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Full-Text Articles in Medicine and Health Sciences
Expanding Access To Vasectomy Services In The Ministry Of Health Of Guatemala, Blanca De Rodriguez, Ricardo Vernon, Jorge Solorzano
Expanding Access To Vasectomy Services In The Ministry Of Health Of Guatemala, Blanca De Rodriguez, Ricardo Vernon, Jorge Solorzano
Reproductive Health
This project tested the effectiveness of a systemic model for introducing vasectomy in service delivery units of the Guatemalan Ministry of Health (MOH), which has four basic components: a) the self-selection of health units according to their response to an invitation to participate in the project; b) the development of a counseling and information model for potential clients; c) training and sensitizing of health teams; and d) on-site training of surgeons. The report concludes that the introduction model for vasectomy in the MOH centers was successful. A high proportion of hospitals that identified vasectomy candidates finished the process, and the …
Encuestas De Voluntad De Pago Para Fijar Precios De Productos Y Servicios De Salud Reproductiva: Manual De Usuarios, Karen G. Fleischman Foreit, James R. Foreit
Encuestas De Voluntad De Pago Para Fijar Precios De Productos Y Servicios De Salud Reproductiva: Manual De Usuarios, Karen G. Fleischman Foreit, James R. Foreit
Reproductive Health
Social programs need to balance volume (coverage) and income (sustainability). The law of supply and demand states that we can not obtain coverage and support at the same time, because when prices rise, demand decreases. This manual presents willingness-to-pay (WTP) surveys that allow program managers to simulate changes in demand related to price, without actually changing prices. The Population Council with The Futures Group International developed these surveys that can be used for existing and new products and services, collect responses from clients with no formal education with sensitivity to their individual characteristics, and provide conservative estimates that accurately predict …
Effects Of Igss' Job Aids-Assisted Balanced Counseling Algorithms On Quality Of Care And Client Outcomes, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Gustavo Gutierrez, Veronica Davila, Carlo Boniato, Alex Rios
Effects Of Igss' Job Aids-Assisted Balanced Counseling Algorithms On Quality Of Care And Client Outcomes, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Gustavo Gutierrez, Veronica Davila, Carlo Boniato, Alex Rios
Reproductive Health
This study identified a need to improve the quality of care at the main maternity hospital of the Social Security Institute (IGSS) in Guatemala. Problems included very short counseling sessions, counseling not focused on clients’ needs, redundancy in the role of physicians and social workers as providers, skewed method mix, and low client return rate for method resupply. The intervention, using Balanced Counseling Algorithms, changed the counseling behavior of physicians and social workers and enhanced the quality of family planning care. The report includes recommendations for continuing these improvements: monitoring provider implementation of the job aids–assisted Balanced Counseling Algorithms, monitoring …
Etude Expérimentale Sur L'Offre De Services À Base Communautaire De Santé De La Reproduction Au Sénégal: Une Étude De Cas Dans Le District Sanitaire De Kébémer, Diouratie Sanogo, Mady Cisse, Adama Ndoye, Laty G. Ndoye, Ousmane Faye, Balla Mbacke Mboup
Etude Expérimentale Sur L'Offre De Services À Base Communautaire De Santé De La Reproduction Au Sénégal: Une Étude De Cas Dans Le District Sanitaire De Kébémer, Diouratie Sanogo, Mady Cisse, Adama Ndoye, Laty G. Ndoye, Ousmane Faye, Balla Mbacke Mboup
Reproductive Health
La Division de la Santé de la Reproduction (DSR) du Ministère de la Santé et de l'Action Sociale du Sénégal, en partenariat avec le programme FRONTIERS in Reproductive Health du Population Council et le Management Sciences for Health, a mené une étude visant à déterminer l'acceptabilité et la faisabilité des modèles de services à base communautaire expérimentés du point de vue de leur acceptabilité, de leur faisabilité, de leur efficacité, de leur performance, et de leur coût et rentabilité. L'objectif général de cette étude était de contribuer à l'élaboration d'un programme intégré rentable visant à accroître l'accessibilité et la disponibilité …
Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan
Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan
Reproductive Health
CARE International, with technical support from the Frontiers in Reproductive Health Program completed a study in Ethiopia and Kenya designed to test the effectiveness of education activities using behavior change communication (BCC) approaches and advocacy activities by religious and other key leaders to abandon female genital cutting (FGC). In Ethiopia, the increased knowledge of harmful FGC effects and human rights issues translated to a positive attitude in support of FGC abandonment and an intention not to cut their daughters in the future. In Kenya, the analysis indicated mixed results in attitude and intended behavior change.
Tulane University Final Report, M. Celeste Marin, Anastasia J. Gage, Suhaila Khan
Tulane University Final Report, M. Celeste Marin, Anastasia J. Gage, Suhaila Khan
Reproductive Health
The Frontiers in Reproductive Health (FRONTIERS) program is a 10-year cooperative agreement between the United States Agency for International Development (USAID) and the Population Council in partnership with Family Health International and Tulane University School of Public Health and Tropical Medicine. This report summarizes the main activities undertaken by Tulane University under its subagreement with the Population Council on the FRONTIERS project from 1998–2004. As a partner, Tulane furthered progress toward all three of the program’s intermediate results: contributing innovative interventions tested to improve reproductive health through the small grants program; helping research staff take a more proactive approach to …
Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena
Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena
Reproductive Health
The purpose of this study was to identify the reasons for the low use of the IUD in Guatemala and to explore the reasons why other reversible methods are selected more frequently than IUDs. The study aimed to determine the availability and acceptability of IUDs as a contraceptive option within the Ministry of Health, the Guatemalan Social Security Institute, and APROFAM. Results indicated that service providers do not take into consideration women’s reproductive needs or intentions when they provide family planning counseling. There are several demand-side factors that affect the use of the IUD, including lack of knowledge about the …
Postabortion Family Planning Operations Research Study In Perm, Russia, Irina Savelieva, John M. Pile, Inna Sacci, Ratha Loganathan
Postabortion Family Planning Operations Research Study In Perm, Russia, Irina Savelieva, John M. Pile, Inna Sacci, Ratha Loganathan
Reproductive Health
EngenderHealth, the Population Council’s FRONTIERS program, and the Research Center of Obstetrics, Gynecology, and Perinatology of the Russian Academy of Medical Sciences, with support from the Perm Health Departments, undertook an operations research study to test models for increasing contraceptive use and reducing the repeat abortion rate among abortion clients in Perm, Russia. The study also assessed the direct and indirect costs of abortion and contraceptive use incurred by women in the year following their index abortion (the abortion which took place the day of entry into the study). The findings of the study were significant for the training interventions …
Improving Quality Of Care For Family Planning Services In Uganda, Joel Okullo, Quinto Okello, Harriet Birungi, Ian Askew, Barbara Janowitz, Carmen Cuthbertson, Florence Ebanyat
Improving Quality Of Care For Family Planning Services In Uganda, Joel Okullo, Quinto Okello, Harriet Birungi, Ian Askew, Barbara Janowitz, Carmen Cuthbertson, Florence Ebanyat
Reproductive Health
The Regional Centre for Quality of Health Care at Makerere University, Uganda in collaboration with the Delivery of Improved Services for Health II Project, the Ministry of Health (MOH), and the Population Council’s FRONTIERS Program, conducted an operations research project to help the MOH improve the quality of family planning services with the aim of helping couples better attain their reproductive goals. The study developed a package of interventions (the Yellow Star Programme—YSP) that sought to increase the readiness of clinics to offer basic family planning services, to improve provider motivation, and to empower clients to request quality services. The …
Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health
Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health
Reproductive Health
In 1999, Frontiers in Reproductive Health collaborated on studies on the impact of interventions to improve quality of care in the Philippines and Senegal. The two interventions were part of a multicountry Population Council study (also undertaken in Pakistan and Zambia) to test whether improving quality affects women’s contraceptive continuation. The Philippines study focused on training in family planning (FP), supportive supervision, and refresher courses to improve client-provider interaction. The Senegal study compared the impact of improved quality of care at five newly established “reference centers” with five clinics that served as controls. Data were gathered through analyses of quality …
Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya
Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya
Reproductive Health
The goal of this study was to determine the sustainability of the postabortion care (PAC) training and service delivery intervention introduced in the Hospital Nacional Daniel Alcides Carrión in Lima, Peru, and the extent to which the outcomes of the intervention have continued. The objectives of the study were to assess changes over time in the following outcomes: the use of manual vacuum aspiration for incomplete abortion, provision of family planning information to postabortion patients, acceptance of contraception by postabortion patients prior to discharge, provision of medical care information to patients, length of hospital stay, and resources used by the …
Using Men As Community-Based Distributors Of Condoms, Cynthia P. Green, Stephanie Joyce, James R. Foreit
Using Men As Community-Based Distributors Of Condoms, Cynthia P. Green, Stephanie Joyce, James R. Foreit
Reproductive Health
The HIV/AIDS epidemic has led program managers to seek approaches to family planning (FP) that will also help combat HIV/AIDS and other sexually transmitted infections (STIs). These approaches include use of simplified STI diagnosis and treatment protocols and promotion of male and female condoms. One aspect of condom promotion that is receiving increased attention is the idea of adding men to community-based distribution (CBD) programs. The male latex condom is the only contraceptive method that, when used correctly and consistently, provides protection against STIs, including HIV/AIDS. Currently, an estimated 6 to 9 billion male condoms are used worldwide annually. However, …
Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols
Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols
Reproductive Health
In Indonesia, paternalistic models of health care, social distance between clients and service providers, and cultural norms discourage family planning clients from playing an active role in consultations. This report discusses the interventions needed to encourage clients to communicate more openly and more vigorously with providers. The study confirmed that educational interventions directed to family planning clients can help them become effective partners in their own care, assuming they meet with receptive providers. Communication interventions like Smart Patient complement and reinforce provider interpersonal communication and counseling training by giving clients the confidence and the skills to take advantage of increased …
Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa
Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa
Reproductive Health
The Hospital Roosevelt is Guatemala’s largest hospital, and serves as a referral and training facility for the entire country. Within the Hospital Roosevelt, the Department of Obstetrics and Gynecology established a Reproductive Health Unit (RHU) to offer family planning information and services to obstetrics inpatients and OB/GYN outpatient clients, and to serve as a training site for medical residents completing their OB/GYN rotations. Hospital administrators requested assistance from the Frontiers in Reproductive Health (FRONTIERS) program to help establish a fee schedule for the RHU, with the goal of paying its own personnel costs after one year of operation. The FRONTIERS …
Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon
Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon
Reproductive Health
Using the results of a previous operations research study, the Ministry of Health of Honduras recently changed the National Women’s Health Service Delivery Guidelines to explicitly authorize nurse auxiliaries to insert IUDs, deliver Depo-Provera, and take Pap smears. These services are new to the rural communities served by rural health centers (RHCs). The objective of this project was to test whether the demand for these newly introduced services would increase if a promotional brochure was distributed in the surrounding communities by the RHC’s clients among potentially interested friends in these communities. The study found that the intervention that was tested …
An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz
An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz
Reproductive Health
Since its inception, the Zimbabwe National Family Planning Council’s (ZNFPC) community-based distribution (CBD) program has made significant and well-documented contributions to the demand for and use of family planning in Zimbabwe. Data from several studies have shown, however, a steady decline in this contribution and that the CBD agents spend more time resupplying existing clients than recruiting new acceptors. Moreover, the CBD program urgently needs to be able to address the AIDS crisis in the country. ZNFPC has undertaken this review to guide it in making appropriate decisions about the future direction of the program, allowing CBDs to have a …
Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health
Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health
Reproductive Health
Aproximadamente la mitad de los partos en Honduras son atendidos en un hospital. Sin embargo, los hospitales generalmente no ofrecen servicios de planificación familiar a las pacientes en el posparto o el postaborto. En 1999, la Secretaría de Salud de Honduras (SSH) y el Population Council iniciaron un proyecto de dos años con el fin de ampliar el acceso a la consejería y a los servicios de planificación familiar después de un parto o de haber recibido tratamiento por un aborto incompleto. La intervención se realizó basándose en un proyecto previo del Population Council que mostró que el 30 por …
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Reproductive Health
Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …
Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health
Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health
Reproductive Health
In 1999, the Honduran Ministry of Health (MOH) revised national guidelines on women’s health services delivery to allow nurse auxiliaries to insert IUDs, give DMPA injections, and take Pap smears. This policy change addresses low contraceptive use among rural women and reflects findings from a 1998 Population Council study that showed that nurse auxiliaries can safely and successfully provide these services. Under the previous guidelines, rural women had limited access to long-term family planning methods. In 2000, the Population Council and the MOH assessed the effectiveness and cost of using a simple leaflet, distributed by nurse auxiliaries, to market the …
Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health
Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health
Reproductive Health
En 1999, la Secretaría de Salud de Honduras (SSH) modificó las Normas de Atención Integral a la Mujer a fin de autorizar a las auxiliares de enfermería a prestar los servicios de inserción de DIU, aplicación del inyectable DMPA y toma de Papanicolaou. Este cambio en las normas aborda el problema de la baja prevalencia en el uso de anticonceptivos en áreas rurales. El cambio también refleja los hallazgos de un estudio anterior, realizado por el Population Council, que mostró que las auxiliares de enfermería pueden proporcionar estos servicios de manera segura y con buena calidad. Anteriormente, las mujeres en …
Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health
Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health
Reproductive Health
At the request of the Family Health Directorate of the Ministry of Health in Burkina Faso, the Reproductive Health Research Network (CRESAR) conducted a study during 1996–98 to introduce emergency care for women with complications from miscarriage or unsafe abortion. With technical assistance from the Population Council and JHPIEGO, CRESAR trained staff at two large hospitals in Ouagadougou and Bobo-Dioulasso to provide postabortion care (PAC). Training for physicians, nurses, and midwives covered manual vacuum aspiration, family planning methods, infection prevention, and communication with patients. Staff also participated in the development of policies and standards for PAC services. To measure changes …
Kenya: L'Identification Des Iar Demeure Hasardeuse: La Prévention Est Primordiale, Frontiers In Reproductive Health
Kenya: L'Identification Des Iar Demeure Hasardeuse: La Prévention Est Primordiale, Frontiers In Reproductive Health
Reproductive Health
No abstract provided.
Report On The International Symposium On Quality Of Care In China, Population Council
Report On The International Symposium On Quality Of Care In China, Population Council
Reproductive Health
In 1995, China’s State Family Planning Commission (SFPC), the governmental agency charged with developing and implementing China’s population policy, issued an official call for the reorientation of the family planning program from a focus on demographic targets to meeting clients’ needs. In support of this reorientation effort, the SFPC selected six rural counties and five urban districts with comparatively good socioeconomic conditions as pilot sites for a quality-of-care experiment. This report provides a summary of an international symposium on quality of care held in Beijing from November 17–19, 1999. The symposium was sponsored by SFPC with the support of the …
Senegal: Capacite A Más Proveedores En Atención Postaborto, Frontiers In Reproductive Health
Senegal: Capacite A Más Proveedores En Atención Postaborto, Frontiers In Reproductive Health
Reproductive Health
No abstract provided.
Kenia: La Identificación De Las Itr Sigue Siendo Un Problema: La Prevención Es Esencial, Frontiers In Reproductive Health
Kenia: La Identificación De Las Itr Sigue Siendo Un Problema: La Prevención Es Esencial, Frontiers In Reproductive Health
Reproductive Health
No abstract provided.
Burkina Faso: Mejorar La Atención Postaborto Beneficia A Pacientes Y Proveedores, Frontiers In Reproductive Health
Burkina Faso: Mejorar La Atención Postaborto Beneficia A Pacientes Y Proveedores, Frontiers In Reproductive Health
Reproductive Health
No abstract provided.
Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health
Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health
Reproductive Health
The Population Council has supported a series of studies to improve the quality of postabortion care (PAC) in Egypt. A 1994 pilot study in two Egyptian hospitals showed that upgrading PAC and training physicians in manual vacuum aspiration (MVA), infection control, and counseling led to significant improvements in the care of postabortion patients. The 1997 study, conducted by the Egyptian Fertility Care Society with support from the Population Council, sought to institutionalize improved postabortion medical care and counseling procedures in ten hospitals. Five senior physicians from each hospital attended a five-day training course in MVA, infection control, and family planning …
Egypte: Développer L'Accès Aux Soins Après Avortement, Frontiers In Reproductive Health
Egypte: Développer L'Accès Aux Soins Après Avortement, Frontiers In Reproductive Health
Reproductive Health
No abstract provided.
Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health
Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health
Reproductive Health
Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, and …
Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health
Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health
Reproductive Health
Since 1990, the Nakuru Municipal Council (Kenya) has implemented a multifaceted program to reduce the incidence of reproductive tract infections (RTIs), especially those that are sexually transmitted, including HIV/AIDS. Staff in the Council’s five health clinics use syndromic management guidelines, based on clients’ reported symptoms and clinical signs, to identify clients with RTIs. In 1998, the Population Council conducted a study to assess the accuracy of syndromic management and determine the best ways to integrate RTI management into existing antenatal (ANC) and family planning (FP) services. After an assessment of existing RTI services, 18 nurses from the five municipal clinics …