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Full-Text Articles in Medicine and Health Sciences

Managing And Preventing Female Genital Cutting (Fgm/C) Among The Somali Community In Kenya, Maryam Sheikh Abdi, Jaldesa Guyo, Ian Askew Jan 2008

Managing And Preventing Female Genital Cutting (Fgm/C) Among The Somali Community In Kenya, Maryam Sheikh Abdi, Jaldesa Guyo, Ian Askew

Reproductive Health

This report details the Council’s innovative work with religious leaders to reduce the practice of FGM/C in the Somali community in Northern Kenya. In the mid to late 2000s, through the USAID Frontiers project, the Council successfully engaged religious leaders and scholars as community educators to correct the customary misconception that FGM/C is a requirement of Islam. Through sermons and training sessions, these leaders were able to dis-associate FGM/C from Islam, raise public awareness about the harms associated with the practice, and encourage its abandonment.


From Pilot To Program: Scaling Up The Kenya Adolescent Reproductive Health Project, Humphres Evelia, Japheth Nyambane, Harriet Birungi, Ian Askew, Rikka Trangsrud, Eva Muthuuri, Irene Chaami, Agnes Odawa, Lucy Musyoka, Susan Mutungi, Margaret Githuiya, Joan Omuruli Jan 2008

From Pilot To Program: Scaling Up The Kenya Adolescent Reproductive Health Project, Humphres Evelia, Japheth Nyambane, Harriet Birungi, Ian Askew, Rikka Trangsrud, Eva Muthuuri, Irene Chaami, Agnes Odawa, Lucy Musyoka, Susan Mutungi, Margaret Githuiya, Joan Omuruli

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program and the Program for Appropriate Technology in Heath collaborated with three Government of Kenya ministries—Education; Health; and Gender, Sports, Culture and Social Services—to design and implement the Kenya Adolescent Reproductive Health Project with the goals of: improving knowledge about reproductive health and encouraging a responsible and healthy attitude toward sexuality among adolescents, delaying the onset of sexual activity among younger adolescents, and decreasing risky behaviors among sexually active adolescents. Key findings from the pilot project showed that the three ministries could successfully implement these interventions with high participation among parents and youth. …


Taking Critical Services To The Home: Scaling-Up Home-Based Maternal And Postnatal Care, Including Family Planning, Through Community Midwifery In Kenya, Annie Mwangi, Charlotte E. Warren Jan 2008

Taking Critical Services To The Home: Scaling-Up Home-Based Maternal And Postnatal Care, Including Family Planning, Through Community Midwifery In Kenya, Annie Mwangi, Charlotte E. Warren

Reproductive Health

With support from USAID, the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project supported the scaling up of a community-based model in Kenya that enabled women to give birth safely at home or be referred to a hospital when attended by a self-employed skilled midwife living in the community. To strengthen the sustainability of this approach FRONTIERS engaged a microfinance NGO to develop a training curriculum on basic business skills and financial literacy, and encouraged the community midwives (CMs) to form clusters or informal associations so that they could be trained in business skills. Following these interventions, CMs proved more …


Feasibility, Acceptability, Effect, And Cost Of Integrating Counseling And Testing For Hiv Within Family Planning Services In Kenya, Wilson Liambila, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Rick Homan, Ibrahim Mohammed, Robert Ayisi, Margaret Gitau, Josephine Kibaru, Mary W. Gathitu, Judith Maua, Helton Jilo, Juma Mwangi, John Njoroge, Anthony K. Wanyoro, Peter Mohammed Njuguna, Andrew Mboche Jan 2008

Feasibility, Acceptability, Effect, And Cost Of Integrating Counseling And Testing For Hiv Within Family Planning Services In Kenya, Wilson Liambila, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Rick Homan, Ibrahim Mohammed, Robert Ayisi, Margaret Gitau, Josephine Kibaru, Mary W. Gathitu, Judith Maua, Helton Jilo, Juma Mwangi, John Njoroge, Anthony K. Wanyoro, Peter Mohammed Njuguna, Andrew Mboche

Reproductive Health

FRONTIERS supported the Division of Reproductive Health and the National AIDS and STI Control Program of the Kenya Ministry of Health to design, implement, and compare two models of integrating counseling and testing (CT) for HIV within family planning (FP) services in terms of their feasibility, acceptability, cost, and effect on the voluntary use of CT, as well as the quality of FP services. The study demonstrated that both models were feasible and acceptable to providers and to clients as means of integrating and linking HIV prevention counseling, condom promotion, and counseling and testing with FP services, and are effective …


Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council Jan 2008

Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council

Reproductive Health

In 2004, FRONTIERS collaborated with UNICEF on a study of female genital mutilation/cutting (FGM/C) in Kenya’s Somali community and on ways of managing maternal care for cut women. The study showed that the health-care system in North Eastern Province, where many Somalis live, is ill prepared to deal with women who have been cut, particularly infibulated women who are pregnant or delivering. The study recommended improving providers’ ability to counsel and treat pregnant cut women as part of an overall improvement of maternal care, and strengthening providers’ role as behavior change agents within communities. In 2005, FRONTIERS launched an intervention …


Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council Jan 2008

Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council

Reproductive Health

Kenya and Malawi have developed national policies to prevent malaria in pregnancy. Measures to prevent malaria among antenatal clients were shown to be sustainable several years after pilot interventions ended. In Malawi, the approach has been expanded nationwide. In most malaria-endemic areas of Africa, women in their first and second pregnancies have the highest risk of acquiring malaria and, consequently, of malaria-associated anemia and low birth-weight. Two USAID-funded interventions aimed at strengthening the prevention and management of malaria in pregnancy were pilot-tested at the district level in Kenya (1998–2002) and Malawi (1998–2004). As noted in this brief, the goal was …


Kenya And Ethiopia: Community And Religious Leaders Are Effective Advocates For Hiv Testing For Young Couples, Population Council Jan 2008

Kenya And Ethiopia: Community And Religious Leaders Are Effective Advocates For Hiv Testing For Young Couples, Population Council

Reproductive Health

Early marriage is common for girls in much of sub-Saharan Africa. A common belief is that marriage protects them from HIV, but studies show that married girls are at much higher risk from HIV and from maternal morbidity and mortality. FRONTIERS conducted operations research in Ethiopia and Kenya to assess the acceptability and feasibility of community-based interventions to raise awareness of the HIV risks of early marriage and promote the use of HIV counseling and testing (C&T) services by couples. The studies were an initial phase in a planned four-year intervention; this brief reports on the feasibility of the approach. …


Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia Jan 2008

Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia

Reproductive Health

As in many developing countries, young people in Kenya and Senegal (aged 10–20) account for about 25 percent of the population. To ensure their future contribution to their countries, it is of vital strategic importance to safeguard their welfare. Rapid social change in both countries exposes youth to sexual and reproductive health (RH) risks, including unintended pregnancy, sexually transmitted infections including HIV, and sexual violence. Beginning in 1999, the Population Council’s FRONTIERS program conducted operations research studies that tested the feasibility, acceptability, and cost of a public-sector, multisectoral intervention to enhance young people’s RH knowledge and behavior. Study findings showed …


Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi Jan 2008

Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi

Reproductive Health

In 2001, the World Health Organization issued guidance on a new model of antenatal care (ANC) called goal-oriented or focused antenatal care (FANC), for implementation in developing countries. The new model reduces the number of required antenatal visits to four, and provides focused services shown to improve maternal outcomes. FANC emphasizes helping women maintain normal pregnancies by identifying existing health conditions, detecting emerging complications, promoting health, preparing for a healthy birth, and educating clients on postpartum care including nutrition, breastfeeding, and family planning. Trials conducted in Argentina, Cuba, Saudi Arabia, and Thailand proved that FANC was safe and was a …


Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council Jan 2008

Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council

Reproductive Health

The Kenyan government’s reproductive health policy highlights service integration and quality of care. While integrating counseling and testing (C&T) for HIV into family planning (FP) can potentially increase the range of services to clients at risk from sexually transmitted infections (STIs) including HIV, few studies have documented the feasibility, effects, or costs of such integration. From 2005–07, the Population Council worked with the Kenyan Ministry of Health to test the feasibility of two models for integrating C&T into existing FP services. Both models featured client education on HIV prevention during FP visits. Providers were trained to routinely use the Balanced …


Highlighting Marital Hiv Risk And Promoting Premarital Vct In Nyanza Province, Kenya, Ben Ochieng, Annabel Erulkar Jan 2008

Highlighting Marital Hiv Risk And Promoting Premarital Vct In Nyanza Province, Kenya, Ben Ochieng, Annabel Erulkar

Reproductive Health

This report describes a project undertaken in Kenya by the Population Council, in collaboration with PATH and Kendu Adventist Hospital, whose objectives were: 1) to design and implement educational strategies to raise awareness of the risks of HIV and early marriage; 2) to promote voluntary counseling and testing (VCT) for couples; and 3) to support and empower newly married girls through community-based clubs. The report notes that the strong technical support and leadership provided by the partners led to successful implementation of most project activities. The partnership enabled scarce resources to be shared, and has ensured that the comparative advantages …


The Potential For Sustainability Of Malaria In Pregnancy Initiatives In East And Southern Africa: Kenya And Malawi, Washington Onyango-Ouma, Sam Agatre Okuonzi, Doreen Ali, Harriet Birungi, Annie Mwangi Jan 2008

The Potential For Sustainability Of Malaria In Pregnancy Initiatives In East And Southern Africa: Kenya And Malawi, Washington Onyango-Ouma, Sam Agatre Okuonzi, Doreen Ali, Harriet Birungi, Annie Mwangi

Reproductive Health

This study assesses the sustainability of initiatives to improve maternal and child health survival by preventing and treating illness from malaria, and documents best practices for promoting sustainability and lessons for replication in countries where malaria is endemic. The study applied the Child Survival Sustainability Assessment framework to initiatives in Kenya and Malawi to analyze progress toward sustainability, including not only a biomedical perspective but also the human, social, and organizational processes that influence sustainability of health projects. The report concludes that Malaria in Pregnancy (MIP) interventions were sustained within and beyond the project districts in both countries. Furthermore, both …


Integrating Tuberculosis Case Finding And Treatment Into Focused Antenatal Care In Kenya, Charlotte E. Warren, Annie Mwangi Jan 2008

Integrating Tuberculosis Case Finding And Treatment Into Focused Antenatal Care In Kenya, Charlotte E. Warren, Annie Mwangi

Reproductive Health

The Population Council/FRONTIERS program, in collaboration with the National Leprosy and Tuberculosis Programme, the Division of Reproductive Health, and the Provincial Health Management Team in Western Province, Kenya, received PEPFAR funding to improve screening for tuberculosis (TB) for pregnant women, including HIV-positive pregnant women. An intervention was tested to strengthen TB case detection to ensure that maternal and child health providers, in addition to providing antenatal care and PMTCT services, also screen and assess the client’s need for TB services and refer for further management. The effectiveness of this approach was demonstrated by the increased number of pregnant women who …


Strengthening Postnatal Care Services Including Postpartum Family Planning In Kenya, Annie Mwangi, Charlotte E. Warren, Nancy Koskei, Holly Blanchard Jan 2008

Strengthening Postnatal Care Services Including Postpartum Family Planning In Kenya, Annie Mwangi, Charlotte E. Warren, Nancy Koskei, Holly Blanchard

Reproductive Health

The objectives of this study were to develop and introduce a strengthened postnatal care package into one hospital and four health centers in one district in Kenya, to document the feasibility, acceptability, and quality of care of the strengthened postnatal care, and to evaluate the effectiveness of the postnatal package on women’s reproductive health behaviors. The study was implemented jointly by the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project and by Jhpiego’s ACCESS-FP project, both funded by USAID. A postnatal care–family planning orientation package for providers was developed that incorporated relevant maternal and newborn healthcare services in the postnatal …


Obstetric Fistula: Can Community Midwives Make A Difference? Findings From Four Districts In Kenya, Charlotte E. Warren, Annie Mwangi Jan 2008

Obstetric Fistula: Can Community Midwives Make A Difference? Findings From Four Districts In Kenya, Charlotte E. Warren, Annie Mwangi

Reproductive Health

As part of the UNFPA Global Campaign to End Obstetric Fistula, the Population Council and UNFPA built on Kenya’s Community Midwifery Approach to develop a comprehensive community midwifery intervention strategy that aimed at increasing skilled attendants at birth and prevention of obstetric fistula. This report seeks to understand the experiences of women affected by fistula and whether community midwives can contribute to preventing obstetric fistula in rural settings in Kenya. The key recommendations emerging from this report are to: update health facility midwives in maternal and neonatal health (MNH) skills including prevention, treatment, and care of obstetric fistula; train more …


Kenya: Islamic Scholars Find No Religious Justification For Fgm/C, Population Council Jan 2008

Kenya: Islamic Scholars Find No Religious Justification For Fgm/C, Population Council

Reproductive Health

In 2004, FRONTIERS undertook a study on the cultural basis of female genital mu­tilation and cutting (FGM/C) in Kenya’s Somali community. The study showed universal support for FGM/C, and indicated that one of the major justifications is the perception that Islam requires female as well as male genital cutting. Interviews with informants showed that belief in the religious justification overrides arguments about the health and human rights aspects and the knowledge that it is illegal in Kenya. In 2005, FRONTIERS launched an intervention to engage the community in discussions about FGM/C to clarify the religious position. FRONTIERS arranged symposia involving …