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PubMed1993

Nepal launches new projects.

The CEDPA Nepal Country Office (NCO), directed by Mana Rana (WIM 5 and S&E 13), has launched an expanded leadership training program for women's NGOs and new service delivery projects under a 5-year grant extension from USAID. With additional support from the UNFPA, the NCO will undertake a new project with the Mothers' Club, a national women's NGO. The project will mobilize women and women's organizations to address grassroots needs. The CEDPA ACCESS Project recently funded the Nepal Red Cross and Family Planning Association of Nepal to begin community-based family planning projects. Trained volunteers will distribute nonclinical contraceptives from their homes, provide services through home visits, and refer clients to clinics. Nancy Russell, a nonprofit manager with 20 years of experience, has been appointed CEDPA resident coordinator for Nepal.

Asia↗
PubMedDate not supplied

Reproductive health in Romania: reversing the Ceausescu legacy.

As a result of the restrictive reproductive health policies enforced under the 25-year Ceausescu dictatorship, Romania ended the 1980s with the highest recorded maternal mortality of any country in Europe--159 deaths per 100,000 live births in 1989. An estimated 87 percent of these maternal deaths were caused by illegal and unsafe abortion. Under the Ceausescu regime, all contraceptive methods were forbidden and induced abortion was available only for women who met extremely narrow criteria. Immediately after the December 1989 revolution that overthrew Ceausescu, the new government removed restrictions on contraceptive use and legalized abortion. This legislative change has had beneficial effects on women's health, seen in the drop in maternal mortality in 1990 to 83 deaths per 100,000 live births--almost half the ratio in 1989. In addition, changes instituted since the revolution have led to the improved availability of reproductive health services and to the creation of new educational and training opportunities related to reproductive health services and to the creation of new educational and training opportunities related to reproductive health. The newly created contraceptive and abortion services have presented health system managers and policymakers with many challenges as they work to expand the availability of high-quality, comprehensive reproductive health care in a setting of economic hardship, political unrest, insufficient infrastructure, and outdated medical knowledge and practice.

Abortion, Legal↗
PubMed1982

Women--the underused human resource: education and training of women for community participation.

This article goes beyond the rhetorical issue of women's participation as a key to implementing water supply and sanitation projects and suggests concrete ways in which training and education can make these plans a reality. With the improvements proposed for the International Drinking Water Supply and Sanitation Decade, women could be freed to do other tasks vital to the well being of the family and the community. Women, the "invisible resource" of society, play and essential part in encouraging family members to use technological advances and should be trained to effectively promote their acceptance. The author highlights the influence women have in the field of public health: with adequate training, for example, they can help control the spread of diarrheal disease with proper hygiene and an understanding of the fecal-oral route of infection. Moreover, she says that the central role women play in socializing the young and their permanence within the household make them suitable as trainees and trainers for water and sanitation projects at the community and household levels. Women should be recruited for these roles and should be consulted at every stage of development; while women's bureaus exist in many countries, the author states that planners often hesitate to call on them for assistance. The article describes several innovative training programs and, along with a bibliography, presents separate case studies for Mexico and Panama.

Africa↗
PubMed1996

Effects of an institutional AIDS prevention intervention: moderation by gender.

AIDS risk reduction programs are being conducted in many institutional settings, but rigorous evaluations of their effectiveness are lacking. This is particularly unfortunate in that these programs are expensive, and tend to be of lower intensity than those that have been shown to be effective. Further, risk reduction is generally regarded as entailing greater difficulty for women, who do not use condoms themselves but must negotiate their use with male partners. We used a quasi-experimental design to evaluate an institutional AIDS prevention program on a New Jersey college campus. Sexual behavior was assessed via linked, anonymous mailed surveys at the beginning and end of an academic year among 1st-year students on the campus and others on a nearby control campus. Responses from the spring survey indicated that intervention campus students had been exposed significantly more than control students to intervention components. While MANCOVA analyses indicated no main effect of treatment group on outcome variable, we obtained a significant group by gender interaction, indicating a significant effect on number of risky encounters for men but not for women. In fact, relative to women on the control campus, women on the intervention campus displayed reduced self-efficacy to perform safe sex at the end of the year. These results may indicate that although men can be effectively reached by low-intensity risk reduction programs, women may not be. In fact, interventions without adequate intensity to provide substantial and individualized negotiation skill training may cause women to experience failure in these efforts.

Adolescent↗
PubMed1992

Comparison of the clinical profile and outcome of women and men in cardiac rehabilitation.

Few data are available regarding the outcome of women in cardiac rehabilitation. To determine whether women differ from men in clinical profile and outcome, 225 consecutive patients were prospectively evaluated in an urban, multidisciplinary, exercise-based cardiac rehabilitation program. Among the 51 women (age 56 +/- 10) and 174 men (age 54 +/- 10), most were: white (84%), married (64%), employed (63%), had had myocardial infarction or revascularization, or both (66%), and traveled less than 10 miles to the program (92%). Risk profiles revealed obesity in 48% (mean Metropolitan Relative Weight = 124 +/- 22%), hypertension in 47%, smoking in 23%, diabetes in 16%, and mean cholesterol of 236 +/- 45 mg/dl. Compared with men, more women were nonwhite, unemployed, unmarried, hypertensive or diabetic (p less than 0.0001) and had higher cholesterol (p less than 0.01). Compliance rates were similar for women (51%) and men (63%) (p = not significant). Univariate predictors of program noncompliance differed between women and men. Initial exercise capacity was less for women than for men, but both groups achieved a similar training effect. Women increased their exercise time by 31% and peak METs by 30%, whereas men showed a 21% increase in exercise time and 16% increase in peak METs achieved (p less than 0.001). Thus, in this cardiac rehabilitation program, women have a less favorable risk factor profile and differ from men with regard to baseline demographics and predictors of program completion. Women, however, have similar rates of compliance and achieve the same improvement in functional capacity with training.

Adult↗
PubMed2001

Reintegrating women leaving jail into urban communities: a description of a model program.

Women are the fastest-growing population in the criminal justice system, and jails reach more people than any other component of the correctional system. About 1 million women pass through US jails each year. Most return to their communities within a few weeks of arrest, and few receive help for the substance abuse, health, psychological or social problems that contribute to incarceration. We describe a model program, Health Link, designed to assist drug-using jailed women in New York City to return to their communities, reduce drug use and HIV risk behavior, and avoid rearrest. The program operates on four levels: direct services, including case management for individual women in the jail and for 1 year after release; technical assistance, training, and financial support for community service providers that serve ex-offenders; staff support for a network of local service providers that coordinate services and advocate for resources; and policy analysis and advocacy to identify and reduce barriers to successful community reintegration of women released from jail. We describe the characteristics of 386 women enrolled in Health Link in 1997 and 1998; define the elements of this intervention; and assess the lessons we have learned from 10 years of experience working with jailed women.

Adult↗
PubMed1995

A quarter-century of experience with career change education: an option for turning specialists into generalists.

The Physician Refresher program, now 25 years old, at the Medical College of Pennsylvania offers training to clinically inactive physicians. The authors examined the characteristics of program participants to determine whether specialists who took the program to prepare for a change to a primary care career made the intended change. Application data from all registrants between 1982 and 1993 were compared with data on previously reported groups from 1968-1975 and 1976-1981. Specialist registrants' subsequent practice activities were documented from the AMA Medical Directory and the American Board of Medical Specialties Directory; a telephone survey elicited their reasons for making or not making the career change to primary care. During the last decade of the program women registrants constituted 36% of the total; international medical graduates (IMGs) 43%; and clinically inactive physicians 38%. Specialists outnumbered those in primary care by two to one. Although 65% of specialists planned to switch to primary care, ultimately only 27% of the total did so; many, especially the IMGs, were serving the disadvantaged. Those who did not switch cited a variety of disincentives, including individual educational needs not met by a general refresher course. If the medical profession accepts the need to devise programs that "retool" specialists to provide primary care, those programs should be specifically designed to address the individual needs of the specialists involved. Concomitantly, the incentives to make the switch need to be enhanced.

Adult↗
PubMed1988

Decree No. 15-88, February 1988.

This Decree approves the Plan of Operations entered into by the Government of Honduras and the UN Children's Fund (UNICEF) with respect to women and children for the years 1987-91. The general objective of the Plan is to monitor and improve the situation of women and children in Honduras by means of providing the following services: 1) early attention to and development of children; 2) basic services for rural women and children; and 3) intersectoral social planning and promotion of infancy. Among the specific services to be provided are literacy training and adult education for women, infant nutrition, and programs of social support for women and children. Further provisions of the Decree set forth the details of the Plan for the year 1987, as well as provisions on past agreements between the Government of Honduras and UNICEF, monitoring and evaluation, and the contributions of the Government of Honduras and UNICEF, among other things. UNICEF's contribution is US$1,465,000.

Adolescent↗