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An Evaluation Of Population Services Zimbabwe’S Mobile Outreach Model, Ravikanthi Rapiti, Saiqa Mullick Jan 2014

An Evaluation Of Population Services Zimbabwe’S Mobile Outreach Model, Ravikanthi Rapiti, Saiqa Mullick

Reproductive Health

This report documents a service evaluation of Population Services Zimbabwe’s (PSZ) mobile outreach program in four provinces of Zimbabwe. The evaluation was conducted by the Population Council between September and October 2013. It provides key findings on the quality of the PSZ outreach program in expanding choice and access to long-acting reversible contraceptives (LARCs) and permanent methods (PMs) of contraception, as well as recommendations for PSZ and other family planning programs to consider in scaling up and strengthening mobile outreach services. The evaluation, conducted by the Population Council, was designed to focus on various components of quality including adequate information …


Induced Abortions And Unintended Pregnancies In Pakistan, 2012, Population Council Jan 2014

Induced Abortions And Unintended Pregnancies In Pakistan, 2012, Population Council

Reproductive Health

The 2012–13 PDHS (Pakistan Demographic and Health Survey) shows that gains in contraceptive prevalence over the past decade have been small, and unmet need has remained high. Using data from a 2012 national study on post-abortion care, we estimate 2.2 million abortions occurred in Pakistan in 2012, and an annual abortion rate of 50 per 1,000 women. A previous study estimated an abortion rate of 27 for 2002. Even accounting for an underestimation of abortion incidence (private sector abortion services could not be included) in the prior study, the abortion rate in Pakistan has likely increased substantially between 2002 and …


Expanding The Evidence Base On Comprehensive Care For Survivors Of Sexual Violence In Sub-Saharan Africa, Population Council Jan 2014

Expanding The Evidence Base On Comprehensive Care For Survivors Of Sexual Violence In Sub-Saharan Africa, Population Council

Reproductive Health

The Expanding the Evidence Base on Comprehensive Care for Survivors of Sexual Violence in sub-Saharan Africa program was a four-year agreement between the Swedish-Norwegian Regional HIV and AIDS Team for Africa, Embassy of Sweden, Lusaka (the S-N Team), and the Population Council. From 2009 to 2013, the program sought to mitigate the impact and incidence of sexual and gender-based violence (SGBV) in sub-Saharan Africa by strengthening the capacities of medical, legal, and justice sectors to care for survivors of such violence. This approach was intended to serve the S-N Team’s larger development objectives of preventing HIV transmission in sub-Saharan Africa …


Promoting Respectful Maternity Care: A Training Guide For Community-Based Workshops—Community Facilitator's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina Jan 2014

Promoting Respectful Maternity Care: A Training Guide For Community-Based Workshops—Community Facilitator's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. The Community Facilitator’s Guide, designed to be used by facilitators to promote respectful maternity care at the community level, can be adapted to educate a variety of stakeholders in community settings (i.e., Community Health Extension …


Population And Health Dynamics In Nairobi's Informal Settlements: Report Of The Nairobi Cross-Sectional Slums Survey (Ncss 2012), African Population And Health Research Center (Aphrc) Jan 2014

Population And Health Dynamics In Nairobi's Informal Settlements: Report Of The Nairobi Cross-Sectional Slums Survey (Ncss 2012), African Population And Health Research Center (Aphrc)

Reproductive Health

This report documents the living conditions and health risks of slum-dwellers across Nairobi’s informal settlements a decade after the Nairobi Cross-sectional Slums Survey (NCSS) of 2000. It aims to not only highlight the needs of slum-dwellers but also inform policymakers on the changes that have occurred in the living conditions of Nairobi’s urban poor since 2000, considering development interventions by the Government of Kenya and its development partners. The NCSS 2012 results highlight marked improvements in environmental, health, and educational indicators among slum dwellers. However, these improvements were not uniform, with subgroups of younger women and women without formal education …


Building Evidence On Effective Programs To Delay Marriage And Support Married Girls In Africa, Population Council Jan 2014

Building Evidence On Effective Programs To Delay Marriage And Support Married Girls In Africa, Population Council

Poverty, Gender, and Youth

In the early 2000s, the Population Council collaborated on the first rigorously evaluated program in Africa to delay the age of marriage and support girls married as children. Berhane Hewan (Light for Eve) targeted married and unmarried girls aged 10–19 in rural areas of Amhara. The program’s four components—community conversations to raise awareness and address cultural and social norms, provision of school supplies to remain in school, conditional asset transfer to address economic incentives to marry girls, and girls’ mentoring groups—were based on formative research and consultations with local leadership. Building on the Berhane Hewan pilot, the Council and partners …


Building The Assets To Thrive: Addressing The Hiv-Related Vulnerabilities Of Adolescent Girls In Ethiopia—Policy Brief, Population Council Jan 2014

Building The Assets To Thrive: Addressing The Hiv-Related Vulnerabilities Of Adolescent Girls In Ethiopia—Policy Brief, Population Council

Poverty, Gender, and Youth

In Eastern and Southern Africa, HIV is the leading cause of death among girls aged 15–19. Despite decades of investment and substantial progress against HIV, adolescent girls remain at disproportionate risk of infection. Few programs have sought to take a “whole girl” approach to addressing the multiple vulnerabilities to HIV infection experienced by the most marginalized adolescent girls in the poorest communities in Africa. “Building the Assets to Thrive: Addressing the HIV-related Vulnerabilities of Adolescent Girls in Ethiopia” is a comprehensive review of three programs implemented and evaluated by the Population Council and the Ethiopian government beginning in 2007: Biruh …


Accessing Adolescent Friendly Health Clinics In India: The Perspectives Of Adolescents And Youth, K.G. Santhya, Ravi Prakash, Shireen J. Jejeebhoy, Santosh Kumar Singh Jan 2014

Accessing Adolescent Friendly Health Clinics In India: The Perspectives Of Adolescents And Youth, K.G. Santhya, Ravi Prakash, Shireen J. Jejeebhoy, Santosh Kumar Singh

Poverty, Gender, and Youth

The recently launched Rashtriya Kishor Swasthya Karyakram (RKSK) health program seeks to enable all adolescents and youth to realize their full potential by making informed and responsible decisions concerning their health and well-being and by accessing the services and support needed to implement their decisions. To realize this vision, the RKSK framework acknowledges that the strengthening of Adolescent Friendly Health Clinics (AFHCs) and the provision of correct knowledge and information through counseling services are two of its seven critical components. As the government makes efforts to roll out the RKSK program at scale across the country, reviewing the experiences of …


Adolescents In Rajasthan 2012: Changing Situation And Needs, Shireen J. Jejeebhoy, Rajib Acharya Jan 2014

Adolescents In Rajasthan 2012: Changing Situation And Needs, Shireen J. Jejeebhoy, Rajib Acharya

Poverty, Gender, and Youth

Several national policies and programs formulated since 2000 have underscored India’s commitment to addressing the multiple needs of youth. The Rashtriya Kishor Swasthya Karyakram (RKSK) program launched in 2014 helped provide the framework for services for young people’s health in general, and their sexual and reproductive health, mental health, and prevention and care of noncommunicable diseases, in particular. The earlier Youth in India: Situation and Needs 2006–2007 study was the first-ever subnationally representative study conducted to identify key transitions experienced by married and unmarried youth in India. Data have now become available from a repeated survey conducted in 2012 in …


Trafficking Of Minor Girls For Commercial Sexual Exploitation In India: A Synthesis Of Available Evidence, K.G. Santhya, Shireen J. Jejeebhoy, Sharmistha Basu Jan 2014

Trafficking Of Minor Girls For Commercial Sexual Exploitation In India: A Synthesis Of Available Evidence, K.G. Santhya, Shireen J. Jejeebhoy, Sharmistha Basu

Poverty, Gender, and Youth

Understanding factors that place minor girls at risk of being trafficked for commercial sexual exploitation (CSE) and the consequences of trafficking for their health and life-course trajectories is limited by the scattered evidence available on these issues. The role of various stakeholders in trafficking, namely, families, traffickers, and brothel owners, and the role of law enforcement agencies in preventing it are also poorly understood. Further, adequate data consolidating the responses of government and nongovernmental organizations to issues related to CSE of minor girls are lacking. There is a need, therefore, to consolidate this scattered body of evidence and to identify …


An Overview Of The Hiv Prevention Landscape In Zimbabwe: Implications For Tenofovir Gel, Population Council Jan 2014

An Overview Of The Hiv Prevention Landscape In Zimbabwe: Implications For Tenofovir Gel, Population Council

HIV and AIDS

Zimbabwe has seen a tremendous shift in the HIV landscape in the last decade, particularly regarding prevalence. Yet many people, especially women, are still at high risk and efforts to identify and implement additional HIV-prevention options remain critical. Topical microbicides are a promising new technology that women can control or initiate, with a number of products tested in clinical trials over the past two decades. As research moves forward, decision-makers and other stakeholders need key background information to inform strategic decision-making regarding introduction of tenofovir gel and other new HIV-prevention products. The Population Council has designed a toolkit to assist …


Baseline Survey Of Nigerian Media Coverage Of Youth Sexual And Reproductive Health And Hiv And Aids Related Issues, January 1st–December 31st, 2012, Population Council Jan 2014

Baseline Survey Of Nigerian Media Coverage Of Youth Sexual And Reproductive Health And Hiv And Aids Related Issues, January 1st–December 31st, 2012, Population Council

HIV and AIDS

To promote more informed public dialogue on youth vulnerabilities, responses to HIV/AIDS, and positive changes in relevant policies and programs via learning and advocacy interventions at the state and national levels in Nigeria, the Population Council commissioned a study of the print and electronic media’s coverage of HIV/AIDS and sexual and reproductive health–related issues among youth aged 15–24 years in Nigeria for the period January 1 to December 31, 2012. The study entailed a content analysis of four national and two regional newspapers, and an online forum that is one of the most frequently visited social media sites in Nigeria. …


Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Nigeria's Youth, Population Council Jan 2014

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Nigeria's Youth, Population Council

HIV and AIDS

This report documents the findings of a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing Nigerian youth and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the national response to HIV. Researchers conducted an analytical review of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in Nigeria. In addition, qualitative and quantitative analyses enabled an evaluation of the factors associated with young people’s sexual …


Setting The Stage For Arv-Based Prevention For Women: A Snapshot Of The Zimbabwean Context, Population Council Jan 2014

Setting The Stage For Arv-Based Prevention For Women: A Snapshot Of The Zimbabwean Context, Population Council

HIV and AIDS

Zimbabwe, with an estimated population of 12.7 million people, is among the countries in sub-Saharan Africa most affected by the HIV epidemic. Given the urgent need for HIV-prevention options for women, a number of projects are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a toolkit developed by the Population Council to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The toolkit includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. …


Evaluation Of The Impact Of The Voucher Program For Improving Maternal Health Behavior And Status In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Syed Abu Jafar Md. Musa, Ashish Bajracharya, Kaji Tamanna Keya, Forhana Rahman Noor, Eshita Jahan, Md. Irfan Hossain, Jyotirmoy Saha, Benjamin Bellows Jan 2014

Evaluation Of The Impact Of The Voucher Program For Improving Maternal Health Behavior And Status In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Syed Abu Jafar Md. Musa, Ashish Bajracharya, Kaji Tamanna Keya, Forhana Rahman Noor, Eshita Jahan, Md. Irfan Hossain, Jyotirmoy Saha, Benjamin Bellows

Reproductive Health

Vouchers, a demand-side financing (DSF) instrument for health-care services, were introduced in Bangladesh in 2006. The DSF program grants vouchers to pregnant women to receive free antenatal, delivery, and postpartum care services as well as free medicine, and financial assistance is provided for transportation. Deliveries with skilled service providers are financially incentivized and providers are reimbursed for their services from a special fund. After piloting DSF initially in 21 subdistricts (upazilas), the government expanded it to another 12 upazilas in 2007 (the second phase), and in its third phase in 2010 the program was expanded to another 11 upazilas. To …


Strengthening The Evidence Base On Social Accountability For Improving Family Planning And Reproductive Health Programs, Victoria Boydell, Jill Keesbury, Kelsey Wright Jan 2014

Strengthening The Evidence Base On Social Accountability For Improving Family Planning And Reproductive Health Programs, Victoria Boydell, Jill Keesbury, Kelsey Wright

Reproductive Health

The concept of accountability is important in the family planning (FP) and reproductive health (RH) sector, building on a rich history of community involvement and civil society participation. There are three categories of FP/RH accountability initiatives: tracking donor and government financial commitments, tracking national-level program implementation, and tracking service-delivery outcomes. The third category, often referred to as “social accountability,” includes the efforts of citizens and civil society to scrutinize and hold duty bearers to account for providing promised services, most often at the subnational or community levels. Social accountability is premised on the assumption that increased and targeted citizen and …


Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council Jan 2014

Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council

HIV and AIDS

The 2011 National Sentinel Surveillance estimated that 1.9 million people in India aged 15 and older were living with HIV. An estimated 39 percent are women. Given the urgent need for HIV-prevention options for women, a number of efforts are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a guide to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The guide includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. The …


Coping With Unintended Pregnancies: Narratives From Adolescents In Nairobi's Slums, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara, Carol Mukiira Jan 2014

Coping With Unintended Pregnancies: Narratives From Adolescents In Nairobi's Slums, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara, Carol Mukiira

Reproductive Health

This qualitative study examined the challenges faced by adolescents in Kenya with regard to unintended pregnancies and how adolescents in urban slum settlements manage and cope with unintended pregnancies. The study’s findings suggest that high levels of unintended pregnancy among young people in Kenya’s urban slums are linked to myths and misconceptions about contraception. Other findings underscore the fact that many young people lack access to contraception and reproductive health services; indicate that unintended pregnancies are linked to sexual violence; and highlight the need for government to manage the high levels of school dropout as a result of an unintended …


Assessment Of Sex Selection In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Forhana Rahman Noor Jan 2014

Assessment Of Sex Selection In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Forhana Rahman Noor

Reproductive Health

According to UN estimates, the sex ratio at birth (SRB) has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. Generally, the SRB becomes skewed in a setting where fertility is declining or low and where son preference exists. Strong son preference compounded by the availability of measures to implement such preference can lead to increased SRB. For example, the increasing availability of prenatal diagnostic technologies, together with declining fertility desires and persistent son preference, has contributed to increased gender-biased sex selection in several Asian countries, including China and India. …


Training Manual On Basic Monitoring And Evaluation Of Social And Behavior Change Communication Health Programs, Praween Kumar Agrawal, Kumudha Aruldas, M.E. Khan Jan 2014

Training Manual On Basic Monitoring And Evaluation Of Social And Behavior Change Communication Health Programs, Praween Kumar Agrawal, Kumudha Aruldas, M.E. Khan

Reproductive Health

Social and behavior change communication (SBCC) interventions are key for addressing social and cultural barriers and achieving goals laid out for health programs. Often these interventions are not evidence based and monitoring and evaluation (M&E) is limited. Lack of trained and skilled human resources for M&E has been a limitation in general. A serious effort is needed to build the capacity of M&E personnel to monitor and evaluate performance of SBCC interventions in terms of reach and effectiveness among intended audiences. The Improving Healthy Behaviors Program of FHI360 aims to provide technical assistance to strengthen capacities to monitor and evaluate …


Balika Fact Sheet: Highlight On Married Adolescents, Population Council Jan 2014

Balika Fact Sheet: Highlight On Married Adolescents, Population Council

Poverty, Gender, and Youth

In Bangladesh, marriage marks the beginning of sanctioned sexual activity as well as increased social isolation. When girls are not in school, they miss the opportunity to interact with same-age peers and form social networks. They may be less likely to gain skills and knowledge and have less earning power. Married adolescents have poorer sexual and reproductive health knowledge and more unequal gender attitudes. Young girls who are married to much-older men are in a disadvantaged position to negotiate in their marital home. This can have implications for realizing sexual and reproductive choice and health rights. This Bangladeshi Association for …


Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Participant's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina Jan 2014

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Participant's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. Workshop objectives outlined in the Participant’s Guide: Outline current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to respectful maternity care and …


Confronting Disrespect And Abuse During Childbirth In Kenya: The Heshima Project, Population Council Jan 2014

Confronting Disrespect And Abuse During Childbirth In Kenya: The Heshima Project, Population Council

Reproductive Health

No woman should be hit, yelled at, or abused in any way during childbirth. However, laboring women in Kenya and elsewhere may experience inhumane treatment in hospitals and clinics. This abuse is a key yet overlooked reason why only four in ten pregnant women in Kenya deliver at health facilities. To increase the number of women delivering in health facilities and thereby reduce maternal deaths, governments, health systems, and practitioners need sound evidence documenting the disrespect and abuse that women experience. Through the Heshima Project, the Population Council is changing how health systems and women think about quality maternity care …


Barriers To Obstetric Fistula Treatment In Low-Income Countries: A Systematic Review, Benjamin Bellows, Rachel Bach, Zoe Baker, Charlotte E. Warren Jan 2014

Barriers To Obstetric Fistula Treatment In Low-Income Countries: A Systematic Review, Benjamin Bellows, Rachel Bach, Zoe Baker, Charlotte E. Warren

Reproductive Health

Obstetric fistula is a maternal morbidity condition that occurs in some low-income countries and is caused by prolonged obstructed labor that results in a hole between the vagina and the bladder or rectum through which urine or feces leak. Unrepaired fistula can lead to lifelong ostracism, stigma, and shame. Obstetric fistula is preventable and treatable, but women in these countries experience delays in seeking repair due to a number of factors including awareness of their condition as well as the potential for treatment, resources necessary for seeking care, lack of skilled fistula surgeons, and long hospital waiting times. UNFPA estimates …


Supporting Girls In Their Transition To Secondary Education: An Exploratory Study Of The Family, School And Community Environments Of Adolescent Girls In Gujarat, K.G. Santhya, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Neeta Shah Jan 2014

Supporting Girls In Their Transition To Secondary Education: An Exploratory Study Of The Family, School And Community Environments Of Adolescent Girls In Gujarat, K.G. Santhya, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Neeta Shah

Poverty, Gender, and Youth

Despite government commitment to universal secondary education in India, few adolescents transition to and successfully complete secondary education. In India, limited efforts have been directed at parents to promote positive attitudes toward education and school completion. Recognizing the need for identifying effective intervention strategies to engage parents and communities to promote secondary education for girls, the Population Council and partners are pilot-testing an intervention to support adolescent girls’ transition to and retention in secondary education. Located in the state of Gujarat, the intervention focuses on girls in the last year of primary school and first year of secondary school and …


Formative Research To Develop An Intervention For Addressing Mental Health/Psychosocial Issues And Hiv Vulnerability Of Marginalized Adolescents In Addis Ababa, Ethiopia, Nrupa Jani, Katie D. Schenk Jan 2014

Formative Research To Develop An Intervention For Addressing Mental Health/Psychosocial Issues And Hiv Vulnerability Of Marginalized Adolescents In Addis Ababa, Ethiopia, Nrupa Jani, Katie D. Schenk

HIV and AIDS

Children and adolescents who migrate from rural regions to Addis Ababa, Ethiopia often flee their households to escape from abusive families, forced marriages, poverty, lack of economic opportunity and education, and other social problems. They are often met with equally harsh, if not worse, challenges when they arrive in Addis Ababa, including treacherous living situations, abusive working conditions with meager compensation, limited opportunities for education and socialization, and absence of family support. This study conducted a qualitative needs assessment to determine type and extent of mental health and psychological needs among adolescent migrants living in Addis Ababa in order to …