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Articles 1 - 30 of 49
Full-Text Articles in Medicine and Health Sciences
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Bagh District, Munir Afridi, Saman Naz, Nayyer Munir
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Bagh District, Munir Afridi, Saman Naz, Nayyer Munir
Reproductive Health
The Primary Healthcare Revitalization, Integration, and Decentralization in Earthquake-affected Areas (PRIDE) program is designed to improve primary health-care services and health outcomes for populations in Bagh and Mansehra districts in northern Pakistan that were affected by the devastating earthquake that struck on October 8, 2005. The project aims to strengthen the financial and human resource management capacities of district health authorities and primary health-care providers. Access to and quality of primary health-care services will be improved through an essential package of health services and improved skills of primary health-care personnel. Community demand for quality services will be improved through an …
Guías De Referencia: Para Instituciones Y Establecimientos De Salud Que Buscan Acreditar La Calidad Y Enfoque De Género De Sus Servicios, Patricia Riveros Hamel, Erica Palenque, Ricardo Vernon, Ignacio Carreno
Guías De Referencia: Para Instituciones Y Establecimientos De Salud Que Buscan Acreditar La Calidad Y Enfoque De Género De Sus Servicios, Patricia Riveros Hamel, Erica Palenque, Ricardo Vernon, Ignacio Carreno
Reproductive Health
Esta guía busca presentar todos los elementos para que las organizaciones de salud reproductiva puedan implantar un sistema para mejorar la calidad de los servicios y su sensibilidad a asuntos de género a través de una estrategia de acreditación. La estrategia de acreditación comienza con una evaluación de las condiciones y servicios que ofrece la clínica, lo que permite identificar los estándares de calidad que no son cumplidos. Posteriormente, el personal de la clínica toma como insumo esta información y elabora un plan de trabajo para resolver los problemas identificados. Si la clínica demuestra cumplir cuando menos el 80 por …
How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit
How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit
Reproductive Health
Most service-delivery interventions begin as pilot projects. When a pilot study of an intervention is successful, managers begin to think about scaling up the project to new areas. Cost is a critical factor influencing the extent and pace of scale-up. This brief explains how to adapt and modify cost information obtained from a pilot project to estimate scale-up costs. The brief shows why the costs of a pilot project alone are not sufficient to predict costs of scale-up and gives examples of how costs are influenced by factors like economies and diseconomies of scale, resource substitution, and intervention modification. The …
Avances En La Atención Postaborto En América Latina Y El Caribe: Investigando, Aplicando Y Expandiendo, Deborah L. Billings, Ricardo Vernon
Avances En La Atención Postaborto En América Latina Y El Caribe: Investigando, Aplicando Y Expandiendo, Deborah L. Billings, Ricardo Vernon
Reproductive Health
This work by the Population Council and Ipas documents the intellectual, financial, and managerial effort that many organizations and institutions in Latin America and the Caribbean have made to achieve the objective of improving the quality and effectiveness of postabortion care services. This volume is a contribution to the preparation of directors, owners, and service providers, and to the creation and implementation of policies and programs based on scientific evidence, which will benefit women and the services themselves. Its five sections include an overview; results from country studies, and information about providers and program components; clinical care with various technologies, …
Contributing Towards Efforts To Abandon Female Genital Mutilation/Cutting In Kenya: A Situation Analysis, Humphres Evelia, Maryam Sheikh Abdi, Carolyne Njue, Ian Askew
Contributing Towards Efforts To Abandon Female Genital Mutilation/Cutting In Kenya: A Situation Analysis, Humphres Evelia, Maryam Sheikh Abdi, Carolyne Njue, Ian Askew
Reproductive Health
The Kenyan Ministry of Gender, Sports, Culture and Social Services, with support from UNFPA/Kenya, commissioned the Population Council to conduct a situation analysis of female genital mutilation/cutting (FGM/C) programs in Kenya, with the overall objective of documenting the current status of and trends in FGM/C programming and to help identify crucial elements that need to be prioritized for support. Results show marked declines in prevalence nationally between generations, suggesting a decline in the practice as well as trends toward “medicalization” in recent years. The practice still continues for different reasons, such as rite of passage, for marriageability, controlling sexuality, religious …
From Pilots To Regional Programs: Expanding Contraceptive Choice And Improving Quality Of Care In Zambia's Copperbelt, Jill Keesbury
From Pilots To Regional Programs: Expanding Contraceptive Choice And Improving Quality Of Care In Zambia's Copperbelt, Jill Keesbury
Reproductive Health
Between 2002 and 2005, the Pilots to Regional Programs (PRP) initiative was implemented in eight rural and periurban districts of Zambia’s Copperbelt region. Implemented by the Zambian Ministry of Health/Central Board of Health in collaboration with the Copperbelt Provincial Health Office and with technical assistance from the Population Council, the PRP initiative had two objectives: to expand contraceptive choice and increase the availability of high-quality reproductive health services, and to field-test a model for scaling up reproductive health interventions. The resulting project was structured around three activities: (1) expanding the method mix, (2) training healthcare workers, and (3) linking the …
Assessing The Feasibility, Acceptability And Cost Of Introducing Postabortion Care In Health Centres And Dispensaries In Rural Tanzania, Monica Wanjiru, Ian Askew, Nzoya Munguti, Saumya Ramarao, Rick Homan, Reheme Kahando, John M. Pile
Assessing The Feasibility, Acceptability And Cost Of Introducing Postabortion Care In Health Centres And Dispensaries In Rural Tanzania, Monica Wanjiru, Ian Askew, Nzoya Munguti, Saumya Ramarao, Rick Homan, Reheme Kahando, John M. Pile
Reproductive Health
The EngenderHealth ACQUIRE Project has been supporting the Tanzanian Ministry of Health (MOH) since early 2005 to decentralize the management of postabortion care (PAC) services to primary healthcare facilities (health centers and dispensaries), with the intention of bringing services closer to women who are unable to access them at district hospitals. Findings from this study were provided to the MOH and ACQUIRE to address issues arising from introduction of the intervention; and in September 2006, to assess the feasibility, cost, and effectiveness of the intervention. Findings show that the intervention appears to have broadened service providers’ range of clinical skills …
Addressing The Needs Of Seasonal Migrants In Nashik, Maharashtra, Anjali B. Borhade
Addressing The Needs Of Seasonal Migrants In Nashik, Maharashtra, Anjali B. Borhade
Reproductive Health
In order to identify the opportunities and options available to address the vulnerabilities of and socioeconomic needs of seasonal migrants, an intervention project was launched by the Disha Foundation, a nongovernmental organization in Nashik city, Maharashtra, India. This report intends to use the project experience as a case study to provide a blueprint for interventions for seasonal migrants to access a range of basic services in areas of destination and to exercise their rights to access available services. The report documents the array of strategies used to enable seasonal migrants to recognize their entitlement and to access available public sector …
Provider Perspectives On Informed Consent In Female Sterilisation Services: Findings From A Facility-Based Study In Chennai, Raja Lakshmi
Provider Perspectives On Informed Consent In Female Sterilisation Services: Findings From A Facility-Based Study In Chennai, Raja Lakshmi
Reproductive Health
The objective of this paper is to explore the perceptions and experiences of providers with regard to the process of informed consent in the provision of female sterilization services in Chennai, south India. It describes the quality of information provided to clients of sterilization, providers’ attitudes toward clients and the quality of decisionmaking, as well as the quality of the consent-taking process in this setting. In addition, providers’ perceptions of the importance of informed consent are discussed. Findings strongly suggest the need to train and sensitize providers in public as well as private facilities on their ethical responsibilities of ensuring …
Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi
Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi
Reproductive Health
The objective of this paper is to explore the experiences of women undergoing a particular form of fertility regulation, namely sterilization or tubal ligation, in a variety of facilities in Chennai, India. The paper examines specifically the nature of information provided to clients, the consent-taking process, the nature of its documentation, and the extent to which clients made an informed choice. The findings underscore that although all the women respondents did wish to practice a method of contraception, and did want to adopt sterilization, several limitations were noted in the process of providing informed consent: inadequate information was provided to …
Young People's Sexual And Reproductive Health In India: Policies, Programmes And Realities, K.G. Santhya, Shireen J. Jejeebhoy
Young People's Sexual And Reproductive Health In India: Policies, Programmes And Realities, K.G. Santhya, Shireen J. Jejeebhoy
Reproductive Health
This paper presents an overview of key policies and government programmes intended to reduce HIV vulnerability and improve sexual and reproductive health among young people in India, and identifies the extent to which these policies and programmes have addressed the gamut of unique sexual and reproductive needs of young women and men. It also explores the extent to which programmes have been adapted to accommodate state-level differences in the sexual and reproductive vulnerability of youth; the review takes the examples of two states, namely, Andhra Pradesh, characterised by both early marriage and high HIV prevalence, and Madhya Pradesh, characterised by …
Mainstreaming Emergency Contraception In Ethiopia's Public Sector: Final Project Report, Jill Keesbury, Hailegiorgis Aytenfisu, Spike Bradford
Mainstreaming Emergency Contraception In Ethiopia's Public Sector: Final Project Report, Jill Keesbury, Hailegiorgis Aytenfisu, Spike Bradford
Reproductive Health
The Ethiopian Ministry of Health, the Ethiopian Society of Obstetricians and Gynecologists, and ECafrique launched a two-year project in 2004 to mainstream emergency contraception (EC) in the country’s public sector. The project aimed at improving reproductive health care among young women and reducing the country’s abortion rate by expanding access to EC. Overall, its goal was to demonstrate the feasibility of integrating EC within the public sector’s broader contraceptive mix and was guided by the following objectives: to scale-up and promote public sector EC services in five of Ethiopia’s most populated regions; to document the characteristics and use patterns of …
Management Of Complications, Pregnancy, Childbirth And The Postpartum Period In The Presence Of Fgm/C, Kenya Ministry Of Health
Management Of Complications, Pregnancy, Childbirth And The Postpartum Period In The Presence Of Fgm/C, Kenya Ministry Of Health
Reproductive Health
This reference manual is intended for health-care providers in Kenya working among communities that have a high prevalence of female genital mutilation/cutting (FGM/C) and those who encounter women and/or girls who have undergone the practice. It was designed particularly for use by nonspecialist clinicians, including nurses/midwives, clinical officers, district medical officers, postgraduate medical officers, and medical students. It is also a resource for medical and other health-service providers at primary, secondary, and tertiary levels, particularly those working in areas with a high prevalence of FGM/C. Since the evidence base for effective clinical practice is constantly evolving, readers are encouraged to …
Developing Regional Operations Research Training Capacity In South Asia, M.E. Khan, James R. Foreit, Sohini Roychowdhury, F. Ram, Chander Shekhar
Developing Regional Operations Research Training Capacity In South Asia, M.E. Khan, James R. Foreit, Sohini Roychowdhury, F. Ram, Chander Shekhar
Reproductive Health
This project’s overall objective was to create a self-sustaining regional operations research (OR) training and research center for South Asia at the International Institute of Population Sciences (IIPS), in Mumbai, India. The goal was to institutionalize operations research (OR) in IIPS by building the teaching and research capabilities of the faculty and research team. Capacity building was accomplished through a training of trainers that included an OR workshop in Nepal, two four-day OR workshops for program managers, one ten-day OR workshop for researchers, and a four-day scientific-writing course for researchers and program managers to provide guidelines for preparing research articles …
Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health
Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health
Reproductive Health
Female genital cutting is strongly supported among the Somali ethnic community in Kenya, and the severest form (infibulation) is primarily practiced. This type of cut is associated with increased incidence and seriousness of obstetric and gynecological problems relative to uncut women and those with less severe forms of FGM/C. As stated in this brief, efforts to encourage abandonment should begin with community discussion about the socio-cultural reasons for cutting. Simultaneously, health-care providers need training in how to manage complications of FGM/C. In 2004, FRONTIERS collaborated with UNICEF on a four-month diagnostic study on FGM/C practices among the Somali community in …
Grandir En Harmonie: Curriculum D'Animation Des Pairs-Éducateurs Et Des Aides-Ados Ou Jeunes Écoutant, Population Council
Grandir En Harmonie: Curriculum D'Animation Des Pairs-Éducateurs Et Des Aides-Ados Ou Jeunes Écoutant, Population Council
Reproductive Health
« Grandir en harmonie » est un curriculum d’animation en santé de la reproduction a l’intention des pair éducateurs et des aides-adolescent(e)s, principalement, pour préparer les adolescent(e)s à aborder la sexualité en connaisance de cause, de manière responsable et dans le respect des valeurs de leur milieu. Son contenu peut aussi être utilisé par les jeunes de 20 à 24 ans, mais avec des méthodes appropriées (panel, thé-débat, etc.). D’autre types d’utilisateurs l’ont expérimenté et ont trouvé que c’était une ressource utile pour la conduite de leurs activités: aides-adolescent(e)s, enseignants, prestataires de santé et autres encadreurs de jeunes. Leurs remarques …
Bolivia: Marketing And Economic Analyses Help Ngos Develop Strategies For Sustainability, Frontiers In Reproductive Health
Bolivia: Marketing And Economic Analyses Help Ngos Develop Strategies For Sustainability, Frontiers In Reproductive Health
Reproductive Health
Many nongovernmental organizations (NGOs) face reduced funding for reproductive health services and are seeking ways to assess and enhance their ability to generate income to cover their service costs. In 2004, following a workshop on financial sustainability presented by the Population Council’s FRONTIERS Program, three Bolivian NGOs—Prosalud; the Center for Research, Education, and Services (CIES); and the Association of Rural Health Programs (APSAR)—developed operations research studies to improve their financial sustainability. The Prosalud and CIES studies included a cost-recovery study, a study measuring clients’ willingness to pay for services, and a market segmentation study to compare the NGOs’ services with …
Kenya: Mobilize Health Care Providers To Advocate Against Fgm/C, Frontiers In Reproductive Health
Kenya: Mobilize Health Care Providers To Advocate Against Fgm/C, Frontiers In Reproductive Health
Reproductive Health
Female genital mutilation/cutting (FGM/C) is illegal in Kenya. The practice has declined slightly, yet it is nearly universal among the Abagusii, a relatively affluent ethnic group residing in the Nyanza province in western Kenya. Half of cut women reported that they had been cut by a health worker, however providers express willingness to advocate against the practice. This study, launched in 2004 by the Population Council’s FRONTIERS Program, examined the role of health providers in FGM/C in Kenya’s Abagusii community. As noted in this brief, the objectives were to understand the motivations behind the medicalization of FGM/C and determine the …
South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health
South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health
Reproductive Health
South Africa’s medical infrastructure is relatively well developed, but its maternal mortality rate remains high and numerous studies document poor maternal care. Shortages in nursing staff are a major factor in quality-of-care problems on maternity wards. A Population Council FRONTIERS study of antenatal care in rural clinics in Kwa-Zulu Natal showed that between one-third and one-half of providers interviewed had worked at their clinics for less than a year. In 2004, FRONTIERS followed up on the Kwa-Zulu Natal study to document factors affecting the tenure, motivations, and working conditions of maternal-health nursing staff in three South African provinces. The study …
Mainstreaming And Scaling Up The Kenya Adolescent Reproductive Health Project, Ian Askew, Humphres Evelia
Mainstreaming And Scaling Up The Kenya Adolescent Reproductive Health Project, Ian Askew, Humphres Evelia
Reproductive Health
From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research (OR) projects to address the reproductive health (RH) needs of adolescents in four countries—Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in two districts of Western Province in Kenya and was known as the Kenya Adolescent Reproductive Health Project (KARHP). The project supported a public sector, multisectoral intervention to enhance young people’s knowledge and behavior regarding HIV prevention and RH. Implemented jointly with PATH, this OR project demonstrated that such an intervention could be implemented by the public sector, that it was acceptable to communities, that its influence …
Achieving Synergies In Prevention Through Linking Sexual And Reproductive Health And Hiv Services, Ian Askew
Achieving Synergies In Prevention Through Linking Sexual And Reproductive Health And Hiv Services, Ian Askew
Reproductive Health
Integration, linkages, and synergies are widely used terms among those interested in strengthening the relationship between sexual and reproductive health services and HIV prevention. These conference proceedings explore the terms conceptually and review the wide range of combinations of SRH and HIV prevention services that have been linked or integrated. Several different combinations have proven feasible and acceptable in pilot situations, but there remains a lack of evidence as to their effectiveness in changing behaviors, including preventing HIV transmission. There is also limited experience with scaling up successful models and a need to move beyond a focus on services to …
Hiv/Aids Programming And Sexuality Of Young People Perinatally Infected With Hiv, Harriet Birungi
Hiv/Aids Programming And Sexuality Of Young People Perinatally Infected With Hiv, Harriet Birungi
Reproductive Health
These conference proceedings draw on preliminary data from an ongoing project implemented by TASO Uganda and the Population Council that contributes to the promotion of sexual and reproductive health rights of young people aged 10–19 years perinatally infected with HIV. The key argument is that HIV/AIDS programming in Uganda and elsewhere in Africa will need to acknowledge that the population of young people perinatally infected with HIV is growing and to specifically target that population. HIV/AIDS programming will also address the sexual desires of young people perinatally infected with HIV by providing them with information and practical support to understand …
Assessment: Frontiers Small Grants Program, Koli Banik
Assessment: Frontiers Small Grants Program, Koli Banik
Reproductive Health
This report reviews the Small Grants Program (SGP) implemented by FRONTIERS. It assesses the SGP’s areas of achievements and challenges, and explores the feasibility of using this approach to build capacity in operations research. The report provides ideas for implementing a successful SGP that can deliver high-quality, relevant, and timely information for program design. Although capacity building was not an objective in the FRONTIERS SGP, it did produce some increased capacity after two years. As was found with other small grants programs, the FRONTIERS experience suggests that considerable resources are required to produce good quality research and final products. Program …
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Mansehra District, Munir Afridi, Saman Naz, Nayyer Munir
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Mansehra District, Munir Afridi, Saman Naz, Nayyer Munir
Reproductive Health
The Primary Healthcare Revitalization, Integration, and Decentralization in Earthquake-affected Areas (PRIDE) program is designed to improve primary health-care services and health outcomes for populations in Bagh and Mansehra districts in northern Pakistan that were affected by the devastating earthquake that struck on October 8, 2005. The project aims to strengthen the financial and human resource management capacities of district health authorities and primary health-care providers. Access to and quality of primary health-care services will be improved through an essential package of health services and improved skills of primary health-care personnel. Community demand for quality services will be improved through an …
Study Of The Effectiveness Of Training Malian Social And Health Agents In Female Genital Cutting Issues And In Educating Their Clients, Nafissatou J. Diop, Fatoumata Traore, Habibatou Diallo, Ousmane Traore, Aissa Haidara Toure, Youssouf Diallo, Madina Sangare, Fatoumata Tandia, Keita Attaher Toure
Study Of The Effectiveness Of Training Malian Social And Health Agents In Female Genital Cutting Issues And In Educating Their Clients, Nafissatou J. Diop, Fatoumata Traore, Habibatou Diallo, Ousmane Traore, Aissa Haidara Toure, Youssouf Diallo, Madina Sangare, Fatoumata Tandia, Keita Attaher Toure
Reproductive Health
This report documents findings of a study to assess the education and training of social and healthcare workers in Mali regarding female genital cutting (FGC). After two decades of campaigning against FGC in Mali, the results are not satisfactory when compared to the levels of human and financial investment. The Mali Division of Family and Community Health, with technical support from the Population Council, conducted this research to highlight certain issues related to the practice of FGC in Mali, in particular health consequences and the role health personnel can play in eradicating the practice. The continued prevalence of FGC among …
Exploring The Choices Of Contraception And Abortion Among Married Couples In Tret, Rural Punjab, Pakistan, Muhammad Shafique Arif, Iram Kamran
Exploring The Choices Of Contraception And Abortion Among Married Couples In Tret, Rural Punjab, Pakistan, Muhammad Shafique Arif, Iram Kamran
Reproductive Health
In Pakistan, the contraceptive prevalence rate is 28 percent, unmet need for family planning services is 33 percent, and unwanted pregnancies are on the rise. A national study showed a fairly high induced abortion rate of 29 per 1,000 married women of reproductive age, and 1 out of 6 pregnancies resulted in induced abortion. This study explored how contraception and induced abortion are perceived as options for avoiding unwanted births by Pakistani men and women, to what extent they deliberately choose one over the other, and the language they use to talk about reproductive behavior decision-making. As noted in this …
Technical Assistance To The Institute Of Reproductive Health, Georgetown University In Researching Introduction Strategies For The Standard Days Contraceptive Method (Sdm), Saumya Ramarao, James R. Foreit
Technical Assistance To The Institute Of Reproductive Health, Georgetown University In Researching Introduction Strategies For The Standard Days Contraceptive Method (Sdm), Saumya Ramarao, James R. Foreit
Reproductive Health
The Institute of Reproductive Health (IRH), Georgetown University tested the impact of introducing the standard days contraceptive method (SDM) with the technical assistance (TA) of Population Council staff. FRONTIERS technical assistance had the immediate effect of allowing IRH to carry out evaluations of the SDM in Asia and Latin America. The IRH studies also produced important lessons learned on strategies for the introduction of natural methods. IRH staff responsible for the India and Ecuador projects learned specific skills in cost-analysis and research instrument design.
Grandir En Harmonie: Document De Références, Population Council
Grandir En Harmonie: Document De Références, Population Council
Reproductive Health
Ce document de référence fournit des informations pour accompagner les animateurs du curriculum « Grandir en harmonie » en santé de la reproduction. Il s’adresse principalement aux pairs éducateurs et aux assistants d’adolescent(e)s pour les aider à préparer les adolescents(e) à aborder la sexualité en connaissance de cause, de manière responsable et dans le respect des valeurs de leur communauté. Son contenu peut également être adapté pour les jeunes de 20 à 24 ans. Le document couvre des sujets tels que : lʼadolescence; les valeurs; le genre; les mutilations génitales féminines; comprendre son corps; le tabagisme, l’alcoolisme et la toxicomanie; …
Consolidating A Gender Perspective In The Procosi Network, Erica Palenque De La Quintana, Patricia Riveros Hamel, Ricardo Vernon
Consolidating A Gender Perspective In The Procosi Network, Erica Palenque De La Quintana, Patricia Riveros Hamel, Ricardo Vernon
Reproductive Health
The Integral Health Coordination Program (Programa de Coordinación en Salud Integral, or PROCOSI) in Bolivia developed a program to certify service delivery and management support NGOs as gender-sensitive. The certification system is based on an initial self-assessment by teams consisting of staff from service delivery (clinical) or management support (administrative) NGOs, followed by the development and implementation of activities to improve the gaps found until a minimum of 80 percent of the designated quality and gender standards are met. At the project’s end, 14 of the 15 participating NGOs had reached compliance with at least 80 percent of the proposed …
Grandir En Harmonie: Les Questions/Réponses Les Plus Fréquentes Posées Par Les Adolescent(E)S, Population Council
Grandir En Harmonie: Les Questions/Réponses Les Plus Fréquentes Posées Par Les Adolescent(E)S, Population Council
Reproductive Health
Ce guide compile les questions les plus fréquemment posées par les adolescent(e)s au cours du curriculum « Grandir en harmonie » en santé de la reproduction. Il s’adresse principalement aux pairs éducateurs et aux assistants d’adolescent(e)s pour les aider à répondre aux adolescent(e)s au sujet de la sexualité en connaissance de cause, de manière responsable et dans le respect des valeurs de leur communauté. Le document couvre des sujets tels que : l’adolescence, la puberté et les changements des corps; la culture et la sexualité; la santé sexuelle et la sexualité à moindre risque; la contraception et les grossesses indésirées; …