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Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows
Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows
Reproductive Health
This document reports on the Government of Kenya’s Output-Based Aid (OBA) vouchers program—an affordable strategy to meet the international and national objectives for improved maternal and reproductive health. To help achieve the global Millennium Development Goals related to maternal and child health, the Kenyan government has launched several initiatives including this Vision 2030 flagship program which harmonizes global and national objectives by improving access and enhancing equity in health service delivery. The report finds that the three maternal health MDG indicators—maternal mortality rate, rate of institutional deliveries, and contraceptive prevalence—can all be improved substantially by scaling up the OBA program. …
Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew
Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew
Reproductive Health
This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …
Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes
Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes
Reproductive Health
Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …
Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru
Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru
Reproductive Health
This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …
The Unfinished Agenda To Meet Fp2020 Goals: 12 Actions To Fill Critical Evidence Gaps, Ian Askew, Martha Brady
The Unfinished Agenda To Meet Fp2020 Goals: 12 Actions To Fill Critical Evidence Gaps, Ian Askew, Martha Brady
Reproductive Health
More than 200 million women in the developing world who want to avoid pregnancy are not using a modern contraceptive method. The international community convened at the London Family Planning Summit in July 2012 and strengthened their resolve to address unmet need. National governments, civil society, and the private sector committed US$2.6 billion toward the goal of making contraceptive information, services, and supplies available to an additional 120 million women and girls by 2020. This book elaborates on one of two influential publications disseminated by the Population Council that assess the situation: Reviewing the Evidence and Identifying Gaps in Family …
Shaping Demand And Practices To Improve Family Health Outcomes: Findings From A Quantitative Survey, Volume 3: Bihar, M.E. Khan, France Donnay, Usha Kiran Tarigopula, Kumudha Aruldas
Shaping Demand And Practices To Improve Family Health Outcomes: Findings From A Quantitative Survey, Volume 3: Bihar, M.E. Khan, France Donnay, Usha Kiran Tarigopula, Kumudha Aruldas
Reproductive Health
This report provides findings of a study undertaken to generate comprehensive information on eight target behaviors that have direct bearing on family health in rural Bihar. Behaviors include: 1) Increasing the proportion of deliveries that occur in a facility and mothers who have access to basic emergency obstetric care; 2) Increasing the proportion of safe deliveries at home; 3) Increasing the uptake of preventive postnatal-care services for newborns and mothers; 4) Increasing the practice of skin-to-skin care/Kangaroo Mother Care for newborns; 5) Increasing the practice of early and exclusive breastfeeding of infants during the first six months of life; 6) …
Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed
Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed
Reproductive Health
The Population Council Bangladesh, in collaboration with the Directorate General of Family Planning and Marie Stopes Bangladesh, with funding from the World Health Organization and the DFID-supported STEP UP project, conducted an 18-month operations research study from January 2012 to June 2013. This operations research tested the feasibility of introducing menstrual regulation with medication (MRM) in Bangladesh and assessed accessibility of the combination regimen of mifepristone and misoprostol in urban and rural health facilities. Based on this study’s results, the feasibility of introducing MRM services in Bangladesh is clear, and women receiving MRM were satisfied with their overall quality of …
Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar
Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar
Poverty, Gender, and Youth
This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …
Understanding Unintended Pregnancy In Bangladesh: Country Profile Report, Fauzia Akhter Huda, Sabiha Chowdhuri, Yolande Robertson, Noushin Islam, Bidhan Krishna Sarker, Ashrafi Jahan Azmi, Laura Reichenbach
Understanding Unintended Pregnancy In Bangladesh: Country Profile Report, Fauzia Akhter Huda, Sabiha Chowdhuri, Yolande Robertson, Noushin Islam, Bidhan Krishna Sarker, Ashrafi Jahan Azmi, Laura Reichenbach
Reproductive Health
The objective of this report is to identify the determinants of unintended pregnancy and unmet need for family planning in Bangladesh and therefore provide a strong body of evidence that will contribute to issue identification, evidence generation, and communication for use of evidence in policy and programming. The evidence generated can be used to find ways to reduce the rate of unintended pregnancy and hence reduce the risk of abortion-related morbidity and mortality; ultimately this will aid Bangladeshi couples in reaching their fertility goals. Results demonstrate that Bangladesh has shown progress and promise in several areas of family planning and …
Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar
Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar
Reproductive Health
Maternal mortality in Ethiopia remains among the highest in the world. A UN Commission Report in 2012 identified 13 life-saving commodities—defined as medicines, medical devices, and health supplies—that effectively address avoidable causes of death during pregnancy and childbirth that, if more widely accessed and properly used, could significantly reduce preventable deaths among women. This assessment, conducted by the Population Council, evaluates the availability of these life-saving commodities that are essential for basic emergency obstetric and neonatal care, and safe and clean delivery services within primary health care in Ethiopia. The report concludes that Ethiopia’s pharmaceutical procurement and supply system is …
Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab
Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab
Reproductive Health
These slides present results from a Population Council study conducted in Egypt aimed at identifying factors that prevent Egyptian couples from attainment of their reproductive goals using a rights-based, gender-sensitive analysis of family planning service demand and supply. The analysis focused on six aspects of clients’ rights: clinic/provider readiness, accessibility and affordability, privacy and confidentiality, choice and autonomy, informed decisionmaking, and the right to complain. The presentation concludes with recommendations for closing gaps that exist with regard to protection of clients’ rights to autonomy, choice, informed decisionmaking, privacy, and confidentiality.
Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community
Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community
Reproductive Health
The East, Central and Southern Africa (ECSA) Health Community, which prioritizes gender-based violence and child sexual abuse as regional health concerns, partnered with the Population Council to convene a pre-conference Expert Committee meeting of the Research, Information and Advocacy Programme. The conference marked a major milestone in the ECSA Health Community’s commitment to promote and support region-wide sharing and utilization of health research and policy information among its member states. This report summarizes the deliberations of the two-day workshop and the recommendations for implementing an advocacy plan to address this important facet of the region’s development agenda.
International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health
International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health
Reproductive Health
The IUSSP Scientific Panel on Reproductive Health, in collaboration with STEP UP and AFIDEP, held a seminar in Nanyuki, Kenya, in May 2013. The seminar brought together 44 scientists, policymakers, and program managers to present and discuss a range of issues relating to the definition, determinants, and consequences of unmet need for family planning and program interventions designed specifically to reduce unmet need in groups at high risk. Based on discussions and presentations, unmet need (and family planning in general) should be looked at both from a development perspective and from a service-delivery and health-sector perspective. Overall, the seminar papers, …
Insights Into Unmet Need In Ghana, Kazuyo Machiyama, John C. Cleland
Insights Into Unmet Need In Ghana, Kazuyo Machiyama, John C. Cleland
Reproductive Health
This study aims to establish the relative importance of lack of access and attitudinal resistance toward use of family planning for different population and geographical strata in Ghana. It is intended to inform policymakers on the priority that should be given to behavior change communication or improved access/information, and also helpful to interventions to reduce health concerns and fear of side effects, such as provision of broader method mix and better counseling. The most far reaching implication concerns the reproductive behavior of the best educated women and those living in the capital or surrounding areas. The results suggest an enduring …
Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland
Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland
Reproductive Health
Results presented in this STEP UP Research Report show that over half of women having unmet need for family planning in Senegal did not intend to use family planning in the future and this was consistent across all population strata. Reasons for non-use confirm the existence of widespread opposition to the use of modern contraception. Unfamiliarity and lack of information is likely to be a reason for such opposition; initial suspicion of contraception has also been documented. Thus a first policy priority, and one that is relatively easy to achieve, is to increase knowledge through the mass media and localized …
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Reproductive Health
Prevention of unintended pregnancy is often considered the key outcome of reducing unmet need; it is the basic right of women and couples to become pregnant only when intended. This paper explores this relationship by reviewing the definition and measurement of unintended pregnancy, identifying key trends in its distribution within and between populations, and analyzing the relationship between unintended pregnancy, demand for family planning, and family planning program performance. The determinants and consequences of unintended pregnancy are reviewed to further understand the implications of using it as a policy and programming goal. The paper concludes by reviewing the broader policy …
Availability, Use And Quality Of Care For Medical Abortion Services—Preliminary Results Of Two Components: Kiis And The Pharmacy Study, Wilson Liambila, Harriet Birungi, Francis Onyango, Brian Mdawida, Vitalis Akora, Thoai Ngo, Kate Reiss
Availability, Use And Quality Of Care For Medical Abortion Services—Preliminary Results Of Two Components: Kiis And The Pharmacy Study, Wilson Liambila, Harriet Birungi, Francis Onyango, Brian Mdawida, Vitalis Akora, Thoai Ngo, Kate Reiss
Reproductive Health
No abstract provided.
Assessing Retention And Motivation Of Public Health-Care Providers (Particularly Female Providers) In Rural Pakistan, Ali M. Mir, Gul Rashida Shaikh, Saleem Shaikh, Neha Mankani, Anushe Hassan, Maqsood Sadiq
Assessing Retention And Motivation Of Public Health-Care Providers (Particularly Female Providers) In Rural Pakistan, Ali M. Mir, Gul Rashida Shaikh, Saleem Shaikh, Neha Mankani, Anushe Hassan, Maqsood Sadiq
Reproductive Health
The main objectives of this project in Pakistan were to explore the core issue of availability of health providers, especially female providers who are required for provision of maternal and neonatal healthcare, and to determine the range of factors that either constrain or motivate providers to serve in key positions in public facilities in rural areas. The study, conducted by the Population Council with funding from the Maternal and Newborn Health Programme ‐ Research and Advocacy Fund, identifies a number of problems faced by healthcare providers working in the public healthcare system in Pakistan and makes the following recommendations for …
Effectiveness Of A Comprehensive Sexual And Gender-Based Violence Prevention Project For In-School Girls In Swaziland, Swaziland Action Group Against Abuse (Swagaa)
Effectiveness Of A Comprehensive Sexual And Gender-Based Violence Prevention Project For In-School Girls In Swaziland, Swaziland Action Group Against Abuse (Swagaa)
Reproductive Health
Swaziland is one of the sub-Saharan African countries affected by sexual and gender-based violence (SGBV) and HIV and AIDS, with women facing greater risk compared to men. In response to increasing reports of violence against women and children in the country, the Swaziland Action Group Against Abuse launched a Girls’ Empowerment Clubs (GEC) program in primary and secondary schools in order prevent SGBV cases. Due to limitations of the program (such as being led by teachers and reliance on volunteers), an intervention study was carried out by the Population Council to test the effectiveness of an enhanced version, “GEC-Plus,” that …
Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai
Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai
Reproductive Health
The objectives of this Population Council study were twofold: first to collect information on prevailing practices of abortion and post‐abortion care in Pakistan and, second, to gauge changes in the magnitude and quality of abortion‐related complications and care during the last decade (since the 2002 national study of “Unwanted Pregnancy and Post‐abortion Complications in Pakistan”). The study found that the level of post‐abortion family planning (FP) counseling in both public and private health facilities offering PAC services was inadequate. There has been no improvement over the decade in the level of counseling reported, and, even more disappointingly, only half of …
Mitigating The Consequences Of Sexual Violence In Zambia By Decentralizing Emergency Medical Responses To Police Victim Support Units: Report On The Feasibility Of Police Provision Of Post-Exposure Prophylaxis For Hiv (Pep) In Zambia, Mary Zama, Mardieh Dennis, Jessica Price, Stephanie M. Topp, Jonathan Kaunda Mwansa, Jill Keesbury
Mitigating The Consequences Of Sexual Violence In Zambia By Decentralizing Emergency Medical Responses To Police Victim Support Units: Report On The Feasibility Of Police Provision Of Post-Exposure Prophylaxis For Hiv (Pep) In Zambia, Mary Zama, Mardieh Dennis, Jessica Price, Stephanie M. Topp, Jonathan Kaunda Mwansa, Jill Keesbury
Reproductive Health
The Zambian Ministry of Home Affairs (housing the Zambia Police Service); the Ministry of Health, the Ministry of Community Development, Mother and Child Health; and the Population Council collaborated on operations research studies to increase provision of emergency medical care to survivors of sexual violence via the Zambia Police Services (ZP). Recognizing the need to strengthen linkages between the police and the health sector and following up on the lessons learned from earlier models of police delivery of emergency contraception, this feasibility study was designed to: determine if victim support unit (VSU) officers could be trained to safely and effectively …
The Contracting World Of Girls At Puberty: Violence And Gender-Divergent Access To The Public Sphere Among Adolescents In South Africa, Kelly Hallman, Nora Kenworthy, Judith A. Diers, Nick Swan, Bashi Devnarain
The Contracting World Of Girls At Puberty: Violence And Gender-Divergent Access To The Public Sphere Among Adolescents In South Africa, Kelly Hallman, Nora Kenworthy, Judith A. Diers, Nick Swan, Bashi Devnarain
Poverty, Gender, and Youth
This Population Council working paper describes a participatory mapping project undertaken with single-sex groups of grade 5 and grade 8–9 children in urban and rural KwaZulu-Natal, South Africa. At grade 5, female self-defined community areas were equal to or larger in size than those of males in both sites. However, wide gender divergence in access to the public sphere was found among grade 8–9 children. Although curtailed spatial access, especially in urban areas, is intended to protect post-pubescent girls, grade 8–9 girls reported most spaces in their small navigable areas unsafe. Reducing girls’ access to the public sphere does not …
Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland
Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland
Reproductive Health
Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on …