Medicine and Health Sciences Commons^™

Beliefs And Practices About Reproductive Tract Infections: Findings From A Series Of Philippine Fgds, Marilou Palabrica-Costello, Carmeli Marie Chaves, Chona R. Echavez, Cecilia Conaco, Mariano Santiago

Reproductive Health

The past decade has been characterized by increasing concern about the medical, social, and economic problems associated with reproductive tract infections (RTIs). The goal of preventing and curing RTIs is now being prioritized by public health agencies in the developing world. Very little research has been conducted on the problem of RTIs in the local context, and it would be helpful for program managers if the knowledge and beliefs now being held about RTIs were more clearly delineated. Knowing more about the way in which these illnesses are viewed by the community, about traditional practices for preventing and curing RTIs, …

An Assessment Of Clinic Based Family Planning Services In Kenya: Results From The 1995 Situation Analysis Study, Lewis Ndhlovu, Julie Solo, Robert A. Miller, Kate Miller, Achola Ominde

Reproductive Health

This study’s objective was to assist the Kenya Ministry of Health (MOH), the National Council for Population and Development (NCPD), NGOs, and donor agencies in planning the expansion and improvement of family planning (FP) and other reproductive health (RH) services provided in Kenya. Data on the functioning of program subsystems and the quality of care provided were collected in May 1995 from 254 maternal and child health/family planning (MCH/FP) facilities throughout the country using a situation analysis approach. The study sample included a representative sample of facilities from the MOH and NGO sectors. It also included a census of all …

Improved Reproductive Health And Std Services For Women Presenting To Family Planning Services In North Jakarta. Final Report Of Activities, Meiwita B. Iskandar, Catherine Vickers, Subadra Indrawati, Siti Nurul Qomariyah

Reproductive Health

The overall goal of this study was to develop an integrated program of reproductive tract infection/sexually transmitted disease (RTI/STD) clinical services within two family planning clinics in low-income neighborhoods in North Jakarta. Multiple training programs to introduce a standardized clinical evaluation for the detection, treatment, and management of RTI/STDs were conducted. Prior and subsequent to training, observations of health care provider (HCP) and client interactions were conducted to evaluate behavior changes among HCPs. Each consenting client received a standardized reproductive health history, a pelvic exam, and provided specimens for laboratory testing to detect RTIs. Through universal screening of the participants …

Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez

Reproductive Health

A Situation Analysis (SA) was conducted in seven local government health centers as part of a larger project studying the feasibility of integrating RTI services within the existing Family Planning/Reproductive Health Program of the Department of Health (DOH). The SA was part of a series of baseline activities conducted by the Family Planning Operations Research and Training Project as part of its study on Integrating RTI Management in Local Government Unit Health Centers. It was conducted by Population Council, Manila, for the DOH. Participating health centers were located in a large and highly urbanized community, a medium-sized city, and two …

Measuring Hospital Use Without Claims: A Comparison Of Patient And Provider Reports., R E. Clark, S K. Ricketts, G J. Mchugo

Dartmouth Scholarship

We compared the validity of hospital admission and length of stay reports from patients, outpatient providers, and hospitals, and we examined possible sources of error. Data were collected from people enrolled in a randomized trial of treatment for severe mental illness and substance use disorders, from community mental health centers (CMHCs), and from hospitals. Reports for each of the 74 study participants covered two-year time periods beginning and ending at various times between 1989 and 1993. We compared reports from the various sources and constructed a hybrid with data from all three sources. Using parametric and non-parametric statistics, we compared …

Postpartum Safety And Satisfaction Following Early Discharge, Dawn M. Guthrie, J. Ivan Williams, Ellen Hodnett, Janet Rush

Kinesiology and Physical Education Faculty Publications

Two Ontario sites were involved in the evaluation of an obstetrical discharge program. Before program implementation a group of eligible women were enrolled as the preprogram control group (n = 542). During the program, eligible women who agreed to early discharge (ED) became the ED group (n = 319), and those opting not to go home early but consenting to participate in the evaluation became the concurrent group (n = 456). All groups were mailed a self-administered postpartum questionnaire. On demographic characteristics, safety and satisfaction, the ED group was comparable to the concurrent group. Hospital readmission rates did not differ …

When Are Research Findings Ready For Use?, Judith A. Floyd

Nursing Faculty Research Publications

No abstract provided.

Proceedings Of The Operations Research Workshop For Lgu Health And Population Officials And Researchers, August 9-13, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This report summarizes the results of the training workshop for health and population officials and researchers who gathered in Boracay, Aklan, Philippines, on August 9-13, 1996, to discuss the tenets and applications of operations research (OR). This workshop was co-sponsored by the Family Planning Service of the Department of Health (DOH) and the Family Planning Operations Research and Training Program of the Population Council, Manila. Fourteen local government units (LGUs) were represented in the workshop: Benguet, Cagayan, Ilocos Sur, Tarlac, Quezon City, Capiz, Negros Oriental, Bacolod, Misamis Oriental, Davao del Sur, Davao City, Maguindanao, North Cotabato, and South Cotabato. They …

Proceedings Of The Operations Research Training Workshop For Program Managers And Researchers, January 15-21, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This document contains the proceedings of the training workshop on operations research (OR) for program managers and researchers held January 15-21, 1996, in Mindoro, Philippines. The workshop was co-sponsored by the Family Planning Service of the Department of Health and the Family Planning Operations Research and Training Program of the Population Council, Manila. Representatives from the health and population offices of ten local government units (LGUs) worked with a select group of researchers to evolve a list of relevant topics for operations research (OR) and develop a concept paper on a chosen OR topic. The LGUs represented in the workshop …

Learning About Sexuality: A Practical Beginning, Sondra Zeidenstein, Kirsten Moore

Poverty, Gender, and Youth

“Learning About Sexuality: A Practical Beginning” is divided into three main parts. The first includes approaches that program staff, activists, and researchers are taking to understand people’s experiences of sexuality. The second explores the explicit and implicit links among health-seeking behavior, contraceptive practice, reproductive health, and sexuality. The chapters in part three focus on activities that challenge entrenched attitudes and behavior about sexuality that have real and potentially harmful effects on women’s and men’s reproductive health. The book features program and research work in all regions of the world with women, men, girls, and boys. The chapters are written by …

Proceedings Of The Operations Research Training Workshop: Mainstreaming Nfp In The Public Sector, August 15-18, 1996, Family Planning Service, Philippine Federation For Natural Family Planning, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This report summarizes the proceedings of the “Operations Research Training Workshop: Mainstreaming Natural Family Planning in the Public Sector,” held August 15-18, 1996, in Boracay, Aklan, Philippines. The workshop was sponsored by the Philippine Federation for Natural Family Planning (NFP), the Family Planning Service of the Department of Health, and the Family Planning Operations Research and Training (FPORT) Program of the Population Council, Manila. Program managers and health officials were trained in operations research (OR) to enhance their understanding and appreciation of OR and its role in integrating NFP technology in the public health sector. Results of several diagnostic and …

Reintroducing Dmpa To The Philippine Family Planning Program: A Longitudinal Study Of Continuing Users And Drop-Outs, Population Council

Reproductive Health

In 1994, the Population Council, Manila, conducted an operations research (OR) project entitled “DMPA Monitoring and Follow-up Studies.” The activity was undertaken to provide accurate and timely support to the DMPA Reintroduction Program of the Department of Health. Commonly known as Depo-Provera, DMPA stands for Depo-Medroxy Progesterone Acetate, an extremely effective injectable contraceptive given every three months. This report focuses on the survey component of these studies which aims to comprehensively examine the influence on DMPA use of factors classified into the following eight major areas: socioeconomic and demographic characteristics; reproductive history; contraceptive history; adoption of DMPA; quality of care …

Unsafe Abortion In Kenya: Findings From Eight Studies, Khama Rogo, Ann Leonard

Reproductive Health

One of the most topical areas in reproductive health today is the consequences of induced and often unsafe abortion. Safe motherhood initiatives continue to highlight the contribution of unsafe abortion to the persistent high rates of maternal mortality and morbidity in sub-Saharan Africa. In some countries, unsafe abortion is responsible for up to half of all maternal mortality and morbidity, with adolescents constituting a significant proportion of those procuring unsafe abortions. In Kenya, concern about the problem of incomplete and septic abortion has increased, particularly on the part of service providers who must treat women suffering from the complications of …

Inopal Ii Final Report, Population Council

Reproductive Health

The goal of the Population Council's “Investigación Operacional en Planificación Familiar y Atención Materno-Infantil para América Latina y el Caribe” (INOPAL) program was to conduct operations research and provide technical assistance to improve the coverage, quality, and sustainability of family planning (FP) services in Latin America and the Caribbean. INOPAL II was the successor to INOPAL I (1984–1989). Like its predecessor, INOPAL II was supported by a contract from the USAID Office of Population, when it was replaced by a new USAID-funded project, INOPAL III. INOPAL II objectives included: expanding access to FP services, improving the operations of programs by …

Dmpa Injectable Use: Findings From The 21-Month Dmpa Monitoring Study, Population Council

Reproductive Health

This report presents the results of the DMPA Monitoring Study undertaken by the Population Council, Manila, as a technical assistance project for the DMPA Reintroduction Program of the Department of Health. The primary objective is to provide data on DMPA utilization and continuation rates to project the logistical needs of the program during the next three years. Data on availability of DMPA supplies and IEC (information, education, and communication) materials relating to DMPA were also monitored to provide some measure of effectiveness of the program's distribution system. The study covers a 21-month observation period from April 1994 to December 1995 …

Indonesia: Utilization Of Completed Operations Research Studies, Meiwita B. Iskandar, Subadra Indrawati

Reproductive Health

In the past eight years, many operations research (OR) programs were implemented in Indonesia to increase the availability, accessibility, and acceptability of services desired by family planning (FP) users. OR has also been employed to improve quality and sustainability by studying the performance, efficiency, and effectiveness of services delivered by providers. Nonetheless, relatively little is known about the true effects of OR studies in identifying and solving program problems in order to support the planning and coordinating of a particular program. Measuring utilization of OR results is not simple. In 1989, USAID signed its last bilateral assistance agreement with the …

Patient Satisfaction Among Users Of The After Hours Program, Helen L. Larocco

Community & Environmental Health Theses & Dissertations

The problem of increasing health care costs and decreasing access to health care services is a major crisis in the U.S. today. One factor contributing to the rising cost of health care is the inappropriate use of emergency rooms, (ERs). In response to escalating costs a local health care corporation implemented a telephone triage program called the After Hours Program, (AHP). The goal of the program was to reduce inappropriate utilization of emergency rooms, and to educate patients to recognize and treat specific health problems independently, i.e., home treatment.

A program evaluation was completed in which different dimensions of patient …

Effect Of Nutrition Intervention On The Outcomes Of Pregnancy: A Rural Urban Comparison, Ranjita Misra

Health Services Research Dissertations

The present study examines the effect of nutritional intervention on two outcomes of pregnancy: birth weight of the baby and gestational age. The study further examines the difference in nutritional intervention in rural and urban areas. The research method used is ex-post facto design. Data for the study is extracted from the health records and tracking sheets of women participating in the Nutrition Intervention Project in Virginia Department of Health. Path analysis and effects analysis are used to analyze the causal and direct effect of the independent variables and each of the outcome variables. A model has been developed grounded …

Quality Of Care In Family Planning Service Delivery In Kenya: Clients' And Providers' Perspectives, Lewis Ndhlovu

Reproductive Health

In recent years, the increasing number of organizations that have studied quality of care in international family planning (FP) programs demonstrates the importance the topic has acquired. To define quality of care in FP, the Bruce–Jain framework of six elements of care (choice of methods, information given to clients, technical competence, interpersonal relations, continuity and follow up, and appropriate constellation of services) have been used as the standard. However, what has been overlooked in this approach is the clients' perspectives of service quality. This study sought to narrow the gap in knowledge about the comparability and consistency in views between …

Report On Norplant® Implants In Indonesia, Andrew A. Fisher, Soledad Diaz, Alejandro N. Herrin, Joedo Prihartono

Reproductive Health

At the request of the Indonesian National Family Planning Coordinating Board, the Population Council’s consultant team reviewed issues related to Norplant® implant service delivery in Indonesia and recommended specific areas for new initiatives, improvements, and further research. The team reviewed secondary sources on the subject and visited Indonesia from April 17–28, 1995. They talked with family planning (FP) officials and observers and made field visits to West Java and Yogyakarta. This report reviews important issues facing the national FP program, particularly regarding Norplant insertions and removals. Program approaches are included, as are an outline for a national assessment study that …

Dmpa Monitoring Study: Findings On Use And Continuation Rates, Population Council

Reproductive Health

This report presents the results of the DMPA Monitoring Study undertaken by Population Council, Manila, as a technical assistance project for the DMPA Reintroduction Program of the Department of Health. The primary objective of the study is to provide data on DMPA (injectable contraceptive) utilization and continuation rates that may be used to project the logistical needs of the program for the next four years (1995–1998). Availability of DMPA supplies, and information, education, and communication (IEC) materials on DMPA in the facilities were also monitored to provide some measure of the effectiveness of the distribution system. The study covers a …

Improving The Counseling And Medical Care Of Postabortion Patients In Egypt, Population Council, Egyptian Fertility Care Society

Reproductive Health

This pilot study conducted in Cairo and Minya examined the effects of improving the medical care and counseling of post-abortion patients in Egypt. A pre-test/post-test, no control group study design was used to measure the effects of an intervention that upgraded physicians' clinical and interpersonal communication skills for the care of post-abortion patients, including counseling and family planning (FP). The study's surveys utilized direct interviews with staff working in the OB/GYN wards, structured observations of treatment procedures and counseling of post-abortion patients, and interviews with patients prior to discharge. Changes in the clinical management of post-abortion patients were introduced through …

A Model Of Costs Of A Cbd Programme, Saumya Ramarao, John Townsend, M.E. Khan

Reproductive Health

This study is a collaborative effort of the Population Council, New Delhi, and the Centre for Development and Population Activities, New Delhi. Cost analysis is an analytical tool that provides program managers and planners with information about existing and potential programs. Existing programs can be evaluated for efficiency and effectiveness, while the resource requirements of future programs can be estimated. In the context of family planning (FP) programs, cost analysis provides policymakers and program managers with sufficient data on efficient ways to meet the demand for FP services with available resources. As FP programs mature and requirements for the resources …

An Overview Of The Effectiveness And Efficiency Of Hiv Prevention Programs, D. R. Holtgrave, Noreen L. Qualls, J. W. Curran, Ronald O. Valdiserri, Mary Guinan, William C. Parra

Public Health Faculty Publications

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly …

The Dmpa Service Provider: Profile, Problems And Prospects, August 1995, Maria Carmela Patron, Marilou P. Costello

Reproductive Health

This report presents the results of interviews conducted with 60 trained DMPA service providers from seven of the ten local government units (LGUs) covered by Phase I of the Philippine Department of Health's DMPA Reintroduction Program. DMPA, or Depot-medroxyprogesterone acetate, is an injectable contraceptive commonly known as Depo-Provera. The interviews were undertaken as part of the DMPA Monitoring and Follow-up Studies sponsored by the Population Council under the Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. While the monitoring study and the follow-up survey focused on DMPA users and dropouts, this study centered on the service …

Improving Community Based Family Planning Services And The Potential For Increasing Contraceptive Prevalence In Bangladesh, Amy Gale Dunston, Peter C. Miller

Reproductive Health

This report contains descriptions of 13 family planning (FP) projects recently implemented in Bangladesh. The results in terms of the contraceptive prevalence rate (CPR) are analyzed to investigate the degree to which improved FP service delivery in Bangladesh can increase contraceptive use in the present status of demand, investigate the programmatic factors most associated with increased prevalence, and make these projects more widely known. Criteria for inclusion included coverage of a geographic area where household distribution of contraceptive supplies was available, and where at least one measurement of CPR has been made through credible survey efforts since July 1988. The …

Support For Research, Dissemination, Utilization, And Policy In Bangladesh, Ubaidur Rob, Donna Nager

Reproductive Health

Through the initiative of the Family Planning Fortnight: Meeting the Future Challenges, held in December 1993, the Government of Bangladesh made a policy statement about the critical importance of dealing with the nation's population problem. The Fortnight provided the strategic framework for developing actions to strengthen the National Family Planning Program that would meet the country's population challenges. To initiate rapid action, the Family Planning Fortnight Steering Committee, under the chairmanship of the Secretary, Ministry of Health and Family Welfare, formed a working group to prepare a report that would capitalize on all earlier efforts and lay out a plan …

Organizational Slack, Efficiency, And Quality Of Care In Acute Care Hospitals, Kyung Ii Youn

Theses and Dissertations

The relationship between technical efficiency and quality of care in hospitals is studied in the context of resource availability in hospital organizations. The resource availability of hospitals is conceptualized by organizational slack.

An integrated model is developed encompassing the source of organizational slack, its impact on technical efficiency and on quality of care, and its impact on the relationship between efficiency and quality. Organizational threat as an environmental factor affecting the level of slack is measured by the level of competition and regulation. Organizational slack is measured using financial and operational indicators of the hospitals. Technical efficiency is estimated by …

Experience With The Dmpa Injectable Contraceptive: Findings From A Survey Of Dmpa Acceptors, Maria Carmela Patron, Marilou P. Costello

Reproductive Health

This report presents the results of a survey of 899 DMPA acceptors who availed of injectable contraceptive services from public health facilities under the Philippine Department of Health's (DOH) DMPA Reintroduction Program. The survey is part of the DMPA Monitoring and Follow-up Studies sponsored by the Population Council’s Manila office in response to a request by the DOH to provide operations research support to the program. Depot-medroxyprogesterone acetate (DMPA), commonly known as Depo-Provera, is a three-month injectable contraceptive. It was recently officially endorsed as a family planning (FP) program method by the DOH, following its approval by the Philippine Bureau …

Development Of Approaches To Community Based Family Planning Outreach In Egypt: Assessment Of Raidats Rifiats Program, Population Council

Reproductive Health

Egypt’s family planning program officially began in 1965. Impressive gains in contraceptive use have been made since 1980, and the contraceptive prevalence rate increased from 24 percent in 1980 to 47 percent in 1992. Egypt’s National Population Policy addresses the nation’s population growth through multiple interventions designed to reduce fertility, including family planning (FP) services. FP accessibility is promoted through a network of public and NG0 FP clinics. A number of years ago, the Egyptian Family Planning Program began using the Raidats Rifiats program to extend services into rural communities. There is concern regarding the program’s ability to recruit women …