World Health & Population
From the Editor-in-Chief
This issue of World Health & Population presents three research papers and a commentary that should be of great interest to our readers. The original papers have all been published online by WHP during the last quarter and are selected here as representative of recent outstanding contributions to the journal.
The first paper in this issue, “Knowledge of Termination of Pregnancy (TOP) Legislation and Attitudes toward TOP Clinical Training among Medical Students Attending Two South African Universities” by Wheeler, Zullig and colleagues presents results from robust surveys of knowledge and attitudes among medical students regarding the progressive South African TOP (i.e., abortion) legislation. Respondents were also asked for a self-assessment of their preparation and training to provide TOP services. Typically, surveys that measure knowledge and attitudes also measure practice, thus the classic KAP model. For medical students however, practice is in the future, and current knowledge and attitudes hopefully can be seen as predictors of practice. The researchers found knowledge of the South African TOP legislation was very high; however, confidence in the adequacy of their training and preparation was considerably lower. Attitudes toward TOP overall varied by a number of demographic categories of medical students, including religion, sexual experience, and relationship history. The authors recommend ongoing assessment and adjustment of medical school curricula in order to best meet the needs for providing TOP services for the South African populations.
Social economic status (SES) is a critical covariate for nearly all multivariable studies in healthcare. SES is notoriously hard to define and measure and a variety of proxies have been used over the years, including household income, household possessions, type of residence, educational level of householders and household expenditures, among others. In “Household Expenditures as a Measure of Socioeconomic Status among Iraqis Displaced in Jordan and Syria” Cope, Doocy and colleagues present an interesting methodological study to validate the use of household expenditures (HE) as a proxy for measuring SES among refugee populations. HE has been used as a successful proxy among settled populations; however its research acceptability among populations displaced and stressed by war and destruction has not been looked at. Cope, Doocy and colleagues conducted cross sectional surveys in the two countries that have received the largest refugee influx from Iraq and found the HE can be used reliability as a proxy for SES in certain situations. They have conducted very solid foundational research in this area; however, more work clearly needs to be done on methods for measuring this important construct among difficult research populations.
The third paper tackles an understanding of changes in condom use in Uganda, reflecting, in part, changing attitudes toward the HIV epidemic and changing prevention policy and national campaigns. In “Trends and Determinants of Condom Use in Uganda,” authors Zaake De Conick and Gaetano Marroone present an analysis of Uganda Demographic and Health Survey (UDHS) data documenting a fall in the prevalence of condom use between two waves of the survey, 1995-2000/2001 and 2000/2001-2006. These time periods coincided with two significant changes in the HIV landscape in Uganda: the widening availability of antiretroviral drugs and a lessening of the nationwide “ABC” (Abstinence, Be faithful, use Condoms) campaign. Also likely affecting the downturn in condom use reflected in the surveys was an unfortunate nationwide recall of defective condoms. De Conick and Marrone conclude that policy changes and further education among women and rural populations in particular are needed if condom use is to regain its previous level and role in HIV prevention programs in Uganda.
The final paper in this issue “Engaging Men in Family Planning Services” by Rebecka Lundgren and colleagues is a commentary on the importance of involving men in family planning activities, in particular through a fertility awareness approach called the Standard Days Method©. Through a series of four country vignettes, the authors, all from Georgetown University (Washington, DC, US), present the case for involving men in understanding fertility awareness in order to broaden the traditional female-centred paradigm of family planning. The authors also posit that taking a couple-centred approach to family planning will result in higher likelihood of success for other, more conventional and interventional family planning approaches and a greater sensitivity by both partners toward critical sexual and reproductive health topics, including intimate partner violence, HIV, sexuality and partner communication.
In conclusion, we hope that you find the papers in this issue interesting and worthwhile, and that you will also consult others recently released online at www.worldhealthandpopulation.com. WHP remains committed to its mission to provide a forum for researchers and policy makers worldwide to publish and disseminate health- and population-related research, and to encourage applied research and policy analysis from diverse global and resource-constrained settings. WHP is indexed on MEDLINE and is accessible through PubMed.
We look forward to continued enthusiastic submission of manuscripts for consideration, peer review and publication. Finally, the editors and publishers of WHP are always interested in any comments or suggestions you might have on the papers or about the journal and our mission. Please feel free to write or email us.
About the Author
John E. Paul, PhD MSPH
Editor-in-Chief, World Health & Population
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