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Biomedical subjects

J T Bertrand

Publications and source records attributed to J T Bertrand.

At least 19 recordsLinked to original sources

Empirically based conversion factors for calculating couple-years of protection.

Couple-years of protection (CYP) is one of several commonly used indicators to assess international family planning efforts. It has been the subject of much debate, relating in part to the specific conversion factors used to translate the quantity of the respective contraceptive methods distributed to a single measure of protection. This article outlines a comprehensive effort to revisit those conversion factors based on the best available empirical evidence. In most instances, the analysis supports previously established standard conversion factors. However, there are two notable departures. Fewer condoms and spermicides are recommended for each CYP (120 vs. 150), primarily because coital frequency among condom users is lower than previously assumed. Furthermore, for sterilization, the authors recommend the use of country or region-specific conversion factors. Every program evaluation indicator has strengths and weaknesses, and the best program evaluation efforts use a variety of indicators. If CYP is used to evaluate programs, however, the authors believe that the conversion factors presented reflect the best available evidence.

Adolescent↗

The results framework--an innovative tool for program planning and evaluation.

This article constitutes a case study of the development and implementation of the "results framework," an innovative planning and evaluation tool that is rapidly becoming a standard requirement for United States Agency for International Development (USAID) projects. The framework is used in a USAID-funded regional initiative for HIV/AIDS prevention in Central America. This new program evaluation and monitoring tool provides many advantages over traditional evaluation approaches that use outside consultants to provide midterm and end-of-project evaluations. The results-framework process, which spans the life of the project, provides an opportunity for program staff, donors, partners, and evaluators to work as a team to collect and use rich, longitudinal data for project planning, implementation, and evaluation purposes.

Central America↗

The male versus female perspective on family planning: kinshasa, zaire.

Males have often been neglected in both family planning programmes and in surveys used to design and evaluate such programmes. A 1988 study on fertility, family planning and AIDS in Kinshasa, Zaire, provides comparable data on 3140 men and 3485 women of reproductive age which served as the basis for analysing male/female differences. The study indicated a fair degree of similarity in the attitudes, beliefs, knowledge levels and practices of men and women regarding fertility and family planning. Where they differed (e.g. on expected or ideal number of children, the desire for more children at parity 7 or above), men tended to be more pronatalist than women. The implications of the findings for future family planning programmes are discussed. Programmes should target males because of their role as decision makers within Zairian society.

Adolescent↗

AIDS knowledge in three sites in Bas-Zaire.

This study surveyed 5,494 women in one urban and two rural sites of Bas-Zaire on their knowledge, attitudes, and practices regarding AIDS. The AIDS Risk Reduction Model (ARRM) was used to analyze the results to better understand factors that may be related to motivation for behavior change. The results show that there are considerable barriers to achieving the first stage of the 3-stage model. Most notably, only a third of the women believed they were at risk of getting AIDS. Those aged 25-29, educated, and married felt themselves to be most at risk. Results are compared to other knowledge, attitudes, and practices studies conducted in Zaire. Policy implications of these results are discussed.

Acquired Immunodeficiency Syndrome↗

The effect of sex education on teenagers in St. Kitts and Nevis.

Knowledge of sexual matters is one of several key factors capable of influencing teenage reproductive behavior. This article reports the results of initial and followup surveys designed to test such knowledge among adolescent students in St. Kitts and Nevis before and after they received a family life/sex education course in the mid-1980s. This course provided information about fundamentals of human reproduction and contraception, human growth and development, emotional development, and issues of adolescent sexuality.

Adolescent↗

Duration and correlates of post-partum abstinence in four sites in Zaire.

Data on 2223 women with a child less than 25 months of age from four sites of two regions in Zaire were analyzed. The univariate correlates of current abstinence were determined on this population. A sub-sample of 778 women was then drawn for the development of multivariable model of predictors of the duration of abstinence. The median duration of abstinence in the two urban and two rural sites ranged from 4.5 to 8.8 months. The final multivariable model showed that low socio-economic status, rural residence, more living children, prolonged duration of breastfeeding and non-Zairian nationality were all important predictors of prolonged duration of abstinence. The relationship of duration of abstinence to that of amenorrhea is also important. While approx. 18% of the women included in this analysis continued to abstain for at least one month beyond the resumption of menses, the vast majority who did resume relations represent a target population for utilization of an alternate means of pregnancy prevention.

Adult↗

AIDS-related knowledge, sexual behavior, and condom use among men and women in Kinshasa, Zaire.

This study was conducted in 1988 among a random sample of 6,625 men and women of reproductive age in all 24 administrative zones of Kinshasa, the capital city of Zaire, to determine existing levels of knowledge regarding AIDS (acquired immunodeficiency syndrome), sexual behavior, knowledge and use of condoms in marital and extramarital relations; perceived risk of AIDS, and attitudes toward testing for the human immunodeficiency virus (HIV). Awareness of AIDS is almost universal, and the vast majority know the four main modes of transmission. Almost half believed in transmission by mosquitoes and in a vaccine or cure for AIDS. The majority of male respondents knew of condoms, but negative attitudes toward condom use are widespread, and few respondents perceived them to play a central role in combatting AIDS.

AIDS Serodiagnosis↗

Post-partum events and fertility control in Kinshasa, Zaïre.

Contraceptive prevalence surveys from sub-Saharan Africa typically show low rates of method use. The current study of one zone in Kinshasa, Zaïre, provides a more detailed view of fertility control in an urban population by examining the relative duration of breast-feeding, amenorrhoea and sexual abstinence during the post-partum period. While motivations to prevent pregnancy remain high until the youngest child is over 24 months, the average duration of abstinence is only 4 months. This paper describes the methods women use to avoid pregnancy and the changes over the post-partum period.

Adolescent↗

Public opinion on and potential demand for vasectomy in semi-rural Guatemala.

In this study of 1,600 men aged 25-50 from semi-rural Guatemala, three-fourths had heard of vasectomy. Among these, 54 per cent approved of it. However, the survey reveals a widespread lack of knowledge regarding the procedure, as well as negative perceptions or doubts about its effect on sexual performance, ability to do hard work, health, and manhood. One-fourth of the respondents who knew of vasectomy and who desired no more children expressed interest in having the operation, a finding which raises questions as to the potential (unrecognized) demand for vasectomy in other developing countries.

Adult↗

Evaluation of family planning communications in El Salvador.

During the 1970s, El Salvador had one of the most active communication programmes for family planning (FP) of any Latin American country. The current study, carried out nationwide among women of reproductive age in El Salvador, indicates that over 90% of women have been reached FP messages via mass or interpersonal channels. Levels of exposure were found to be relatively lower among women who live in rural areas, who work at home or not at all, who have little education, who are not married or live in union, and who are under 19 or over 40. The study was completed at a time of political stability in the country, and these data were to be used as a guideline for designing future communication programmes with respect to content, target population, and channels. With regard to communication research, this study yielded findings which usefully supplement those already recorded through a number of investigations of the subject.

Adult↗