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Understanding Community Health Volunteer Incentive Preferences In Kenya, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health Oct 2021

Understanding Community Health Volunteer Incentive Preferences In Kenya, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

In Kenya, community health services are implemented through community health units. Community health volunteers (CHVs) who serve these units are chosen by the community and trained by community health extension workers. This brief summarizes qualitative and quantitative findings from the Frontline Health project’s discrete choice experiment study in Kenya, which aimed to understand incentive preferences of CHVs with the aim of improving motivation, performance, and retention of CHVs.


Identifying Factors That Support Community Health Worker Motivation, Job Satisfaction, And Retention In Haiti, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health Oct 2021

Identifying Factors That Support Community Health Worker Motivation, Job Satisfaction, And Retention In Haiti, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) play a critical role in Haiti’s health system, by connecting communities—particularly rural and hard-to-reach populations—to healthcare services. The Frontline Health project conducted a study to better understand the types of incentive structures that can best support the CHWs in Haiti and this brief summarizes those findings.


Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project Oct 2021

Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project

Reproductive Health

As the global health community demonstrates an increasing commitment to investing in community health workers (CHWs) to achieve universal health coverage in lower- and middle-income countries, the need to effectively measure community health system performance is paramount. Embedded in the Integrating Community Health partnership (2017–2021), with support from the Bill & Melinda Gates Foundation, the Population Council and Last Mile Health co-led the Frontline Health (FLH) project, a four-year research, policy, and advocacy initiative aimed at developing core metrics and CHW reform processes, advancing their adoption, and promoting institutionalization of robust community health policies. This brief describes the Population Council’s …


Integrate Project Results: Family Planning Knowledge And Quality Of Care Received From Community Pharmacists And Patent And Proprietary Medicine Vendors, The Integrate Project Aug 2021

Integrate Project Results: Family Planning Knowledge And Quality Of Care Received From Community Pharmacists And Patent And Proprietary Medicine Vendors, The Integrate Project

Reproductive Health

In Nigeria, Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of care for many common illnesses. Although CPs and PPMVs are not formally recognized as family planning (FP) service providers, 22% of modern contraceptive users report receiving their last method from a PPMV and 12% from a private pharmacy. PPMVs are popular for FP because of their widespread availability, consistent drug stocks, extended hours, personable interactions, and lack of separate fees for consultations. As the Federal Ministry of Health explores expanding its task sharing policy to include CPs and PPMVs, evidence is needed on …


Women's Perceptions On The Effects Of Covid-19 On Access And Use Of Private Sector Family Planning Services In Nigeria: The Integrate Project, The Integrate Project Aug 2021

Women's Perceptions On The Effects Of Covid-19 On Access And Use Of Private Sector Family Planning Services In Nigeria: The Integrate Project, The Integrate Project

Reproductive Health

In Nigeria, Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of care for many common illnesses. Although CPs and PPMVs are not formally recognized as family planning (FP) service providers, 22% of modern contraceptive users report receiving their last method from a PPMV and 12% from a private pharmacy. PPMVs are popular for FP because of their widespread availability, consistent drug stocks, extended hours, personable interactions, and lack of separate fees for consultations. As in many places, the COVID-19 pandemic poses unprecedented challenges to health services in Nigeria. By limiting person-to-person contact, especially during …


Preferred Incentives For Improving Community Health Worker Satisfaction And Retention In Bangladesh, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health Jul 2021

Preferred Incentives For Improving Community Health Worker Satisfaction And Retention In Bangladesh, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) are critical actors within community health systems, providing a range of reproductive, maternal, child, and primary health information, counseling, and services. To better understand factors that influence CHWs’ work motivation and satisfaction in Bangladesh, the Frontline Health project, implemented with collaborators from Johns Hopkins Bloomberg School of Public Health, and supported by the government of Bangladesh’s Directorate General of Health Services and the Directorate General of Family Planning, conducted a discrete choice experiment (DCE) study. This brief presents key qualitative findings from the DCE study in Bangladesh and implications for program and policy stakeholders.


Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah Jun 2021

Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Ghana is working toward achieving universal health coverage (UHC). This is driven, in part, by the Sustainable Development Goals (SDGs), specifically SDG 3—Good Health and Well-Being, which seeks to ensure healthy lives and promote well-being for all at all ages. Achieving this feat will improve equity of access as people, especially the poor can access quality health services without financial hardships. Ensuring equitable access to family planning (FP) is essential to securing the well-being of women and supporting the health and development of communities. One pathway to ensuring equity is the inclusion of FP in affordable insurance. While the inclusion …


Optimizing Delivery Of Hiv Testing Services To Strengthen The Continuum Of Care, Project Soar Apr 2021

Optimizing Delivery Of Hiv Testing Services To Strengthen The Continuum Of Care, Project Soar

HIV and AIDS

HIV testing is a critical entry point to life-saving antiretroviral therapy (ART) for those diagnosed with HIV and to prevention services for those at high risk of acquiring HIV. Despite advances in testing, there remain a variety of social and programmatic challenges that prevent access to HIV testing services, particularly for men and key populations. HIV program managers and policymakers are increasingly invested in understanding how best to deliver HIV testing services to different populations and to maximize health system resources at facility and community levels. Project SOAR has contributed to the evidence base and catalyzed research use by examining …


Improving Patient Outcomes Through Innovative, Community-Based Hiv Treatment Strategies, Project Soar Apr 2021

Improving Patient Outcomes Through Innovative, Community-Based Hiv Treatment Strategies, Project Soar

HIV and AIDS

Despite the availability of life-saving treatment for HIV, several barriers prevent patient access to high-quality services. HIV program managers and policymakers have shown increasing interest in understanding how best to deliver HIV treatment to different populations and maximize health-system resources at facility and community levels. Project SOAR recognizes the key role that treatment services play in achieving UNAIDS’ 90-90-90 goals for controlling the HIV epidemic through testing, treatment, and viral suppression by 2020. Project SOAR has contributed to the evidence base and catalyzed research use by assessing innovative strategies for antiretroviral treatment (ART) delivery that support different populations in remaining …


Advances In Conceptualizing And Measuring Stigma Among People Living With Hiv, Project Soar Apr 2021

Advances In Conceptualizing And Measuring Stigma Among People Living With Hiv, Project Soar

HIV and AIDS

Stigma, defined as the co-occurrence of labeling, stereotyping, separation, status loss, and discrimination in a context in which power is exercised, has a negative impact on the health of people living with HIV (PLHIV), contributing to psychosocial stress, coercion and violence, job loss, and social exclusion. Widely recognized as a barrier to accessing HIV care, it is paramount that programs and policies are designed to mitigate HIV-related stigma to achieve the UNAIDS’ 90-90-90 goals. Project SOAR recognizes the importance of addressing stigma to control the HIV epidemic through testing, treatment, and viral suppression. Project SOAR has contributed to the evidence …


Approaches To Research Utilization And Capacity Strengthening, Project Soar Apr 2021

Approaches To Research Utilization And Capacity Strengthening, Project Soar

HIV and AIDS

Research plays a critical role in strengthening programming and policymaking. Donors and other stakeholders are increasingly focused on ensuring that their research investments yield positive health and development outcomes. Yet, there are many challenges in ensuring study findings are used by relevant decisionmakers to inform policies and programs. Recognizing the need to invest in research uptake efforts beyond dissemination of final findings, Project SOAR utilized an active approach to facilitating research utilization (RU) to fulfil the commitment of implementation science to promote the systematic uptake of research finding into routine practice. Project SOAR assembled and implemented a systematic and proactive …


Improving Data Access And Use For Hiv Biomedical Prevention Interventions, Project Soar Apr 2021

Improving Data Access And Use For Hiv Biomedical Prevention Interventions, Project Soar

HIV and AIDS

Over the past decade, biomedical prevention interventions—including voluntary medical male circumcision (VMMC) and oral pre-exposure prophylaxis (PrEP)—have resulted in substantial gains in controlling the global HIV epidemic. Despite the inclusion of these highly effective interventions in multinational strategies and global prevention toolkits, their effective implementation rests upon context-specific, data-driven delivery to priority populations and geographies. Project SOAR has contributed to the evidence base by increasing access to and use of data through user-friendly interfaces and dissemination strategies, advancing VMMC and PrEP as vital prevention interventions in the global discourse. SOAR’s biomedical prevention portfolio has supported data-driven planning, implementation, and monitoring …


Reproductive Health Care In The Time Of Covid-19: Perspectives Of Poor Women And Service Providers From Rahim Yar Khan, Punjab, Iram Kamran, Tahira Parveen, Rehan M. Niazi, Irfan Masood Dec 2020

Reproductive Health Care In The Time Of Covid-19: Perspectives Of Poor Women And Service Providers From Rahim Yar Khan, Punjab, Iram Kamran, Tahira Parveen, Rehan M. Niazi, Irfan Masood

Reproductive Health

This study was conducted by the Population Council in Rahim Yar Khan district of Punjab, with the support of the United Nations Population Fund (UNFPA), to uncover urgently needed evidence about the challenges and needs of poor women and health care providers during the COVID-19 pandemic. Over 200 poor women—beneficiaries of the Benazir Income Support Programme (BISP), one of the largest social protection programs in the world—and 60 public and private sector health care providers participated in this investigation of BISP beneficiaries’ knowledge of COVID-19, the effects of the pandemic on their lives, mental health and wellbeing, and their access …


Scales To Measure Motivation Among Community Health Workers, And Trust And Empowerment Among Their Clients: A Guide, Frontline Health Project Nov 2020

Scales To Measure Motivation Among Community Health Workers, And Trust And Empowerment Among Their Clients: A Guide, Frontline Health Project

Reproductive Health

This How-To Guide presents five multi-item scales to measure motivation among community health workers (CHWs), as well as clients' trust in CHWs, and empowerment within community health systems. The scales presented are intended for use in community health programs and in combination with other indicators in the CHW Performance Measurement Framework (published by the Frontline Health project in 2019) for routine data monitoring to improve quality and accountability in community health.


Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah Nov 2020

Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Contraceptive use in Ghana has remained low despite annual increases since 2012. Having a high unmet need for family planning (FP) suggests that there may be barriers to access and uptake. Over time, several policies, including Ghana’s Costed Implementation Plan from 2015–20, have suggested FP initiatives to improve contraceptive use yet they have not been entirely implemented. Further, although FP was included in the health insurance act passed in 2003, amended in 2008, and revised in 2012, which indicated that health-care benefits include FP, people continue to pay out of pocket for services at National Health Insurance Authority facilities because …


Frontline Health: Harmonizing Metrics, Advancing Evidence, Accelerating Policy—Project Overview Brief, Frontline Health Project Oct 2020

Frontline Health: Harmonizing Metrics, Advancing Evidence, Accelerating Policy—Project Overview Brief, Frontline Health Project

Reproductive Health

Despite decades of technological and medical progress globally, half the world’s population still lacks access to essential health care due to insufficient numbers and types of health workers, especially in remote settings. There is growing recognition that well-supported community health workers (CHWs) are essential for effective delivery of primary health care (PHC). Despite broad consensus on the importance of CHWs, few countries have successfully integrated them as part of PHC at scale, and many lack official statistics on the performance of CHW programs. USAID, UNICEF, and the Bill & Melinda Gates Foundation developed a Memorandum of Understanding to collaborate on …


Best Bets: Vouchers For Rights-Based, Voluntary Family Planning—International Evidence On Financing Of Family Planning, Benjamin Bellows, Moazzam Ali, Ali M. Mir Oct 2020

Best Bets: Vouchers For Rights-Based, Voluntary Family Planning—International Evidence On Financing Of Family Planning, Benjamin Bellows, Moazzam Ali, Ali M. Mir

Reproductive Health

To meet the FP2020 and Sustainable Development Goals (SDGs), significant investments are required by countries and donors in priority areas, including sustainable financing, reaching all adolescents, expanding availability of services to the poorest and hard-to-reach populations, and improving the quality and increasing the range of methods available. Studies show that vouchers can substantially contribute to SDG goals by expanding contraceptive access and choice among underserved populations. Vouchers can be an effective financing tool to enhance equity, increase access, and improve the quality of FP services available to underserved populations within Pakistan.


Project Soar Research Informs National Policy Change In Tanzania Expanding Access To Hiv Services For Marginalized Populations, Population Council Oct 2020

Project Soar Research Informs National Policy Change In Tanzania Expanding Access To Hiv Services For Marginalized Populations, Population Council

Research Utilization and Impact Briefs

A recent Project SOAR study evaluated community-based delivery of antiretroviral treatment to female sex workers (FSWs) in Tanzania, demonstrating the value of this approach to improve HIV care. Informed by these findings, the Government of Tanzania changed national guidance to allow for community-based HIV treatment to better meet the needs of marginalized populations, including FSWs.


Facing Covid-19: Knowledge, Attitudes, Practices, And Challenges Of Healthcare Providers, Population Council Oct 2020

Facing Covid-19: Knowledge, Attitudes, Practices, And Challenges Of Healthcare Providers, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). During this study, 60 health care providers that represented 60 unique health facilities in Punjab’s Rahim Yar Khan district were interviewed by telephone, to evaluate how much they know about COVID-19 symptoms, prevention, and treatment, as well as their individual attitudes, practices, and challenges during the ongoing pandemic. To assess how the situation evolved during the critical first three months of …


Poor Women's Reproductive Health And Family Planning Challenges And Needs During The Covid-19 Pandemic, Population Council Oct 2020

Poor Women's Reproductive Health And Family Planning Challenges And Needs During The Covid-19 Pandemic, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). The study conducted 164 interviews by telephone with beneficiaries of the Benazir Income Support Programme (BISP) in Rahim Yar Khan, Pakistan, previously surveyed in 2019, to determine how much those most vulnerable to the effects of COVID-19 know about the disease and its effects, in addition to understanding the pandemic’s effects on their lives, including their mental health and well-being as …


Modeling The Impact Of Inclusion Of Family Planning Services In Ghana's National Health Insurance Scheme, Justin Archer, Gillian Eva, Augustine Ankomah, Saumya Ramarao, Kamil Fuseini, Anne Coolen, Stephen Duku, Benjamin Bellows Sep 2020

Modeling The Impact Of Inclusion Of Family Planning Services In Ghana's National Health Insurance Scheme, Justin Archer, Gillian Eva, Augustine Ankomah, Saumya Ramarao, Kamil Fuseini, Anne Coolen, Stephen Duku, Benjamin Bellows

Reproductive Health

While access to and uptake of modern family planning (FP) in Ghana has steadily risen over the last decade, the modern Contraceptive Prevalence Rate (mCPR) among all women reached only 22% in 2019 with 30% of women still reporting unmet need. To increase FP uptake via mitigation of cost barriers among women with unmet need, the Government of Ghana is seeking to integrate claims-based FP services into the National Health Insurance Scheme benefits package. The impact of these activities has the potential to be significant with the proportion of women accessing modern FP shifting dramatically to public facilities over the …


Best Bets: Additional Funding For Family Planning—International Evidence On Financing Of Family Planning, Zeba Sathar Aug 2020

Best Bets: Additional Funding For Family Planning—International Evidence On Financing Of Family Planning, Zeba Sathar

Reproductive Health

Additional financing for family planning (FP) in Pakistan is strongly justified, not only to increase contraceptive prevalence, reduce unmet FP need, and avert millions of unwanted pregnancies, but also to reduce maternal mortality and effect improvements in other spheres of development. As a safeguard against unintended fertility, FP contributes to national savings in multiple ways, and additional annual funding of $93 million—or 40 cents per capita—is a relatively minor investment that promises huge dividends.


Best Bets For Accelerating Family Planning In Pakistan: Inducting Men, Sharing Responsibility, Kiren Khan, Zeba Sathar Aug 2020

Best Bets For Accelerating Family Planning In Pakistan: Inducting Men, Sharing Responsibility, Kiren Khan, Zeba Sathar

Reproductive Health

Pakistan's family planning (FP) program remains more or less exclusively aimed at women, yet evidence from both international as well as programming from within Pakistan suggests that including men in FP could improve results. Given the large youth cohort entering reproductive life in Pakistan, there are compelling grounds for also including younger men and adolescent boys, especially those about to wed, within the country's reproductive health (RH) and FP strategies.


Best Bets For Accelerating Family Planning In Pakistan: The Case For Engaging Family Physicians And The For-Profit Private Sector, Ashfaq Rehman, Anam Malkani Aug 2020

Best Bets For Accelerating Family Planning In Pakistan: The Case For Engaging Family Physicians And The For-Profit Private Sector, Ashfaq Rehman, Anam Malkani

Reproductive Health

Many women in the developing world already rely on private sector providers for various types of treatment, as well as for family planning (FP) services, due to ease of access, shorter waiting times, and a perception of better service. Drug shops and pharmacies are also important for improving access and basic information about contraceptive products. Private pharmacies and shops are key when public sector facilities face frequent shortages and stock outs.


Best Bets For Accelerating Family Planning In Pakistan: Invest In Community Health Workers, Ali M. Mir, Kiren Khan Aug 2020

Best Bets For Accelerating Family Planning In Pakistan: Invest In Community Health Workers, Ali M. Mir, Kiren Khan

Reproductive Health

Integration of trained, equipped, and supported community health workers (CHWs) within a health system is recognized as a proven high impact practice for family planning (FP) services, with evidence from around the world confirming the need to complement facility-based FP services with CHW programs, particularly in areas where people’s access to health care is limited. There is also substantial evidence that delivering essential health services through CHWs can be cost-effective in a diversity of contexts, with a review of FP programs in 10 developing countries revealing that the average cost per couple-year of protection (CYP) was considerably lower among programs …


Improving Data Reporting To Nhmis From The Private Sector In Nigeria: Lessons From A Dhis2 Pilot With Community Pharmacists And Patent And Proprietary Medicine Vendors, Population Council Mar 2020

Improving Data Reporting To Nhmis From The Private Sector In Nigeria: Lessons From A Dhis2 Pilot With Community Pharmacists And Patent And Proprietary Medicine Vendors, Population Council

Reproductive Health

The IntegratE Project is a four-year initiative (2017–21) implemented by the Population Council and partners that seeks to increase access to contraceptive methods by involving the private sector (community pharmacists [CPs] and patent and proprietary medicine vendors [PPMVs]) in family planning (FP) service delivery in Lagos and Kaduna States, Nigeria. The project aims to establish a regulatory system with the Pharmacists Council of Nigeria to ensure that CPs and PPMVs provide quality FP services, comply with FP regulations, and report service statistics to the Health Information Management System (HMIS). To achieve this, the project is implementing: a pilot three-tiered accreditation …


The Effects Of A Family Planning Training On Community Pharmacists And Patent And Proprietary Medicine Vendors’ Knowledge In Nigeria: Preliminary Pre And Posttest Results, The Integrate Project, Population Council Mar 2020

The Effects Of A Family Planning Training On Community Pharmacists And Patent And Proprietary Medicine Vendors’ Knowledge In Nigeria: Preliminary Pre And Posttest Results, The Integrate Project, Population Council

Reproductive Health

The IntegratE Project is a four-year initiative (2017–21) implemented by the Population Council and partners that seeks to increase access to contraceptive methods by involving the private sector (community pharmacists [CPs] and patent and proprietary medicine vendors [PPMVs]) in family planning (FP) service delivery in Lagos and Kaduna States, Nigeria. The project aims to establish a regulatory system with the Pharmacists Council of Nigeria to ensure that CPs and PPMVs provide quality FP services, comply with regulations, and report service statistics to the Health Information Management System. To achieve this, the project is implementing: a pilot three-tiered accreditation system for …


Quality Of Care Received For Family Planning From Community Pharmacists And Patent And Proprietary Medicine Vendors In Lagos And Kaduna, Nigeria: The Integrate Project, Population Council Mar 2020

Quality Of Care Received For Family Planning From Community Pharmacists And Patent And Proprietary Medicine Vendors In Lagos And Kaduna, Nigeria: The Integrate Project, Population Council

Reproductive Health

The IntegratE Project is a four-year initiative (2017–21) implemented by the Population Council and partners that seeks to increase access to contraceptive methods by involving the private sector (community pharmacists [CPs] and patent and proprietary medicine vendors [PPMVs] in family planning (FP) service delivery in Lagos and Kaduna States, Nigeria. The project aims to establish a regulatory system with the Pharmacists Council of Nigeria to ensure that CPs and PPMVs provide quality FP services, comply with regulations, and report service statistics to the Health Information Management System. To achieve this, the project is implementing: a pilot three-tiered accreditation system for …


Strengthening In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril Jan 2019

Strengthening In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

This brief details Council efforts to develop effective, and costed, in-service training and continuing education modules for frontline health workers in Bauchi and Cross River states in Nigeria. This project was funded by WHO to aid the training and development of Nigeria's public health worker sector.


Population Council's Support For Nigeria's Third National Human Resources For Health Conference And Efforts To Institutionalize Hrh Conferences In Nigeria, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril Jan 2019

Population Council's Support For Nigeria's Third National Human Resources For Health Conference And Efforts To Institutionalize Hrh Conferences In Nigeria, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

This project brief describes the Population Council's partnership efforts with public health stakeholders in Nigeria to plan and host a third national conference for provision of necessary and relevant information on critical health issues to health staff and stakeholders throughout Nigeria.