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Full-Text Articles in Demography, Population, and Ecology
Introduction Of Quality Of Care And A Gender Perspective In Reproductive Health Service Organizations In Latin America And The Caribbean, Patricia Riveros, Antonieta Martin, Ricardo Vernon
Introduction Of Quality Of Care And A Gender Perspective In Reproductive Health Service Organizations In Latin America And The Caribbean, Patricia Riveros, Antonieta Martin, Ricardo Vernon
Reproductive Health
In 2005 and with the technical assistance of the Frontiers in Reproductive Health (FRONTIERS) Program, the Integrated Health Coordination Program (PROCOSI), a Bolivian network of 33 nongovernmental organizations, designed and tested a set of four guidelines to help organizations deliver high-quality reproductive health services with a gender perspective. The guidelines were: 1) to present a strategy to certify organizations as “gender sensitive” healthcare providers; 2) to present the knowledge staff members should know to be certified; 3) to describe procedures to collect and analyze the data to evaluate implementation of the strategy; and 4) to describe how to assess strategy …
Evaluation Of The Long-Term Impact Of The Tostan Programme On The Abandonment Of Fgm/C And Early Marriage: Results From A Qualitative Study In Senegal, Nafissatou J. Diop, Amadou Moreau, Helene Benga
Evaluation Of The Long-Term Impact Of The Tostan Programme On The Abandonment Of Fgm/C And Early Marriage: Results From A Qualitative Study In Senegal, Nafissatou J. Diop, Amadou Moreau, Helene Benga
Reproductive Health
In 1998–99, a village empowerment program was implemented in the Thiès/Fatick and Kolda regions of Senegal by the nongovernmental organization Tostan, to mobilize communities to hold public declarations in support of abandoning harmful traditional practices, including female genital mutilation/cutting (FGM/C) and child marriage. The information presented in this report indicates that many did end the practices following a public declaration, however, the lack of follow-up in the field and the absence of support mechanisms pose a large obstacle. Nevertheless, the program achieved significant results: knowledge of life skills resulting in positive changes and a shift in the perception of FGM/C …
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
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
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 …
Empowering Communities To Make Pregnancy Safer: An Intervention In Rural Andhra Pradesh, Dipa Sinha
Empowering Communities To Make Pregnancy Safer: An Intervention In Rural Andhra Pradesh, Dipa Sinha
Reproductive Health
Recognizing that multiple factors are responsible for adverse pregnancy-related outcomes, a community-based intervention was implemented in Mominpet, in Andhra Pradesh, India in collaboration with the M.V. Foundation, a nongovernmental organization. The intervention focused on improving maternal health outcomes by raising awareness and building family and community support for pregnant women; involving pregnant women’s families, notably their husbands, in pregnancy-related care; and supporting pregnant women to access health services. This report describes the experience and outcomes of the intervention. In particular, it explores the extent to which the intervention was effective in increasing community support for safe motherhood on the one …
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Reproductive Health
In 1998, the nongovernmental organization Tostan implemented a village empowerment program in southern and western Senegal to help communities, especially women, improve living and health conditions in their villages, and to mobilize villages to hold public declarations supporting abandonment of harmful practices, particularly female genital mutilation/cutting (FGM/C) and child marriage. The program included modules on hygiene, literacy and numeracy, human rights, and children’s and women’s health. The Tostan approach has since been implemented more broadly in Senegal and in Burkina Faso, Guinea, and Sudan. In 2005–06, FRONTIERS evaluated the long-term impact of the program, focusing on the abandonment of FGM/C …
Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council
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 …
Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council
Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council
Reproductive Health
The World Health Organization recommends that women receive information on family planning (FP) during antenatal care (ANC), immediately after birth, and during postpartum and well-baby care. However, few studies have assessed the effect of information during each of these stages on women’s use of contraceptive methods. Data collected by FRONTIERS in the Dominican Republic, Haiti, and Nicaragua have been analyzed to answer this question. Use of maternal care services, exposure to FP information, and use of postpartum contraception varies among countries. All women interviewed in the Dominican Republic attended ANC services and delivered in a facility; ANC use and institutional …
Africa Regional Sexual And Gender-Based Violence Network Consultation: Technical Exchange And Planning Meeting, Population Council
Africa Regional Sexual And Gender-Based Violence Network Consultation: Technical Exchange And Planning Meeting, Population Council
Reproductive Health
In March 2008, the Population Council brought together members of the Africa Regional Sexual and Gender Based Violence (SGBV) Network for a South-South technical exchange meeting. The objectives were to identify best practices from existing programs, provide an evidence base for new programming, and develop mechanisms for South-South technical assistance. As detailed in this report, discussions covered the medical, legal, and psychosocial issues associated with SGBV prevention and response activities. Participants identified the following: Protocols and guidance documents are essential for ensuring comprehensive, quality response at all levels. Enabling access and utilization of the full range of medical services remains …
Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)
Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)
Reproductive Health
The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to the hospital. PAIMAN is compiling data from three data sources and making efforts to improve the functioning of these Health Information Systems (HISs) for efficient management of health services at the district level through generation of quality data and their …
Exploring Positive Women's Lives In Namakkal District, India, P. Kousalya, Deepika Ganju
Exploring Positive Women's Lives In Namakkal District, India, P. Kousalya, Deepika Ganju
Reproductive Health
This report describes an initiative that was undertaken to document the experiences of HIV-positive ever-married women in Namakkal district, Tamil Nadu, India. The initiative sought to explore the circumstances in which women learned about their HIV status; their feelings on finding out they were HIV-positive; the nature of husband–wife relationships prior to and following disclosure of women’s HIV status; the extent of support or discrimination that women experienced from family members, friends, and neighbors; treatment-seeking behaviors; and women’s perspectives about ways in which the multiple needs of HIV-infected women can be met. Drawing on the testimonies of these women gathered …
Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon
Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon
Reproductive Health
The first days, weeks, and months after a delivery represent a period of substantial information and service needs for both mother and child, including treatment of hemorrhage and infections, breastfeeding information and support, nutritional complements and micronutrients, immunizations for children and mothers, counseling for managing intimate partner violence and depression, and, most importantly, contraception. In areas of high HIV prevalence, contraceptives and antiretroviral therapy are especially critical elements of postpartum care. Yet despite its strategic importance, few organizations have made it a priority to address women's reproductive health and fertility needs during the year following delivery. The situation is compounded …
Assessing The Need And Opportunities For Improved Linkages Between Conditional Cash Transfers And Reproductive Health Programs In Latin America And The Caribbean, Ricardo Vernon, M. Estela Rivero-Fuentes
Assessing The Need And Opportunities For Improved Linkages Between Conditional Cash Transfers And Reproductive Health Programs In Latin America And The Caribbean, Ricardo Vernon, M. Estela Rivero-Fuentes
Reproductive Health
The objective of this project was to document the structure and functioning of conditional cash transfer (CCT) programs in Latin America and the Caribbean, to assess opportunities for improved linkages between CCTs and reproductive health programs, and to explore the role that operations research may have in the improvement of CCT programs. Activities were conducted in the Dominican Republic, El Salvador, Honduras, Jamaica, Nicaragua, and Peru. Operational problems identified by CCT programs included the targeting and selection of beneficiaries, monitoring compliance with conditions for receiving cash transfers, the systems used to provide the transfers, and management weaknesses. Recommendations are made …
Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia
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 …
Profile Of Abortion Seekers In Ghana And Their Decision-Making Processes, Philomena Nyarko, Cletus Adohinzin, Saumya Ramarao, Placide Tapsoba, Ayorinde Ajayi
Profile Of Abortion Seekers In Ghana And Their Decision-Making Processes, Philomena Nyarko, Cletus Adohinzin, Saumya Ramarao, Placide Tapsoba, Ayorinde Ajayi
Reproductive Health
In 2006, a consortium of agencies, including the Population Council, came together to provide technical and financial support to the Government of Ghana in the rollout of comprehensive abortion care (CAC) services. The consortium collaborated with the government in expanding women’s access to modern family planning and CAC. The consortium’s program, Reducing Maternal Mortality and Morbidity (R3M), aims to reduce unwanted pregnancy and severe complications and deaths caused by unsafe abortion. The formative research in this report was undertaken to provide a profile of beneficiaries, their needs for information and services, their decision-making process in seeking care, and the quality …
Romance And Sex Before Marriage Among Young Women And Men In Maharashtra, International Institute For Population Sciences (Iips)
Romance And Sex Before Marriage Among Young Women And Men In Maharashtra, International Institute For Population Sciences (Iips)
Poverty, Gender, and Youth
Premarital partnerships among youth are widely discouraged in India. Indeed, there is a widespread perception that youth do not find opportunities to mix and form romantic relationships, and that premarital sex is negligible. These kinds of perceptions are often cited to argue against the provision of sexuality or family life education and sexual and reproductive health services to unmarried young people. While several small studies have noted that sizable proportions of young people, particularly young men, are sexually active before marriage, the lack of rigorous evidence on the levels and patterns of intimate partnerships among youth continues to hamper the …
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Reproductive Health
In 2006, FRONTIERS collaborated with the National Committee Against the Practice of FGM/C on an analysis of recent trends in female genital mutilation/circumcision (FGM/C) in rural and urban Burkina Faso. The study, conducted to help develop policies and programs for FGM/C abandonment in Burkina Faso and more widely in Africa, had three components: a description of the institutional, political, and programmatic environment in Burkina; a secondary analysis of data from existing studies; and an assessment of the community’s perceptions and behavior regarding FGM/C, as well as the factors that contribute to abandonment or continuation of the practice. For the policy …
Increasing Women's Use Of The Iud For Family Planning, Ricardo Vernon
Increasing Women's Use Of The Iud For Family Planning, Ricardo Vernon
Reproductive Health
The intrauterine device (IUD) is highly effective, easy to use, and has few side effects. The device costs the provider about US$2 and offers a duration of protection that makes it the most cost-effective of the temporary methods if used for two years or more. The IUD's many advantages also make it a good alternative for reducing unmet need for long-term contraception around the world. Between 5 and 17 percent of all married women of reproductive age in 53 less developed countries do not want to have more children but are not using a contraceptive method. Because the IUD can …
Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi
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 …
Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)
Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)
Reproductive Health
The World Health Organization estimates that 585,000 women die from pregnancy-related conditions each year. Pregnancy-related conditions, including dysfunctional labor, hemorrhage, infection, toxemia, and unsafe abortion, are the leading cause of death among women of reproductive age in many developing countries. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan, through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to …
South Africa: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council
South Africa: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council
Reproductive Health
The South African government wishes to expand availability and use of counseling and testing (C&T) for HIV. One option is to integrate C&T into well-attended services, such as family planning (FP). In 2004, the Population Council began a three-year study with the Department of Health in North West Province. The study tested the feasibility, acceptability, and cost of two models for integrating HIV prevention services within established FP programs, and evaluated their quality against standard practice. In the testing-model clinics, providers provided C&T services at the same consultation; in the referral-model clinics, providers offered HIV counseling and referred clients to …
Manual For Building Capacity Of Trainers And Program Managers In Emergency Contraception, Sharif M.I. Hossain, M.E. Khan, Mary Philip Sebastian, Sohini Roychowdhury
Manual For Building Capacity Of Trainers And Program Managers In Emergency Contraception, Sharif M.I. Hossain, M.E. Khan, Mary Philip Sebastian, Sohini Roychowdhury
Reproductive Health
This manual equips trainers with appropriate knowledge on emergency contraceptive pills (ECPs). Emergency contraception (EC) refers to any method of contraception that can be used by a woman to prevent an unwanted pregnancy within three days of unprotected intercourse or a contraceptive accident such as condom leakage. This manual discusses ECPs and the provision of related services. After a day’s training, trainers have the knowledge and skills necessary to train service providers and workers on ECPs. The manual is divided into four sessions. The first provides an overview of the demographic and reproductive health (RH) situation in South and South …
The Female Condom In Ghana: Exploring The Current State Of Affairs And Gauging Potential For Enhanced Promotion, Reshma Naik, Martha Brady
The Female Condom In Ghana: Exploring The Current State Of Affairs And Gauging Potential For Enhanced Promotion, Reshma Naik, Martha Brady
Poverty, Gender, and Youth
The female condom (FC) is the only safe and effective female-initiated method that provides simultaneous protection against unintended pregnancy as well as sexually transmitted infections, including HIV. An exploratory exercise was conducted by the Population Council to gain an understanding of the current and historical landscape of FC procurement, distribution, and programming in Ghana and to explore the viability of enhancing national FC promotion. The exercise revealed that a large-scale launch of the FC occurred in Ghana in 2000 and was largely successful in raising product awareness; however, uptake remained low. Momentum has waned since the initial launch and financial …
Sexuality Education For Youth In Maharashtra: Yes Or No?, International Institute For Population Sciences (Iips)
Sexuality Education For Youth In Maharashtra: Yes Or No?, International Institute For Population Sciences (Iips)
Poverty, Gender, and Youth
Serious reservations have been expressed in Maharashtra about the sexuality component of programs intended to build awareness of safe and healthy behaviors for school-going youth. This policy brief answers: Is there a need for sexuality education in school and out-of-school in Maharashtra? Are the concerns expressed supported by evidence? Evidence was obtained from the Youth in India: Situation and Needs study conducted in Maharashtra, which explored young people’s awareness of sexual and reproductive matters, sexual experiences of youth, parent–child communication on sexual and reproductive matters, and experience and acceptability of sexuality education programs. Parents were asked whether they had discussed …
Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council
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: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council
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 …
Financial Capacity Building For Ngo Sustainability, John H. Bratt, Rick Homan, Barbara Janowitz, James R. Foreit
Financial Capacity Building For Ngo Sustainability, John H. Bratt, Rick Homan, Barbara Janowitz, James R. Foreit
Reproductive Health
While demand for family planning and reproductive health services is increasing worldwide, a number of recent trends threaten the financial sustainability of donor-supported NGOs that provide these services. First, the U.S. Agency for International Development has seen its funding for population assistance decline since 1995. A second reason is the growth of government-funded programs that provide these services for low-income clients, which reduced the need for NGOs to focus programs entirely on the poor. Health-sector reform has created opportunities for NGOs via public–private partnerships in some countries, but sustained public-sector support is unlikely given limited economic growth in domestic economies …
Delinking Female Genital Mutilation/Cutting From Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi
Delinking Female Genital Mutilation/Cutting From Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi
Reproductive Health
Female genital mutilation or cutting (FGM/C) is practiced in at least 28 countries in sub-Saharan Africa, a few countries in the Middle East and Asia, and among immigrant populations from these countries in Europe, North America, and Australia. Worldwide, an estimated 100 to 140 million girls and women have undergone the practice, and at least three million girls are at risk each year. The Somali ethnic community in Kenya as well in Somalia, Djibouti, and Ethiopia, has practiced female genital cutting for centuries and the practice appears to have remained largely unchanged. The Population Council’s FRONTIERS program carried out two …
Regional Workshop To Use The Findings From Operations Research To Increase The Access, Quality And Integration Of Contraceptive Services In Latin America And The Caribbean, M. Estela Rivero-Fuentes, Antonieta Martin
Regional Workshop To Use The Findings From Operations Research To Increase The Access, Quality And Integration Of Contraceptive Services In Latin America And The Caribbean, M. Estela Rivero-Fuentes, Antonieta Martin
Reproductive Health
In October 2007, the Frontiers in Reproductive Health (FRONTIERS) program held a three-day regional workshop in La Antigua, Guatemala, to disseminate results of its operations research projects. During the workshop, participants received contraceptive technology updates, and learned about effective strategies tested by FRONTIERS to increase access to the IUD and vasectomy; and about integration of family planning with postpartum, postabortion, and PMTCT. Researchers discussed study results, program managers explained how they were used, and practitioners talked about implementing the interventions—a combination of perspectives that successfully transmitted the message that the interventions were not difficult to apply, could have a great …
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Reproductive Health
A program to operationalize and institutionalize a gender perspective in reproductive health services in Bolivia resulted in a significant reduction in unmet need for contraception, increased client satisfaction, and improved communication between partners. Bolivia’s Integral Health Coordination Program (PROCOSI) encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their RH programs. In 2005, FRONTIERS collaborated with PROCOSI to test the feasibility and costs of a system for certifying that its member organizations provided gender-sensitive RH services. The two-year project followed a 2000 intervention to incorporate gender perspectives in PROCOSI clinics that led …