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The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain

Poverty, Gender, and Youth

Since 1982, the Maternal and Child Health and Family Planning Extension Project has compiled longitudinal panel data on rural women’s contact with household service providers who visit homes to discuss family planning and offer services to women on request. This study tests the hypothesis that home-based services reinforce customs of purdah (female seclusion) by sustaining the dependency and isolation of the women served by the program. Results show that household services improve women’s status. This effect is largely attributable to the impact of outreach on effective fertility regulation. Findings do not support the hypothesis that household service delivery is detrimental …

Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline

Poverty, Gender, and Youth

Theories of the fertility transition now routinely reserve a place for diffusion effects. Two fundamental behavioral mechanisms account for such effects: social learning and social influence. Social learning refers to the acquisition of information from others. The information might have to do with a new technology or with the health, social, and economic consequences of decisions. In the case of fertility, individuals might learn from others about the availability of a new contraceptive, or about health side effects of certain contraceptives, or about the apparent gains and losses from having fewer children and investing in their schooling. Social influence refers …

Application Of Hierarchical Monte Carlo Simulation To The Estimation Of Human Exposure To Mercury Via Consumption Of King Mackerel (Scomberomorus Cavalla), W. Leonard Balthis

MUSC Theses and Dissertations

Data from mercury poisoning episodes in Japan and Iraq have been used to derive threshold levels for health effects in humans, and the U. S. Environmental Protection Agency (EPA) has established a reference dose (RfD) for methylmercury of 0.30 µg/kg/day. It is desirable, therefore, to predict exposures for various populations, and examine these exposures in relation to the established RfD. Given data on mercury concentrations in fish, and rates of fish consumption among human populations, it is possible to calculate exposure in one of several ways. One of the simplest ways involves the use of average values to compute a …

What Can Be Done To Foster Multisectoral Population Policies? Summary Report Of A Seminar, Population Council, Overseas Development Council

Poverty, Gender, and Youth

The 1994 International Conference on Population and Development in Cairo was a watershed moment in the definition of population policies. The meeting put an end to the unproductive debate on which is more instrumental in achieving voluntary fertility decline: providing family planning (FP) services or improving social and economic development. The answer was that both are essential. The Cairo meeting also defined the most desirable services and the kind of development that was most empowering, particularly with respect to achieving reproductive choice. Despite this strong dual message from Cairo, only the call for a move away from a narrow vision …

Étude De L'Effet De L'Interaction Entre L'Asymétrie Du Mouvement Et La Coactivation Musculaire Sur Le Chargement Lombaire Chez Des Sujets Sains Et Lombalgiques. Phase 1 : Développement Et Validation D'Un Modèle Biomécanique Articulaire À Solution Physiologique Optimale, Denis Gagnon, Patrick Loisel

Rapports de recherche scientifique

Les maux de dos sont coûteux pour les travailleurs et les employeurs. Il est reconnu que l’origine des maux de dos réside partiellement dans des perturbations du rôle mécanique normal des tissus et structures internes du tronc. Pour la plupart des activités de la vie courante, le tronc joue un rôle primordial dans la transmission des forces entre les membres inférieurs et supérieurs. Les muscles du tronc sont les principaux responsables de sa stabilité et de sa mobilité en fonction des besoins de l’activité effectuée.

Pour quantifier et étudier les phénomènes internes se produisant au niveau des structures anatomiques, une …

Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Five categories of possible government influence on a nation’s fertility are explored: (1) through publicly funded programs that explicitly seek to affect family-size outcomes (2) through the legal order and system of public administration (3) through measures that affect economic opportunity, social mobility, and gender relations; (4) through public-sector expenditures and transfer payments keyed to age or family status; and (5) through the state’s supplanting of local beliefs and traditions with the symbols of national identity and through the parallel expansion of cultural frames of reference. Aside from the first of these, intentions to influence fertility are either incidental or …

Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia

Poverty, Gender, and Youth

This is the first of several editions of Quality/Calidad/Qualité that describe methodologies designed to assist family planning program managers and staff to self-assess the quality of services they are providing. These tools give program sponsors an opportunity to identify shortfalls in their service environment and propose solutions. This issue focuses on AVSC International's COPE (client-oriented, provider-efficient) methodology, a self-assessment tool that has now been used in 35 countries around the world. The report examines the experience of the National Family Planning Association of Kenya, provides some lessons learned, and demonstrates that these self-assessment exercises are, in fact, resulting in system-wide …

Clinic-Based Family Planning And Reproductive Health Services In Africa: Findings From Situation Analysis Studies, Kate Miller, Robert A. Miller, Ian Askew, Marjorie C. Horn, Lewis Ndhlovu

Reproductive Health

The United States Agency for International Development (USAID) supported publication of “Clinic-Based Family Planning and Reproductive Health Services in Africa: Findings from Situation Analysis Studies.” The book reflects USAID's commitment to improving quality of reproductive health (RH) care and expanding access for underserved groups. Nowhere are these efforts more important than in Africa, where use of family planning (FP) and other measures of RH status are lowest among the world’s regions. Providing high-quality health services that meet couples' reproductive needs is a socially just and humane goal in itself. Moreover, higher-quality services can be expected to result in better outcomes …

Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad

Reproductive Health

This paper offers a broad definition of quality of care and presents a comprehensive conceptual framework for the assessment of quality of reproductive health services and methodological approaches for its measurement. It presents three studies that were conducted between 1990 and 1991 by members of the regional Reproductive Health Working Group from Egypt, Jordan, and Tunisia. The studies provide examples of applications of the framework and its measurement using multiple data sources. Selected findings are presented to illustrate comparative results between countries. Based on the lessons learned from the studies, examples of reproductive health interventions that may improve the quality …

Advances And Challenges In Postabortion Care Operations Research: Summary Report Of A Global Meeting, Dale Huntington

Reproductive Health

The Global Meeting on Postabortion Care: Advances and Challenges in Operations Research was held at the Population Council’s New York office on January 19–21, 1998, to review progress made by three regional operations research (OR) projects in improving delivery of postabortion care. The resources of the three OR contracts were pooled, and, in collaboration with Ipas and the Ebert Program, approximately 65 researchers, senior program managers, and government officials from Africa, Latin America, the Middle East, and Southeast Asia were convened. Three objectives guided the planning of the meeting: review progress in the development of OR methodologies pertaining to postabortion …

Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council

Reproductive Health

Much literature has been written about improving the quality of reproductive health (RH) care at service delivery points (SDPs) because women deserve quality services, and as a means of increasing use of family planning (FP) and other RH services. There are six fundamental dimensions of quality of care: choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to encourage continuity, and an appropriate constellation of services. Improving these elements is thought to increase client satisfaction, resulting in an increase in contraceptive use and eventually fertility decline. Existing research has not convincingly demonstrated this link between quality of …

Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller

Reproductive Health

The Planned Parenthood Association of Ghana (PPAG) is one of the most active nongovernmental organizations delivering reproductive health (RH) services in Ghana, focusing particularly on youth issues and services. USAID suggested to the Population Council’s Africa OR/TA Project II staff that PPAG might benefit from technical assistance. A large and well-funded IPPF program to promote sexual health among youth of the Volta Region offered a good opportunity to begin OR work. Earlier, the program was envisioned as a demonstration educational program of five years duration. Further discussions suggested that this program was unlikely to be duplicated anywhere, because of its …

Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob

Reproductive Health

The national family planning and maternal child health (FP-MCH) program in Bangladesh has raised FP acceptance among couples of reproductive age significantly. A major challenge still facing the program, however, is strengthening its reproductive health (RH) component. The Population Council launched a pilot project to examine the feasibility of strengthening comprehensive reproductive tract infection (RTI) and sexually transmitted disease (STD) services at the Health and Family Welfare Center level. The project had three phases. First, a needs assessment was conducted. Then the components of the intervention were identified, designed, and implemented. And at the third phase, an evaluation was carried …

Strengthening The Utilization Of Family Planning Operations Research: Findings From Case Studies In Africa, Julie Solo, Annamaria Cerulli, Robert A. Miller, Ian Askew, Elizabeth Pearlman

Reproductive Health

The goal of undertaking operations research (OR) on family planning (FP) and reproductive health (RH) services is to strengthen the ability of programs and policies to maximize access to and quality of these services. This report addresses the need for a greater understanding of how information from OR studies is utilized. The Africa OR/TA Project II undertook a study to assess the extent to which information from OR studies conducted under the Africa OR/TA Project I (1988–1993) was utilized. The study also examined the factors influencing how study results were utilized. Case studies of several OR projects were undertaken to …

Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab

Reproductive Health

As more work in the area of male involvement in reproductive health (RH) is expected in Egypt, it is important that researchers and donor agencies become aware of existing studies, topics covered, and main research findings so duplication can be avoided. It is also important that policymakers and program managers learn about the results of existing studies so they can use those results in designing more effective policies to increase male involvement in Egypt. To address this need, the Population Council’s ANE OR/TA Project organized a seminar on “Disseminating Results of Research on Male Involvement in Reproductive Health in Egypt” …

Analysis Of Price Change On The Perceptions And Use Of Dmpa Among Clients Using Reproductive Health Services In Uttar Pradesh, India, Leila Caleb-Varkey, John Townsend, Sneh Vishwanath, Sudha Tiwari

Reproductive Health

Depo-medroxy Progesterone Acetate (DMPA) is a progesterone-only injectable contraceptive that has been approved by the Government of India for provision in the commercial sector, where it is marketed under the brand name Depo-Provera. In 1996, it was available at rates between Rs. 140 to Rs. 180 per injection. At this price it is often beyond the reach of many women wanting a safe and effective contraceptive. In January 1996, DMPA was provided to women in three cities of Uttar Pradesh through Parivar Seva Sanstha’s (PSS) clinics at Rs. 150. In July 1996, as part of operations research (OR), the price …

Workshop On Youth Across Asia, John Townsend, Ann P. Mccauley, Kokila Agarwal

Reproductive Health

The issues facing youth across Asia are as diverse as the cultures they represent. Issues involving schooling, employment, sexuality, and marriage take on increased significance for young people aged 10–24 in every country. Decisions made by youth and their families will dramatically affect their individual welfare. Few programs outside of public education systems exist at a sufficiently large scale to assist youth. Decisions to stay in school, opportunities to learn skills and manage resources, the exercise of sexual responsibility, and the process of family formation all impact both personal welfare and community development. Gender-equality issues compound many of the problems. …

Increasing Demand For Reproductive Health Services In A Peruvian Clinic, Federico R. Leon, Anibal Velasquez, Lissette Jimenez, Alicia Calderon

Reproductive Health

Over the past few years, well-established family planning (FP) organizations in developing countries, such as INPPARES, the IPPF affiliate in Peru, have strived to implement the Cairo Agenda. In the process of including reproductive health (RH) in FP care, they have dedicated human resources and infrastructure to provide RH services seldom offered in the past. The problem these organizations now face is to increase use of the newly available RH care. Currently, clients seeking FP services may leave clinics unaware of the other RH care provided. At a time when international donors are phasing out financial assistance, the partially idle …

Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health

Reproductive Health

The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …

Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga

Reproductive Health

Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …

Factors Affecting The Outputs And Costs Of Community-Based Distribution Of Family Planning Services In Tanzania, Jane Chege, Naomi Rutenberg, Barbara Janowitz, Andrew Thompson

Reproductive Health

This study assesses the cost-effectiveness of reimbursement schemes for community-based distribution (CBD) programs in Tanzania, and answers whether agents who receive monetary incentives perform better and are more cost-effective than those that receive nonmonetary incentives. Fieldwork was undertaken in April and May 1997, and data forming the basis of the analysis was collected from four CBD programs. These programs vary in their remuneration schemes and status of their CBD agents, size, and geographical coverage; the range of activities undertaken by the agents; and supervision and management structures. As noted in this report, CBD agents who receive monetary remuneration see more …

Youth Talk About Sexuality: A Participatory Assessment Of Adolescent Sexual And Reproductive Health In Lusaka, Zambia, Tamara Fetters, Evans Mupela, Naomi Rutenberg

Reproductive Health

Thirty-six percent of Zambia’s 9 million inhabitants are between 10 and 19 years of age, and most adolescents are sexually active by their mid-teens. Pregnant teenagers have an elevated risk of maternal mortality and complications related to birth. In 1990, at Lusaka’s University Teaching Hospital, self-induced abortion accounted for up to 30 percent of maternal mortality, and one-quarter of these deaths occurred in women under 18 years. Sexually transmitted infections (STIs) are a major health problem for adolescents, yet only a small proportion protect themselves from pregnancy and STIs. There are many barriers to improving the situation, including opposition by …

Recherches Opérationnelles Sur Les Soins Post-Abortum: Progrès Et Défis. Compte Rendu D'Une Réunion Mondiale, Dale Huntington

Reproductive Health

Les femmes qui ont subi des complications à la suite d’un avortement incomplet sont parmi les patientes les plus négligées des soins de santé de la reproduction. Une réunion mondiale sur le thème des recherches opérationnelles sur les soins post-abortum a été organisée au Population Council du 19 au 21 janvier 1998; elle a permis de faire le point sur les progrès réalisés grâce aux trois projets régionaux de recherches opérationnelles sur l’amélioration des prestations de soins post-abortum. Trois objectifs ont été poursuivis lors de la planification de la réunion : 1) examen des progrès accomplis concernant la mise au …

Etude Participative Pour L’Identification Des Stratégies Communautaires De Lutte Contre La Pratique De L’Excision Dans Le Bazéga, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council

Reproductive Health

No abstract provided.

Evaluation De La Prise En Charge De La Maternité Sans Risque Et De La Survie De L'Enfant Au Niveau Communautaire De Bazéga, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council

Reproductive Health

No abstract provided.

Analyse Situationnelle Des Programmes De Santé De La Reproduction, Population Council

Reproductive Health

En 1997, le Ministère de la Santé, en collaboration avec la mission de l'USAID en Guinée, a lancé un programme quinquennal "Pour Renforcer les Interventions en Santé Reproductif et MST/SIDA" (PRISM). Afin de mieux planifier ce nouveau programme de Santé de la Reproduction, et surtout de mesurer son impact sur les indicateurs clés de qualité de service, des données complètes et fiables sur les différents sous-systèmes cliniques étaient indispensables. Cette étude sert à établir des données de base et fournit des informations qui seront utiles pour développer les activités du programme. Les objectifs spécifiques sont : d'évaluer la qualité et …

Evaluation De La Stratégie De Reconversion Des Exciseuses Pour L'Eradication Des Mutilations Génitales Féminines Au Mali, Population Council

Reproductive Health

No abstract provided.

Etude De L'Efficacité De La Formation Du Personnel Socio-Sanitaire Dans L'Education Des Client(E)S Sur L'Excision Au Mali, Nafissatou J. Diop, Fatoumata Traore, Habibatou Diallo, Ousmane Traore, Aissa Haidara Toure, Youssouf Diallo, Madina Sangare, Fatoumata Tandia Keita, Attaher Toure

Reproductive Health

Cette etude a permis de mettre en avant le profil de l’excision au Mali et de documenter les consequences de sa pratique. L’importance de la prevalence de I’excision chez les ethnies du Mali et la tendance remarquée de son accroissement chez les ethnies qui ne la pratiquait pas sont des importantes raisons pour justifier I’intensification de la lutte. Le terrain est propice aux changements car la grande majorité des femmes qui excisent leurs filles le font par pur conformisme parce que la tradition le veut ou parce que tout le monde le pratique. Des pistes de recherche, tels le sujet …

Introduction Des Soins Obstétricaux D'Urgence Et De La Planification Familiale Pour Les Patientes Présentant Des Complications Liées À Un Avortement Incomplet, Population Council, Jpiego

Reproductive Health

En 1997, le Centre de Formation et de Recherche en Santé de la Reproduction en partenariat avec la Clinique Gynécologique et Obstétricale du CHU Le Dantec ont entrepris une étude de faisabilité sur l’introduction des Soins Après Avortement dans trois structures sanitaires de référence de la région de Dakar. Cette expérience pilote a été appuyée par le Population Council dans le cadre du projet de Recherche Opérationnelle et d’Assistance Technique (RO/AT II) en Afrique et par JHPIEGO qui a appuyé le volet Formation/Prestations de service. Elle s’inscrit dans le cadre de la mise en œuvre des recommandations issues des conférences …

Getting Men Involved In Family Planning: Experiences From An Innovative Program, Directorate Of Family Planning, National Institute Of Population Research And Training, Population Council

Reproductive Health

This study was designed to determine the effect of interventions on accelerated proactive male involvement in family planning (FP) and factors influencing acceptance of male contraceptive methods. It was observed that a program can be successful if management cadres can be motivated and involved in the process. Other findings suggest the importance of education and communication materials, supply of information, orientation of fieldworkers, and mobilization of resources including hands-on refresher training. Misconceptions about male contraception (particularly vasectomy) are rampant in traditional Bangladeshi society, thus ideas should be positively expressed through visual aids. Among the various communications materials, at least one …