Reproductive Health Matters articles from November 2002

Reproductive Health Matters archives from November 2002

Health sector reforms: implications for sexual and reproductive health services.(Editorial)
November 1, 2002... SINCE the mid-1980s, long before the International Conference on Population and Development (ICPD) in Cairo in 1994, fundamental changes have been taking place in the financing, management and structure of health care provision, described at...

Understanding health sector reforms and sexual and reproductive health services: a preliminary framework.
November 1, 2002... Abstract To understand the implications of health sector reforms for sexual and reproductive health services, there are three major dimensions to consider. The first two relate to the context in which health sector reforms are introduced: the...

An overview of changing agendas in health sector reforms.
November 1, 2002... Abstract This paper discusses health sector reforms and what they have meant for sexual and reproductive health advocacy in low-income countries. Beginning in the late 1980s, it outlines the main macro-economic shifts and policy trends which...

Between intent and achievement in sector-wide approaches: staking a claim for reproductive health.(Commentary)
November 1, 2002... Abstract Since 1995, sector-wide approaches (SWAps) to health development have significantly influenced health aid to developing countries. SWAps offer guidelines for new partnerships with international donors led by government, new...

Objectivity in priority setting tools in reproductive health: context and the DALY.(Disability Adjusted Life-Year )
November 1, 2002... Abstract The Disability Adjusted Life-Year (DALY) heralded a new age in the development of an evidence base for priority setting and resource allocation. The DALY was intended to represent sound measurement of the incidence and prevalence of...

The politics of priority setting for reproductive health: breast and cervical cancer in Ghana.
November 1, 2002... Abstract Priority setting for reproductive health is affected by health sector reform policies, the often politically charged nature of issues such as abortion, decreasing funding for reproductive health activities and the broad agenda of the...

Universal coverage and its impact on reproductive health services in Thailand.
November 1, 2002... Abstract Thailand has recently introduced universal health care coverage for 45 million of its people, financed by general tax revenue. A capitation contract model was adopted to purchase ambulatory and hospital care, and preventive care and...

Quality of hysterectomy care in rural Gujarat: the role of community-based health insurance *.
November 1, 2002... Abstract Community-based health insurance (CBHI) may be a mechanism for improving the quality of health care available to people outside the formal sector in developing countries. The purpose of this paper is to identify problems associated...

The role of oversight in the health sector: the example of sexual and reproductive health services in India.
November 1, 2002... Abstract This paper examines the role of oversight in influencing the health sector, using examples from sexual and reproductive health services in India. Rather than simply trying to provide services through traditional bureaucratic...

Chinese maternal health in adjustment: claim for life.
November 1, 2002... Abstract Health sector reforms in China, instituted starting in 1985, have centred on cost recovery, with fee-for-service revenue replacing public budget funding. The share of public funding for maternal health services was reduced greatly,...

Privatisation of health services and the reproductive health of rural Chinese women.
November 1, 2002... Abstract China's rural health care system has undergone major changes since the early 1980s, when the country began privatising rural health services. Following fiscal devolution, the rural primary health service was transformed into a...

Women's health, changes and challenges in health policy development in Lithuania.
November 1, 2002... Abstract Health is a sensitive mirror of social circumstances. This paper looks at the situation of women's health in Lithuania in the context of the social, political and economic transition in the country following independence in 1990, and...

Gender dimensions of user fees: implications for women's utilization of health care.
November 1, 2002... Abstract This paper looks at the implications of user fees for women's utilization of health care services, based on selected studies in Africa. Lack of access to resources and inequitable decision-making power mean that when poor women face...

Short-changing reproductive health.(Commentary)
November 1, 2002... Abstract Health sector reformers, particularly the economists among them, are prone to reject calls for more financial support for reproductive health as "special pleading" even when the argument is made that reproductive health is a basic...

ICPD goals and targets worth revisiting in the context of health sector reforms.(Current Policy)(International Conference on Population and Development)
November 1, 2002... AT the International Conference on Population and Development (ICPD) in 1994, countries endorsed a Programme of Action containing a broad range of goals and targets in the broad area of sexual and reproductive health [1]. In 1996, the World...

UN special session on children: Bush administration continues its attacks on sexual and reproductive health.(Current Policy)
November 1, 2002... THE Bush Administration is increasing its efforts to weaken existing international agreements on sexual and reproductive health and rights, including the Programme of Action of the 1994 International Conference on Population and Development...

Counsellors' perspectives on antenatal HIV testing and infant feeding dilemmas facing women with HIV in Northern Tanzania.(HIV/AIDS)
November 1, 2002... Abstract This study investigated the infant feeding advice that counsellors were giving HIV-infected pregnant women in Moshi, Tanzania, the factors they thought had an impact on women's infant feeding choices and their role in influencing these...

Special report: HIV/AIDS, sexual and reproductive health at AIDS 2002 Barcelona.(HIV/AIDS)
November 1, 2002... THE biennial AIDS Conference is so large that everyone who goes has a different conference There were thousands of presentations and posters at the meeting. Many repeated what we already know--that unsafe sex and IV drug use transmit HIV; that...

Applying public health and social justice principles to AIDS in Africa.(HIV/AIDS)
November 1, 2002... This review [1] argues that some approaches to HIV/AIDS are poorly adapted to the crisis in Africa, which should be defined and treated as an infectious disease emergency, and argues for a reconsideration of policy and practices in HIV testing...

HIV drug treatment cost-effective in resource-poor settings.(HIV/AIDS)
November 1, 2002... There was a time in the 1980s when no one wanted to recognise the importance of ADDS; it was only advocacy on the part of the populations who first acknowledged they had it that put this disease on the map. Everyone said HIV treatment drugs...

Treatment Action Campaign wins against government appeal, South Africa.(HIV/AIDS)
November 1, 2002... A high court in South Africa ordered the government to provide access to treatment to reduce the risk of mother-to-child transmission of HIV at birth, following a case filed by the Treatment Action Campaign and others in 2001. The national...

Brazil to share generic drugs and technical know-how with other countries.(HIV/AIDS)
November 1, 2002... Brazil has implemented a comprehensive HIV prevention and treatment programme that has been a major success. The prevention arm focuses on condom use and has achieved a significant reduction in the rate of HIV incidence, particularly in more...

Thailand offers transfer of technical know-how in drug production.(HIV/AIDS)(Brief Article)
November 1, 2002... The Thai Health Ministry has launched a programme called the Thai/Africa Collaboration to provide government-to-government transfer of technology of pharmaceutical know-how to interested African countries, based on their existing capacities and...

New Indian health minister to include treatment and care in AIDS programme.(HIV/AIDS)(Brief Article)
November 1, 2002... In a significant shift, the new Health Minister for India, Shatrughan Sinha, acknowledged at the AIDS Conference in Barcelona that care and treatment were a necessary part of an appropriate response to HIV in India. India had previously...

WHO approves 40 AIDS drugs.(HIV/AIDS)(World Health Organization)
November 1, 2002... The fray over patented and generic anti-AIDS treatment drugs was made more complicated when the World Health Organization approved a list of 40 quality drugs, which includes anti-retrovirals, antibacterials, anti-fungals and anticancer drugs....

Presumptive STD treatment greatly reduces STD rates, South Africa.(HIV/AIDS)(sexually transmitted diseases)
November 1, 2002... At two mobile clinics for sex workers servicing miners in South Africa, peer educators encouraged all women at high risk to attend monthly for examination, STD treatment and counseling. One group of women with STD symptoms was given monthly...

Presumptive STD treatment reduces sexual risk behaviour, Nairobi.(HIV/AIDS)(sexually transmitted diseases)
November 1, 2002... This clinical trial assessed whether antibiotic prophylaxis would reduce HIV acquisition in women sex workers. In May 1998 a cohort of HIV seronegative sex workers was established in Nairobi, half of whom were randomly assigned to receive 1 gm...

Contracting private sector GPs to provide STD services, South Africa.(HIV/AIDS)(Author Abstract)
November 1, 2002... Syndromic management of STDs is one of the strategic components outlined by the Department of Health (DoH) in South Africa for fighting HIV. The Western Cape Province has 25 health districts, within which all public health facilities use this...

Violence, not STDs, main concern of young West African sex workers.(HIV/AIDS)(Brief Article)
November 1, 2002... Focus group discussions were held with 16 peer educators of young sex workers from seven West African nations over a three-month period by a UNAIDS researcher in Cote d'Ivoire. An unexpected finding was that STDs were not the primary concern of...

Improving services for women sex workers in Cambodia.(HIV/AIDS)
November 1, 2002... In Cambodia, clinics for the management of STDs in women sex workers were established by the National Center for HIV/AIDS, Dermatology and STD in conjunction with the Institute of Tropical Medicine, Belgium, but without addressing other...

Couple counselling on sexual communication and reproductive health during antenatal care, Zimbabwe.(HIV/AIDS)(Brief Article)
November 1, 2002... Traditionally, couples in Zimbabwe communicate about sex and sexuality through third parties like uncles and aunts. With the advent of the HIV/ AIDS epidemic this has been seen as one of the barriers to negotiation for safer sex and adoption of...

Integrated care for HIV-positive pregnant Ethiopian women, Jerusalem.(HIV/AIDS)
November 1, 2002... Of the 87 women currently given care at this AIDS clinic, 88.5% are immigrants from Africa, mostly Ethiopia. This population is characterized by intercultural differences, language barriers, poverty, social withdrawal and stigmatization,...

First efforts at integration of HIV information into family planning clinic services in Uganda.(HIV/AIDS)
November 1, 2002... In 1999 family planning (FP) and HIV programme managers in Uganda developed a package of interventions to strengthen the integration of HIV into FP care. The package included a two-day training on HIV counselling skills, supervisory visits...

Sterilization among HIV-positive pregnant women in two Brazilian cities.(HIV/AIDS)
November 1, 2002... In Brazil HIV infection among women of reproductive age continues to rise. Though little is known about contraceptive use among HIV-positive women, female sterilization is the most popular method of contraception for Brazilian women in general....

Unmet need among women for HIV/AIDS, reproductive and sexual health services in Chiangrai, Thailand.(HIV/AIDS)
November 1, 2002... HIV-positive women in Chiangrai province, Thailand, have many reproductive health problems and unmet needs. 101 HIV-positive women of reproductive age were surveyed and 20 were interviewed in-depth by HIV-positive women interviewers who were...

Low clinical progression after pregnancy in HIV-positive women on HAART, London.(HIV/AIDS)
November 1, 2002... Data on the long-term outcome of H1V infection in women who receive ARV therapy during pregnancy are scarce. To determine clinical and immunological outcome in HIV-positive women who commence therapy before or during pregnancy, a prospective...

Antiretroviral treatment for women during pregnancy safe for babies, USA.(HIV/AIDS)
November 1, 2002... Medical practice in the USA has been to give HIV-positive pregnant women antiretroviral treatment as if they were not pregnant, on the theory that taking care of the disease is best for both mother and child. Until recently, there has been no...

Mothers say: "Focus on mothers as well as infants".(HIV/AIDS)
November 1, 2002... Therapeutic prevention of mother-to-child transmission of HIV is increasingly available in Kenya. With voluntary HIV counselling and testing (VCT). In-depth interviews and focus group discussions were conducted with 411 antenatal care (ANC)...

Anaemia due to pregnancy and HIV = risk of early post-natal death, Harare.(HIV/AIDS)
November 1, 2002... In developed countries, anaemia is common during HIV and significantly associated with earlier death. This form of anaemia results from changes in cytokine production, blunted erythropoietin (EPO) response, and antiretroviral use, especially...

Female condom use reduced unprotected sex among HIV-positive women, Brazil.(HIV/AIDS)
November 1, 2002... A prospective descriptive study evaluated the acceptance, adherence and use of the female condom among 76 HIV-positive women attending specialist clinics in Campinas, Brazil. The women were asked to record sexual acts and male condom use on a...

Women's concerns about antiretroviral therapy during pregnancy, Australia.(HIV/AIDS)
November 1, 2002... A qualitative research project in Australia collected data in 2001 on the use of and attitudes to antiretroviral therapy during pregnancy among 33 HIV-positive women. Of the 33 participants, 27 women had 47 children; 23 of these children were...

Mothers-to-mothers-to-be: peer support for HIV-positive pregnant women, Cape Town.(HIV/AIDS)
November 1, 2002... Many women, when diagnosed with HIV during pregnancy, are unable or unwilling to tell partner, family or friends, resulting in emotional isolation. In Cape Town, South Africa's publicly funded mother-to-child transmission prevention programmes,...

Infant feeding and HIV status, Kampala.(HIV/AIDS)
November 1, 2002... In January 2000, a Ministry of Health-supported programme of prevention of mother-to-child transmission of HIV was started in Nsambya Hospital in Kampala, Uganda. Short-course antiretrovirals, zidovudine or nevirapine, are offered in late...

War and peacekeeping forces spread HIV.(HIV/AIDS)
November 1, 2002... Graca Machel's report to the UN, Impact of Armed Conflict on Children says: "Adolescents are at extreme risk during armed conflict. They are targets for recruitment into armed forces and armed groups; they are targets for sexual exploitation...

Use of condoms and STD services among young people in western Kenya.(HIV/AIDS)
November 1, 2002... Prior to implementing a controlled intervention trial of condom promotion, we conducted formative research among adolescents and young adults in western Kenya, to identify obstacles to condom use, attitudes and beliefs that should be addressed...

HIV and pregnancy prevention programme in secondary schools, Barcelona.(HIV/AIDS)
November 1, 2002... Parlem Clar (Straight Talk) is an HIV and pregnancy prevention programme for secondary school youth aged 17. It promotes condom use, enables access to condoms in the school setting and is partially delivered by peer educators. It consists of...

In-school HIV/AIDS programmes.(HIV/AIDS)
November 1, 2002... Schools that provide HIV/AIDS prevention programmes to their students need to be aware that some students have sex at early ages, that students' knowledge about sex, HIV and prevention is uneven, and that both male and female students are...

Cone biopsy can be used to treat carcinoma in situ of the cervix in HIV-positive women.(HIV/AIDS)
November 1, 2002... Despite lack of evidence, some physicians feel that hysterectomy may be a better option for preventing the recurrence of cervical intra-epithelial neoplasia. A retrospective case-control study in North America of 45 HIV-positive women diagnosed...

Could topical vaginal oestrogen treatment increase women's resistance to HIV infection?(HIV/AIDS)
November 1, 2002... The human vaginal epithelium is well-supplied with HIV-receptive Langerhans cells, overlain by a stratified squamous epithelium. This epithelium is oestrogen-dependent, being thickest at around the time of ovulation, and thinnest just before...

First round for the Global Fund.(HIV/AIDS)
November 1, 2002... The Global Fund to Fight AIDS, Tuberculosis and Malaria awarded a total of US$378 million over two years to 40 programmes in 31 countries. Its Board also agreed a fast-track process to approve an additional US$238 million for 18 proposals in 12...

Review of financial resources for HIV/AIDS, Vietnam.(HIV/AIDS)
November 1, 2002... The HIV/AIDS epidemic is growing rapidly in Vietnam. Government officials and UNAIDS in Vietnam undertook a study on the human and financial resources and goods and services for HIV/ AIDS available in the period 1997-2001. Questionnaires were...

Internet sexual health chatroom.(HIV/AIDS)
November 1, 2002... With the advent of advances in computer technology, sexual health promotion can be packaged in more innovative ways so as to sustain sexual health promotion campaigns. Health and development issues are now commonly discussed using e-mail...

Zimbabwe programme for young people: plenty of lessons.(HIV/AIDS)
November 1, 2002... The Zimbabwe National Family Planning Council with technical assistance from the Johns Hopkins University Population Communication Services launched a project called Promotion of Youth Responsibility. This was a six-month multimedia campaign to...

Swedish website on sexuality for young women.(HIV/AIDS)
November 1, 2002... In September 2001 LAFA, a project of Stockholm County Council, Sweden, launched a new website on the Internet called . The site is directed towards young women and contains information about the female body and sexual organs, women's sexuality...

Catch the Sperm: Swiss HIV computer game.(HIV/AIDS)
November 1, 2002... At the beginning of 2001, many Swiss NGO Internet sites offered a large quantity of good material on HIV/AIDS, but they suffered from a chronic lack of visitors. The national AIDS prevention campaign (STOP AIDS) set up a portal which would...

Condom promotion campaigns among youth: Brazil, Tanzania, Mexico.(HIV/AIDS)
November 1, 2002... Football and condoms are a winning combination in Brazil. A new line of condoms depicting the logos of the most popular Brazilian teams went on sale in February 2002 and has already become a commercial success. Television advertisements in...

South African study traces condom usage.(HIV/AIDS)
November 1, 2002... Early analysis of a pilot study in South Africa to trace the fate of condoms distributed at four clinics reveals that condoms are used quite rapidly, and that the overall rate of actual condom use is high and wastage lower than anticipated in a...

WHO/CONRAD technical consultation on nonoxynol-9, World Health Organization, Geneva, 9-10 October 2001: summary report *.(HIV/AIDS)
November 1, 2002... Abstract This report summarises the evidence presented to a technical consultation on the safety of N-9 and its effectiveness for protection against pregnancy, sexually transmitted infections and HIV, organized by the World Health Organization...

Considerations regarding re-use of the female condom: information update, 10 July 2002 *: World Health Organization.(HIV/AIDS)
November 1, 2002... Abstract The World Health Organization (WHO) recommends use of a new male or female condom for every act of intercourse where there is a risk of unplanned pregnancy and/or sexually transmitted infection, including HIV. Since access to female...

Integrating reproductive health services in sub-Saharan Africa.(Law and Policy)
November 1, 2002... An analysis of policy for the integration of HIV/STD programmes and maternal and child health and family planning (MCH/FP) services in Ghana, Kenya, South Africa and Zambia reveals that in spite of significant efforts at national level,...

Avoiding medical poverty and ensuring equity in health sector reform.(Law and Policy)
November 1, 2002... Positive assumptions about some central pillars of health sector reform are collapsing in light of actual rather than predicted effects experienced by families and communities in developing countries. User fees and the growth of out-of-pocket...

Effect on health equity analysed in World Health Report 2000.(Law and Policy)(Brief Article)
November 1, 2002... The World Health Report 2000 introduced a new approach to measuring health inequalities but does not provide guidance on resource allocation or improving national health policy. It also fails to measure social inequalities and other social...

Targeted redistribution could support more equitable health sector reform.(Law and Policy)(health sector reform in Tanzania)
November 1, 2002... This paper aims to provide an alternative framework for achieving a more equitable and sustainable distribution of health services and resources, using the example of Tanzania. Like most African countries, health sector reform in Tanzania began...

Basic health insurance in Bolivia and equity for the poor.(Law and Policy)
November 1, 2002... Reform of Bolivia's health sector centres around a three-pronged, equity-oriented approach, namely basic health insurance (SBS) administered by local government; a strategic "epidemiological field" approach, administered by the national...

Sterilisation abuse in Peru leads to apology.(Law and Policy)(Brief Article)
November 1, 2002... During Fujimori's presidency in the 1990s, previously limited public family planning services in Peru were greatly increased, including for sterilisation. Under the programme, some 200,000 Peruvian women were sterilised, almost three times more...

Appalling treatment of pregnant women in North Korean prisons reported.(Law and Policy)(Brief Article)
November 1, 2002... Thousands of women who fled to China in 2000-01 were later deported, and many are currently in North Korean prison camps. Escapees from the camps report appalling conditions, including that pregnant women prisoners are being forced to undergo...

Global fertility decline faster than predicted.(Law and Policy)(Brief Article)
November 1, 2002... Contrary to previous predictions that population growth in the developing world would continue unmitigated for several decades, there has been a significant reduction in fertility rates, especially in some countries with the largest...

Bush administration seeks more funding for abstinence-only education.(Law and Policy)(Brief Article)
November 1, 2002... The Bush administration has proposed a dramatic increase in the funding for abstinence-only education programmes. The intention is to ensure "parity" between what the federal government spends on abstinence-only education and family planning...

UK court rules that donor children have right to know their origins.(Law and Policy)(Brief Article)
November 1, 2002... Sperm and egg donors in the UK should lose their fight to anonymity, according to recommendations by the Human Fertilisation and Embryology Authority in response to a consultation paper on possible changes to the law. Infertility specialists...

IVF procedures need more regulation and monitoring.(Law and Policy)(Brief Article)
November 1, 2002... Mistakes identified during IVF procedures in the Netherlands and US point to the need for more stringent regulation and monitoring. In 1993, a white Dutch couple gave birth to twins--one white and one black. It was found that the pipette used...

Italian government regulates assisted reproductive technology.(Law and Policy)
November 1, 2002... A bill was recently approved in one house of the Italian Parliament to regulate assisted reproductive technology (ART), which has been unregulated for 36 years. It must still be approved by the Senate. The measure places a long list of bans and...

Australian government moves to deny IVF to single and lesbian women.(Law and Policy)(Brief Article)
November 1, 2002... In a move to prevent single and lesbian women from accessing in vitro fertilisation (IVF), Australian prime minister John Howard has denied MPs a conscience vote on the matter. Additionally, the cabinet is planning to change the Sex...

Economic crisis in Zimbabwe increases sanitary protection costs.(Law and Policy)(Brief Article)
November 1, 2002... The economic crisis in Zimbabwe has pushed the price of sanitary pads and tampons beyond the reach of many women. Women's groups first raised the issue more than a year ago but costs have continued to rise and analysts predict they will keep...

Abortion with vaginal misoprostol alone--88% effective.(Service Delivery)(Brief Article)
November 1, 2002... A trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for medical abortion found that mifepristone + vaginal misoprostol was more effective (95.7%) for termination of pregnancies of 56 days or less. However, an 88%...

Abortion with sublingual misoprostol alone--86% effective.(Service Delivery)(Brief Article)
November 1, 2002... Researchers have found that 600 [micro]g misoprostol administered sublingually (under the tongue) every three hours for a maximum of five doses resulted in an overall complete abortion rate of 86%. The regimen, used by 50 women requesting...

Incorrect information about medical abortion on certain internet sites.(Service Delivery)(Brief Article)
November 1, 2002... Many websites about medical abortion targeted at the general public contain incorrect information, i.e. information that differs from recommendations, clinical trial results and side effects reported in peer-reviewed medical journals. An...

US FDA, Pharmacia new ruling on misoprostol.(Service Delivery)(Food and Drug Administration)(Brief Article)
November 1, 2002... In April 2002, the US Food and Drug Administration (FDA), in conjunction with the pharmaceutical company Pharmacia, removed the contra-indication for use of misoprostol (brand name Cytotec) in pregnant women. The FDA clarified that this...

Medical abortion to be more widely available in UK.(Service Delivery)(Brief Article)
November 1, 2002... The British government is planning to allow family planning clinics to offer early medical abortion. At present medical abortion can only be provided to women attending hospital-based abortion clinics and other licensed day units. Family...

Modified surgical procedure for second-trimester abortion introduced in Vietnam.(Service Delivery)(Brief Article)
November 1, 2002... A modified dilatation and evacuation procedure is now provided by the Hanoi Obstetrics-Gynaecology Hospital in place of a less safe method previously being used. One-third of all pregnancies in Vietnam end in abortion, up to 3% in the second...

Providing family planning after abortions, Turkey.(Service Delivery)
November 1, 2002... The abortion rate in Turkey fell steadily following the legalisation of abortion in 1983, but was still relatively high in the early 1990s largely due to many women relying on abortion for fertility control in the absence of adequate family...

Women on Waves set to sail again.(Service Delivery)(Brief Article)
November 1, 2002... Women on Waves, the Dutch abortion rights ship, is committed to working with local women's groups in countries where abortion is illegal [1]. In April 2001, before its pilot voyage to Ireland in 2002, Women on Waves applied for a Dutch license...

Emergency contraception over-used in Thailand.(Service Delivery)(Brief Article)
November 1, 2002... Evidence is emerging that some women in Thailand are using emergency contraception (EC) as a regular form of birth control. Frequent use decreases the effectiveness of EC, putting a woman at greater risk of becoming pregnant. Researchers are...

Contraceptive implant provision expanded in Kenya.(Service Delivery)
November 1, 2002... A well-supervised and careful expansion of contraceptive implant services in Kenya between 1992 and 1996 has resulted in quality services being provided at more than 70 sites in the country. Key strategies include on the job training and...

High rates of episiotomy in Latin America unjustified.(Service Delivery)(Brief Article)
November 1, 2002... Evidence shows that routine episiotomy is not justified because it increases the risk of perineal suturing and complications by seven days postpartum, produces unnecessary pain and discomfort, and has potentially harmful longer-term effects....