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Full-Text Articles in Demography, Population, and Ecology

Priority Setting For Reproductive Health At The District Level In The Context Of Health Sector Reforms In Ghana, Harriet Birungi, Philomena Nyarko, Ian Askew, Ayorinde Ajayi, Gifty Addico, Edward Addai, Caroline Jehu-Appiah Jan 2006

Priority Setting For Reproductive Health At The District Level In The Context Of Health Sector Reforms In Ghana, Harriet Birungi, Philomena Nyarko, Ian Askew, Ayorinde Ajayi, Gifty Addico, Edward Addai, Caroline Jehu-Appiah

Reproductive Health

This report outlines results of an in-depth assessment carried out in Ghana in order to provide a better understanding of key factors affecting reproductive health (RH) prioritization at the district level; and to make recommendations for policy dialogue, advocacy, resource allocation, and RH program implementation. In particular, the study examined whether or not districts are connecting to the central process of priority setting and reasons for not doing so. The report includes recommendations for bridging the policy implementation gap, including: ensuring that RH advocates participate in national policy dialogue; investing in systems development for procurement and delivery of drugs and …


Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen Jan 2006

Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project, an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan, was a three-year project (2003 to 2006) funded by the European Union. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas to accomplish its goals: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role …


Make Better Use Of Provider Time In Public Health Clinics, Barbara Janowitz Jan 2006

Make Better Use Of Provider Time In Public Health Clinics, Barbara Janowitz

Reproductive Health

Funding for reproductive health services is stagnant or declining globally, yet population projections, particularly in Africa, indicate that demand for services will increase in the near term. Between 2002 and 2025, for example, the population of women of childbearing age (15–49) is expected to increase by 2 percent annually in sub-Saharan Africa. With this growth will come increased demand for contraception, and other reproductive health services such as antenatal care, safe birthing services, and postpartum care for mothers and children. Concern about increasing demand for services has led program managers to examine the productivity and costs of existing programs. While …


Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller Jan 2006

Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller

Reproductive Health

Maternal mortality in Pakistan is believed to be quite high, at about 350–500 maternal deaths per 100,000 live births. Reducing maternal mortality is one of the major objectives of the Government of Pakistan. Interventions required to address maternal mortality include safe motherhood, which means a woman’s ability to have a safe and healthy pregnancy and delivery. The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal and neonatal mortality in a predominantly rural district of Pakistan. The vast majority of maternal deaths are attributed to delays in …


Building Capacity To Utilize Operations Research: Strategies And Lessons Learned, James R. Foreit Jan 2006

Building Capacity To Utilize Operations Research: Strategies And Lessons Learned, James R. Foreit

Reproductive Health

The effectiveness of development assistance depends on good decision-making. Many donors and international health agencies such as USAID, DFID, and WHO are placing more emphasis on the utilization of research results for policy and program development. Yet, while there is a long tradition of training researchers to produce research, there are few lessons on how to teach managers to request and use research results for making program decisions. Addressing this gap has been a major strategy of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS). Since its inception in 1998, FRONTIERS has complemented its support for operations research (OR) …


Costs Of Reproductive Health Services Provided By Four Christian Health Association Of Ghana (Chag) Hospitals, James Boateng, Henry Surnye, Alex Mensah, Bismark Boateng, Philomena Nyarko, Nzoya Munguti, John H. Bratt Jan 2006

Costs Of Reproductive Health Services Provided By Four Christian Health Association Of Ghana (Chag) Hospitals, James Boateng, Henry Surnye, Alex Mensah, Bismark Boateng, Philomena Nyarko, Nzoya Munguti, John H. Bratt

Reproductive Health

The Christian Health Association of Ghana (CHAG) is a large faith-based NGO which currently serves an estimated 35 percent of the Ghanaian population, mainly in remote rural areas. This study built capacity within the CHAG secretariat to calculate the economic cost and cost recovery levels of selected reproductive health services in four CHAG-affiliated hospitals. Techniques learned in the study are applicable to most costing problems, not just to reproductive health. Information obtained in the study forms the basis for negotiating reimbursement under the Ghana National Health Insurance Scheme, and for setting cost recovery and containment policies. CHAG senior managers plan …


Acceptability And Sustainability Of The Who Focused Antenatal Care Package In Kenya, Harriet Birungi, Washington Onyango-Ouma Jan 2006

Acceptability And Sustainability Of The Who Focused Antenatal Care Package In Kenya, Harriet Birungi, Washington Onyango-Ouma

Reproductive Health

The objectives of this study were to assess the Kenyan Ministry of Health’s capacity to adapt focused antenatal care (ANC) at the service delivery level so that it can be sustained, and to examine the extent to which adaptation of the package has increased coverage and quality of key ANC services and the overall quality of care received by pregnant women. The study showed that focused ANC is acceptable to both clients and providers and the approach has also received tremendous support from both the government and health development partners. However, the sustainability of the focused ANC package is contingent …


Correlates Of Inter-Birth Intervals: Implications Of Optimal Birth Spacing Strategies In Mozambique, Saumya Ramarao, John Townsend, Ian Askew Jan 2006

Correlates Of Inter-Birth Intervals: Implications Of Optimal Birth Spacing Strategies In Mozambique, Saumya Ramarao, John Townsend, Ian Askew

Reproductive Health

The Optimal Birth Spacing Initiative (OBSI) was created under the auspices of USAID to place optimal birth spacing on the global leadership priority agenda. As part of this initiative, Advance Africa documented a pilot intervention to introduce the new spacing message in Mozambique. The FRONTIERS program of the Population Council collaborated with Advance Africa providing technical input, and assistance in the conceptualization of intervention design and evaluation. This paper was written to inform Advance Africa’s efforts in Mozambique and includes a short review of correlates of birth intervals; a presentation of results from analysis of Mozambique-DHS 1997 data that identify …


Developing Regional Capacity In Operations Research And Economic Evaluation In South Asia, M.E. Khan, Sohini Roychowdhury, James R. Foreit, Sharif M.I. Hossain, Geetha Vaithyanathan Jan 2006

Developing Regional Capacity In Operations Research And Economic Evaluation In South Asia, M.E. Khan, Sohini Roychowdhury, James R. Foreit, Sharif M.I. Hossain, Geetha Vaithyanathan

Reproductive Health

This project contributed significantly to the capacity-building of regional professionals in planning, implementing, and monitoring of reproductive health programs in South Asia. During 2001–05, professionals from 17 countries received training in various aspects of reproductive health in nine workshops, including operations research, economic evaluation, qualitative research methods, proposal writing, and process documentation and enhancing the utilization of research findings in reproductive health programs. Forty-three percent of workshop participants were program managers from government health programs and nongovernmental organizations. Success in leveraging resources from other collaborating agencies and other donors helped the project to organize more workshops than originally planned and …


Tuko Pamoja: Adolescent Reproductive Health And Life Skills Curriculum, Path, Population Council Jan 2006

Tuko Pamoja: Adolescent Reproductive Health And Life Skills Curriculum, Path, Population Council

Reproductive Health

As they move through adolescence, young people begin to have different kinds of relationships with their peers, family members, and adults; good communication and other skills can help ensure that these relationships are satisfying and mutually respectful. Young people need to learn to manage new feelings about sexuality to make responsible decisions about their health, reproduction, and parenthood. This manual, the second edition of the Kenya Adolescent Reproductive Health Curriculum, is for teachers; community, religious, and youth group leaders; health care professionals; and anyone working with young people. The curriculum is designed to delay sexual debut and promote sexual and …


Systematic Screening: A Strategy For Determining And Meeting Clients' Reproductive Health Needs, James R. Foreit Jan 2006

Systematic Screening: A Strategy For Determining And Meeting Clients' Reproductive Health Needs, James R. Foreit

Reproductive Health

Systematic screening is a strategy to integrate reproductive health services at the provider level. Integration is the proactive provision of multiple reproductive health services in the same facility at the same time. Systematic screening is a simple intervention to increase the number of services received at a single client visit. In this strategy, providers use a checklist or questionnaire to identify each client’s needs and desires for reproductive health services. They then provide these services during the same visit, through an appointment at the same clinic, or through referral to another facility. The Population Council’s Frontiers in Reproductive Health Program …


Scaling Up A Reproductive Health Curriculum In Youth Training Courses, Laila Rahman, M. Mazharul Islam, Ubaidur Rob, Ismat Bhuiya, M.E. Khan Jan 2006

Scaling Up A Reproductive Health Curriculum In Youth Training Courses, Laila Rahman, M. Mazharul Islam, Ubaidur Rob, Ismat Bhuiya, M.E. Khan

Reproductive Health

The Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Bangladesh Ministry of Health and Family Welfare, the Urban Family Health Partnership, and two nongovernmental service delivery partners, carried out the Global Youth project in northwestern Bangladesh from 1999–2003. The important lesson learned from that project was that reproductive health education could increase reproductive health knowledge in adolescents, particularly in areas related to reproductive biology, family planning, pregnancy, sexually transmitted infections, HIV, and AIDS. The population-based surveys further showed that contrary to common belief, reproductive health education does not increase sexual activity; instead it increases the use …


Cost Analysis Of Reproductive Health Services In Pcea Chogoria Hospital, Kenya, Nzoya Munguti, Moses Mokua, Rick Homan, Harriet Birungi Jan 2006

Cost Analysis Of Reproductive Health Services In Pcea Chogoria Hospital, Kenya, Nzoya Munguti, Moses Mokua, Rick Homan, Harriet Birungi

Reproductive Health

Presbyterian Church of East Africa Chogoria Hospital is a faith-based nongovernmental organization providing a wide range of healthcare services. The organization faces a number of challenges related to sustainability: declining donor support (especially for reproductive health services), low cost recovery levels, and increasing poverty levels among its clientele. In response to these concerns, a team from Chogoria Hospital attended a one-week workshop on financial sustainability held in Ghana and developed a small-scale operations research project to determine the cost of providing a selected number of reproductive health (RH) services and to evaluate their cost recovery levels. The study found that …


Technical Assistance To Organizations In Guinea Seeking To Reduce Female Genital Cutting, Nafissatou J. Diop Jan 2006

Technical Assistance To Organizations In Guinea Seeking To Reduce Female Genital Cutting, Nafissatou J. Diop

Reproductive Health

This reports details the technical assistance the Population Council’s FRONTIERS program provided to WHO’s Africa Bureau to implement a project addressing medicalization of female genital cutting (FGC), and to support Tostan in replicating its program in Guinea. Technical assistance had several aims: to improve the effectiveness of strategies to abandon FGC in Guinea, to assist WHO in developing and implementing a project to reduce FGC medicalization by health providers, to build the capacity of Guinean organizations to appropriately monitor and evaluate their FGC-related activities, and to enable the Comité de Lutte contre les Pratiques Traditionnelles portant Atteinte aux Femmes (CPTAFE) …


Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz Jan 2006

Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz

Reproductive Health

Female genital mutilation (FGM) is a traditional practice that affects women and girls in several African countries. It is practiced in a variety of ways, classified by WHO into four broad types all found in Kenya. In some communities it is associated with passage into maturity; in others, it is considered a symbol of ethnic identity, a religious obligation, or a necessary prerequisite for marriage, either through symbolizing attainment of womanhood or as a means of preserving and demonstrating virginity. FGM is considered a harmful traditional practice because it may be associated with a variety of short- and long-term health …


Cost Of Training Programs And Willingness To Pay For Training: An Application Of Break-Even Analysis In Uganda, Nicholas Mugumya, Juliana K. Nyombi, Michael Matsiko, Rick Homan, Harriet Birungi, Nzoya Munguti Jan 2006

Cost Of Training Programs And Willingness To Pay For Training: An Application Of Break-Even Analysis In Uganda, Nicholas Mugumya, Juliana K. Nyombi, Michael Matsiko, Rick Homan, Harriet Birungi, Nzoya Munguti

Reproductive Health

The AIDS Support Organization (TASO) provides care and support to persons living with HIV/AIDS in Uganda. The organization has also developed a large number of training courses related to AIDS care and counseling that are offered to local and regional organizations. To explore alternatives for increasing the sustainability of the training center, a team from TASO attended a one-week workshop on financial sustainability and developed an operations research study to determine ways in which the training center could increase its revenues and reduce costs. The report finds that with updated fees as well as changes to the structure of some …


Safe Motherhood Applied Research And Training (Smart) Report 3: Changes In Knowledge And Behavior Of Women And Families, Muhammad Shafique Arif, Peter C. Miller, Nayyer Munir, Irfan Masood Jan 2006

Safe Motherhood Applied Research And Training (Smart) Report 3: Changes In Knowledge And Behavior Of Women And Families, Muhammad Shafique Arif, Peter C. Miller, Nayyer Munir, Irfan Masood

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was conceived as an operations research project designed to test the effectiveness of two different strategies for improving maternal and neonatal health in Pakistan. To evaluate the results of this test, several types of evaluative research were conducted, including qualitative studies of various types, health systems assessments, evaluations of specific components, and household surveys. The household surveys are the subject of this report, which is Report 3 (Changes in knowledge and behavior of women and families) in a series of six. The surveys are two types: a large-scale, before-after household survey …


Safe Motherhood Applied Research And Training (Smart) Report 4: Knowledge And Behaviour Of Service Providers, Zakir Hussain Shah, Saima Pervaiz Jan 2006

Safe Motherhood Applied Research And Training (Smart) Report 4: Knowledge And Behaviour Of Service Providers, Zakir Hussain Shah, Saima Pervaiz

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role in decision-making and seeking care for their families in matters relating to maternal and newborn …


Acceptability And Feasibility Of Introducing The Who Focused Antenatal Care Package In Ghana, Harriet Birungi, Philomena Nyarko, Margaret Armar-Klemesu, Daniel Arhinful, Sylvia Deganus, Henrietta Odoi-Agyarko, Gladys Brew Jan 2006

Acceptability And Feasibility Of Introducing The Who Focused Antenatal Care Package In Ghana, Harriet Birungi, Philomena Nyarko, Margaret Armar-Klemesu, Daniel Arhinful, Sylvia Deganus, Henrietta Odoi-Agyarko, Gladys Brew

Reproductive Health

The main objective of this study, undertaken by Noguchi Memorial Institute for Medical Research in collaboration with the Ghana Health Service and FRONTIERS, with USAID funding, was to examine the extent to which adaptation of the WHO focused antenatal care (ANC) package influenced quality of care received by pregnant women and its acceptability to both providers and clients. The results indicate that national-level support for focused ANC is high. The package appears to have been well accepted by both clients and providers because of its comprehensiveness and the individualized care. The process of stimulating changes in focused ANC service delivery …


Sexual Harassment In The Workplace: Experiences Of Women In The Health Sector, Paramita Chaudhuri Jan 2006

Sexual Harassment In The Workplace: Experiences Of Women In The Health Sector, Paramita Chaudhuri

Reproductive Health

The objective of this report is to explore sexual harassment of women in the health sector in Kolkata, West Bengal, India. Specifically, it explores women’s perceptions of the occurrence of sexual harassment in hospital settings, and probes women’s own experiences of sexual harassment and incidents of sexual harassment in the hospital environment about which women are aware. The study also investigates the nature of action taken to seek redress, and the extent to which working women are aware of the complaint mechanism outlined by the Supreme Court. Findings confirm the persistence of sexual harassment in the workplace, the reluctance of …