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International Public Health

Contraceptives

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Reduce Contraception Discontinuation In Bangladesh By Improving Counseling On Side Effects, Fauzia Akhter Huda, Sabiha Chowdhuri Jan 2014

Reduce Contraception Discontinuation In Bangladesh By Improving Counseling On Side Effects, Fauzia Akhter Huda, Sabiha Chowdhuri

Reproductive Health

High rates of contraceptive discontinuation and method failure could cause Bangladesh to lose the progress made in increasing contraceptive use over the past 20 years. This policy brief concludes that if women are adequately counseled and supported to sustain their use of more effective contraceptive methods, they will need less medical attention, have fewer unintended pregnancies, and reduce the workload for medical clinics. Furthermore, if providers are adequately trained and supported in counseling and managing side effects and in helping women to switch methods when they do have a problem, the Family Planning Clinical Contraception Services Delivery Program would meet …


Introduction Of Emergency Contraceptive Pills (Ecps) Through Lady Health Workers (Lhws) Program In Pakistan: Findings Of An Evaluation Study, Arshad Mahmood, Yasir Bin Nisar Jan 2012

Introduction Of Emergency Contraceptive Pills (Ecps) Through Lady Health Workers (Lhws) Program In Pakistan: Findings Of An Evaluation Study, Arshad Mahmood, Yasir Bin Nisar

Reproductive Health

This report documents the findings from a five-day study tour of Pakistani officials to Bangladesh, organized by the Population Council, to afford an opportunity for representatives of both the Ministry of Health and Population Welfare to learn from the experience of Bangladesh in introducing emergency contraceptive pills (ECPs) through their National Public Health System. One of the recommendations was to enhance the availability of emergency contraception in Pakistan by making it available through outlets of the health system, especially through the network of the community-based Lady Health Workers (LHWs). There is a high unmet need for ECP in LHW areas, …


Providers' Attitudes And Practices Regarding Emergency Contraception In India: Key Findings, M.E. Khan, Isha Bhatnagar, Deepthi S. Varma, Anvita Dixit Jan 2012

Providers' Attitudes And Practices Regarding Emergency Contraception In India: Key Findings, M.E. Khan, Isha Bhatnagar, Deepthi S. Varma, Anvita Dixit

Reproductive Health

This policy brief reports key findings of a study in India that explored providers’ knowledge of how emergency contraception (ECP) works and its safety and effectiveness, their perceptions of the frequency of repeat use, their provision of ECP, and their attitudes toward women who seek it. Many of the findings of this study are encouraging. Most providers believed that ECP is an effective and safe method to prevent pregnancy and that it cannot induce abortion, and half supported the over-the-counter provision of ECP. Nevertheless, the study revealed many biases and gaps in knowledge. Recommendations include a number of ways to …


Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In India: Final Survey Report, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady Jan 2012

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In India: Final Survey Report, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECPs) among providers in public and private facilities and pharmacies in India. This study’s objectives were: 1) to assess providers’ knowledge of ECP’s biological mechanism; 2) to understand providers’ knowledge and attitudes about ECP’s safety, effectiveness, and availability as an over-the-counter drug; and 3) to identify providers’ definitions of “repeated use” and profiling of women who are “repeated users” of ECP. The study recommends intervention programs and advocacy strategies to increase knowledge and access to ECP.


Providers' And Key Opinion Leaders' Attitudes And Practices Regarding Emergency Contraception In Senegal: Key Findings, Babacar Mane, Martha Brady, Saumya Ramarao, Fatou Bintou Mbow Jan 2012

Providers' And Key Opinion Leaders' Attitudes And Practices Regarding Emergency Contraception In Senegal: Key Findings, Babacar Mane, Martha Brady, Saumya Ramarao, Fatou Bintou Mbow

Reproductive Health

This study examines providers’ and key opinion leaders’ knowledge, attitudes, and practices regarding the emergency contraceptive pill (ECP) in Senegal, and synthesizes the findings to suggest program and policy recommendations. Analysis of providers’ opinions and beliefs reveals that although many providers believe ECP is a safe product, persistent negative views remain. KOLs and providers recognize the importance of ECP for preventing unintended pregnancy and are supportive of the integration of ECP into national guidelines. They note, however, the need to improve accessibility and quality of provision. Given the magnitude of sexual violence and abuse, considerable interest exists in devising strategies …


Attitudes, Croyances Et Pratiques Des Leaders D'Opinion Clés (Loc) Et Des Prestataires Sur La Contraception D'Urgence (Cu) Au Sénégal, Babacar Mane, Saumya Ramarao, Martha Brady, Fatou Bintou Mbow, Ababacar Thiam Jan 2012

Attitudes, Croyances Et Pratiques Des Leaders D'Opinion Clés (Loc) Et Des Prestataires Sur La Contraception D'Urgence (Cu) Au Sénégal, Babacar Mane, Saumya Ramarao, Martha Brady, Fatou Bintou Mbow, Ababacar Thiam

Reproductive Health

In Senegal, initiatives for mainstreaming the emergency contraceptive pill (ECP) in the family planning program are fairly recent. Service statistics indicate, however, that ECP distribution through the public sector is very low. While most users access ECPs through the private sector, the volume of sales is not clear, due to the absence of an operational information system of EC distribution through pharmacies. In an effort to strengthen EC provision in Senegal and reposition EC within the FP program, the Population Council conducted a study in collaboration with the Reproductive Health Division of the Ministry of Health, Senegal to document the …


Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Concerning Emergency Contraception: A Multicountry Study In India, Nigeria, And Senegal, Martha Brady, M.E. Khan, Babatunde A.O. Ahonsi, Babacar Mane, Ian Askew, Saumya Ramarao Jan 2012

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Concerning Emergency Contraception: A Multicountry Study In India, Nigeria, And Senegal, Martha Brady, M.E. Khan, Babatunde A.O. Ahonsi, Babacar Mane, Ian Askew, Saumya Ramarao

Reproductive Health

The Population Council conducted a cross-sectional, descriptive, multicountry study in India, Nigeria, and Senegal aimed at understanding the attitudes, beliefs, and practices of providers and key opinion leaders (KOLs) regarding the provision and use of emergency contraception (ECP). The overarching goal of this study was to investigate and document providers’ attitudes, beliefs, and practices regarding ECP, and to capture the opinions and insights of providers and KOLs on a range of policy and program issues. Findings indicate that many provider-related barriers can be overcome through implementation of targeted interventions such as training and values clarification, whereas other barriers will require …


Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni Jan 2012

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

Despite significant progress in product development, procurement, and distribution in the past few decades, emergency contraception’s (EC) capacity to benefit many women in countries such as Nigeria is hampered by a number of potential barriers, that are not well understood. The Population Council, with support from the International Consortium for Emergency Contraception, documented EC-related knowledge, attitudes, and practices among providers in Nigeria as well as perceptions of key opinion leaders who help shape the policy environment for EC and family planning in general. Findings suggest significant gaps in Nigeria, potentially necessitating continuous training and re-training to help dispel misperceptions and …


Key Opinion Leaders' Views Regarding Emergency Contraception In India, M.E. Khan, Isha Bhatnagar, Deepthi S. Varma, Anvita Dixit Jan 2012

Key Opinion Leaders' Views Regarding Emergency Contraception In India, M.E. Khan, Isha Bhatnagar, Deepthi S. Varma, Anvita Dixit

Reproductive Health

This policy brief explores the views of key opinion leaders (KOLs) in the field of reproductive health and family welfare on provision of emergency contraception (ECPs). The study’s objective was to gain a better understanding of how the attitudes and beliefs of KOLs might influence policy and program implementation, either encouraging or opposing ECP promotion and service delivery. Results suggest strong support by the majority of KOLs to continue the sale of ECP as an over-the-counter drug. KOLs also emphasized the importance of comprehending and addressing the main barriers to ECP provision and use: poor knowledge, lack of training, moral …


Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria: Key Findings, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni Jan 2012

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria: Key Findings, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

This brief reports on a study in Nigeria to document provider attitudes, beliefs, and practices regarding emergency contraception (ECP), and to identify key opinion leaders’ opinions and insights pertaining to policy and programmatic issues in that country. Findings reveal that ECP is well known in urban Nigeria. Its provision is controlled mainly by the largely unregulated and unmonitored private sector. Government plays a distant role, thereby leaving family planning and ECP supply almost entirely in the hands of donor agencies. For wider availability and affordability of ECP products in both the private and public sectors, official policy action is required, …


Attitudes, Beliefs, And Practices Of Providers And Key Opinion Leaders On Emergency Contraception In India, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady Jan 2012

Attitudes, Beliefs, And Practices Of Providers And Key Opinion Leaders On Emergency Contraception In India, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECP) among providers in public and private facilities and pharmacies in India. The objectives of the study were to: assess providers' knowledge of ECP's biological mechanism; understand providers' knowledge and attitudes about ECP's safety, effectiveness, and availability as an OTC drug; and identify providers' definitions of “repeated use” and profiling women who are “repeated users” of ECP. This study's findings show that most providers, including doctors and some KOLs, were incorrectly informed about ECP's mechanism of action. Service guidelines are necessary for accurate and …


Emergency Contraception: Idea To Program, Saumya Ramarao, John Townsend, Sarah Raifman Jan 2010

Emergency Contraception: Idea To Program, Saumya Ramarao, John Townsend, Sarah Raifman

Reproductive Health

This report summarizes the role of the Population Council in generating evidence, providing technical leadership, and demonstrating at scale that emergency contraception (EC) can be easily integrated into national family planning programs and other reproductive health services. Since the 1990s, the Population Council, along with other partners, has contributed to the changes seen in the provision and availability of EC, now available in over 140 countries around the world. While much progress has been made in the campaign for access to EC, the Council is committed to improving existing methods of service delivery and to leading advocacy efforts and research …


Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina Jan 2010

Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina

Reproductive Health

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the …


Improving Access To Long-Term Contraceptives In Rural Guatemala Through The Ministry Of Health, Edwin Montufar, Carlos Morales, Ricardo Vernon, Carlos Brambila, Jorge Solorzano Jan 2005

Improving Access To Long-Term Contraceptives In Rural Guatemala Through The Ministry Of Health, Edwin Montufar, Carlos Morales, Ricardo Vernon, Carlos Brambila, Jorge Solorzano

Reproductive Health

The purpose of this study was to test a model to train nurse auxiliaries at health centers and posts in Guatemala and to determine whether these providers could deliver adequate, cost-effective services. The training model consisted of: a) selection of nurse auxiliaries; b) two-day group training; c) on-the-job training, including work with actual clients at the trainees’ work centers; and d) certification of trainees who had conducted at least five quality insertions under supervision. This study has shown that nonprofessional health providers can effectively provide quality IUD services in Guatemala. The main recommendation derived from the project is to scale …


Effects Of Igss' Job Aids-Assisted Balanced Counseling Algorithms On Quality Of Care And Client Outcomes, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Gustavo Gutierrez, Veronica Davila, Carlo Boniato, Alex Rios Jan 2004

Effects Of Igss' Job Aids-Assisted Balanced Counseling Algorithms On Quality Of Care And Client Outcomes, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Gustavo Gutierrez, Veronica Davila, Carlo Boniato, Alex Rios

Reproductive Health

This study identified a need to improve the quality of care at the main maternity hospital of the Social Security Institute (IGSS) in Guatemala. Problems included very short counseling sessions, counseling not focused on clients’ needs, redundancy in the role of physicians and social workers as providers, skewed method mix, and low client return rate for method resupply. The intervention, using Balanced Counseling Algorithms, changed the counseling behavior of physicians and social workers and enhanced the quality of family planning care. The report includes recommendations for continuing these improvements: monitoring provider implementation of the job aids–assisted Balanced Counseling Algorithms, monitoring …


Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena Jan 2003

Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena

Reproductive Health

The purpose of this study was to identify the reasons for the low use of the IUD in Guatemala and to explore the reasons why other reversible methods are selected more frequently than IUDs. The study aimed to determine the availability and acceptability of IUDs as a contraceptive option within the Ministry of Health, the Guatemalan Social Security Institute, and APROFAM. Results indicated that service providers do not take into consideration women’s reproductive needs or intentions when they provide family planning counseling. There are several demand-side factors that affect the use of the IUD, including lack of knowledge about the …


One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo Jan 2003

One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo

Reproductive Health

This report presents a one-year assessment of quality-of-care improvements in Peru, following provider training on the job aids–assisted Balanced Counseling Strategy. Results showed significant enhancement of quality of care, an increase in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) …


Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health Jan 2002

Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health

Reproductive Health

In 1999, Frontiers in Reproductive Health collaborated on studies on the impact of interventions to improve quality of care in the Philippines and Senegal. The two interventions were part of a multicountry Population Council study (also undertaken in Pakistan and Zambia) to test whether improving quality affects women’s contraceptive continuation. The Philippines study focused on training in family planning (FP), supportive supervision, and refresher courses to improve client-provider interaction. The Senegal study compared the impact of improved quality of care at five newly established “reference centers” with five clinics that served as controls. Data were gathered through analyses of quality …


Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health Jan 2001

Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

En 1999, la Secretaría de Salud de Honduras (SSH) modificó las Normas de Atención Integral a la Mujer a fin de autorizar a las auxiliares de enfermería a prestar los servicios de inserción de DIU, aplicación del inyectable DMPA y toma de Papanicolaou. Este cambio en las normas aborda el problema de la baja prevalencia en el uso de anticonceptivos en áreas rurales. El cambio también refleja los hallazgos de un estudio anterior, realizado por el Population Council, que mostró que las auxiliares de enfermería pueden proporcionar estos servicios de manera segura y con buena calidad. Anteriormente, las mujeres en …


Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar Jan 2001

Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar

Reproductive Health

The Honduran Ministry of Health (MOH) and the Population Council’s INOPAL III Project tested the acceptability of postpartum/postabortion contraception at the Escuela Hospital, the largest in the country. The project showed that more than 30 percent of the women seen for a delivery or a complication due to abortion, were interested in adopting a contraceptive method prior to discharge from the hospital. Given the success of the project, the MOH asked the Population Council’s FRONTIERS program for technical and financial support to extend those services to five additional hospitals in the country. Important improvements were found for the four indicators …


Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health Jan 2001

Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

In 1999, the Honduran Ministry of Health (MOH) revised national guidelines on women’s health services delivery to allow nurse auxiliaries to insert IUDs, give DMPA injections, and take Pap smears. This policy change addresses low contraceptive use among rural women and reflects findings from a 1998 Population Council study that showed that nurse auxiliaries can safely and successfully provide these services. Under the previous guidelines, rural women had limited access to long-term family planning methods. In 2000, the Population Council and the MOH assessed the effectiveness and cost of using a simple leaflet, distributed by nurse auxiliaries, to market the …


Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health Jan 2000

Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, 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 …


Burkina Faso: Mejorar La Atención Postaborto Beneficia A Pacientes Y Proveedores, Frontiers In Reproductive Health Jan 2000

Burkina Faso: Mejorar La Atención Postaborto Beneficia A Pacientes Y Proveedores, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


Senegal: Capacite A Más Proveedores En Atención Postaborto, Frontiers In Reproductive Health Jan 2000

Senegal: Capacite A Más Proveedores En Atención Postaborto, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon Jan 1999

Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon

Reproductive Health

The goal of this project was to inform physicians, pharmacists, and female factory workers about emergency contraception (EC) through mailings of booklets and posters. These materials were developed in a previous operations research project conducted by the Instituto Mexicano de Investigación de Familia y Población and supported by the Population Council INOPAL III project with funding from USAID. The study found that recipients generally liked the print materials and welcomed information about EC. Within three weeks of receiving the materials, many reported that they had taken immediate action to make EC available and/or to educate others about EC. This project …


Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu Jan 1999

Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu

Reproductive Health

Quality of services is playing an increasingly important role in many family planning (FP) programs. In 1995, a national Situation Analysis Study of 254 health facilities was conducted in Kenya to assess the status and quality of FP services in the country. An in-depth survey of a subsample of 28 health facilities was conducted the following year. From these facilities, 1,834 women were interviewed about their experiences with services at facilities when they sought antenatal, child health, and FP services. The goal of the survey was to examine the links between quality of care in FP services and contraceptive behavior. …


Rapid Appraisal Of Ipp-Vi Training Of Anms In Uttar Pradesh, M.E. Khan, Saumya Ramarao, R.B. Gupta, Sulbha Swaroop, Leila Caleb-Varkey, Anoop K. Saxena, Anil Mishra Jan 1996

Rapid Appraisal Of Ipp-Vi Training Of Anms In Uttar Pradesh, M.E. Khan, Saumya Ramarao, R.B. Gupta, Sulbha Swaroop, Leila Caleb-Varkey, Anoop K. Saxena, Anil Mishra

Reproductive Health

This report provides findings of a rapid appraisal of the Auxiliary Nurse Midwife (ANM) training program in Uttar Pradesh, India. The appraisal was undertaken by the Population Council and State Innovations in Family Planning Agency (SIFPSA). As SIFPSA is in the process of planning a training program to strengthen the technical skills and competence of ANMs and update their contraceptive knowledge, it was felt that a rapid appraisal of the training program would help in understanding the strengths and weaknesses of previous training efforts. The ANM training initiatives of SIFPSA would then build upon the experiences gained from earlier training …