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A deeper understanding of how structure and environment shape the sexual and reproductive health vulnerabilities of youths across a range of outcomes has implications for the development of successful policies and programs. We have discussed some of the key structural and environmental factors that influence the sexual and reproductive health of adolescents, particularly in low- and middle-income countries, and the importance of engaging adolescents in identifying solutions. We have highlighted 2 case studies that describe structural or environmental approaches to improving adolescent sexual and reproductive health and made recommendations to more systematically incorporate attention to structure and environment to improve global adolescent health. [ABSTRACT FROM AUTHOR]

Treating household water with low-cost, widely available commercial bleach is recommended by some organizations to improve water quality and reduce disease in developing countries. I analyzed the chlorine concentration of 32 bleaches from 12 developing countries; the average error between advertised and measured concentration was 35% (range=-45%-100%; standard deviation=40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing. [ABSTRACT FROM AUTHOR]

India provided one of the most challenging chapters of the world-wide smallpox eradication program. The campaign was converted from a project in which a handful of officials tried to impose their ideas on a complex health bureaucracy to one in which its components were constantly adapted to the requirements of a variety of social, political, and economic contexts. This change, achieved mainly through the active participation of workers drawn from local communities in the 1970s, proved to be a momentous policy adaptation that contributed to certification of smallpox eradication in 1980. However, this lesson appears to have been largely forgotten by those currently managing the Global Polio Eradication Initiative. We hope to show ways in which contemporary efforts to eliminate polio woridwide might profitably draw on historical information, which can indicate meaningful ways in which institutional adaptability is likely to help counter the political and social challenges being encountered in India. (Am J Public Health. 2009; 99:1176-1184. doi:10.2105/AJPH.2008.135624.) [ABSTRACT FROM AUTHOR]