Health services for reproductive tract infections among female migrant workers in industrial zones in Ha Noi, Viet Nam: an in-depth assessment

BACKGROUND: Rural-to-urban migration involves a high proportion of females because job opportunities for female migrants have increased in urban industrial areas. Those who migrate may be healthier than those staying in the village and they may benefit from better health care services at destination, but the 'healthy' effect can be reversed at destination due to migration-related health risk factors. The study aimed to explore the need for health care services for reproductive tract infections (RTIs) among female migrants working in the Sai Dong industrial zone as well as their services utilization. METHODS: The cross sectional study employed a mixed method approach. A cohort of 300 female migrants was interviewed to collect quantitative data. Two focus groups and 20 in-depth interviews were conducted to collect qualitative data. We have used frequency and cross-tabulation techniques to analyze the quantitative data and the qualitative data was used to triangulate and to provide more in-depth information. RESULTS: The needs for health care services for RTI were high as 25% of participants had RTI syndromes. Only 21.6% of female migrants having RTI syndromes ever seek helps for health care services. Barriers preventing migrants to access services were traditional values, long working hours, lack of information, and high cost of services. Employers had limited interests in reproductive health of female migrants, and there was ineffective collaboration between the local health system and enterprises. These barriers were partly caused by lack of health promotion programs suitable for migrants. Most respondents needed more information on RTIs and preferred to receive these from their employers since they commonly work shifts--and spend most of their day time at work. CONCLUSION: While RTIs are a common health problem among female migrant workers in industrial zones, female migrants had many obstacles in accessing RTI care services. The findings from this study will help to design intervention models for RTI among this vulnerable group such as communication for behavioural impact of RTI health care, fostered collaboration between local health care services and employer enterprises, and on-site service (e.g. local or enterprise health clinics) strengthenin

Historical emissions of carbonaceous aerosols from biomass and fossil fuel burning for the period 1870–2000

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94787/1/gbc1172.pd

Explaining inconsistencies between data on condom use and condom sales

BACKGROUND: Several HIV prevention programs use data on condom sales and survey-based data on condom prevalence to monitor progress. However, such indicators are not always consistent. This paper aims to explain these inconsistencies and to assess whether the number of sex acts and the number of condoms used can be estimated from survey data. This would be useful for program managers, as it would enable estimation of the number of condoms needed for different target groups. METHODS: We use data from six Demographic and Health Surveys to estimate the total annual number of sex acts and number of condoms used. Estimates of the number of sex acts are based on self-reported coital frequency, the proportion reporting intercourse the previous day, and survival methods. Estimates of the number of condoms used are based on self-reported frequency of use, the proportion reporting condom use the previous day and in last intercourse. The estimated number of condoms used is then compared with reported data on condom sales and distribution. RESULTS: Analysis of data on the annual number of condoms sold and distributed to the trade reveals very erratic patterns, which reflect stock-ups at various levels in the distribution chain. Consequently, condom sales data are a very poor indicator of the level of condom use. Estimates of both the number of sexual acts and the number of condoms used vary enormously based on the estimation method used. For several surveys, the highest estimate of the annual number of condoms used is tenfold that of the lowest estimate. CONCLUSIONS: Condom sales to the trade are a poor indicator of levels of condom use, and are therefore insufficient to monitor HIV prevention programs. While survey data on condom prevalence allow more detailed monitoring, converting such data to an estimated number of sex acts and condoms used is not straightforward. The estimation methods yield widely different results, and it is impossible to determine which method is most accurate. Until the reliability of these various estimation methods can be established, estimating the annual number of condoms used from survey data will not be feasible. Collecting survey data on the number of sex acts and the number of condoms used in a fixed time period may enable the calculation of more reliable estimates of the number of sex acts and condoms used

DIET AND THE GEOGRAPHICAL DISTRIBUTION OF MULTIPLE SCLEROSIS

Data are presented to suggest that a geographical predisposing factor (G.P.F.) in multiple sclerosis (M.S.) may reflect regional dietary differences, and, further, that this factor is directly related to milk production or consumption. A number of biochemical hypotheses are proposed which would predict a resultant weakened blood-brain barrier or immunological defence, or the production of defective myelin, which would then increase susceptibility to the aetiological agent, possibly a virus. From the standpoint of brain development, two different ideas emerge--one, that differences in the composition of bovine and human milk, particularly during weaning, lead to the G.P.F.; the other, that drinking of milk beyond the normal nursing period is detrimental. More epidemiological studies are needed, with emphasis on diet, especially during periods of rapid brain development. Cow's milk may be an unfortunate substitute for human milk in infancy or a risky food source thereafter, or both. Epidemiological data raise these questions but do not provide ready answers. The milk correlation could be spurious, but at least ideas based on such a correlation pay attention to the most important epidemiological clue in M.S.--namely, the geographical distribution of the disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/22234/1/0000668.pd

Differentials of fertility in North and South Gondar zones, northwest Ethiopia: A comparative cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Ethiopia is one of the most densely populated countries in Africa with an estimated population of 77.1 million in mid-2007. Uncontrolled fertility has adversely influenced the socio-economic, demographic and environmental situations of the country. It is one of the largest and poorest countries that, even in the midst of crisis, has maintained high levels of fertility. This study was aimed at investigating the most important factors influencing fertility behavior in Northwest Ethiopia.</p> <p>Methods</p> <p>A comparative cross-sectional study which included 2424 women aged 25 years and above was undertaken in the Amhara region of Northwest Ethiopia. The study subjects were grouped into high fertile and low fertile categories. There were 1011 and 1413 women in the high and low fertile groups, respectively. A multi-stage cluster sampling stratified by place of residence was employed to select the required study subjects. Both bivariate and multivariate logistic regression techniques were used to analyze the data.</p> <p>Results</p> <p>Among the 25 variables considered in this study, only 9 of them were found significantly and independently associated with the level of fertility. Women with at least secondary education were at a lower risk of high fertility with OR = 0.37 (95% CI: 0.21 to 0.64) compared to those with no formal education. However, women with primary education did not show any significant difference when compared with the same baseline group. Age at first marriage was inversely associated with the number of children ever born alive. Place of residence, household expenditure, number of children who have died, attitude towards using contraceptives, women's knowledge on the safe period, and current marital status were the other variables that showed significant associations with the level of fertility.</p> <p>Conclusion</p> <p>Female education beyond the primary level, reduced infant and child mortality, delayed marriage and correct knowledge on the safe period during the menstrual cycle were amongst the main factors that had a bearing on high fertility.</p

Reductions in abortion-related mortality following policy reform: evidence from Romania, South Africa and Bangladesh

Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform

The role of governance in realising the transition towards sustainable societies

It is widely known that governance is central to the successful implementation of sustainable development policies and measures. Yet, there is a paucity of research which explore the links between governance and sustainability. This paper attempts to address this research need by providing an analysis of the role of governance in enabling – and to some extent – fostering a transition towards sustainable societies. A set of indicators for assessing the capacity for and willingness and commitment to transition to a more sustainable society is presented, enabling identification of direction of change. This paper presents the results of a study, in the context of which sustainability governance has been comparatively investigated in a sample of European countries with, by methodological purpose, very different economic, environmental, political and social conditions (Denmark, Finland, Germany, Latvia, Lithuania and Poland). Lessons learnt and examples of good practice – which may be replicable elsewhere-are outlined. For instance, it is discussed that limited knowledge about sustainable development amongst municipal development planners and decision-makers, deficiencies in policy integration, intersectoral cooperation, municipality and stakeholder cooperation and urban management practices are major reasons for weak governance practices in sustainable development. Furthermore, some recommendations on the role of sustainability governance are made, so as to allow the integration of the principles of governance into sustainability practice and hence provide a more general basis upon which a transition towards sustainable societies may become a reality in different types of European countries and societies. The scientific value of this paper lies in identifying opportunities for integrating principles of governance into sustainability practice, as well as outlining the basis for sustainability transitions, providing a general picture of required policy measures. The paper offers a unique comparative analysis of sustainability governance in the Baltic Sea countries, outlining some of the challenges in sustainability governance in the Baltic Sea region