Medicine and Health Sciences Commons^™

Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …

Contraceptive Use Dynamics In Pakistan 2008-09, Arshad Mahmood, Syeda Saman Naz

Reproductive Health

This report looks at contraceptive use dynamics in Pakistan, focusing on contraceptive discontinuation, method failure, and contraceptive switching, as well as the reasons for discontinuation. The study found that almost one-third of discontinuations were due to side effects followed by one-fifth of them by the method failure. Side effects were the most common reason for discontinuing modern methods (IUDs and hormonal methods), while failure was the most common reasons for discontinuing barrier and traditional methods (condom, rhythm, withdrawal). Based on the findings of this study, this report suggests that better training of health providers and better information and counseling of …

Bellagio Consensus: Recommendations For Action To Increase Access To Highly Effective, Long-Acting, Reversible Contraception, Population Council

Reproductive Health

This brief and statement offers recommendations for action to increase access to highly effective, long-acting, reversible contraception (LARCs) and accelerate progress toward meeting the Millennium Development Goal of universal access to reproductive health services.

Attitudes, Beliefs, And Practices Of Key Opinion Leaders (Kol) And Providers About Emergency Contraception (Ec) In Senegal, Babacar Mane, Saumya Ramarao, Martha Brady, Fatou Bintou Mbow, Ababacar Thiam

Reproductive Health

In 2010, the Reproductive Health Division in Senegal, with support from Population Council, performed an assessment of the emergency contraception (EC) integration process into the national health system through a national forum on EC. This forum revealed that there was a real promotional problem regarding EC in the national health system despite the efforts made. There was widespread lack of public awareness of the product, rumors concerning EC due to the sensitive nature of the product, low inclusion of EC in routine service delivery, especially during initial counseling in family planning awareness campaigns , and a better method of keeping …

Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey

Reproductive Health

An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and …

Providers' Attitudes And Practices Regarding Emergency Contraception In India: Key Findings, M.E. Khan, Isha Bhatnagar, Deepthi S. Varma, Anvita Dixit

Reproductive Health

This policy brief reports key findings of a study in India that explored providers’ knowledge of how emergency contraception (ECP) works and its safety and effectiveness, their perceptions of the frequency of repeat use, their provision of ECP, and their attitudes toward women who seek it. Many of the findings of this study are encouraging. Most providers believed that ECP is an effective and safe method to prevent pregnancy and that it cannot induce abortion, and half supported the over-the-counter provision of ECP. Nevertheless, the study revealed many biases and gaps in knowledge. Recommendations include a number of ways to …

Increasing Access To Family Planning And Reproductive Health Services Through Community Work: A Case Study Of A Dual Cadre Model In India, Jaleel Ahmad, Isha Bhatnagar, M.E. Khan

Reproductive Health

Before the introduction of Accredited Social Health Activists (ASHAs) in India, mid-level auxiliary nurse midwives (ANMs) were responsible for community health education and services such as antenatal care, delivery, IUCD insertion, and sterilization referrals. The Population Council studied how community extension work and some primary care responsibilities have been shifted to ASHAs, who are tasked with identifying pregnant women; facilitating ANC check-ups; motivating women for institutional deliveries during ANC checkups; and organizing child immunization. Establishing dual worker cadres in India by shifting community extension tasks from ANMs to local ASHAs has been well conceived. Task shifting has allowed ANMs, as …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In India: Final Survey Report, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECPs) among providers in public and private facilities and pharmacies in India. This study’s objectives were: 1) to assess providers’ knowledge of ECP’s biological mechanism; 2) to understand providers’ knowledge and attitudes about ECP’s safety, effectiveness, and availability as an over-the-counter drug; and 3) to identify providers’ definitions of “repeated use” and profiling of women who are “repeated users” of ECP. The study recommends intervention programs and advocacy strategies to increase knowledge and access to ECP.

Providers' And Key Opinion Leaders' Attitudes And Practices Regarding Emergency Contraception In Senegal: Key Findings, Babacar Mane, Martha Brady, Saumya Ramarao, Fatou Bintou Mbow

Reproductive Health

This study examines providers’ and key opinion leaders’ knowledge, attitudes, and practices regarding the emergency contraceptive pill (ECP) in Senegal, and synthesizes the findings to suggest program and policy recommendations. Analysis of providers’ opinions and beliefs reveals that although many providers believe ECP is a safe product, persistent negative views remain. KOLs and providers recognize the importance of ECP for preventing unintended pregnancy and are supportive of the integration of ECP into national guidelines. They note, however, the need to improve accessibility and quality of provision. Given the magnitude of sexual violence and abuse, considerable interest exists in devising strategies …

The Africa Regional Sexual And Gender-Based Violence Network Annual Partners Meeting: June 26-27 2012, Mombasa, Kenya—Meeting Report, Population Council

Reproductive Health

The Population Council convened an annual partners meeting of its Africa Regional Sexual and Gender-Based Violence (SGBV) Network. Over 30 participants attended the meeting whose objectives were: 1) to facilitate South-South technical exchange and information-sharing on the changing landscape of violence among partners, donors, and other experts; and 2) to reflect on the ways in which research is translating into policy and practice. This report highlights the myriad ways in which activities conducted under this Network have influenced policy, practice, and funding considerations in the region, while detailing the progress of Network partners on their projects, built around several key …

Expanding Access To Comprehensive Reproductive Health And Hiv Information And Services For Married Adolescent Girls In Nyanza Province, Chi-Chi Undie, Harriet Birungi, Francis Obare, Ben Ochieng, Wilson Liambila, Erick Oweya, Ian Askew, Rob Burnet, Bridget Deacon, Aisha Mohamed

Reproductive Health

The objectives of this operations research study, conducted by the Population Council’s APHIA II Operations Research Project in Kenya, were to: 1) identify and design a set of interventions that promote the uptake of comprehensive reproductive health (RH)/family planning (FP) and HIV prevention services and information among married adolescent girls; and 2) expand access to comprehensive RH/FP and HIV prevention services and information among this population. The study demonstrated that the combined use of interactive media and community health worker visitation, health information provision, and referrals, is an effective means of reinforcing RH/FP and HIV messages, and of increasing access …

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs, Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …

Évaluation De Processus : Programme Filles Eveillées Pour Adolescentes Migrantes Employées De Maison Au Burkina Faso Urbain 2012, Leah Jarvis, Gisele Kaboré

Poverty, Gender, and Youth

Le programme «Filles Éveillées» a été conçu pour apporter aux adolescentes migrantes employées de maison les compétences, les connaissances et le capital social qui leur permettent de réduire leurs vulnérabilités et de s’ouvrir de nouveaux débouchés. Les observations tirées de la collecte de données quantitatives et qualitatives ont révélé le succès considérable du programme: il est largement apprécié et a été bien reçu par les participantes, les mentors, les membres de la communauté et tous les autres intéressés. En sa qualité de programme pilote, les obstacles à une mise en œuvre sans incidents auraient été inévitables, mais par leur détermination …

Replication Of The Community Mobilization For Postabortion Care (Commpac) Model In Naivasha District, Rift Valley Province, Kenya: An Evaluation Report, Chi-Chi Undie, Francis Obare, Saumya Ramarao

Reproductive Health

The Population Council’s RESPOND project worked with districts and communities in Kenya to: strengthen service delivery points to provide postabortion care (PAC) services; conduct community mobilization to improve involvement in and knowledge of the prevention and treatment of postabortion complications; build community capacity to address needs related to PAC; and encourage involvement in community action of those most marginalized and most affected by postabortion complications. The program succeeded at increasing knowledge of critical danger signs; enabling providers to effectively offer PAC services; and raising awareness of PAC, among other goals. The intervention was less successful in increasing FP knowledge, current …

Le Consensus De Bellagio : Recommandations Pour Améliorer L'Accès Aux Méthodes De Contraception Efficaces, Réversibles À Longue Durée D'Action, Population Council

Reproductive Health

Ce communiqué et cette déclaration proposent des recommandations pour améliorer l'accès aux méthodes de contraception efficaces, réversibles à longue durée d'action (LARC) et accélérer les progrès vers la réalisation de l'Objectif du Millénaire pour le développement relatif à l'accès universel aux services de santé reproductive.

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This brief and statement offers recommendations for action to increase access to highly effective, long-acting, reversible contraception (LARCs) and accelerate progress toward meeting the Millennium Development Goal of universal access to reproductive health services.

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

Despite significant progress in product development, procurement, and distribution in the past few decades, emergency contraception’s (EC) capacity to benefit many women in countries such as Nigeria is hampered by a number of potential barriers, that are not well understood. The Population Council, with support from the International Consortium for Emergency Contraception, documented EC-related knowledge, attitudes, and practices among providers in Nigeria as well as perceptions of key opinion leaders who help shape the policy environment for EC and family planning in general. Findings suggest significant gaps in Nigeria, potentially necessitating continuous training and re-training to help dispel misperceptions and …

Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya: An Assessment Of Acceptability, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Harriet Birungi, Jill Keesbury, Ian Askew

Reproductive Health

Most research on intimate-partner violence (IPV) screening has been conducted in developed countries, so this study in Kenya serves as one of the first in a developing-country context to assess the acceptability of IPV screening from the perspective of providers and clients in public healthcare settings. The study conducted in Kenyatta National Hospital in Nairobi found that routine screening for IPV is acceptable to providers and clients at that location. However, to be effective as a routine service, the system needs to be reinforced in specific ways, including greater assurance of confidentiality, more positive provider attitudes, and higher respect for …

Defining Effective Voucher Management Information Systems: A Blueprint For Information Systems To Support Scalable Reproductive Health Voucher Programs, Based On System Evaluations With Programs In Bangladesh, Cambodia, Kenya, Uganda, And Tanzania, Mahad Ibrahim, Benjamin Bellows, Jaspal S. Sandhu

Reproductive Health

This document defines the key elements of information systems to support the development of effective, scalable voucher information systems. It is based on an engagement between the Gobee Group and the Population Council to strengthen information systems of reproductive health voucher programs in five countries in 2011–12. At the time of publication of this document, the Population Council was in the midst of a multiyear evaluation of five of the biggest reproductive health programs worldwide, an effort supported by the Bill & Melinda Gates Foundation. While the work supporting this report has been focused on reproductive health voucher programs—which provide …

Réseaux Sociaux Et Les Capacités Financières Des Filles Employées De Maison À Bobo-Dioulasso, Gisele Kaboré

Poverty, Gender, and Youth

Depuis plus d’une année, le Population Council assure la mise en œuvre du projet «Filles Éveillées» ciblant les travailleuses domestiques dans les zones urbaines au Burkina Faso. L’objectif de cette étude est d’avoir une meilleure connaissance des réseaux sociaux des filles—soit avec les personnes dans sa nouvelle communauté soit avec des personnes dans son village à travers la technologie—depuis leurs zones d’origine, sachant que la phase de transit n’est pas bien comprise mais que ça peut influencer le séjour de la fille en ville. Cette étude a pour objectif de cerner les capacités et les modes de gestion financières des …

Female Disadvantage In The Egyptian Labor Market: A Youth Perspective, Maia Sieverding

Poverty, Gender, and Youth

In this brief, three aspects of female youth’s disadvantage in the labor market are analyzed: low labor force participation, high unemployment, and concentration in the public sector. These issues are closely interrelated and can be addressed through a set of policies that promote family-friendly employment conditions and the formalization of the private sector. The establishment of job search services for female youth is also critical to addressing the gender gap in unemployment.

La Santé Des Adolescentes Vulnérables : Un Investissement Stratégique Doublement Rentable, Jennifer Catino

Poverty, Gender, and Youth

Le monde compte aujourd’hui 1,2 milliard d’adolescents âgés de 10 à 19 ans. Près de 90% d’entre eux vivent dans les pays en développement et environ 600 millions sont de sexe féminin. L’adolescence représente normalement une période de santé florissante bien que sujette à de nombreux changements socio-développementaux dont les implications affectent, tout particulièrement, la santé des filles. La plupart des centaines de millions de filles et jeunes femmes du monde en développement vivent dans des conditions et des circonstances qui les rendent vulnérables aux risques de santé et sociaux. Ces adolescentes sont souvent pauvres, déscolarisées, mariées, migrantes, membres de …

Recours Aux Données Pour Révéler Et Sélectionner Les Adolescentes Les Plus Vulnérables, Sarah Engebretsen

Poverty, Gender, and Youth

Il est crucial d’investir dans les adolescentes du monde en développement, où une proportion déjà importante et grandissante de la population tombe dans la catégorie des moins de 24 ans. Il est essentiel pour protéger les droits à la scolarité, à l'intégrité corporelle et au mariage légal et choisi, et pour réduire la fertilité tout en augmentant la capacité de production. Il est essentiel de rendre les filles visibles si l’on veut que l’investissement soit ciblé sur les groupes qui présentent le plus grand risque de bilans non favorables. Tel est le principe de ce compte rendu: son but est …

Training Manual On The Use Of Magnesium Sulphate In The Management Of Severe Pre-Eclampsia And Eclampsia [Trainee Version], Federal Ministry Of Health, Population Council

Reproductive Health

This training manual provides detailed, descriptive, and practical instructions and tips necessary to respond to obstetric emergencies (severe pre-eclampsia and eclampsia). The manual is an integral part of the collaborative efforts between the Federal Ministry of Health and the MacArthur Foundation to scale up the use of magnesium sulphate in the management of severe pre-eclampsia and eclampsia in Nigerian health facilities. Magnesium sulphate has been established as the gold standard in the management of severe pre-eclampsia and eclampsia, but lack of knowledge and necessary skill have been identified as some of the factors responsible for its limited use in Nigeria. …

Female Disadvantage In The Egyptian Labor Market: A Youth Perspective [Arabic], Maia Sieverding

Poverty, Gender, and Youth

In this brief, three aspects of female youth’s disadvantage in the labor market are analyzed: low labor force participation, high unemployment, and concentration in the public sector. These issues are closely interrelated and can be addressed through a set of policies that promote family-friendly employment conditions and the formalization of the private sector. The establishment of job search services for female youth is also critical to addressing the gender gap in unemployment.

Résumé Exécutif—Les Programmes De Planification Familiale Du Xxie Siècle: Fondement Et Conception, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Ce document contient le résumé exécutif de «Les programmes de planification familiale pour le XXIe siècle: Fondement et conception». La première moitié de l'ouvrage explique pourquoi un financement et un soutien accrus en faveur des programmes de planification familiale volontaire sont nécessaires. La seconde moitié explique comment les programmes renforcés de planification familiale volontaire peuvent être structurés de manière à fonctionner avec plus d’efficacité. La planification familiale est l'une des interventions les plus réussies de développement de ces 50 dernières années. Elle est unique en termes d’avantages potentiels, et englobe le développement économique, la santé maternelle et infantile, …

Report Of The Voucher And Accreditation Evaluation Project Meeting, Reproductive Health Vouchers Evaluation Team, Population Council

Reproductive Health

This is a report on a technical advisory meeting that brought together 45 participants from the five country programs being evaluated through the Reproductive Health Voucher and Accreditation (V&A) project, which is implemented by the Population Council with financial support from the Bill and Melinda Gates Foundation. This group met for the first time as a newly emerging “voucher community” to learn from the successes and challenges faced in this early growth phase of emerging V&A programs that deliver maternal and reproductive health services. In addition to standardizing the collection of performance and financing metrics, who would use such data …

Executive Summary—Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

This document contains the executive summary of “Family Planning Programs for the 21st Century: Rationale and Design.” The first half of the book makes the case for why increased funding and support for voluntary family planning programs are needed. The second half explains how reinvigorated voluntary family planning programs can be structured to operate more effectively. Family planning is one of the most successful development interventions of the past 50 years. It is unique in its range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …

Filles Eveillées ('Girls Awakened'): A Pilot Program For Migrant Adolescent Girls In Domestic Service In Urban Burkina Faso, Sarah Engebretsen, Gisele Kaboré, Leah Jarvis

Poverty, Gender, and Youth

Young people in Burkina Faso, especially adolescent girls, have few economic opportunities, particularly in rural areas. This drives migration to urban areas in search of employment. In 2010, the Population council conducted formative research on migrant adolescent girls in domestic service in urban Burkina Faso. Findings revealed that girls typically live with their employers and spend long days performing arduous work, leaving little time for schooling, building social networks, and developing skills necessary for adulthood. Most programs designed for this population intervene after something has gone wrong rather than building girls’ protective assets. In response to these findings, the Population …

Observations Initiales Et Finales De Filles Eveillées : Programme Pilote De Renforcement Des Compétences Des Adolescentes Migrantes Employées De Maison. Cohorte 1 (2011–2012), Bobo-Dioulasso, Sarah Engebretsen

Poverty, Gender, and Youth

Le Burkina Faso abrite la dixième population la plus jeune du monde, avec 45% de la population de moins de 15 ans. Les jeunes au Burkina Faso, en particulier les adolescentes, ont peu d'opportunités économiques, en particulier dans les zones rurales. Cela alimente la migration vers les milieux urbaines à la recherche de travail. Seules, les filles sont physiquement et économiquement vulnérables et beaucoup courent un risque élevé de violence sexiste. Le Population Council a mené une recherche formative en 2010 dans le but de mieux comprendre la situation des adolescentes migrantes employées de maison au Burkina Faso urbain, et …

A Review And Evaluation Of Multi-Sectoral Response Services ('One-Stop Centers') For Gender-Based Violence In Kenya And Zambia, Jill Keesbury, Washington Onyango-Ouma, Chi-Chi Undie, Catherine Maternowska, Frederick Mugisha, Emmy Kageha, Ian Askew

Reproductive Health

An increasingly popular strategy for addressing sexual gender based violence (SGBV) is through the establishment of one-stop centers‘ (OSCs), which provide integrated, multi-disciplinary services in a single physical location. The goals of this assessment were two-fold: first, to assess the effectiveness of different OSC models in terms of health and legal outcomes for survivors, and the cost-effectiveness of these models; and second, to identify lessons learned in OSC implementation with recommendations for both start-up and scale-up. Findings from this study offer the first form of systematic evidence on the effectiveness of OSCs, which can guide national-level policymakers and program managers …