Medicine and Health Sciences Commons^™

Assessing Effectiveness Of A Person-Centered Group Anc-Pnc Model Among First-Time Young Mothers And Their Partners For Improving Quality And Use Of Mnch-Fp Services, Sharif M.I. Hossain, Shongkour Roy, Sigma Ainul, Abdullah Al Mahmud Shohag, A.T.M. Rezaul Karim, Ubaidur Rob

Sexual and Reproductive Health, Rights, and Choices

This baseline report is part of an operations research project “Healthy Women, Healthy Families (HWHF): Shustha Ma, Shustha Poribar” led by Management Sciences for Health (MSH) in partnership with BRAC, SCOPE, and the Population Council. The project aims to improve quality and increase utilization of maternal, newborn, and child health (MNCH) and family planning (FP) services and information for young mothers-to-be, first-time mothers (FTMs) aged 15-24, and their partners in the urban municipality of Tongi, Gazipur District, Bangladesh, through a group antenatal care ANC-PNC approach. The objectives of this study are to establish baseline values of selected HWHF project …

More Than Brides Alliance—Marriage: No Child’S Play, Endline Evaluation Brief, Population Council

Poverty, Gender, and Youth

This brief summarizes key results from the endline evaluation of the More than Brides Alliance (MTBA) project “Marriage: No Child’s Play” (MNCP) in India, Malawi, Mali, and Niger. The MTBA consists of partners Save the Children Netherlands, Simavi, Oxfam Novib, and the Population Council, along with 25 local implementing partners. The MNCP project—which took place from 2016 to 2020—aimed at being holistic and targeting pathways to child marriage on multiple levels simultaneously, treating communities as either having the full MNCP package or no intervention. The Population Council’s MNCP evaluation was designed to estimate program impact and trends among girls at …

Health And Ideations Of Married Female Adolescents, Breakthrough Research

Reproductive Health

This brief provides rigorous evidence-based insights to implementers and researchers of social and behavior change (SBC) programs that seek to improve knowledge, attitudes, norms, and behaviors of married female adolescents. The brief focuses on married adolescents’ uptake of services and health knowledge in Kebbi, Sokoto, and Zamfara states in northwestern Nigeria using a subset of data from a household survey of married women ages 15–49 years. It is one of a series of briefs that present findings from a Breakthrough RESEARCH study that uniquely captures data on a wide range of psychosocial drivers of behavioral outcomes in the areas of …

Chipatala Cha Pa Foni, Malawi's 'Health Center By Phone,' Improving Information Given About Pregnancy-Related Symptoms, Breakthrough Research, Villagereach

Reproductive Health

The Health Center by Phone, or "Chipatala cha pa Foni" (CCPF), was developed by Malawi’s Ministry of Health and VillageReach as a community-based hotline in the Balaka district of Malawi. CCPF was identified as an existing national health strategy with potential for providing Malawi’s women and their families important postpartum hemorrhage information. Because CCPF archives de-identified audio recordings of all calls, 28 telephone transcripts were qualitatively examined to assess whether women experiencing pregnancy-related complications such as postpartum bleeding call CCPF, and how hotline workers respond to them.

Diet Diversity Among Pregnant Women And Young Children—Insights For Improving Malaria, Family Planning, And Maternal And Child Health Outcomes In Northwestern Nigeria Through Social And Behavior Change Programming, Breakthrough Research

Reproductive Health

This research brief provides rigorous, evidence-based insights to policy-makers, implementers, and researchers of social and behavior change (SBC) programs on maternal and child nutrition during the 1,000-day period between a woman’s pregnancy and her child’s second birthday. It is one of a series of briefs presenting findings from a Breakthrough RESEARCH study that uniquely captures data on a wide range of psychosocial drivers of behavioral outcomes in family planning, malaria, and maternal, newborn and child health and nutrition (MNCH+N) in the three northwestern states of Nigeria.

Évaluation De La Performance Des Agents De Santé Communautaires En Haïti: Principales Conclusions D’Une Étude À Méthodologie Mixte, Frontline Health Project, Zanmi Lasante

Reproductive Health

Ce document résume les principales conclusions qualitatives et quantitatives de l'étude de référence du projet Frontline Health en Haïti. Les résultats révèlent que les ASC en Haïti sont des membres hautement fiables et appréciés de leurs communautés et fournissent des liens cruciaux vers les services d'orientation ; cependant, davantage de formation et de soutien concernant les références sont nécessaires.

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This brief summarizes key qualitative and quantitative findings from the Frontline Health project's referral study in Haiti. Findings reveal that CHWs in Haiti are highly trusted and valued members of their communities and provide crucial links to referral services; however, …

Assessing The Performance Of Community Health Workers In Haiti: Key Findings From A Mixed-Methods Study, Frontline Health Project, Zanmi Lasante

Reproductive Health

This brief summarizes key qualitative and quantitative findings from the Frontline Health project's referral study in Haiti. Findings reveal that CHWs in Haiti are highly trusted and valued members of their communities and provide crucial links to referral services; however, more training and support around referrals is needed.

Preferred Incentives For Improving Ugandan Community Health Worker Job Satisfaction And Retention, Frontline Health Project

Reproductive Health

This research brief summarizes key quantitative and qualitative results from the Frontline Health project's discrete choice experiment in Uganda. This study was implemented in two phases, and revealed that community health workers in Uganda are motivated by a mix of financial and non-financial incentives to perform.

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 …

Overview Of High Impact Practices For Improved Prevention, Detection, And Management Of Hypertensive Disorders In Pregnancy, Population Council

Reproductive Health

As part of the Ending Eclampsia Project and supported by the Pre-eclampsia Technical Working Group, the Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving the prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). HDPs affect 10 percent of women globally and are major contributors to maternal and newborn mortality, morbidity, and disability. Providing essential services and health education for women at all levels of the health system is necessary to improve survival rates and quality of life for those who experience HDPs and their newborns. Inspired by Family Planning HIPs, …

High Impact Practices—Task Sharing For Hypertensive Disorders In Pregnancy: Improving Early Detection And Management Of Hypertensive Disorders In Pregnancy, Karen Kirk

Reproductive Health

The Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). This brief focuses on one of those strategies: task sharing, which is the expansion of the levels of health providers who can appropriately deliver health services. Key points presented in this brief are: optimizing available human resources through task sharing can be an effective strategy to increase access to health services; task sharing key services for the prevention, detection, and management of hypertensive disorders in pregnancy can help prevent maternal and newborn morbidity …

High Impact Practices—Detecting And Managing Hypertension In The Extended Postnatal Period: Preventing Postnatal Pre-Eclampsia And Eclampsia, Charlotte E. Warren

Reproductive Health

The Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). This brief focuses on one of those strategies: detecting and managing hypertension in the extended postnatal period. Key points presented are: the extended postnatal period provides an opportunity to monitor a woman’s blood pressure (BP) and check for persistent hypertension; if BP is measured routinely at any contact with the health system during the extended postnatal period, hypertension is more likely to be detected and managed appropriately; women with pre-eclampsia have a 3.7-fold …

High Impact Practices—Encouraging Empowerment And Self-Care Through Participatory Women’S Groups And Group Antenatal Care: Supporting Women To Be At The Center Of Their Own Care As Active Participants, Tracy Mcclair

Reproductive Health

The Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). This brief focuses on one of those strategies: encouraging empowerment and self-care through participatory women’s groups and group antenatal care. Key points presented are: highly participatory, group-based interventions—such as community-based women’s groups and group antenatal and postnatal care (ANC/PNC)—provide opportunities for women to share their experiences and knowledge with others, discuss the local context for challenges and how to address them, and promote empowerment and agency; participation in these groups is associated with …

A Case Study Of Ovc Case Management Through The Zambia Family (Zamfam) Project—Brief, Population Council

HIV and AIDS

The ZAMFAM program aims to improve the care and resilience of orphans and vulnerable children (OVC) as well as young people living with HIV in Zambia by providing support and protection and by strengthening the capacity of children, families, and the community to better manage the socioeconomic shocks of the HIV/AIDS epidemic. A case study approach was employed to understand actors and perceptions, and to document best practices by the program. This brief summarizes the case study findings. The ZAMFAM program utilized several approaches to improving the well-being of OVC. Services or referrals were provided to beneficiaries through home visitation …

A Case-Study Of Ovc Case Management Through The Zambia Family (Zamfam) Project, Lyson Phiri, Drosin Mulenga, Nancy Choka, Caila Brander, Nachela Chelwa, Nkomba Kayeyi

HIV and AIDS

Zambia’s HIV prevalence is estimated at 11% among adults aged 15–49 years and 1% among children younger than 15 years. An estimated 10% of Zambia’s population is at high risk of being orphaned or vulnerable due to the HIV epidemic. The Zambia Family (ZAMFAM) project aims to improve the care and resilience of vulnerable populations while supporting HIV epidemic control. ZAMFAM used a case management approach that tracks beneficiaries from identification to graduation. The Population Council conducted a qualitative case study to understand actors and perceptions, and document best practices. Program beneficiaries viewed the ZAMFAM program as having made a …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Uganda, Justus Barageine, Charity Ndwiga, Hassan Kanakulya, Pooja Sripad

Reproductive Health

The Population Council, in collaboration with Fistula Care Plus and EngenderHealth, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing fistula screening, diagnosis, and treatment in Uganda. Following a baseline assessment, researchers implemented a multi-pronged intervention utilizing a mobile hotline, transport voucher, and mass media tools to increase community awareness. This brief provides key messages and recommendations for overcoming barriers hindering access to fistula care services. Health systems and external stakeholder support are essential for sustaining trends.

Prévention Du Mariage D’Enfants Dans La Région De L’Est, Burkina Faso, Gisele Kaboré, Julien Ouedraogo, Annabel Erulkar, Sara Chace Dwyer

Reproductive Health

En collaboration avec la Direction Provinciale de la Femme, de la Solidarité Nationale et de la Famille du Burkina Faso et des partenaires communautaires de la région orientale du Burkina Faso, le Projet Evidence a mis à l'échelle des approches éprouvées pour retarder le mariage des jeunes filles en sensibilisant aux effets négatifs du mariage précoce. Les approches étaient basées sur des preuves produites dans une étude menée par le Population Council de 2013 à 2016 dans la province de Léraba. Dans cette étude, le report de l'âge du mariage pour les filles de 15 à 17 ans et la …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Bangladesh, Pooja Sripad, Sharif M.I. Hossain, Charity Ndwiga, Charlotte E. Warren

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically subordinate women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care (ANC) use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. …

Implementing Components Of The Primary Health Care Pre-Eclampsia/Eclampsia Model In Bangladesh: A Cost Analysis, Sharif M.I. Hossain, Pooja Sripad, Sara Chace Dwyer

Reproductive Health

Between 2016 and 2018, the Population Council, in collaboration with the Directorate General of Family Planning and Obstetrical and Gynecological Society of Bangladesh, implemented an intervention to confront pre-eclampsia/eclampsia (PE/E). This was part of the Ending Eclampsia project, a five-year USAID investment that implemented aspects of the Primary Health Care (PHC) PE/E Model in Bangladesh, Nigeria, and Pakistan. The intervention in Bangladesh comprised two components of the PHC for PE/E Model: 1) Task sharing to detect and manage PE/E (MgSO4 and referral) with PHC providers (Family Welfare Visitors, Sub-Assistant Community Medical Officers, and Nurse-Midwives), and 2) Introducing antihypertensive drug provision …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Ethiopia, Charlotte E. Warren, Pooja Sripad, Charity Ndwiga

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically disadvantage women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care (ANC) use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. …

Antihypertensive Drugs, Population Council

Reproductive Health

Pre-eclampsia (PE) is a condition in pregnant women marked by an increase in blood pressure and protein in the urine after 20 weeks gestation. Eclampsia is a life-threatening condition characterized by convulsions in women with PE. PE/E and other hypertensive disorders in pregnancy increase risk of preterm births. Providing high-quality and regular antenatal care improves the prevention and early detection of PE and can prevent its progression to eclampsia. Prescribing low-dose aspirin and calcium to at-risk women can prevent PE and eclampsia. PE and eclampsia can be managed by administering antihypertensive drugs and magnesium sulphate (MgSO4). MgSO4 is the safest …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Nigeria, Pooja Sripad, Charity Ndwiga, Charlotte E. Warren

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically subordinate women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

Assessing The Effect Of A Primary Health Care Intervention For Improving Pre-Eclampsia And Eclampsia Knowledge And Practice In Bangladesh, Sharif M.I. Hossain, Shongkour Roy, Kanij Sultana, Charlotte E. Warren

Reproductive Health

In resource-poor countries such as Bangladesh, proven life-saving commodities for pregnant women have not been optimally examined, such as magnesium sulphate (MgSO4) to manage severe pre-eclampsia/eclampsia, use of anti-hypertensives to manage high blood pressure during pregnancy, aspirin prophylaxis for pregnant women at high risk of PE/E, as well as task shifting to lower health-worker cadres, and community involvement. There has been no systematic review of research and programming on PE/E prevention, early detection, and treatment in Bangladesh. With support from USAID, the Ending Eclampsia project has been expanding access to proven, underutilized interventions and commodities for PE/E prevention, early detection, …

Implementing Components Of The Phc For Pe/E Model In Nigeria: A Cost Analysis, Pooja Sripad, Sara Chace Dwyer, Gloria Adoyi

Reproductive Health

Between 2016 and 2018, the Population Council, in partnership with the Nigerian Federal and State Ministries of Health, implemented an intervention to confront pre-eclampsia/eclampsia (PE/E) in three states—Cross River, Ebonyi, and Kogi. This was part of the Ending Eclampsia project, a five-year USAID investment that implemented aspects of the Primary Health Care (PHC) PE/E Model in Bangladesh, Nigeria, and Pakistan. The intervention in Nigeria was comprised of five components of the PHC for PE/E Model: 1) Task sharing to detect and manage PE/E (MgSO4 and referral) with PHC providers; 2) Introducing antihypertensive drug provision at the PHC level; 3) Engaging …

Feasibility And Acceptability Of Community Health Extension Workers To Identify And Treat Hypertension Associated With Pregnancy: Implementation Research Report, Emmanuel Nwala, Udochisom Anaba, Pooja Sripad, Salisu Mohammed Ishaku, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy, experienced by 10 percent of women globally, are major contributors to maternal and newborn mortality, morbidity, and disability. Task shifting essential health services to mitigate insufficient human resources is recommended to strengthen and expand the health workforce and rapidly increase access to quality services. Nigeria’s task-shifting policy recommends that community health extension workers administer a loading dose of magnesium sulphate for severe pre-eclampsia or eclampsia prior to referral to a higher-level facility. This study tested the feasibility and acceptability of community health extension workers at primary health care facilities in Ebonyi state in detecting and managing …

Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara

Reproductive Health

Studies investigating the association between male circumcision and HIV have demonstrated the protective effect of male circumcision. In some settings, FGM/C and male circumcision are considered “equivalent” procedures. This working paper presents findings of a study that investigates the effect of FGM/C on the likelihood of HIV infection for women in practicing communities in Ethiopia, Gambia, Kenya, and Sierra Leone.

"No To Circumcision": The Road To Effective Social Marketing Campaigns In Egypt, Salma Abou Hussein, Sarah Ghattass

Reproductive Health

To inform the design and scale up of initiatives that can drive a change in attitudes and behaviors toward FGM/C abandonment, there is a rising need to understand the perspectives of individuals who are exposed to social marketing campaigns (SMCs), which are a key intervention to promote the abandonment of the practice. This working paper presents the findings of a study that sought to understand how, where, and why SMCs for FGM/C abandonment are working, and with what impact, to inform design and scale-up of campaigns that can foster new perspectives, expectations, and behaviors.

Post-Intervention Analysis Of Pre-Eclampsia And Eclampsia In Three Nigerian States, Salisu Mohammed Ishaku, Emmanuel Nwala, Gloria Adoyi, Charles Nwigwe, Solomon Kongyamba, Udochisom Anaba, Caroline Johnson, Karen Kirk, Pooja Sripad, Charlotte E. Warren

Reproductive Health

In the last three decades, global maternal mortality has decreased by almost 45 percent, but approximately 830 women still die daily from largely preventable pregnancy complications. Since 2015, the Ending Eclampsia project, with support from USAID, has been working to expand proven, underutilized interventions and commodities for pre-eclampsia/eclampsia (PE/E) prevention, early detection, and treatment, and to strengthen global partnerships for care of hypertensive disorders in pregnancy (HDP), of which PE/E are the severest forms. A systematic review of the literature identifies a number of articles reporting PE/E burdens within set populations, common risk factors, adverse outcomes, and mortality rates, but …

Assessing Quality Of Care And Outcomes For Women And Their Infants In Nigeria After Pregnancies Complicated By Hypertensive Disorders, Salisu Mohammed Ishaku, Gloria Adoyi, Innocent Agbo, Karen Kirk, Pooja Sripad, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy (HDPs) are the leading cause of maternal mortality in Nigeria—now killing more women than postpartum hemorrhage. Various factors, including lack of capacity among lower-level health-care providers to detect, manage, and refer complications, have been indicated as reasons for most of these deaths. A landscape analysis of pre-eclampsia/eclampsia (PE/E) in Nigeria identified a lack of further information after delivery about the women who experienced HDPs. In this study, the Ending Eclampsia project recruited women with HDPs around the time of childbirth, and prospectively followed them for up to one year postpartum. The study evaluated the care these …

Assessing The Feasibility Of Primary Health Care Provider Prescription Of Anti-Hypertensive Medication To Pregnant Women In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Shongkour Roy, Pooja Sripad, Charlotte E. Warren

Reproductive Health

Hypertensive disorders of pregnancy (HDPs)—which are major contributors of maternal and newborn mortality, morbidity, and disability—are preventable. About 24 percent of maternal deaths in Bangladesh each year are due to pre-eclampsia and eclampsia (PE/E). A known cause of death in women with PE/E is cerebrovascular accident, which occurs due to rapidly increasing blood pressure (BP). Elevated BP associated with pregnancy should be detected and appropriately managed before onset of convulsions (eclampsia) and other life-threatening complications. For women presenting with severe PE/E, magnesium sulphate (MgSO4) is the recommended drug for convulsion management. Anti-hypertensive medicines are also recommended for control of high …