Validation of night blindness reports among children and women in a vitamin A deficient population in rural Tanzania.

OBJECTIVE: This study validates different definitions of reported night blindness (XN) in a vitamin A deficient African population with no local term for XN. DESIGN: Case-control study with follow-up after treatment. SETTING: Eight primary schools and health centres in rural Tanzania. SUBJECTS: A total of 1214 participants were screened for reported XN and other eye signs of xerophthalmia: 461 children aged 24-71 months, 562 primary school-age children and 191 pregnant or breast-feeding women. All 152 cases of reported XN were selected for the validation study and group matched with 321 controls who did not complain of XN. XN reports were validated against serum retinol concentrations and pupillary dark adaptation measurements in cases and controls. INTERVENTION: All children and women who reported XN or had other signs of active xerophthalmia were treated with vitamin A and followed up 3-4 weeks later. Half of the untreated control group who had their serum retinol examined in the baseline examination were also followed up. RESULTS: The overall prevalence of reported XN was 12.5%. At baseline, mean pupillary threshold (-1.52 vs -1.55 log cd/m(2), P=0.501) and median serum retinol concentrations (0.95 vs 0.93 micromol/l, P=0.734) were not significantly different in cases and controls either overall or in each population group. More restricted case definitions reduced the prevalence of reported XN to 5.5% (P<0.001), but there was still no significant difference between cases and controls although the results were in the expected direction. After treatment, the median serum retinol concentration improved significantly only in the most deficient group, the young children. Dark adaptation improved in all the subgroups but the difference was only significant for young children and primary school-age children when the restricted case definitions were used. CONCLUSIONS: XN reports are a poor indicator of vitamin A deficiency in this population. SPONSORSHIP: Task Force Sight and Life, Basel, Switzerland.

Understanding the Intersectoral Collaboration of Rural Community Health Workers and Teachers: The Example of Addressing Violence against Women and Girls in Vulindlela, South Africa

Objectifs: Cette étude a documenté la collaboration intersectorielle entre les agents de santé communautaires (ASC) et les enseignants visant à combattre la violence à l’égard des femmes et des filles à Vulindlela, une communauté rurale Sud-Africaine. La collaboration entre ces acteurs, les facteurs qui influencent leur collaboration et les avenues possibles pour une amélioration de cette collaboration ont été explorés. Méthodes: Six ASC et cinq enseignants ont pris part à cette recherche participative qui a inclut l'utilisation du dessin comme méthodologie visuelle. La collecte de données a été réalisée en quatre phases, avec un total de huit entretiens de groupes. La stratégie d’analyse principale a inclus une approche dirigée du contenu narratif et une approche de comparaison constante. Résultats: Le système de collaboration entre les enseignants et les ASC manque de définition et ces acteurs ne peuvent donc en faire l’utilisation. Par conséquent la collaboration actuelle entre ces acteurs a été jugée peu développé, impromptue et informelle. De nombreuses contraintes à la collaboration ont été identifiées, y compris le manque de motivation de la part des enseignants, la nature des relations entre les acteurs, et la capacité individuelle limitée des ASC. Conclusion: Compte tenu des nombreuses contraintes à la collaboration entre ces ASC et les enseignants, il n'est pas évident que cette collaboration conduira aux résultats espérés. Dans l'absence de motivation suffisante et d’une prise de conscience réaliste des défis par les acteurs eux-mêmes, les initiatives externes pour améliorer la collaboration sont peu susceptibles de succès.

Level Of Women Participation In Rural Development - A Comparative Study Of Governmental And Non-Governmental Organisations In Kerala

The study is intended to estimate the existing rate of participation of women beneficiaries in the development programmes of different organisations in Kerala. It would enable one to understand whether participation is at the satisfactory level or not. Given the rate of participation, the major thrust of the analysis is on the impact of governmental and non-governmental organisations on the rate of participation. This is undertaken under the assumption that NGOs, due to their proximity to people and their needs, ensure better participation rates. Besides the organisational differences, the other major determinants of women participation such as their socio-economic characteristics, psychological make up, the nature of the programme etc. are also highlighted. 0 Since the ascribed status of women in society is inferior, the role of organisers, development personnel and local leaders is also pointed out. Thus the basic objective of the study is women participation and its determinants in the development programmes

Nutrition in Transition: Dietary Patterns of Rural Amazonian Women During a Period of Economic Change

Objectives: The goal of this study was to understand the relationship between economic change (wage labor, retirement, and the Bolsa Familia program) and dietary patterns in the rural Amazon and to determine the extent to which these changes followed the pattern of the nutrition transition. Methods: The study was longitudinal. The weighed-inventory method and economic interviews were used to collect data on dietary intake and household economics in a sample of 30 and 52 women in 2002 and 2009, respectively. Twenty of the women participated in both years and make-up the longitudinal sub-sample. Comparative statistics were used to identify changes in dietary patterns over time and multiple linear regressions were used to explore the relationship between economics, subsistence strategies, and diet. Results: There was a significant decline in kcal (P < 0.01) and carbohydrate (P < 0.01) but no change in protein intake over time in both the larger and smaller, longitudinal subsample. The percent of energy, carbohydrate, protein, and fat purchased increased in the larger and longitudinal samples (P <= 0.02) and there was an increase in refined carbohydrate and processed, fatty-meat consumption over time. The abandonment of manioc gardens was associated with increased dependence on purchased food (P = 0.03) while receipt of the Bolsa Familia was associated with increased protein intake and adequacy (P = 0.02). Conclusions: The dietary changes observed are only in partial agreement with predictions of the nutrition transition literature. The relationship between the economic and diet changes was shaped by the local context which should be considered when implementing CCT programs, like the Bolsa Familia. Am. J. Hum. Biol. 23:458-469, 2011. (C) 2011 Wiley-Liss, Inc.

Negotiating collective and individual agency : a qualitative study of young women's reproductive health in rural India

The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women's reproductive health needs. Inspired by Foucault's power idiom and Bandura's agency framework, we explore young women's opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women's reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of "modern" contraception. This approach could prevent unintended pregnancies and expand young women's agency.

Modernización y los cambios en las condiciones de vida de la mujer campesina = Modernization and the changing life chances of women in low-income rural families

Incluye Bibliografía

Expanding Women's Worlds?: Development, Gender, and Environment in Rural Morocco

This honors thesis is an anthropological exploration of women's cooperatives in two regions of rural Morocco. Specifically, I am interested in how contemporary development projects such as the cooperative are understood by the peoples of these regions. By conducting first-hand ethnographic research among women's cooperatives in two drastically different environments of rural Morocco, I gain further insight into the roles that culture and geography play in determining the 'success' of cooperatives inlocal communities. In using the term 'success,' I will compare notions of success as used by both Western development organizations as well as local people in Morocco. I examine and analyze the very delicate and complex interaction that occurs between largely Western development agencies and local cultures particularly through the lens of gender. I will also convey the importance of an exchange of cultural practices through development projects rather than the imposition of one cultural system on another. In writing this thesis, I hope to contribute to the growing field of the anthropologyof development, a subset of cultural anthropology that examines international development practices and the economic, social, and political factors that have an impact on the local culture. I examine cooperatives from the perspectives of both the people whoparticipate in them through personal interviews as well as development institutions through an ongoing body of published literature. Focusing on gender implications that such development initiatives have on the rural cultures of Morocco, I argue that gender identities are crucial aspects of local cultures that must be addressed within development practices. On a broader scale, I argue that a deeper knowledge of local cultures is essential if development agencies are to be 'successful' in non-Western cultures.

Retention in care of HIV-infected pregnant and lactating women starting art under Option B+ in rural Mozambique.

OBJECTIVE In 2013, Mozambique adopted Option B+, universal lifelong antiretroviral therapy (ART) for all pregnant and lactating women, as national strategy for prevention of mother-to-child transmission of HIV. We analyzed retention in care of pregnant and lactating women starting Option B+ in rural northern Mozambique. METHODS We compared ART outcomes in pregnant ("B+pregnant"), lactating ("B+lactating") and non-pregnant-non-lactating women of childbearing age starting ART after clinical and/or immunological criteria ("own health") between July 2013 and June 2014. Lost to follow-up was defined as no contact >180 days after the last visit. Multivariable competing risk models were adjusted for type of facility (type 1 vs. peripheral type 2 health center), age, WHO stage and time from HIV diagnosis to ART. RESULTS Over 333 person-years of follow-up (of 243 "B+pregnant", 65″B+lactating" and 317 "own health" women), 3.7% of women died and 48.5% were lost to follow-up. "B+pregnant" and "B+lactating" women were more likely to be lost in the first year (57% vs. 56.9% vs. 31.6%; p<0.001) and to have no follow-up after the first visit (42.4% vs. 29.2% vs. 16.4%; p<0.001) than "own health" women. In adjusted analyses, risk of being lost to follow-up was higher in "B+pregnant" (adjusted subhazard ratio [asHR]: 2.77; 95% CI: 2.18-3.50; p<0.001) and "B+lactating" (asHR: 1.94; 95% CI: 1.37-2.74; p<0.001). Type 2 health center was the only additional significant risk factor for loss to follow-up. CONCLUSIONS Retaining pregnant and lactating women in option B+ ART was poor; losses to follow-up were mainly early. The success of Option B+ for prevention of mother-to-child transmission of HIV in rural settings with weak health systems will depend on specific improvements in counseling and retention measures, especially at the beginning of treatment. This article is protected by copyright. All rights reserved.

Young women's economic daily lives in rural Ethiopia

In rural Ethiopia, livelihood diversification is essential for households to be able to sustain themselves. Declining agricultural profits and a land shortage have accelerated this diversification. While the past literature has ignored young women's economic contributions in its discussions about livelihood diversification, this research indicates that the current rapid educational expansion for girls has changed their economic role in their households. This has resulted in changes in the conventional life courses of women in rural Ethiopia as they have more choices in terms of education, marriage, and the types and location of their economic activities, due to the increasing importance of young women's economic contributions to their households and their improved educational opportunities. The aim of this paper is to elucidate how the economic environment and government educational policy have affected young women's lives in terms of education, marriage, economic activities, and intra-household power relationships, especially with their parents.

Relationship between young women and parents in rural Ethiopia

In rural Ethiopia, parents play an important role in the major life events of their daughters such as education and marriage. However, parents’ roles have been evolving, likely due to the rapid expansion of educational opportunities for girls and the growing need of cash income among rural households. Currently, encouraging their daughters to take up further education and jobs in the formal sector contrasts with rural Ethiopian women’s conventional life course events in the past, which are characterized by early marriage and low educational profiles. An interview analysis with parents of young women indicated that under the continuing de-agrarianization among rural households, women are expected to have their own cash income generating activities to qualify as marriage partners.

Marriage, dowry, and women's status in rural Punjab, Pakistan

Dowry is a common custom observed in South Asian countries. It has been a target of an opposition movement because it is assumed to be a root cause of women's mistreatment, for example, in the form of sex-selective abortion, girls' malnutrition, female infanticide, and domestic homicide called "dowry murder." Despite its alleged evil consequences and the legal ban or restrictions on it, the custom has been extended, and recently, the dowry amount seems to be increasing. However, there is little empirical evidence of dowry's effects. This study empirically investigates the effects of dowry on women's status in rural Pakistan. We conducted a unique survey in rural Punjab, Pakistan, to explore the marriage practices there and to answer the research question. Results show that a higher dowry amount enhances women’s status in the marital household. This implies that an outright ban on dowries does not necessarily improve women's welfare at this time.