This article assesses the impact of community-based reproductive health services (CBRHS) and programmes on contraceptive use in Ethiopia. The 1993 National Population Policy provided a strong political backing to community-based contraceptive programmes, which grew in number and outreach to the community. The article shows that 'women living in areas covered by the CBRHS programme were three times more likely to use contraception than the average Ethiopian woman'. The study concludes that scaling up the programme nationwide would have the effect of doubling the national contraceptive prevalence rate
This is an evaluation study conducted in KwaZulu Natal, South Africa. It provides insights into whether learners who participated in a fact-based, interactive course had more knowledge about HIV risks, prevention, and care practices; more positive attitudes toward prevention practices and people living with HIV and AIDS; and a higher prevalence of reported safe behaviours, than comparable learners who did not participate in the course
During the past 20 years, substantial reductions have occurred in the proportion of young women who report marrying as teenagers in sub-Saharan Africa. An oft-stated consequence of a delay in age at marriage is a rise in the proportion of young women who engage in premarital sex. This paper investigates the links between changing age at marriage and premarital sexual behavior in 27 sub-Saharan African countries in which Demographic and Health Surveys were conducted between 1994 and 2003. Using multiple-decrement life tables to examine the competing risks of premarital sex and marriage without prior sexual experience, we answer the largely unaddressed question of how reductions in the prevalence of early marriage have affected the likelihood of initiating premarital sex. Our analysis reveals that although the age of first sexual activity has either remained the same or increased, a shift in the context of sexual debut from marriage to before marriage has taken place in many countries. We assess whether the increase in the proportion of young women who report premarital sex is influenced by an increase in exposure resulting from delayed marriage or by an increase in the rate of premarital sex. The evidence on this point is mixed; in some settings greater exposure explains more of the increase, whereas in others an increased rate of premarital sex dominates
The timing of first union merits investigation not only because of the close temporal link between marriage and the onset of childbearing, but also because the age when men and women marry has implications for the organization of family life and for gender relations within society. This paper begins by reviewing the contributions of various social science disciplines to an understanding of the timing of marriage. Using current status data from 73 countries provided by the United Nations Population Division and retrospective data from 52 Demographic and Health Surveys conducted between 1990 and 2001, we then examine recent trends in the timing of first marriage or union for men and women in the developing world. With the exception of South America for both sexes and South and Southeast Asia for men, substantial declines have occurred in the proportion of young men and women who are married. Given the differentials in the timing of marriage by educational attainment and residence, we assess whether the decline in the proportion of young people who are married is related to increases in schooling and urbanization. Expansion of schooling for women has had some impact, but a considerable portion of the reduction in early marriage is not explained by changes in levels of education. We consider other factors that might account for the increase in age at marriage. Finally, we review what is known about the consequences of changing age at marriage with a particular focus on risk of HIV infection.
This website offers a number of online resources about disability and sexuality. Topics include gay and lesbian sexuality, aging and sexuality, sexuality and disabled adolescents, and more. The site also contains references to other resources and an online forum
'The Population Council has developed a novel framework for training providers to deliver client-centered reproductive health services. The essence of the approach is to bring about behaviour change in providers by making them more receptive and responsive to client needs. Further, providers are taught to treat clients with respect and dignity, to assess their reproductive health needs holistically within the context of their household circumstances, and to negotiate solutions that clients are able to implement. Known by the acronym SAHR, this approach involves four interconnected steps: Salutation, Assessment, Help, and Reassurance. Through operations research, SAHR was successfully tested in Pakistan in 2000-02. The training manual describes the SAHR approach and is meant to facilitate training of reproductive health providers in how to offer client-centered services. The manual is written in fairly generic terms and can be used, with slight modifications, in any setting or country. The manual has three sections. Section One, the introduction, is an overview of the contents. Section Two, the trainer's guide, comprises the training modules. Each module describes the individual components of client-provider interaction and includes learning objectives, key learning points, a schedule, and a list of materials required. Trainer notes and step-by-step instructions for each activity are included within each module. Section Three contains support materials to help trainers prepare for the sessions.'
This paper discusses findings from a review of 83 evaluations of sex and HIV education programmes. The analysis found substantial positive impact on sexual behaviours in more than two-thirds of the evaluations and identified 17 characteristics of the most effective curricula used in the programmes evaluated. More information on this review is available, including links to data sheets on each of the 83 evaluations. [Publisher's abstract, amended]
These fact sheets aim to provide policy makers with concise information about gender related aspects of the HIV/AIDS pandemic. They deal with core facts and issues in thematic areas and are underpinned by an analysis which clarifies how gender issues are fuelling the crisis. Each theme presents a self-contained set of issues and recommendations and many of the themes are interlinked. All of them are connected by a concern to promote a gender-enlightened and comprehensive response to HIV/AIDS and its impacts
This study explores the sexual and reproductive health needs and experiences of people with disabilities, as well as perceptions about HIV and AIDS and disability. The purpose is to address the accessibility of health communication for people with different impairments. This study would be useful for anyone with an interest in HIV and AIDS and disability
This is a report on two PLACE assessments conducted in Tashkent in 2002 and 2003. The aim was to investigate whether there was an overlap in drug use and sexual networks, and to identify the implications for HIV prevention. The findings suggest that there is a significant overlap among youth, drug users and sex workers, and that the rate of new partnership formation remains high, while condom availability has decreased. It suggests that interventions need to focus on the sites where youth and drug users socialise and where sex workers solicit clients
The PLACE method is designed to expose sexual and injection drug use networks, identify sites where high-risk populations overlap and help focus interventions where they are most needed. This report presents both a baseline assessment of HIV/AIDS risks and an evaluation of condom promotion programmes in four cities in Central Asia. The report shows that sexual and drug use networks are extensive and diffuse. The rate of new partnership formation is also very high, and the use of condoms with new partners is "quite high". Injection drug use is common, and needles are often shared. The report calls for programmes and interventions to concentrate their efforts on sites at high risk, where there is an overlap of high-risk populations (people meeting new partners, youth, injection drug users, sex workers)
This study examined the potential of trained young people, who were members of anti-AIDS clubs, to contribute to care, support, and stigma-reduction activities, and to determine the impact of their involvement in these activities on their HIV-related beliefs and behaviours
In a time when young people are increasingly at risk of unintended pregnancy and sexually transmitted infections, the role of contraception in preventing these is crucial. This issue of YouthLens looks at how education, services and products can help protect youth against unintended pregnancy and sexually transmitted infections, including HIV. It stresses that young people should be targeted with appropriate messages
This report presents the findings of a study on the effects of exposure to life skills education based on student recall of 11 life skills topics on sexual and reproductive health and HIV and AIDS-related knowledge, attitudes, and behaviours of adolescents in selected areas of KwaZulu Natal
This valuable new report looks at the levels of infection of HIV and AIDS, the levels of orphaning and child headed households, sexual debut and sexual experiences and risk factors and risk environments for children aged 2-14 in South Africa. This has been investigated as the HSRC recognizes that there is very little known about HIV prevalence rates among children or about the risk factors that predispose them to becoming infected. The study looks at the social and community risk factors that predispose children to HIV infection as well as the impact of the epidemic on children in terms of orphan status and child headed households. It examines children’s knowledge of HIV and AIDS prevention, their knowledge about sexual behaviour and HIV as well as their own patterns of sexual behaviour and changes in that behaviour. This study is interesting as it explicitly includes young children
The strategy presented in this document is the World Health Organization's first global strategy on reproductive health. It was adopted by the 57th World Health Assembly (WHA) in May 2004. Three of the eight Millennium Development Goals (MDGs) are directly related to reproductive and sexual health, namely, improving maternal health, reducing child mortality and combating HIV/AIDS, malaria and other diseases. This strategy addresses five priority aspects of reproductive and sexual health: improving antenatal, delivery, postpartum and newborn care; providing high-quality services for family planning, including infertility services; eliminating unsafe abortion; combating sexually transmitted infections, including HIV, reproductive tract infections, cervical cancer and other gynaecological morbidities; and promoting sexual health. This document is intended for policy-makers within governments, international agencies, professional associations, nongovernmental organisations and other institutions
"The Men in Maternity (MiM) study investigated the feasibility, acceptability and cost of a new, more comprehensive, model of maternity care that encouraged husbands' participation in their wives' antenatal and postpartum care. The study specifically assessed the impact of the intervention on family planning in the postpartum period and STI preventitive practices among men and women. The study was conducted in collaboration with the Employees' State Insurance Corporation (ESIC), Delhi Directorate at their primary health facilities called dispensaries"
"The Reproductive Health Research Unit (RHRU) University of the Witwatersrand, in partnership with the FRONTIERS Program of the Population Council, and the KwaZulu Natal Department of Health conducted a three-year operations research study titled "Men in Maternity" (MIM) in the Ethekwini district. The study was completed in July 2003...The intervention was clinic-based and included two broad strategies: improving antenatal care services by strengthening the existing antenatal package and service monitoring and supervision; and introducing couple counseling by providing training to health providers, inviting partners of antenatal women to attend counseling twice during pregnancy and once post delivery, and providing information to couples with a new antenatal booklet...At follow-up few differences were found between the control and intervention groups to support the hypothesized effect of the intervention. Significant differences were found only in changing communication, partner assistance during pregnancy emergencies, and knowledge of the condom as a method of dual protection"
This report focuses on the impact of the a life skills programme curriculum that was introduced to ninth grade students in KwaZulu Natal
This is a seachable database designed to present information on previously implemented programmes in an accessible format. It focuses on public health interventions and programme models rather than medical practices. It is continually updated, and each submission is reviewed by a technical advisory review board
Source e-bulletin on Disability and Inclusion