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Articles 1 - 30 of 46
Full-Text Articles in Demography, Population, and Ecology
Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows
Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows
Reproductive Health
This document reports on the Government of Kenya’s Output-Based Aid (OBA) vouchers program—an affordable strategy to meet the international and national objectives for improved maternal and reproductive health. To help achieve the global Millennium Development Goals related to maternal and child health, the Kenyan government has launched several initiatives including this Vision 2030 flagship program which harmonizes global and national objectives by improving access and enhancing equity in health service delivery. The report finds that the three maternal health MDG indicators—maternal mortality rate, rate of institutional deliveries, and contraceptive prevalence—can all be improved substantially by scaling up the OBA program. …
Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland
Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland
Reproductive Health
Results presented in this STEP UP Research Report show that over half of women having unmet need for family planning in Senegal did not intend to use family planning in the future and this was consistent across all population strata. Reasons for non-use confirm the existence of widespread opposition to the use of modern contraception. Unfamiliarity and lack of information is likely to be a reason for such opposition; initial suspicion of contraception has also been documented. Thus a first policy priority, and one that is relatively easy to achieve, is to increase knowledge through the mass media and localized …
Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community
Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community
Reproductive Health
The East, Central and Southern Africa (ECSA) Health Community, which prioritizes gender-based violence and child sexual abuse as regional health concerns, partnered with the Population Council to convene a pre-conference Expert Committee meeting of the Research, Information and Advocacy Programme. The conference marked a major milestone in the ECSA Health Community’s commitment to promote and support region-wide sharing and utilization of health research and policy information among its member states. This report summarizes the deliberations of the two-day workshop and the recommendations for implementing an advocacy plan to address this important facet of the region’s development agenda.
Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar
Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar
Reproductive Health
Maternal mortality in Ethiopia remains among the highest in the world. A UN Commission Report in 2012 identified 13 life-saving commodities—defined as medicines, medical devices, and health supplies—that effectively address avoidable causes of death during pregnancy and childbirth that, if more widely accessed and properly used, could significantly reduce preventable deaths among women. This assessment, conducted by the Population Council, evaluates the availability of these life-saving commodities that are essential for basic emergency obstetric and neonatal care, and safe and clean delivery services within primary health care in Ethiopia. The report concludes that Ethiopia’s pharmaceutical procurement and supply system is …
Day Of Dialogue: Expanding Opportunities For Increased Access To Emergency Contraception (Ec) In Nigeria, Population Council
Day Of Dialogue: Expanding Opportunities For Increased Access To Emergency Contraception (Ec) In Nigeria, Population Council
Reproductive Health
In order to create a supportive policy and service delivery environment for emergency contraception (EC) and improve uptake in Nigeria, the Population Council conducted a survey of service providers’ knowledge, attitudes, and practices regarding EC, supplemented by in-depth interviews with key opinion leaders regarding their perceptions. This study revealed gaps that have implications for policy and programming. In collaboration with the International Consortium for Emergency Contraception, the Population Council convened a “Day of Dialogue” on EC to discuss the key research findings and to recommend strategic considerations for repositioning EC within the country's family planning program. This report describes the …
Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab
Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab
Reproductive Health
These slides present results from a Population Council study conducted in Egypt aimed at identifying factors that prevent Egyptian couples from attainment of their reproductive goals using a rights-based, gender-sensitive analysis of family planning service demand and supply. The analysis focused on six aspects of clients’ rights: clinic/provider readiness, accessibility and affordability, privacy and confidentiality, choice and autonomy, informed decisionmaking, and the right to complain. The presentation concludes with recommendations for closing gaps that exist with regard to protection of clients’ rights to autonomy, choice, informed decisionmaking, privacy, and confidentiality.
Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew
Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew
Reproductive Health
This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …
Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu
Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu
Reproductive Health
Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The specific objectives of the initiative were to: increase knowledge, awareness, and use of EC among Kenyan women; increase knowledge and awareness of EC among health providers; and strengthen EC provision in both the private and public sectors. This policy brief describes a toolkit designed for policymakers and service providers which draws on the achievements, lessons learned, and experiences from this project.
Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes
Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes
Reproductive Health
Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …
Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland
Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland
Reproductive Health
Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on …
Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru
Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru
Reproductive Health
This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …
Insights Into Unmet Need In Ghana, Kazuyo Machiyama, John C. Cleland
Insights Into Unmet Need In Ghana, Kazuyo Machiyama, John C. Cleland
Reproductive Health
This study aims to establish the relative importance of lack of access and attitudinal resistance toward use of family planning for different population and geographical strata in Ghana. It is intended to inform policymakers on the priority that should be given to behavior change communication or improved access/information, and also helpful to interventions to reduce health concerns and fear of side effects, such as provision of broader method mix and better counseling. The most far reaching implication concerns the reproductive behavior of the best educated women and those living in the capital or surrounding areas. The results suggest an enduring …
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Reproductive Health
Prevention of unintended pregnancy is often considered the key outcome of reducing unmet need; it is the basic right of women and couples to become pregnant only when intended. This paper explores this relationship by reviewing the definition and measurement of unintended pregnancy, identifying key trends in its distribution within and between populations, and analyzing the relationship between unintended pregnancy, demand for family planning, and family planning program performance. The determinants and consequences of unintended pregnancy are reviewed to further understand the implications of using it as a policy and programming goal. The paper concludes by reviewing the broader policy …
High Hiv Incidence Among Male Injection Drug Users In Delhi, India, Waimar Tun, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, Avina Sarna
High Hiv Incidence Among Male Injection Drug Users In Delhi, India, Waimar Tun, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, Avina Sarna
HIV and AIDS
India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability …
A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland
A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland
HIV and AIDS
No standardized process exists for developing a set of agreed upon terms, definitions, and translations in local languages that ensures participants understand both technical and nontechnical terms used in a clinical trial context. HIV prevention trials deal with a disease that is stigmatized and with sexual behaviors that may not be openly discussed, thus care must be taken in the selection of words to ensure terms are appropriate for use in the context of a clinical trial and understandable but not offensive. The lack of a standardized process can make it difficult for researchers to decide which words to use, …
Hivcore Operations Research Workshop Summary Report, Nrupa Jani
Hivcore Operations Research Workshop Summary Report, Nrupa Jani
HIV and AIDS
Over the past decade, unprecedented progress has been made in the scale-up of HIV treatment, care, and support, yet substantial coverage gaps remain. Targeted operations research and program evaluation can play a significant role in ensuring efficient and effective service delivery, scaling up to reach more clients and on a broader geographical scope, enhancing quality of care, and improving the health status and health systems in developing country settings. With funding from USAID, the Population Council and partners are responding to these critical service delivery issues through HIVCore. HIVCore improves the efficiency, effectiveness, scale, and quality of HIV and AIDS …
From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit
From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit
HIV and AIDS
HIV treatment, care, and support, and PMTCT programs are most effective when based on the best available research evidence. This is the fundamental premise of evidence-based medicine. Equally well known is the dilemma of transforming evidence into practice, which is the subject of knowledge translation and implementation science. Even when the findings of clinical trials make their way into international and national program guidelines, they run up against competing priorities within public health and community programs, resource constraints, and institutional and human inertia. Understanding how to effectively change the approach used in program operations requires understanding how programs work in …
Capturing The Demographic Dividend In Pakistan, Zeba Sathar, Rabbi Royan, John Bongaarts
Capturing The Demographic Dividend In Pakistan, Zeba Sathar, Rabbi Royan, John Bongaarts
Poverty, Gender, and Youth
Pakistan’s demographic profile is changing: fertility is slowly decreasing, and people are living longer. If Pakistan succeeds in strengthening education and bringing the full panoply of reproductive rights and reproductive health services to women, it will have taken two important steps in transforming demographic change into poverty reduction and better lives for the great majority of Pakistanis. If it also takes other policy actions that can spur productive employment and investment, positive outcomes are all the more likely. This book brings together many ideas that have been discussed for some time in Pakistan and around the world, including extensive development …
Day Of Dialogue: Mainstreaming Emergency Contraception In The National Family Welfare Program, Population Council
Day Of Dialogue: Mainstreaming Emergency Contraception In The National Family Welfare Program, Population Council
Reproductive Health
The Population Council, in collaboration with the Family Planning Association of India, hosted a Day of Dialogue which addressed issues related to access, availability and use of emergency contraception pills (ECP). Some of the key issues addressed in this consultation included: provider knowledge on mechanism of action and attitudes toward easy access to ECP and its link to premarital sex and promiscuity, repeated use of ECP, and lack of information about ECP among potential users. The Population Council shared key findings of a recent study on knowledge, attitudes, and opinions of gynecologists and pharmacists on ECP use. The one-day consultation …
Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed
Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed
Reproductive Health
The Population Council Bangladesh, in collaboration with the Directorate General of Family Planning and Marie Stopes Bangladesh, with funding from the World Health Organization and the DFID-supported STEP UP project, conducted an 18-month operations research study from January 2012 to June 2013. This operations research tested the feasibility of introducing menstrual regulation with medication (MRM) in Bangladesh and assessed accessibility of the combination regimen of mifepristone and misoprostol in urban and rural health facilities. Based on this study’s results, the feasibility of introducing MRM services in Bangladesh is clear, and women receiving MRM were satisfied with their overall quality of …
Challenges In Impact Evaluation, Anrudh K. Jain
Challenges In Impact Evaluation, Anrudh K. Jain
Reproductive Health
These notes are for a presentation given at the Consultation on Social and Behavioral Change Interventions for Enhancing Child Survival in South Asia organized by UNICEF, USAID, and Population Council in New Delhi, India. The slides identify challenges for conducting impact evaluations by describing the anticipated process for behavior change communication using women’s support groups, issues encountered in the process, and evaluation designs. Examples from the Population PAIMAN project are used to illustrate ways to address these challenges.
Gender-Based Violence: A Qualitative Exploration Of Norms, Experiences And Positive Deviance, Shireen J. Jejeebhoy, K.G. Santhya, Shagun Sabarwal
Gender-Based Violence: A Qualitative Exploration Of Norms, Experiences And Positive Deviance, Shireen J. Jejeebhoy, K.G. Santhya, Shagun Sabarwal
Reproductive Health
This report presents the findings of formative research the Population Council conducted, with support from UK aid, in the district of Patna, India that aimed to better understand the context of violence—physical, emotional, and sexual—against women and girls, and notably, the prevailing norms about men’s entitlement and women’s acquiescence to violence. Findings suggest that violence against women and girls is widespread and widely justified, that women are perceived as having few options but to tolerate violence, and that the most common response to violence is silence. At the same time, many women and some positive deviant men recognize the injustice …
Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai
Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai
Reproductive Health
The objectives of this Population Council study were twofold: first to collect information on prevailing practices of abortion and post‐abortion care in Pakistan and, second, to gauge changes in the magnitude and quality of abortion‐related complications and care during the last decade (since the 2002 national study of “Unwanted Pregnancy and Post‐abortion Complications in Pakistan”). The study found that the level of post‐abortion family planning (FP) counseling in both public and private health facilities offering PAC services was inadequate. There has been no improvement over the decade in the level of counseling reported, and, even more disappointingly, only half of …
Reviewing The Evidence And Identifying Gaps In Family Planning Research: The Unfinished Agenda To Meet Fp2020 Goals, Ian Askew, Martha Brady
Reviewing The Evidence And Identifying Gaps In Family Planning Research: The Unfinished Agenda To Meet Fp2020 Goals, Ian Askew, Martha Brady
Reproductive Health
The Population Council produced this paper to help guide discussions and considerations regarding the key evidence gaps and research investments needed to achieve the FP2020 goal and objectives. The paper focuses primarily on the social science, implementation, and operations research that will be needed to achieve the first three objectives. Research shows that through high-quality voluntary family planning (FP) programs, governments can reduce fertility and generate substantial improvements in health, wealth, human rights, and education. Family planning programs for the 21st century will require thoughtful design—engaging both public and private sectors—to meet the growing need for safe and effective FP …
The Adolescent Girls Vulnerability Index: Guiding Strategic Investment In Uganda, Sajeda Amin, Karen Austrian, Michelle Chau, Kimberly Glazer, Eric P. Green, David Stewart, Marie Stoner
The Adolescent Girls Vulnerability Index: Guiding Strategic Investment In Uganda, Sajeda Amin, Karen Austrian, Michelle Chau, Kimberly Glazer, Eric P. Green, David Stewart, Marie Stoner
Poverty, Gender, and Youth
Adolescence (from the ages of 10 to 19 years) is a critical stage of human development during which children experience rapid social, physical, psychological, and emotional changes on the path from childhood to adulthood. The decisions that are made during this period of life affect not only the individual well-being of young people, but also the well-being of the entire society. The Adolescent Girls Multilevel Vulnerability Index (AGI) was developed based on a growing recognition of the need to channel resources to vital—yet highly vulnerable and vastly underserved—populations of adolescent girls in Uganda specifically, and the East and Southern Africa …
Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt, Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi
Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt, Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi
Poverty, Gender, and Youth
This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the …
Follow-Up Study Of Migrant Adolescent Girls In Domestic Service Who Participated In The First Cohort Of The Filles Éveillées ("Girls Awakened") Program, Sarah Engebretsen
Follow-Up Study Of Migrant Adolescent Girls In Domestic Service Who Participated In The First Cohort Of The Filles Éveillées ("Girls Awakened") Program, Sarah Engebretsen
Poverty, Gender, and Youth
Circular migration (from rural to urban areas and back) among adolescents is common throughout West Africa, with the principle motivation being the search for economic opportunities, including domestic work. The evidence base on adolescent migration and domestic work is fairly thin. Evidence on programmatic effectiveness generally ends at program completion and does not follow adolescents over time. The current study follows a subsample of migrant adolescent girls in domestic service in urban Burkina Faso who participated in the first cohort of the Filles Éveillées (Girls Awakened) pilot program. Filles Éveillées was designed to provide migrant girls in domestic service with …
Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi
Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi
Poverty, Gender, and Youth
The decision to engage in the development of girl-friendly savings accounts was made as part of the Population Council’s work with adolescent girls in Kenya. In June 2008 the Council and MicroSave Consulting started the Safe and Smart Savings Products for Vulnerable Adolescent Girls. Based on the market research and prior experience with developing programs for adolescent girls, a product concept for a group-based savings account was developed, in which the group model was used to address the legal constraints of minors not being able to hold individual accounts. In Kenya and Uganda, two financial institutions were identified, and the …
The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Rwanda 2010, Population Council
The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Rwanda 2010, Population Council
Poverty, Gender, and Youth
“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Rwanda 2010” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …
Financial Inclusion Of Female Garment Workers, Sigma Ainul, Md. Irfan Hossain, Sajeda Amin, Ubaidur Rob
Financial Inclusion Of Female Garment Workers, Sigma Ainul, Md. Irfan Hossain, Sajeda Amin, Ubaidur Rob
Poverty, Gender, and Youth
Since the 1980s rapid growth in the manufacturing of ready-made garments for export has created new opportunities for women industrial workers in Bangladesh. This study explores ways of improving the financial capabilities of these young, inexperienced wage earners through a targeted program of financial education. It also aims to identify scalable financing models that can be replicated to increase the opportunities of garment workers. The project culminated in a workshop to share results from the research study and to elicit discussions and recommendations based on the findings of the study. Recommendations include a preference for in-factory training in peri-urban areas, …