Do M.,Global Development Systems
Disaster Medicine and Public Health Preparedness | Year: 2015
Objective We aimed to examine the relationship between exposure to the 2010 Haiti earthquake and pregnancy wantedness, interpregnancy interval, and birth weight. Methods From the nationally representative Haiti 2012 Demographic and Health Survey, information on size of child at birth (too small or not) was available for 7280 singleton births in the previous 5 years, whereas information on birth weight was available for 1607 births. Pregnancy wantedness, short (<1 year) interpregnancy interval, and maternal-reported birth weight were compared before and after the earthquake and by level of damage. Multiple logistic regression and linear regression analyses were conducted. Results Post-earthquake births were less likely to be wanted and more likely to be born after a short interpregnancy interval. Earthquake exposure was associated with increased likelihood of a child being born too small: timing of birth (after earthquake vs. before earthquake, adjusted odds ratio [aOR]: 1.27, 95% confidence interval [CI]: 1.12-1.45), region (hardest-hit vs. rest of country; aOR: 1.43, 95% CI: 1.14- 1.80), and house damage (aOR: 1.27 95% CI: 1.02-1.58). Mean birth weight was 150 to 300 g lower in those exposed to the earthquake. Conclusions Experience with the earthquake was associated with worse reproductive and birth outcomes, which underscores the need to provide reproductive health services as part of relief efforts. Copyright © Society for Disaster Medicine and Public Health, Inc. 2015.
Ettenger A.,Jacaranda Health |
Barnighausen T.,Harvard University |
Barnighausen T.,Africa Center for Health and Population Studies |
Castro A.,Global Development Systems
Health Policy and Planning | Year: 2014
Prevention of mother-to-child transmission of HIV was added to standard antenatal care (ANC) in 2000 for Colombians enrolled in the two national health insurance schemes, the 'subsidized regime' (covering poor citizens) and the 'contributory regime' (covering salaried citizens with incomes above the poverty threshold), which jointly covered 80% of the total Colombian population as of 2007. This article examines integration of HIV testing in ANC through the relationship between ordering an HIV test with the type of health insurance, including lack of health insurance, using data from the nationally representative 2005 Colombia Demographic and Health Survey. Overall, health-care providers ordered an HIV test for only 35% of the women attending ANC. We regressed the order of an HIV test during ANC on health systems characteristics (type of insurance and type of ANC provider), women's characteristics (age, wealth, educational attainment, month of pregnancy at first antenatal visit, HIV knowledge, urban vs. rural residence and sub-region of residence) and children's characteristics (birth order and birth year). Women enrolled in the subsidized regime were significantly less likely to be offered and receive an HIV test in ANC than women without any health insurance (adjusted odds ratio = 0.820, P < 0.001), when controlling for the other independent variables. Wealth, urban residence, birth year of the child and the type of health-care provider seen during the ANC visit were significantly associated with providers ordering an HIV test for a woman (all P < 0.05). Our findings suggest that enrolment in the subsidized regime reduced access to HIV testing in ANC. Additional research is needed to elucidate the mechanisms through which the potential effect of health insurance coverage on HIV testing in ANC occurs and to examine whether enrolment in the subsidized regime has affected access to other essential health services. © 2013 The Author. All rights reserved.
Hembling J.,Global Development Systems |
Andrinopoulos K.,Global Development Systems
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV | Year: 2014
Intimate partner violence (IPV) is a significant public health problem with a demonstrated link to increased sexually transmitted infection (STI)/HIV-related risk and vulnerability. While IPV is an important issue in Central America, the link to STI/HIV risk has not been explored in this region. In this study, the relationship between emotional and physical/sexual IPV and the STI/HIV-related risk behaviors of sex worker patronage and infidelity is assessed among male IPV perpetrators using data from a national survey conducted in 2009 in Guatemala (n = 4773 married/partnered men). Bivariate associations between background characteristics and emotional and physical IPV perpetration were explored. Logistic regression models were run to test associations between IPV for each sexual risk behavior. Perpetration of emotional and physical/sexual IPV was more common among married/partnered men who were older than 24, had more education, lived in urban areas, or were in common law versus married unions. Reports of past-year emotional IPV perpetration increased as wealth quintile increased. After adjusting for demographics and other characteristics, physical/sexual IPV perpetration was associated with past-year infidelity (AOR 1.9, 95% CI: 1.1-3.6). Lifetime emotional IPV (AOR 1.4, 95% CI: 1.1-1.7) and physical/sexual IPV 1.6 (95% CI 1.2-2.0) were positively associated with a history of sex worker patronage. Endorsement of traditional gender role norms showed a marginally positive association with past-year infidelity in the adjusted model (AOR 1.3, 95% CI 1.0-1.8). The study findings from Guatemala reinforce the growing evidence globally that male IPV perpetrators are more likely to engage in risky sexual behavior, including sex worker patronage and main partner infidelity. The concurrency of violence and increased STI/HIV risk may compound the health risks for female victims of IPV who also face injury and psychological trauma. Integration of prevention and screening of IPV and STI/HIV prevention services should be adopted in Guatemala and other similar contexts. © 2014 Taylor and Francis.
Paz-Soldan V.A.,Global Development Systems
African journal of reproductive health | Year: 2012
Using a sample of 656 men and 930 women from rural Malawi in 2000, the authors examined the association between various individual and community level factors, as well as participation in social groups, and four reproductive health outcomes: intentions to use any contraceptives in the next six months, current use of modem contraceptives, wanting an HIV test, and having had an HIV test. Women in social groups have higher odds of reporting intentions to use contraceptives, wanting an HIV test, and of having had an HIV test than those not in groups. Among men, social group participation is only slightly associated with having had an HIV test. For all, education is positively associated with all four outcomes, and number of children is associated with intentions to use and actual use of contraceptives. At a community level, proximity to a health center or school is positively associated with three outcomes for women and with use of modern contraceptive methods for men.
Patel B.,Global Development Systems
Advance Engine Design and Performance | Year: 2013
Customers seek alternatives and options Urea SCR will continue to be a leading NOx abatement technology, but there are technical limitations HC LNC has been demonstrated to be a viable option for commercial trucks; natural fit with Brazil's ethanol infrastructure Gaseous ammonia dosing technology may be an effective option for new LDV regulations Technology ‡ Optimization The right technology is critical, but its only part of emission control strategy System & Performance Engineering = Optimization An optimized emission control solution balances engine, fuel, & aftertreatment technology together with costs early during development.
Global Development Systems | Date: 2014-06-26
Global Development Systems | Date: 2016-11-30
Global Development Systems | Date: 2014-06-27
Global Development Systems | Date: 2014-06-26