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Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi Jan 2000

Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi

Reproductive Health

Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also …


Intra-Household Decision-Making On Health And Resource Allocation In Borgou, Bénin, Pierre Ngom, Salome Wawire, Timothee Gandaho, Pierre Klissou, Toussaint Adjimon, Mbaye Seye, Emile Akouanou, Laurie Winter Jan 2000

Intra-Household Decision-Making On Health And Resource Allocation In Borgou, Bénin, Pierre Ngom, Salome Wawire, Timothee Gandaho, Pierre Klissou, Toussaint Adjimon, Mbaye Seye, Emile Akouanou, Laurie Winter

Reproductive Health

The African Population and Health Research Centre carried out this study, with support from FRONTIERS and USAID, in order to inform Benin’s Projet Intégré en Santé Familiale (Integrated Project on Family Health—PROSAF) about socio-cultural factors in Borgou that can impede health improvements. More specifically, the study aimed to identify key players in household decisionmaking processes, map out patterns of health-seeking behavior, elucidate how such patterns are associated with prevailing health services utilization, assess community valuation of existing health services and products, and recommend to PROSAF approaches to identified target groups for their intervention. The findings indicate that for all the …


Increasing The Coverage Of Reproductive Health Issues In The Egyptian Press, Sahar Hegazi, Mona Khalifa Jan 2000

Increasing The Coverage Of Reproductive Health Issues In The Egyptian Press, Sahar Hegazi, Mona Khalifa

Reproductive Health

This project, based on previous experiments of the FRONTIERS and POLICY projects, aimed to widen media coverage in Egypt of critical reproductive health issues and to communicate related research findings in a more systematic manner. Increasing coverage in the Egyptian press first required an assessment of the current coverage. Second, a network was formed of about 20 journalists from newspapers and magazines of different publishing houses, followed by four roundtable discussions on critical reproductive health issues. The results of evaluation sheets from the roundtable discussions showed a general increase in the journalists’ knowledge about reproductive health issues, especially for important …


Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi Jan 2000

Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi

HIV and AIDS

A growing body of scientific publications suggests that male circumcision is associated with reduced risk of HIV infection in sub-Saharan Africa. Thus, male circumcision is being considered as a potential intervention in the prevention of sexually transmitted HIV infection, even though this procedure has profound cultural implications and carries the risk of complications, and its benefits are realized only many years later. This report presents the findings of a meeting of international researchers, organized by the Horizons Project to explore the programmatic and research implications of the association between male circumcision and HIV prevention. Most studies on male circumcision and …


Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health Jan 2000

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 …


Peru: Tell Clients How To Use Their Chosen Method, Frontiers In Reproductive Health Jan 2000

Peru: Tell Clients How To Use Their Chosen Method, Frontiers In Reproductive Health

Reproductive Health

In 1998, the Peruvian Ministry of Health (MOH) issued quality of care norms to ensure that family planning providers respond to clients’ reproductive health care needs and goals. In mid-1999, the Population Council collaborated with the MOH on a study to determine whether length of counseling sessions affects amount of information provided. The study focused on 19 health centers in 10 urban areas. Six simulated clients (women posing as clients) made a total of 114 visits to the health centers during June–July 1999. Each client was trained to say that she wanted to switch from the rhythm method to a …


Egypt: Encourage Journalists To Cover Reproductive Health, Frontiers In Reproductive Health Jan 2000

Egypt: Encourage Journalists To Cover Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

To raise public awareness of reproductive health (RH) issues, the Population Council’s Frontiers project and the Futures Group’s Policy project jointly organized four press briefings and provided background materials to key journalists from Arabic newspapers and magazines. From May 1999 to June 2000, project staff worked closely with 20 Egyptian journalists, including editors of women’s pages and senior editors. The press briefings covered youth, marriage patterns, contraceptive technology, and menopause. The press kit prepared for each briefing contained fact sheets, reference materials, a contact list of key experts, and an evaluation sheet. To assess RH reporting and track coverage resulting …


Report On The International Symposium On Quality Of Care In China, Population Council Jan 2000

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 …


Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk Jan 2000

Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk

Reproductive Health

This paper is part of the Policy Series in Reproductive Health, which shares research undertaken by the Reproductive Health Working Group (RHWG). It describes the Reproductive Health Intervention Study, which designed and tested a model of essential reproductive health (RH) services. RHWG was established in 1988 as part of a special program on the health of women and children within the context of the family and community initiated by the Population Council’s Regional Office for the West Asia and North Africa region. The paper identifies a framework of basic service components that address RH and shows that their delivery is …


An Assessment Of The Community Based Distribution Programs In Ghana, Jane Chege, Diouratie Sanogo, Ian Askew, Angela Bannerman, Steve Grey, Evam Kofi Glover, Francis Yankey, Joana Nerquaye-Tetteh Jan 2000

An Assessment Of The Community Based Distribution Programs In Ghana, Jane Chege, Diouratie Sanogo, Ian Askew, Angela Bannerman, Steve Grey, Evam Kofi Glover, Francis Yankey, Joana Nerquaye-Tetteh

Reproductive Health

This study was carried out to describe the major NGO community-based distribution (CBD) programs in Ghana, and to assess in some detail the functioning, quality of care, and performance of the Planned Parenthood Association of Ghana (PPAG) program. The study showed that national coverage by the NGO programs is extensive—virtually all the 110 districts in the 10 regions have at least one program. However, coverage within districts is sparse, as each program covers only a few communities. The results have been communicated to the NGOs whose programs were included in the study and PPAG has already identified a number of …


Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson Jan 2000

Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson

Poverty, Gender, and Youth

The main objectives of this study are to review existing methodologies for projecting future trends in contraception, evaluate the validity of the assumptions underlying these projections, propose methodological improvements, and assess the prospects for new methods of contraception in the coming decade. The prevalence of contraception in the developing world has increased dramatically over the past several decades from near zero to around 60 percent in 2000. Demand for contraception can be expected to continue to rise rapidly for the next few decades as population size continues to grow and fertility declines further to near the replacement level. As a …


Some Preconditions For Fertility Decline In Bengal: History, Language Identity, And An Openness To Innovations, Alaka Malwade Basu, Sajeda Amin Jan 2000

Some Preconditions For Fertility Decline In Bengal: History, Language Identity, And An Openness To Innovations, Alaka Malwade Basu, Sajeda Amin

Poverty, Gender, and Youth

This paper argues that looking solely for the immediate causes of reproductive change may fail to take into account not only the impact of policies and programs but the societal decision to adopt these policies and programs to begin with. The paper examines the historical origins and spread of ‘modern’ ideas in Bangladesh and the state of West Bengal in India. It concludes that a colonial history in which education and modernization processes took hold very early among the elite in the larger Bengal region was paradoxically accompanied by a strong allegiance to the Bengali language. This strong sense of …


Unmet Need For Family Planning In Developing Countries And Implications For Population Policy, John B. Casterline, Steven W. Sinding Jan 2000

Unmet Need For Family Planning In Developing Countries And Implications For Population Policy, John B. Casterline, Steven W. Sinding

Poverty, Gender, and Youth

Unmet need for family planning has been a core concept in international population discourse for several decades. In this paper we reevaluate its utility. We review the history of unmet need and the development of increasingly refined methods of its empirical measurement. We then turn to the main questions that have been raised about unmet need during the past decade, some of which concern the validity of the concept and others its role in the post-ICPD environment. The discussion draws heavily on empirical research conducted during the 1990s, much of it localized, in-depth studies combining quantitative and qualitative methodologies, that …


Adolescent Pregnancy And Parenthood In South Africa, Carol E. Kaufman, Thea De Wet, Jonathan Stadler Jan 2000

Adolescent Pregnancy And Parenthood In South Africa, Carol E. Kaufman, Thea De Wet, Jonathan Stadler

Poverty, Gender, and Youth

South Africa’s total fertility rate is estimated to be one of the lowest in sub-Saharan Africa, less than 3.0 births per woman nationally and declining. At the same time, adolescent childbearing levels remain high more than 30 percent of 19-year-old girls are reported to have given birth at least once. Using evidence from focus groups conducted in urban and rural areas in South Africa with young black women and men, and with the parents of teenage mothers, we consider the experience of early parenthood. Specifically, the analysis explores four aspects of teenage childbearing as it relates to key transitions into …


Schooling Opportunities For Girls As A Stimulus For Fertility Change In Rural Pakistan, Zeba Sathar, Cynthia B. Lloyd, Cem Mete, Minhaj Ul Haque Jan 2000

Schooling Opportunities For Girls As A Stimulus For Fertility Change In Rural Pakistan, Zeba Sathar, Cynthia B. Lloyd, Cem Mete, Minhaj Ul Haque

Poverty, Gender, and Youth

This paper tests Caldwell’s mass schooling hypothesis in the context of rural Pakistan. His hypothesis was that the onset of the fertility transition is closely linked to the achievement of “mass formal schooling” of boys and girls. Punjab and Northwest Frontier Province (NWFP) were selected for this study because they appear to be on the leading edge of the demographic transition-a transition that has only recently begun-as suggested by rapid recent increases in contraceptive practice. The study covered a range of rural villages or communities with very different socioeconomic and schooling conditions in order to examine the effects of both …


A Comparative Analysis Of Anti-Trafficking Intervention Approaches In Nepal, Catrin Evans, Pankaja Bhattarai, Celine Daly, Vaishali Sharma Mahendra, Nick Langton Jan 2000

A Comparative Analysis Of Anti-Trafficking Intervention Approaches In Nepal, Catrin Evans, Pankaja Bhattarai, Celine Daly, Vaishali Sharma Mahendra, Nick Langton

Poverty, Gender, and Youth

This report on current intervention models is part of a larger research study entitled “Intervention Needs for the Prevention of Trafficking and the Care and Support of Trafficked Persons in the Context of an Emerging HIV/AIDS Epidemic in Nepal.” The United States Agency for International Development supported this comprehensive study under the Population Council’s Horizons Program. The Population Council subcontracted the Asia Foundation in Kathmandu to conduct the research. This report documents and analyzes current intervention models for the prevention of trafficking and the care and support of trafficked persons in Nepal. Between August and September 2000, two researchers interviewed …


Alone You Are Nobody, Together We Float: The Manuela Ramos Movement, Judith Bruce, Debbie Rogow Jan 2000

Alone You Are Nobody, Together We Float: The Manuela Ramos Movement, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

Quality/Calidad/Qualité, a publication of the Population Council, highlights examples of clinical and educational programs which bring a strong commitment, as well as innovative and thoughtful approaches, to the issue of quality care in sexual and reproductive health. The series is based on the philosophy that women and their partners have a fundamental right to respectful treatment, information, choice, and follow-up from reproductive health care providers. This issue discusses improving women’s health and well being through a range of empowerment strategies in rural Peru.


A Participatory Evaluation Of The Life-Skills Training Programme In Myanmar, Unicef, Population Council Jan 2000

A Participatory Evaluation Of The Life-Skills Training Programme In Myanmar, Unicef, Population Council

Poverty, Gender, and Youth

In 1993 UNICEF/Myanmar launched an innovative project aimed at preventing the further spread of HIV/AIDS through the promotion of reproductive health. One of the activities undertaken was life-skills training for women and youth, conducted in collaboration with the Myanmar Red Cross Society (MRCS) and the Myanmar Maternal and Child Welfare Association (MMCWA). The objective of the training activities was to encourage and promote informed decision-making and care-seeking behavior among youth and women. The training aims to provide detailed and accurate information concerning sexuality, birth spacing, sexually transmitted diseases, and HIV/AIDS, and to provide skills for youth and women to enable …


Kenya: Offer Family Planning On Hospital Wards, Frontiers In Reproductive Health Jan 2000

Kenya: Offer Family Planning On Hospital Wards, Frontiers In Reproductive Health

Reproductive Health

In Kenya, more than one in three women hospitalized for gynecological problems has complications from miscarriage or unsafe abortion. These women generally receive no information or services for family planning (FP) or other reproductive health needs. During 1996–97, the Kenya Ministry of Health, the Population Council, and Ipas tested three models for providing postabortion care (PAC) and FP information and services in two areas of the hospital. Researchers compared model effectiveness by using surveys before and after the intervention. As concluded in this brief, the most effective way to ensure that women being treated for incomplete abortion obtain FP is …


Egypt: Family Planning Providers Should Encourage Clients To Discuss Sexual Problems, Frontiers In Reproductive Health Jan 2000

Egypt: Family Planning Providers Should Encourage Clients To Discuss Sexual Problems, Frontiers In Reproductive Health

Reproductive Health

This 1999 study examined the feasibility and impact of introducing the discussion of sexuality during family planning (FP) consultations. Conducted by the Population Council in collaboration with the Egyptian Ministry of Health and Population (MOHP), the study took place in four MOHP clinics and two affiliated private clinics. Nurses and physicians at all six clinics attended a two-day training session on contraceptives with an emphasis on barrier methods. Providers in the three clinics that had been randomly chosen as intervention sites also received three days of training on sexuality, gender, and counseling skills. To assess the acceptability of sexuality counseling …


Burkina Faso And Mali: Female Genital Cutting Harms Women's Health, Frontiers In Reproductive Health Jan 2000

Burkina Faso And Mali: Female Genital Cutting Harms Women's Health, Frontiers In Reproductive Health

Reproductive Health

In collaboration with the Ministries of Health (MOH) of Burkina Faso and Mali, the Population Council conducted two studies in 1998 to describe the occurrence and severity of health problems related to female genital cutting (FGC). Study participants were consenting women who received a pelvic exam during prenatal, family planning (FP), obstetric, or gynecological consultations at MOH clinics. Providers were trained to observe the types and complications of FGC. To assess their potential role as change agents, providers in Mali also received training on the health effects of FGC and client counseling. In Burkina Faso, health providers recorded information on …


Mali: Empower Health Workers To Advocate Against Female Genital Cutting, Frontiers In Reproductive Health Jan 2000

Mali: Empower Health Workers To Advocate Against Female Genital Cutting, Frontiers In Reproductive Health

Reproductive Health

The various initiatives to eradicate FGC in Mali over the past two decades have had little impact on this traditional practice. This study assessed the use of health personnel to combat FGC, as recommended by the World Health Organization. Conducted in 1998 by the Association de Soutien au Developpement des Activites de Population, a nongovernmental organization, and the Ministry of Health, the study covered 14 urban and rural health centers in Bamako and Segou. In the eight health centers that served as experimental sites, 59 health providers, including physicians, midwives, nurses, and aides, attended a three-day training course on identifying …


Peru: Managers Must Monitor Quality Of Care Regularly, Frontiers In Reproductive Health Jan 2000

Peru: Managers Must Monitor Quality Of Care Regularly, Frontiers In Reproductive Health

Reproductive Health

In the late 1980s, Peru’s National Family Planning Program within the Ministry of Health (MOH) assigned method-specific targets to clusters of health facilities. In 1998, the MOH changed its policies to ensure that services responded to individual reproductive health needs and wishes. It eliminated method quotas, ended voluntary surgical contraception campaigns, and issued norms to ensure quality of care and informed choice. In 1999, the Population Council collaborated with the MOH to determine whether providers were complying with the new guidelines and, secondarily, to develop a monitoring system to assess compliance over time. As concluded in this brief, family planning …


Adolescents And Reproductive Health In Pakistan: A Literature Review, Ayesha Khan Jan 2000

Adolescents And Reproductive Health In Pakistan: A Literature Review, Ayesha Khan

Reproductive Health

This report reviews research and findings on adolescents and reproductive health in Pakistan. The material is drawn from a range of national surveys and medical research, as well as information gathered by nongovernmental organizations. Although adolescents make up a quarter of the population of Pakistan, they are still a new subject for research. The characterization of adolescents for this review is individuals ages 10–19, whether or not they are married, sexually active, or parents. The discussion of the research material is based on the assumption that adolescence is a developmental phase, a transition from childhood to adulthood. Basic data on …


The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council Jan 2000

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …


The Female Condom: Dynamics Of Use In Urban Zimbabwe, Deanna Kerrigan, Steve Mobley, Naomi Rutenberg, Andrew A. Fisher, Ellen Weiss Jan 2000

The Female Condom: Dynamics Of Use In Urban Zimbabwe, Deanna Kerrigan, Steve Mobley, Naomi Rutenberg, Andrew A. Fisher, Ellen Weiss

HIV and AIDS

In July 1997, Population Services International (PSI), at the request of the Zimbabwe National AIDS Coordination Programme, launched a social marketing program for the female condom in Zimbabwe. To avoid stigma associated with condoms and STI prevention, the female condom was marketed as a family planning product or “contraceptive sheath” under the brand name “Care.” It was initially sold through pharmacies and clinics at a heavily subsidized retail price of US $0.24 for two; distribution has since expanded to other urban outlets, including supermarkets and convenience stores. Approximately one year after the start of the social marketing program, the Horizons …


Integrating Issues Of Sexuality Into Egyptian Family Planning Counseling, Nahla G. Abdel-Tawab, Laila Nawar, Hala Youssef, Dale Huntington Jan 2000

Integrating Issues Of Sexuality Into Egyptian Family Planning Counseling, Nahla G. Abdel-Tawab, Laila Nawar, Hala Youssef, Dale Huntington

Reproductive Health

The Population Council studied the acceptability of including sexuality issues in family planning (FP) in Egypt, a conservative society with social restrictions around discussions of sex. The study results showed that sexuality counseling is acceptable to family planning clients in Egypt; in fact, sexuality-related problems and concerns were found to be very common in the study group. Similarly, training family planning service providers on issues of sexuality is both feasible and acceptable to providers. The report offers recommendations for refining existing FP training programs and services including: integrating issues of sexuality into FP counseling, training FP service providers on the …


Peer Education And Hiv/Aids: Past Experience, Future Directions, Deanna Kerrigan, Ellen Weiss Jan 2000

Peer Education And Hiv/Aids: Past Experience, Future Directions, Deanna Kerrigan, Ellen Weiss

HIV and AIDS

Peer education typically involves training and supporting members of a given group to effect change among members of the same group. Peer education is often used to effect changes in knowledge, attitudes, beliefs, and behaviors at the individual level. However, peer education may also create change at the group or societal level by modifying norms and stimulating collective action that contributes to changes in policies and programs. Worldwide, peer education is one of the most widely used strategies to address the HIV/AIDS pandemic. This report presents findings from a project designed to identify components and principles that influence HIV/AIDS peer …


Enhancing The Use Of Emergency Contraception In A Refugee Setting: Findings From A Baseline Survey In Kakuma Refugee Camps, Kenya, Esther G. Muia, Joyce Olenja Jan 2000

Enhancing The Use Of Emergency Contraception In A Refugee Setting: Findings From A Baseline Survey In Kakuma Refugee Camps, Kenya, Esther G. Muia, Joyce Olenja

Reproductive Health

In August 1992, the International Rescue Committee (IRC) at the request of the United Nations, the United Nations High Commission for Refugees, and the Kenyan Government, initiated a primary health care program in the Kakuma Refugee Camp. Since then, the population of the camp has continued to grow, and activities have moved from a crisis to a maintenance phase. In January 1997, IRC assumed the additional responsibility of the camp hospital, bringing the entire health sector under their management. IRC's programs focus on maintaining and improving public health and promoting self-reliance, particularly of the most vulnerable communities. This project focuses …


Managing Population-Environment Systems: Problems Of Institutional Design, Geoffrey Mcnicoll Jan 2000

Managing Population-Environment Systems: Problems Of Institutional Design, Geoffrey Mcnicoll

Poverty, Gender, and Youth

In population–environment systems human activity is inherently part of the system rather than something to be minimized in order to maintain or restore “natural” environmental conditions. Issues arising in managing such systems are discussed in this paper. The system’s boundaries must be identified, defining its human participants and its ecological content. Procedures for monitoring demographic and environmental change in the system must be set up and consensus must be reached on how to evaluate that change.