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Articles 1 - 30 of 40
Full-Text Articles in Demography, Population, and Ecology
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 …
Assessing The Feasibility, Acceptability And Cost Of Introducing Postabortion Care In Health Centres And Dispensaries In Rural Tanzania, Monica Wanjiru, Ian Askew, Nzoya Munguti, Saumya Ramarao, Rick Homan, Reheme Kahando, John M. Pile
Assessing The Feasibility, Acceptability And Cost Of Introducing Postabortion Care In Health Centres And Dispensaries In Rural Tanzania, Monica Wanjiru, Ian Askew, Nzoya Munguti, Saumya Ramarao, Rick Homan, Reheme Kahando, John M. Pile
Reproductive Health
The EngenderHealth ACQUIRE Project has been supporting the Tanzanian Ministry of Health (MOH) since early 2005 to decentralize the management of postabortion care (PAC) services to primary healthcare facilities (health centers and dispensaries), with the intention of bringing services closer to women who are unable to access them at district hospitals. Findings from this study were provided to the MOH and ACQUIRE to address issues arising from introduction of the intervention; and in September 2006, to assess the feasibility, cost, and effectiveness of the intervention. Findings show that the intervention appears to have broadened service providers’ range of clinical skills …
Addressing The Needs Of Seasonal Migrants In Nashik, Maharashtra, Anjali B. Borhade
Addressing The Needs Of Seasonal Migrants In Nashik, Maharashtra, Anjali B. Borhade
Reproductive Health
In order to identify the opportunities and options available to address the vulnerabilities of and socioeconomic needs of seasonal migrants, an intervention project was launched by the Disha Foundation, a nongovernmental organization in Nashik city, Maharashtra, India. This report intends to use the project experience as a case study to provide a blueprint for interventions for seasonal migrants to access a range of basic services in areas of destination and to exercise their rights to access available services. The report documents the array of strategies used to enable seasonal migrants to recognize their entitlement and to access available public sector …
Provider Perspectives On Informed Consent In Female Sterilisation Services: Findings From A Facility-Based Study In Chennai, Raja Lakshmi
Provider Perspectives On Informed Consent In Female Sterilisation Services: Findings From A Facility-Based Study In Chennai, Raja Lakshmi
Reproductive Health
The objective of this paper is to explore the perceptions and experiences of providers with regard to the process of informed consent in the provision of female sterilization services in Chennai, south India. It describes the quality of information provided to clients of sterilization, providers’ attitudes toward clients and the quality of decisionmaking, as well as the quality of the consent-taking process in this setting. In addition, providers’ perceptions of the importance of informed consent are discussed. Findings strongly suggest the need to train and sensitize providers in public as well as private facilities on their ethical responsibilities of ensuring …
Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi
Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi
Reproductive Health
The objective of this paper is to explore the experiences of women undergoing a particular form of fertility regulation, namely sterilization or tubal ligation, in a variety of facilities in Chennai, India. The paper examines specifically the nature of information provided to clients, the consent-taking process, the nature of its documentation, and the extent to which clients made an informed choice. The findings underscore that although all the women respondents did wish to practice a method of contraception, and did want to adopt sterilization, several limitations were noted in the process of providing informed consent: inadequate information was provided to …
Mainstreaming Emergency Contraception In Ethiopia's Public Sector: Final Project Report, Jill Keesbury, Hailegiorgis Aytenfisu, Spike Bradford
Mainstreaming Emergency Contraception In Ethiopia's Public Sector: Final Project Report, Jill Keesbury, Hailegiorgis Aytenfisu, Spike Bradford
Reproductive Health
The Ethiopian Ministry of Health, the Ethiopian Society of Obstetricians and Gynecologists, and ECafrique launched a two-year project in 2004 to mainstream emergency contraception (EC) in the country’s public sector. The project aimed at improving reproductive health care among young women and reducing the country’s abortion rate by expanding access to EC. Overall, its goal was to demonstrate the feasibility of integrating EC within the public sector’s broader contraceptive mix and was guided by the following objectives: to scale-up and promote public sector EC services in five of Ethiopia’s most populated regions; to document the characteristics and use patterns of …
Kenya: Mobilize Health Care Providers To Advocate Against Fgm/C, Frontiers In Reproductive Health
Kenya: Mobilize Health Care Providers To Advocate Against Fgm/C, Frontiers In Reproductive Health
Reproductive Health
Female genital mutilation/cutting (FGM/C) is illegal in Kenya. The practice has declined slightly, yet it is nearly universal among the Abagusii, a relatively affluent ethnic group residing in the Nyanza province in western Kenya. Half of cut women reported that they had been cut by a health worker, however providers express willingness to advocate against the practice. This study, launched in 2004 by the Population Council’s FRONTIERS Program, examined the role of health providers in FGM/C in Kenya’s Abagusii community. As noted in this brief, the objectives were to understand the motivations behind the medicalization of FGM/C and determine the …
South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health
South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health
Reproductive Health
South Africa’s medical infrastructure is relatively well developed, but its maternal mortality rate remains high and numerous studies document poor maternal care. Shortages in nursing staff are a major factor in quality-of-care problems on maternity wards. A Population Council FRONTIERS study of antenatal care in rural clinics in Kwa-Zulu Natal showed that between one-third and one-half of providers interviewed had worked at their clinics for less than a year. In 2004, FRONTIERS followed up on the Kwa-Zulu Natal study to document factors affecting the tenure, motivations, and working conditions of maternal-health nursing staff in three South African provinces. The study …
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 …
Achieving Synergies In Prevention Through Linking Sexual And Reproductive Health And Hiv Services, Ian Askew
Achieving Synergies In Prevention Through Linking Sexual And Reproductive Health And Hiv Services, Ian Askew
Reproductive Health
Integration, linkages, and synergies are widely used terms among those interested in strengthening the relationship between sexual and reproductive health services and HIV prevention. These conference proceedings explore the terms conceptually and review the wide range of combinations of SRH and HIV prevention services that have been linked or integrated. Several different combinations have proven feasible and acceptable in pilot situations, but there remains a lack of evidence as to their effectiveness in changing behaviors, including preventing HIV transmission. There is also limited experience with scaling up successful models and a need to move beyond a focus on services to …
Hiv/Aids Programming And Sexuality Of Young People Perinatally Infected With Hiv, Harriet Birungi
Hiv/Aids Programming And Sexuality Of Young People Perinatally Infected With Hiv, Harriet Birungi
Reproductive Health
These conference proceedings draw on preliminary data from an ongoing project implemented by TASO Uganda and the Population Council that contributes to the promotion of sexual and reproductive health rights of young people aged 10–19 years perinatally infected with HIV. The key argument is that HIV/AIDS programming in Uganda and elsewhere in Africa will need to acknowledge that the population of young people perinatally infected with HIV is growing and to specifically target that population. HIV/AIDS programming will also address the sexual desires of young people perinatally infected with HIV by providing them with information and practical support to understand …
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 …
Consolidating A Gender Perspective In The Procosi Network, Erica Palenque De La Quintana, Patricia Riveros Hamel, Ricardo Vernon
Consolidating A Gender Perspective In The Procosi Network, Erica Palenque De La Quintana, Patricia Riveros Hamel, Ricardo Vernon
Reproductive Health
The Integral Health Coordination Program (Programa de Coordinación en Salud Integral, or PROCOSI) in Bolivia developed a program to certify service delivery and management support NGOs as gender-sensitive. The certification system is based on an initial self-assessment by teams consisting of staff from service delivery (clinical) or management support (administrative) NGOs, followed by the development and implementation of activities to improve the gaps found until a minimum of 80 percent of the designated quality and gender standards are met. At the project’s end, 14 of the 15 participating NGOs had reached compliance with at least 80 percent of the proposed …
Health Systems And Maternal Mortality, Neonatal Mortality And Child Health: Review Of Selected Service Delivery Models, Md. Noorunnabi Talukder, Ubaidur Rob
Health Systems And Maternal Mortality, Neonatal Mortality And Child Health: Review Of Selected Service Delivery Models, Md. Noorunnabi Talukder, Ubaidur Rob
Reproductive Health
Effective maternal and child health services at the community level in developing countries are rarely available. In many developing countries the health systems cannot provide quality maternal and child health care services due to lack of adequate human resources; shortages of equipment, drugs, and supplies; and absence of proper referral mechanisms. Strengthening health systems is central to improving maternal and child health. A variety of targeted interventions have been implemented in the health systems of developing countries. This study was conducted to identify the health service delivery models that have contributed to the reduction of maternal, infant, and child mortality …
Kenya: Multisectoral Engagement Increases Support For Adolescent Reproductive Health, Frontiers In Reproductive Health
Kenya: Multisectoral Engagement Increases Support For Adolescent Reproductive Health, Frontiers In Reproductive Health
Reproductive Health
In 1999, FRONTIERS launched the Kenya Adolescent Reproductive Health Project (KARHP), testing a multisectoral approach to improving young people’s reproductive health knowledge and behavior at community, school, and health-facility levels in two pilot districts in the Western Province. The intervention involved three key government ministries—Education, Science and Technology, Health, and Gender, Sports, Culture, and Social Services—with input from community leaders, parents, and youth. Positive findings from the study convinced the three ministries and USAID to institutionalize and scale up selected elements from the pilot project. In 2003, FRONTIERS and PATH began providing technical assistance aimed at mainstreaming and expanding cost-effective …
Tuko Pamoja: A Guide For Peer Educators, Program For Appropriate Technology In Health (Path)
Tuko Pamoja: A Guide For Peer Educators, Program For Appropriate Technology In Health (Path)
Reproductive Health
This guide was developed by Program for Appropriate Technology in Health (PATH) and is part of the Kenya Adolescent Reproductive Health Project’s Tuko Pamoja (We Are Together) series. Based on KARHP’s Adolescent Reproductive Health and Life Skills Curriculum, the guide is designed to help facilitate dialogue between adults and young people on issues related to adolescent reproductive health. It can be used to help peer educators share information and lead discussions with their peers on physical and emotional changes during adolescence, staying healthy, planning for the future, making good decisions, and preventing pregnancy and HIV and AIDS. The information can …
Increasing Dual Protection Among Rickshaw Pullers In Bangladesh, Ismat Bhuiya, Mizanur Rahman, Ubaidur Rob, M.E. Khan, K.M. Zahiduzzaman
Increasing Dual Protection Among Rickshaw Pullers In Bangladesh, Ismat Bhuiya, Mizanur Rahman, Ubaidur Rob, M.E. Khan, K.M. Zahiduzzaman
Reproductive Health
The main objective of this study, conducted in six urban clinics of Dhaka, Bangladesh was to increase contraceptive use among rickshaw pullers, with special emphasis on condom use. The study tested two strategies to increase access to family planning and reproductive health (RH) information and services: a) an educational campaign together with improved availability of condoms; and b) an educational campaign alone. Findings show that rickshaw pullers’ knowledge on contraceptive methods increased significantly in both the experimental sites compared to the control site. Use of any contraceptive method increased significantly in the experimental sites, and condom use increased significantly in …
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Mansehra District, Munir Afridi, Saman Naz, Nayyer Munir
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Mansehra District, Munir Afridi, Saman Naz, Nayyer Munir
Reproductive Health
The Primary Healthcare Revitalization, Integration, and Decentralization in Earthquake-affected Areas (PRIDE) program is designed to improve primary health-care services and health outcomes for populations in Bagh and Mansehra districts in northern Pakistan that were affected by the devastating earthquake that struck on October 8, 2005. The project aims to strengthen the financial and human resource management capacities of district health authorities and primary health-care providers. Access to and quality of primary health-care services will be improved through an essential package of health services and improved skills of primary health-care personnel. Community demand for quality services will be improved through an …
Senegal: Mainstreaming Adolescent Health: Building On Local Support Systems, Frontiers In Reproductive Health
Senegal: Mainstreaming Adolescent Health: Building On Local Support Systems, Frontiers In Reproductive Health
Reproductive Health
In 1999, FRONTIERS began a three-year collaboration with the World Health Organization, the Center for Research and Training, the Population Training Group, and the Ministries of Health, Education, and Youth to test the feasibility, effectiveness, and cost of school-, clinic-, and community-based interventions to improve the reproductive health of youth aged 10–19. This adolescent reproductive health (ARH) study showed that the multisectoral, multidisciplinary approach increased knowledge about youth reproductive health among young people, the community, schools, and health-care providers. As noted in this brief, one of the guiding principles of the ARH study was to build sustainability through existing institutions, …
Management Of Complications, Pregnancy, Childbirth And The Postpartum Period In The Presence Of Fgm/C, Kenya Ministry Of Health
Management Of Complications, Pregnancy, Childbirth And The Postpartum Period In The Presence Of Fgm/C, Kenya Ministry Of Health
Reproductive Health
This reference manual is intended for health-care providers in Kenya working among communities that have a high prevalence of female genital mutilation/cutting (FGM/C) and those who encounter women and/or girls who have undergone the practice. It was designed particularly for use by nonspecialist clinicians, including nurses/midwives, clinical officers, district medical officers, postgraduate medical officers, and medical students. It is also a resource for medical and other health-service providers at primary, secondary, and tertiary levels, particularly those working in areas with a high prevalence of FGM/C. Since the evidence base for effective clinical practice is constantly evolving, readers are encouraged to …
Emergency Contraception, Female Condoms And Iuds In Kenya's Public Sector: Findings From A National Diagnostic Assessment, Jill Keesbury, Benter Owino, Spike Bradford
Emergency Contraception, Female Condoms And Iuds In Kenya's Public Sector: Findings From A National Diagnostic Assessment, Jill Keesbury, Benter Owino, Spike Bradford
Reproductive Health
In 2005, the Kenya Ministry of Health, Department of Reproductive Health (DRH), began an initiative to strengthen the provision of emergency contraception (EC) in the public sector. As a first step, 700,000 units of the dedicated EC product Postinor 2 were procured by UNFPA for use in government facilities and select providers were trained on its administration. In 2006, the DRH requested assistance from ECafrique, the African Forum on Emergency Contraception, to expand access to the product. This report documents the results of a diagnostic assessment conducted at the outset of this initiative. It examines the provision and utilization of …
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 …
Bangladesh: Rh Curriculum Enhances Vocational Students' Knowledge And Behavior, Frontiers In Reproductive Health
Bangladesh: Rh Curriculum Enhances Vocational Students' Knowledge And Behavior, Frontiers In Reproductive Health
Reproductive Health
In 2004, the Population Council’s FRONTIERS Program and the Bangladesh Ministry of Youth and Sports collaborated on an intervention to introduce reproductive health education into government-run vocational-training courses. The training, offered to males and females aged 15–30, includes livestock husbandry, electronics, and secretarial work. The intervention built upon the positive results of the 1999 Bangladesh Youth Reproductive Health Study, which introduced a life-skills curriculum into secondary schools. The interactive reproductive health curriculum was modified to suit older adolescents and youth attending courses at vocational training centers. Topics included reproductive biology, family planning, pregnancy, sexually transmitted infections, critical thinking, and negotiation …
How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit
How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit
Reproductive Health
Most service-delivery interventions begin as pilot projects. When a pilot study of an intervention is successful, managers begin to think about scaling up the project to new areas. Cost is a critical factor influencing the extent and pace of scale-up. This brief explains how to adapt and modify cost information obtained from a pilot project to estimate scale-up costs. The brief shows why the costs of a pilot project alone are not sufficient to predict costs of scale-up and gives examples of how costs are influenced by factors like economies and diseconomies of scale, resource substitution, and intervention modification. The …
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 …
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Bagh District, Munir Afridi, Saman Naz, Nayyer Munir
Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Bagh District, Munir Afridi, Saman Naz, Nayyer Munir
Reproductive Health
The Primary Healthcare Revitalization, Integration, and Decentralization in Earthquake-affected Areas (PRIDE) program is designed to improve primary health-care services and health outcomes for populations in Bagh and Mansehra districts in northern Pakistan that were affected by the devastating earthquake that struck on October 8, 2005. The project aims to strengthen the financial and human resource management capacities of district health authorities and primary health-care providers. Access to and quality of primary health-care services will be improved through an essential package of health services and improved skills of primary health-care personnel. Community demand for quality services will be improved through an …
Strengthening Financial Sustainability Through Integration Of Voluntary Counseling And Testing Services With Other Reproductive Health Services, Rumeli Das, Kaushik Biswas, Pradeep Panda, M.E. Khan, Rick Homan
Strengthening Financial Sustainability Through Integration Of Voluntary Counseling And Testing Services With Other Reproductive Health Services, Rumeli Das, Kaushik Biswas, Pradeep Panda, M.E. Khan, Rick Homan
Reproductive Health
In West Bengal, India, the Child in Need Institute (CINI) operated an HIV/AIDS voluntary confidential counseling and testing center and a reproductive health clinic at separate locations. Concerns about lack of service coordination as well as cost and revenue considerations led CINI to integrate the two services. CINI conducted an operations research study to examine the impact of integration on utilization and revenues. The objective of the study was to examine whether integration of services would yield an increase in clients served and improve the financial position of the program. The study found that integrating services was associated with increased …
Contributing Towards Efforts To Abandon Female Genital Mutilation/Cutting In Kenya: A Situation Analysis, Humphres Evelia, Maryam Sheikh Abdi, Carolyne Njue, Ian Askew
Contributing Towards Efforts To Abandon Female Genital Mutilation/Cutting In Kenya: A Situation Analysis, Humphres Evelia, Maryam Sheikh Abdi, Carolyne Njue, Ian Askew
Reproductive Health
The Kenyan Ministry of Gender, Sports, Culture and Social Services, with support from UNFPA/Kenya, commissioned the Population Council to conduct a situation analysis of female genital mutilation/cutting (FGM/C) programs in Kenya, with the overall objective of documenting the current status of and trends in FGM/C programming and to help identify crucial elements that need to be prioritized for support. Results show marked declines in prevalence nationally between generations, suggesting a decline in the practice as well as trends toward “medicalization” in recent years. The practice still continues for different reasons, such as rite of passage, for marriageability, controlling sexuality, religious …
Provision Of Emergency Contraceptive Services Through Paraprofessionals In India, Shiv Kumar, Chander Shekhar, N.K. Gupta, Malabika Roy, M.E. Khan, Mary Philip Sebastian, Rukma Idnani, Ardash Bhargava, Vinita Salvi
Provision Of Emergency Contraceptive Services Through Paraprofessionals In India, Shiv Kumar, Chander Shekhar, N.K. Gupta, Malabika Roy, M.E. Khan, Mary Philip Sebastian, Rukma Idnani, Ardash Bhargava, Vinita Salvi
Reproductive Health
In 2004, with funding for technical assistance provided by USAID, the Indian Council of Medical Research funded and collaborated with the Frontiers in Reproductive Health (FRONTIERS) program of the Population Council on a two-year study to assess the usefulness and effectiveness of using paraprofessionals in educating and providing emergency contraception (ECP) services to potential users. Based on the findings and advocacy efforts, the Indian Ministry of Health and Family Welfare introduced ECP as an over-the-counter medication beginning in September 2005. This made it possible for paraprofessionals in the National Family Planning Program to provide ECP services, making the method widely …