Demography, Population, and Ecology Commons^™

L’Offre Des Anneux Vaginaux Contraceptifs— La Planification Familiale Postpartum: Experience Du Sénégal, Fatou Mbow, Babacar Mane, Saumya Ramarao

Reproductive Health

Le Gouvernement du Sénégal, à travers l’adoption du Plan National d’Action pour la Planification Familiale, s’est résolument engagé dans une politique de repositionnement de la planification familiale (PF) qui s’est fixé comme objectif d’augmenter le taux de prévalence contraceptive. L’introduction de l’anneau vaginal à progestérone (AVP) dans la gamme des méthodes contraceptives devra apporter une perspective intéressante pour la promotion de la planification familiale post-partum (PFPP). Pour faciliter cette introduction, il demeure important de bien comprendre le contexte dans lequel évolue le programme national de PF en général et celui de la PFPP en particulier. Grâce à un financement de …

Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council

Reproductive Health

Fear of disrespect and abuse along with misconceptions about procedures required to assist women during childbirth often negatively influence the decision to seek care at a health facility. Maternity Open Days provide an opportunity for pregnant women and their families to interact with health care providers and visit maternity units to demystify birthing practices and mitigate fears regarding childbirth in a facility. Such an approach brings together women, their families, and providers to enable pregnant women to understand what happens in a maternity unit. This brief is part of a Respectful Maternity Care Resource Package developed by the Kenya Heshima …

Landscape Analysis On Pre-Eclampsia And Eclampsia In Bangladesh, Charlotte E. Warren, Sharif M.I. Hossain, Rahat Ara Nur, Kanij Sultana, Karen Kirk, Amy Dempsey

Reproductive Health

Globally more than 800 women die every day from preventable complications related to pregnancy and childbirth, and 99 percent of these deaths occur in developing countries. Every day approximately 7,200 babies are stillborn. Pre-eclampsia and eclampsia (PE/E) contribute significantly to these mortalities. Eclampsia is the second most common direct cause of maternal death in Bangladesh followed by post-partum hemorrhage. Through the Ending Eclampsia project, the Population Council is seeking to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of PE/E. In resource-poor countries, particularly Bangladesh, magnesium sulphate (MgSO4) for management of severe PE/E, …

Strengthening The Role Of Patent Medicine Vendors In The Provision Of Injectable Contraception In Nigeria, Population Council, The Evidence Project

Reproductive Health

The majority of contraceptive services in Nigeria are offered in private settings, including Patent Medicine (PM) shops. PM shops are informal businesses owned by Patent Medicine Vendors (PMVs) licensed to sell patent or proprietary drugs. Injectable contraception is the most popular modern contraceptive method in Nigeria. However PMVs are not regulated to sell or administer injectable contraceptives because the businesses do not receive formal training. Despite this, some PMVs are selling and administering injectable methods in response to high demand. The Evidence Project, in collaboration with the Federal Ministry of Health, conducted implementation research to: demonstrate the feasibility of PMVs …

Peer Mentoring: An Effective Strategy For Integrating Hiv And Srh Services, Integra Initiative

Reproductive Health

Mentoring is an innovative approach to improving provider skills without compromising service delivery by harnessing the potential of existing providers. In Kenya, a peer-mentorship approach was designed and tested to improve service providers’ skills, knowledge, and capacity to provide high-quality integrated HIV and SRH services. A central component was to understand providers’ opinions on mentoring, so as to build a practical and sustainable mentorship model. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London …

Distribution D'Anneaux Vaginaux Contraceptifs, Population Council

Reproductive Health

Dans le cadre de son projet “Distribution d’anneaux vaginaux contraceptifs”, le Population Council a conclu un accord de coopération avec l’USAID pour introduire deux nouvelles méthodes contraceptives modernes sur les marchés en développement: l’anneau vaginal contraceptif à progestérone, un anneau contraceptif d’une durée d’action de trois mois spécifiquement conçu pour espacer les grossesses durant l’allaitement; et un anneau vaginal contraceptif expérimental d’une durée d’utilisation d’un an—l’anneau vaginal contraceptif Nestorone®/ethinyl estradiol—qui peut être utilisé par les femmes sexuellement actives en âge de reproduction (15 à 49 ans) pour retarder ou espacer les grossesses. Le Population Council vise à élargir le choix …

An Innovative Financing Model For The Progesterone Contraceptive Vaginal Ring Through Voucher Programs, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

This technical report introduces the theoretical framework for the demand generation and supply chain mechanisms for an effective reproductive health voucher system. The key roles and functions of an effective voucher system are described. A methodology for implementation of a voucher system for the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR), also referred to as the PCVR Voucher Based Care (VBC) program, has been designed to introduce the PCVR in the context of choice, equity in price, and range of outlets, ensuring quality of care and consistent availability of services. The model provides a framework and guidelines on how the …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Facilitator’S Guide, Population Council

Reproductive Health

This training guide was produced by the Population Council as part of the Respectful Maternity Care (RMC) Resource Package developed by the Kenya Heshima Project. The Heshima Project, as part of the USAID Translating Research into Action (TRAction) project, was tasked with determining the manifestations, types, and prevalence of disrespect and abuse (D&A) in childbirth; identifying and exploring the potential drivers of D&A; and designing, implementing, monitoring, and evaluating the impact of interventions for reducing D&A including generating lessons for scale-up. The Resource Package is based on the most effective interventions, and provides practical, low-cost, and easily adaptable strategies for …

Health Facility Guidelines And Management Benchmarks: Improving Workplace Health Services And Health Management In Factories, Farms And Other Workplaces In Low- And Middle-Income Countries, David Wofford, Marat Yu, Lauren Shields, Maria Pontes

Reproductive Health

This document contains a set of voluntary health and management guidelines for corporations and their supply chains to promote continual improvement and application of good practices, better access to men’s and women’s health services, and more effective use of health resources at workplaces in the developing world. It is focused on both quality of health services provided at the workplace and adequacy of company policies and management systems to ensure that workers have access to health services. The main goals of the guidelines are to: 1) help enterprises—multinational companies and their supplier or subsidiary companies in developing countries—improve the management …

Reducing Maternal And Child Mortality In Balochistan: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This brief explains why FP must be prioritized in Balochistan, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 41 percent of maternal deaths, 35 percent of infant deaths, and 74 percent of young child deaths. FP’s wider health benefits include reduced …

Standard Days Method Of Contraception: Evidence On Use, Implementation, And Scale Up, Kelsey Wright, Hiba Iqteit, Karen Hardee

Reproductive Health

In 2002, an article in Contraception reported on a trial for a new method of contraception, the Standard Days Method (SDM). SDM is a fertility awareness-based family planning (FP) method that identifies the eighth through nineteenth days of a woman’s menstrual cycle as the fertile window. SDM users abstain or use barrier methods during their fertile periods to prevent pregnancy. The trial established a first-year method failure rate of 5 per 100 woman years with correct use, and 12 per 100 women for typical use. Over the decade since the publication of the original efficacy trial, the Georgetown University Institute …

Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council

Reproductive Health

Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.

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This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …

Family Planning Through The Lens Of Men: Readiness, Preferences, And Challenges, Iram Kamran, Zeba Tasneem, Tahira Parveen, Rehan M. Niazi

Reproductive Health

Family planning (FP) is urgently needed in Pakistan but progress remains slow. In its 2002 Population Policy, the country pledged to reduce its total fertility rate to 2.2 by 2020; at the London Summit in 2012, it committed to increase the contraceptive prevalence rate (CPR) to 55 percent by the same year. Despite important achievements, Pakistan’s current CPR is only 35 percent, the total fertility rate is 3.8, and 20 percent of married couples of reproductive age express unmet need for FP. FP programming has largely been directed at women, and husbands have been regarded, at best, as interested bystanders. …

The Raise Health Initiative For Workers, Companies, And Communities, The Evidence Project

Reproductive Health

RAISE Health is an initiative to improve the health of factory and farm workers (women and men) in developing countries through changes in global and corporate policies and workplace practices. Effective management of workplace health is good for companies and workers alike, resulting in better health and morale, better labor-management relations, empowerment of women, and better use of company health investments. Worker health is typically one of the most neglected areas in business operations. As this activity brief notes, RAISE Health is a major activity of the USAID-funded Evidence Project. The goal of the initiative is to utilize the existing …

The Availability And Quality Of Family Planning Services Across Eight Districts In Pakistan: The Potential And The Constraints, Gul Rashida, Iram Kamran, Khan Muhammad, Rehan M. Niazi, Tahira Parveen

Reproductive Health

This report forms part of a multipronged investigation to determine why, despite evident unmet need for family planning, contraceptive prevalence especially for modern methods remains so low in Pakistan. The research, conducted by the Population Council with the support of the Research and Advocacy Fund, consists of four component studies: 1) review of relevant academic, program, and policy literature; 2) a qualitative study of perspectives of men, women, and service providers in the country on family planning; 3) a situation analysis of contraceptive quality, supply, and access factors at health facilities; and 4) an examination of supply issues affecting the …

Delivering Contraceptive Vaginal Rings—Task Shifting And Task Sharing In The Delivery Of Family Planning Services: Experiences From Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

This report describes the task-shifting and task-sharing policies and experiences relevant to the provision of family planning (FP) services in Kenya and the potential place for contraceptive vaginal rings. The feasibility, effectiveness, and acceptability of mid- and lower-level providers in the provision of FP services is documented. The report highlights how the provision of integrated RH/FP/HIV services could be delivered by various levels in the national health care system through task-sharing. Opportunities for facilitating delivery of the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR) within the national health care system in Kenya are also described. Kenya has in place policies …

Expanding Access To Rights-Based Family Planning: Activity Brief, The Evidence Project

Reproductive Health

The human rights dimensions of family planning programs have been recognized for nearly half a century and affirmed in numerous declarations, conventions, and treaties endorsed by governments and the international community. While discourse about respecting, protecting, and fulfilling these rights is growing, a gap persists between human rights rhetoric and integrating rights in family planning policy, programs, and practice. Governments and programs struggle with defining and operationalizing a rights-based approach to family planning. Overall, there is scant evidence on: how to implement rights-based family planning (RBFP) programming, how to measure rights-based programming and outcomes, and the effect on family planning/reproductive …

Reducing Maternal And Child Mortality In Punjab: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Punjab’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 45 percent of maternal deaths, 26 percent of infant deaths, and 76 percent of young child deaths. FP’s wider health …

Prospects For Economic Growth In Balochistan Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq

Reproductive Health

Balochistan is currently undergoing a demographic transition from a situation of high fertility and high mortality to one of lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, Balochistan’s per capita income will be 165 percent higher than today’s levels if there is no decline in fertility, but 388 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in Balochistan will determine whether per capita income in the province grows by 295 percent or by 388 percent by 2050. …

Reducing Maternal And Child Mortality In Sindh: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Sindh, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. Evidence shows that FP is one of the most powerful tools at the government’s disposal for a rapid reduction in maternal, infant, and child mortality. FP’s wider health benefits include reduced anemia among women; lower …

Prospects For Economic Growth In Punjab Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq

Reproductive Health

Punjab is currently undergoing a demographic transition from a situation of high fertility and high mortality to one of lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, Punjab’s per capita income will be 210 percent higher than today’s levels if there is no decline in fertility, but 431 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in Punjab will determine whether per capita income in the province grows by 333 percent or by 431 percent by 2050. …

Anneau Vaginal À Progestérone: Évite Les Grossesses, Population Council

Reproductive Health

Cette fiche de renseignements fournit des informations sur l’utilisation de l’anneau contraceptif vaginal à la progestérone pour prévenir la grossesse. L'anneau vaginal à progestérone (AVP) offre une nouvelle manière de fournir un moyen de contraception. Il a été prouvé qu'il s'agit d'une méthode contraceptive sûre et efficace pour les femmes qui allaitent. Utilisé par ces femmes, l'AVP évite les grossesses en inhibant la croissance folliculaire et, par conséquent, empêchant l'ovulation; renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation; étendant l'aménorrhée post-partum; et épaississant la glaire cervicale, et donc en empêchant les spermatozoïdes d'atteindre l'ovule. L'AVP donc étend la gamme …

Union Health And Family Welfare Centers In Chittagong And Munshiganj: Are They Ready To Provide 24-Hour Normal Delivery Services? (Brief), Population Council

Reproductive Health

To date, the Directorate General of Family Planning (DGFP) of Bangladesh’s Ministry of Health and Family Welfare has established approximately 3,900 Union Health and Family Welfare Centers (UHFWCs) in rural areas providing: family planning; menstrual regulation; vaccinations; and general, reproductive, and maternal health services six days a week. About 1,500 UHFWCs have been upgraded with the necessary staff and equipment to provide normal delivery services round-the-clock in rural areas. In rural areas, public-sector health facilities, including UHFWCs, contribute to only 12 percent of institutional deliveries. Until now, Family Welfare Visitors (FWVs) posted at UHFWCs performed only 0.3 percent of deliveries. …

Introduction Of Dmpa In Public Health Facilities Of Uttar Pradesh And Rajasthan: An Evaluation, M.E. Khan, Anvita Dixit, Jaleel Ahmad, G. Pillai

Reproductive Health

India is committed to achieving the goals of FP2020, which, besides substantially increasing new contraceptive users, also demands adopting a rights-based approach and ensuring easy access, choice, and good quality services. The contraceptive method mix in India has been dominated by female sterilization for a long time. No new contraceptive method has been added to the national family welfare program for decades. Use of injectable contraceptives was approved in 1994 in the private sector, but is still not part of the national program. Recently some initiatives have been taken to make Depo Medroxyprogesterone Acetate (DMPA) available through the public sector …

Investigating The Low Patterns Of Modern Contraceptive Use In Pakistan, Iram Kamran, Zeba Tasneem, Tahira Parveen, Yasmin Zehra Zaidi

Reproductive Health

This report documents the study “Investigating the Low Patterns of Modern Contraceptive Use in Pakistan” conducted by the Population Council Pakistan in 2014 as part of an extensive research project to determine why use of modern contraceptives in the country remains so low despite large unmet need. The family planning (FP) scenario in Pakistan has changed significantly in recent years, and it is now recognized that the reasons most often cited for unmet need require reappraisal, with qualitative research required for a deeper understanding of the attributes, experiences, reservations, and preferences that women, men, and service providers associate with specific …

Reducing Maternal And Child Mortality In Khyber Pakhtunkhwa: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family Planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why family planning must be prioritized in Khyber Pakhtunkhwa, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 37 percent of maternal deaths and 57 percent of infant deaths. FP’s wider health benefits include reduced …

Prospects For Economic Growth In Khyber Pakhtunkhwa Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq

Reproductive Health

Khyber Pakhtunkhwa (KP) is currently undergoing a demographic transition from a situation of high fertility and high mortality to one of lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, KP’s per capita income will be 167 percent higher than today’s levels if there is no decline in fertility, but 412 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in KP will determine whether per capita income in the province grows by 316 percent or by 412 percent …

Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, The Evidence Project

Reproductive Health

In 2008, the Government of India launched the National Health Insurance program, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in urban and rural areas to access a range of private health services. Enrolled families can access packages of services from RSBY-participating private hospitals, including family planning (FP) and other reproductive health (RH) services. Despite the availability of insurance coverage, poor families’ utilization of RSBY for FP/RH services is believed to be negligible. The Evidence Project is conducting a study in three cities in Uttar Pradesh to better understand the factors affecting utilization of RSBY …

The Impact Of Population, Health, And Environment Projects: A Synthesis Of Evidence, Rachel Winnik Yavinsky, Carolyn Lamere, Kristen P. Patterson, Jason Bremner

Reproductive Health

This working paper synthesizes the existing research and results from projects that integrate family planning with environment, livelihoods, natural-resource management, and other non-health development sectors. The report synthesizes the published and gray literature on current and past integrated projects and the experiences of implementers to generate a summary of the state of knowledge on integrated family planning and environment projects. Specifically, this synthesis documents what is being measured by integrated projects, the proven benefits of integration, and gaps in the evidence base. Based on this analysis, the synthesis highlights and discusses successes and challenges for documenting the impact of integrating …

Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend

Reproductive Health

Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …