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Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah
Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah
Reproductive Health
Ghana is working toward achieving universal health coverage (UHC). This is driven, in part, by the Sustainable Development Goals (SDGs), specifically SDG 3—Good Health and Well-Being, which seeks to ensure healthy lives and promote well-being for all at all ages. Achieving this feat will improve equity of access as people, especially the poor can access quality health services without financial hardships. Ensuring equitable access to family planning (FP) is essential to securing the well-being of women and supporting the health and development of communities. One pathway to ensuring equity is the inclusion of FP in affordable insurance. While the inclusion …
Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah
Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah
Reproductive Health
Contraceptive use in Ghana has remained low despite annual increases since 2012. Having a high unmet need for family planning (FP) suggests that there may be barriers to access and uptake. Over time, several policies, including Ghana’s Costed Implementation Plan from 2015–20, have suggested FP initiatives to improve contraceptive use yet they have not been entirely implemented. Further, although FP was included in the health insurance act passed in 2003, amended in 2008, and revised in 2012, which indicated that health-care benefits include FP, people continue to pay out of pocket for services at National Health Insurance Authority facilities because …
Modeling The Impact Of Inclusion Of Family Planning Services In Ghana's National Health Insurance Scheme, Justin Archer, Gillian Eva, Augustine Ankomah, Saumya Ramarao, Kamil Fuseini, Anne Coolen, Stephen Duku, Benjamin Bellows
Modeling The Impact Of Inclusion Of Family Planning Services In Ghana's National Health Insurance Scheme, Justin Archer, Gillian Eva, Augustine Ankomah, Saumya Ramarao, Kamil Fuseini, Anne Coolen, Stephen Duku, Benjamin Bellows
Reproductive Health
While access to and uptake of modern family planning (FP) in Ghana has steadily risen over the last decade, the modern Contraceptive Prevalence Rate (mCPR) among all women reached only 22% in 2019 with 30% of women still reporting unmet need. To increase FP uptake via mitigation of cost barriers among women with unmet need, the Government of Ghana is seeking to integrate claims-based FP services into the National Health Insurance Scheme benefits package. The impact of these activities has the potential to be significant with the proportion of women accessing modern FP shifting dramatically to public facilities over the …
Strengthening In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril
Strengthening In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril
Reproductive Health
This brief details Council efforts to develop effective, and costed, in-service training and continuing education modules for frontline health workers in Bauchi and Cross River states in Nigeria. This project was funded by WHO to aid the training and development of Nigeria's public health worker sector.
Population Council's Support For Nigeria's Third National Human Resources For Health Conference And Efforts To Institutionalize Hrh Conferences In Nigeria, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril
Population Council's Support For Nigeria's Third National Human Resources For Health Conference And Efforts To Institutionalize Hrh Conferences In Nigeria, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril
Reproductive Health
This project brief describes the Population Council's partnership efforts with public health stakeholders in Nigeria to plan and host a third national conference for provision of necessary and relevant information on critical health issues to health staff and stakeholders throughout Nigeria.
Maximizing Utilization Of Research, Frontiers In Reproductive Health
Maximizing Utilization Of Research, Frontiers In Reproductive Health
Reproductive Health
Operations research (OR) can only be judged successful if results are utilized for making decisions to strengthen RH/FP policies and service delivery. How can this best be achieved? How can both process and impact of OR be measured? Drawing from ten years of FRONTIERS in Reproductive Health OR experience, a number of key principles for promoting research utilization, illustrated with documented examples, are presented here. One important first step is clarifying terms used, almost interchangeably, in research utilization, as it incorporates a range of ways in which research can be used for making decisions to strengthen RH/FP policies and programs. …
Capacity Building: Creating A Culture Of Evidence-Based Decisionmaking, Frontiers In Reproductive Health
Capacity Building: Creating A Culture Of Evidence-Based Decisionmaking, Frontiers In Reproductive Health
Reproductive Health
For research to have significant impact, it is important to have not only trained individuals and institutions capable of conducting research, but also program managers and donors who believe in making decisions based on evidence. The focus on fostering research utilization through capacity building has been a major contribution of the FRONTIERS legacy. The FRONTIERS capacity-building initiative began in 1999 in response to the need for developing-country partners and institutions to conduct research, understand study findings, and develop policies and programs based on evidence. This is one of eight Legacy Papers synthesizing major lessons learned in research conducted under the …
Gender And Reproductive Health Services: Putting Gender Perspective Into Practice, Frontiers In Reproductive Health
Gender And Reproductive Health Services: Putting Gender Perspective Into Practice, Frontiers In Reproductive Health
Reproductive Health
Promoting gender equity is widely acknowledged as important for improving reproductive health (RH) programs, as gender shapes all aspects of RH service delivery. Thus promoting gender equity—fairness and justice in responsibilities and access to benefits for women, men, girls, and boys—is a major goal for RH programs. But how can programs operationalize the concept of gender perspective when delivering family planning (FP) and other RH services? What impact does this have on use and effectiveness? FRONTIERS projects have improved understanding of the impact of gender issues on RH and have helped identify effective actions for incorporating gender perspective into services. …
Financial Sustainability Of Reproductive Health Services—Understanding Costs: An Essential Skill In Reproductive Health Programs, Frontiers In Reproductive Health
Financial Sustainability Of Reproductive Health Services—Understanding Costs: An Essential Skill In Reproductive Health Programs, Frontiers In Reproductive Health
Reproductive Health
Reproductive health (RH) services remain a low priority for most developing country health programs and face continuing reductions in donor funding and competition from other priorities, such as HIV and malaria. Thus, it is important to understand the costs of interventions and to compare them with existing or alternative service-delivery strategies. FRONTIERS studies provide important lessons about measuring costs and effectiveness of public and nongovernmental programs, planning for costing during scale-up, and improving understanding of issues influencing financial sustainability. This is one of eight Legacy Papers synthesizing major lessons learned in research conducted under the FRONTIERS in Reproductive Health Program. …
Female Genital Mutilation/Cutting: Change Is Possible, Frontiers In Reproductive Health
Female Genital Mutilation/Cutting: Change Is Possible, Frontiers In Reproductive Health
Reproductive Health
Changing long-standing cultural practices—even when such practices are harmful—is difficult, but the impressive success in reducing the acceptability and incidence of female genital mutilation/cutting (FGM/C) in several settings shows it is possible. Research by FRONTIERS in Burkina Faso, Egypt, Ethiopia, Kenya, Mali, and Senegal has provided insight into the sociocultural and religious underpinnings of FGM/C and has identified approaches that, over time, have contributed to individual and community decisions to abandon the practice. This information can help reduce the risk of undergoing FGM/C faced by three million girls and women every year. This is one of eight Legacy Papers synthesizing …
Integration Of Services: Making Integrated Services A Reality, Frontiers In Reproductive Health
Integration Of Services: Making Integrated Services A Reality, Frontiers In Reproductive Health
Reproductive Health
Programs seeking to provide a more comprehensive RH service may establish or strengthen referrals between related yet separately provided services that enable a client to receive the range of needed services. There are two main rationales for integrating services. First, many clients have needs for several services; and second, there is an expectation that providing integrated or linked services can be more efficient programmatically. Little empirical evidence exists to support these underlying rationales, or to guide policies and programs in organizing services effectively and efficiently. Lessons from FRONTIERS have demonstrated not only the demand for multiple services, but also the …
India: Quality Assurance Procedure Monitors And Improves Quality Of Services, Population Council
India: Quality Assurance Procedure Monitors And Improves Quality Of Services, Population Council
Reproductive Health
A quality assurance (QA) procedure was pilot-tested and subsequently scaled up throughout the state of Gujarat, India, after demonstrating that a 65-item checklist is an efficient tool for identifying and remedying gaps in service delivery. From 2004–06, FRONTIERS developed and tested a standardized QA procedure. The State Ministry of Health and Family Welfare (MOHFW) used the procedure to assess health-care services in rural clinics in two pilot districts each in the states of Gujarat and Maharashtra. Based on positive results, the State MOHFW expanded the QA procedure in a phased manner throughout all 25 districts of Gujarat. The model is …
Operations Research For Managers Of Reproductive Health Programs, James R. Foreit, M.E. Khan
Operations Research For Managers Of Reproductive Health Programs, James R. Foreit, M.E. Khan
Reproductive Health
The course presented in this publication defines operations research (OR) as the study of factors under the control of health program managers and other decision-makers. The purpose of OR is to improve programs and provide information for management decision-making. Successful OR is characterized by a close collaboration between program managers and researchers throughout the study. The course focuses on OR as a branch of the behavioral sciences and deals with formative research and field experiments. It concentrates on improving the research knowledge of managers who have had little or no training in research. The focus of this interactive course is …
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 …
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 …
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 …
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 …
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 …
Mainstreaming Adolescent Reproductive Health In Senegal: Enhancing Utilization Of The Findings From The Youth Reproductive Health Project, Nafissatou J. Diop, Anta Fall Diagne
Mainstreaming Adolescent Reproductive Health In Senegal: Enhancing Utilization Of The Findings From The Youth Reproductive Health Project, Nafissatou J. Diop, Anta Fall Diagne
Reproductive Health
From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research projects to address the reproductive health (RH) needs of adolescents in four countries—Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in urban areas of Saint-Louis and Louga, in northwestern Senegal, and was known as Improving the Reproductive Health of Youth in Senegal. The project supported a public-sector, multisectoral intervention to enhance young people’s knowledge and behavior regarding HIV prevention and RH, and systematically tested its feasibility, acceptability, effectiveness, and cost. The intervention had a significant positive impact on young people’s awareness and understanding of RH issues. The pilot …
Cross-Cultural Adaptation Of Reproductive Health Services In Bolivia, Fernando Gonzales Salguero, Antonieta Martin, Rosario Perez Mendoza, Ricardo Vernon
Cross-Cultural Adaptation Of Reproductive Health Services In Bolivia, Fernando Gonzales Salguero, Antonieta Martin, Rosario Perez Mendoza, Ricardo Vernon
Reproductive Health
The Bolivian Ministry of Health and Sports and the Integral Health Project, with the technical assistance of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS), tested several strategies to make health services in Bolivia more culturally appropriate for the country’s indigenous peoples. The goal of the project was to increase women’s access to, use of, and satisfaction with health services in general, and reproductive health services in particular, through: a) enhanced understanding and acceptance of the “other” culture; b) improving communication skills; c) facilitating and promoting use of the Quechua language in clinics; d) systematically screening clients’ health service …
Use Of Systematic Screening To Increase The Provision Of Reproductive Health Services In Bolivia, James R. Foreit, Ricardo Vernon, Patricia Riveros Hamel
Use Of Systematic Screening To Increase The Provision Of Reproductive Health Services In Bolivia, James R. Foreit, Ricardo Vernon, Patricia Riveros Hamel
Reproductive Health
The objective of this study was to determine if the use of a checklist to screen for unmet service needs could increase the number of services per visit provided to clients using rural Bolivian health facilities. Measurement included changes in services per visit before and after the introduction of the intervention, and a comparison of services received at screened and non-screened visits. Findings show that, to the degree that provider compliance can be secured, systematic screening of clients appears to be an effective method for reducing unmet health service needs. The findings of this study replicate those of other studies …
Improving Adolescent Reproductive Health In Bangladesh, Ismat Bhuiya, Ubaidur Rob, Asiful Haider Chowdhury, Laila Rahman, Nazmul Haque, Susan E. Adamchak, Rick Homan, M.E. Khan
Improving Adolescent Reproductive Health In Bangladesh, Ismat Bhuiya, Ubaidur Rob, Asiful Haider Chowdhury, Laila Rahman, Nazmul Haque, Susan E. Adamchak, Rick Homan, M.E. Khan
Reproductive Health
An operations research project was launched in northwestern Bangladesh with the objective of preventing adverse outcomes and promoting healthy lifestyles among adolescents by providing reproductive health education and services. The Population Council, in collaboration with the Urban Family Health Partnership and its three nongovernmental service delivery partners, worked in three urban areas of the country. On the basis of its findings, the study first recommends implementation of a combination of reproductive health interventions at the school, community, and health-facility levels, accompanied by community sensitization, to effectively respond to adolescent reproductive health needs. Second, information providers such as teachers and facilitators …
The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig
The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig
Reproductive Health
This project provides convincing empirical evidence on the impact of quality of care on contraceptive use and fertility behavior through analysis of a unique longitudinal data set from rural Bangladesh. The findings from this project add important new and methodologically rigorous evidence to the emerging literature on the implications of service quality on contraceptive behavior. The results reaffirm the importance of female fieldworker outreach—both in terms of quality and the number of visits—on contraceptive use dynamics in rural Bangladesh. In addition to these substantive findings, the study makes important methodological contributions in assessing the impact of programmatic variables—especially quality of …
Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand
Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand
Reproductive Health
The Population Council has been providing technical assistance and conducting Operations Research (OR) studies in family planning and reproductive health for over two decades. These studies are designed to identify problems and test strategies to resolve those problems, providing program managers, administrators, and policymakers with the information they need to improve service-delivery systems. The ultimate goal is that strategies tested through OR will be adopted, leading to changes in policy or operational procedures at institutional, national, or international levels. These changes are what we refer to as impact. The purpose of the new approach to evaluation described in this Evaluation …
Baseline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Wesley H. Clark, Barbara Mensch, Bela Patel Uttekar
Baseline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Wesley H. Clark, Barbara Mensch, Bela Patel Uttekar
Reproductive Health
The Population Council’s Frontiers in Reproductive Health Program and Policy Research Division, in collaboration with CARE India, is conducting an operations research study of an intervention designed to improve the lives and prospects of young women in several urban slum areas of Allahabad, Uttar Pradesh. The project aims to take a preexisting reproductive health program for adolescents and test the feasibility and impact of adding four additional components to it: 1) counseling about savings formation and livelihoods, 2) training in vocational skills, 3) assistance in opening savings accounts, and 4) follow-up support. CARE India is managing the larger adolescent reproductive …
Midline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Barbara Mensch, Wesley H. Clark, Shahina Begum, Bela Patel Uttekar, Sohini Roychowdhury
Midline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Barbara Mensch, Wesley H. Clark, Shahina Begum, Bela Patel Uttekar, Sohini Roychowdhury
Reproductive Health
The Population Council in collaboration with CARE India has been conducting an operations research (OR) study to investigate the impact of adding a livelihoods component to the Action for Slum Dwellers' Reproductive Health, Allahabad (ASRHA) Project in Uttar Pradesh run by CARE India. The ASRHA Project selected peer educators from the slums and trained them in providing reproductive health (RH) information, communication skills, and group formation techniques. After the peer educators completed training, they conducted group sessions about livelihoods and savings. RH sessions were held alongside vocational counseling sessions. Population Council staff provided vocational training courses, both in the slums …
Operations Research In Reproductive Health And Family Planning At The Cairo Demographic Center, Magdi A. Ibrahim, James R. Foreit, M.E. Khan
Operations Research In Reproductive Health And Family Planning At The Cairo Demographic Center, Magdi A. Ibrahim, James R. Foreit, M.E. Khan
Reproductive Health
This report evaluates the effectiveness of a two-year training program at the Cairo Demographic Center to increase the number of researchers using operations research (OR), and to help institutionalize the ability of the Center to offer training in operations research in reproductive health. It also provides feedback for OR curriculum development. The project trained researchers with program and policymaking responsibilities and provided participants with the experience of designing an OR project, and built participants’ skills in communicating research results to managers. Participant evaluations showed that, overall, the course met its objectives. The training that the students received in OR has …
Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend
Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend
Reproductive Health
The International Conference on Population and Development in 1994 led to an upsurge in interest in implementing reproductive health (RH) programs worldwide. The urgency to act has led to the development of disparate activities in several developing countries including India. While programs have been growing in numbers, their quality is in question. A fundamental problem has been lack of capacity at all levels of the health service system to respond to the paradigm shift articulated by the advocates of the reproductive health and rights agenda. To redesign programs, considerable research must be undertaken to understand the health needs and sociocultural …
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
Reproductive Health
To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …
Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health
Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health
Reproductive Health
El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …