurrence of the problem. Only when a collage of services in the prevention, treatment, and rehabilitation realms is available for the individual adolescent can it be said that a meaningful program exists.