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Youth Centres In Ghana: Assessment Of The Planned Parenthood Association Of Ghana Programme, Evam Kofi Glover, Annabel Erulkar, Joana Nerquaye-Tetteh

Reproductive Health

The sexual and reproductive health of adolescents has become a major public concern, particularly with the advent of HIV/AIDS. Many organizations have tried to find strategies to reach youth with reproductive health (RH) information and services through various service delivery models. One such model has been the multipurpose youth center approach. Multipurpose youth centers typically include recreational or vocational services as entry points for RH and family planning (FP) information and services. There is some evidence in a variety of African settings (notably Kenya and Zimbabwe) suggesting that these centers are underutilized and not cost-effective. As a result, the Planned …

Peru Logistics Chain Analysis, Jeanne Noble, James R. Foreit

Reproductive Health

The inventory module of situation analysis, developed by the Population Council, has been adapted to help generate indicators of logistics system functioning suggested by the Evaluation Project and to provide an analytical framework that permits more accurate estimations of the frequency, location, and patterns of logistics problems. In 1996, the module was implemented in southern Peru. In 1997, the same module was implemented in the province of Santa and two provinces of Huancavelica. Comparable information was obtained from 149 service delivery points (SDPs) in four departments. Data include inventories of contraceptive supplies and materials required for safe delivery of contraception; …

Evaluation De La Stratégie De Distribution À Base Communautaire, Banza Baya, Georges Guiella, Christine Ouedraogo, Gabriel Pictet

Reproductive Health

Ce rapport d’évaluation de l’intervention de la DSF se base sur quatre séries d’enquête au Burkina Faso: l’enquête quantitative de base (avril-mai 1996), l’enquête qualitative de base (1996), et l’enquête de premier passage (avril-mai 1998) et l’enquête d’évaluation qualitative DBC (novembre 1998). L’intervention s’attachera à valider les hypothèses du Laboratoire de santé communautaire (LSC), à analyser la mise en œuvre de l’intervention, à tenter de saisir ses effets et d’étudier les mérites respectifs des deux stratégies testées dans le Bazèga, conformément au protocole d’évaluation proposé par l’UERD et validé par les partenaires du LSC (DSF, Population Council, Mwangaza Action et …

An Assessment Of The Zimbabwe Family Planning Programme: Results From The 1996 Situation Analysis Study, Lewis Ndhlovu, Hazel M.B. Dube, Caroline S. Marangwanda

Reproductive Health

Within the past ten years, the Zimbabwe National Family Planning Council (ZNFPC) has conducted two major studies for assessing the availability and quality of reproductive health services. The two studies, generally referred to as Situation Analysis studies, were conducted in 1991 and 1996. The 1996 survey collected data from 192 health facilities spread throughout Zimbabwe. During this exercise, an inventory of physical facilities, equipment, and educational materials was taken. In addition, 758 provider–client interactions of new and revisit clients were observed. Exit interviews were conducted with service providers, and with family planning and maternal and child health clients. In this …

Tobacco Wars: Will The Rule Of Law Survive?, Robert A. Levy

Journal of Health Care Law and Policy

No abstract provided.

Needs And Risks Facing The Indonesian Youth Population, Desti Murdijana

Reproductive Health

Youth are the leaders of tomorrow, but right now they face a formidable collection of problems that will determine the quality of their future lives and the lives of us all. Education, jobs, substance abuse, violence, sexuality, and marriage are examples of adolescent issues that demand special attention from researchers, youth activists and advocates, parents, and policymakers. In attempting to address these complex issues, we must be willing to confront ignorance, controversy, and cultural obstacles. Clear and focused policy and strategies must play a basic role in tackling these issues facing Indonesian adolescents. This paper provides a concise situation analysis …

Incentive Schemes For School Attendance In Rural Bangladesh, Sajeda Amin, Gilda Sedgh

Poverty, Gender, and Youth

This paper examines the impact of two incentive schemes on school attendance in rural Bangladesh: a food-for-education program for poor primary school children and a female secondary school scholarship scheme. The data come from an in-depth village study, before and after the programs went into effect. Both programs provide direct financial incentives to families to send their children to and keep them in school. The data also allow for an assessment of an informal school program sponsored by BRAC, a national non-governmental institution, at the study sites. School enrollment in the target population increased more rapidly than would have been …

Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett

Poverty, Gender, and Youth

Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d’Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda …

The Uncharted Passage: Girls' Adolescence In The Developing World, Barbara Mensch, Judith Bruce, Margaret E. Greene

Poverty, Gender, and Youth

Adolescence is a formative time of transition to adulthood. What happens between the ages of 10 and 19 shapes how girls and boys live out their lives as women and men—not only in the reproductive arena, but in the social and economic realm as well. Yet, despite its impact on human development, adolescence has been sidelined as a research and policy subject in developing countries. While all adolescents deserve our attention, the needs of adolescent girls in the developing world are particularly pressing. This monograph focuses on these girls, presenting statistics to examine the social and economic context of their …

Covert Contraceptive Use: Prevalence, Motivations, And Consequences, Ann E. Biddlecom, Bolaji M. Fapohunda

Poverty, Gender, and Youth

This paper examines women’s covert use of contraceptives, that is, use without the knowledge of their husbands. Covert use may highlight conflict between husbands and wives about family planning, or it may reflect behaviors that spouses find difficult to discuss together. This study addresses three questions: 1) How is covert use measured in different settings? 2) How prevalent is it? and 3) What are the factors underlying covert use? We examine these questions by drawing on existing studies and detailed survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and a subsample of …

The Onset Of Fertility Transition In Pakistan, Zeba Sathar, John B. Casterline

Poverty, Gender, and Youth

Recent trends in fertility and contraceptive prevalence indicate that the marital fertility transition in Pakistan, which has been anticipated for three decades, has begun in the 1990s. Before that decade, the total fertility rate had exceeded 6 births per woman for at least three decades, and fewer than 10 percent of married women practiced contraception. The most recent survey data, collected in 1996- 97, show a total fertility rate of 5.3 births per woman and a contraceptive prevalence rate of 24 percent. Underlying this development are macroeconomic trends that have led to widespread economic distress at the household level, and …

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 …

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 …

The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

In Kenya, adolescent girls fare poorly relative to boys in an educational system characterized by enormous growth, deteriorating quality, and rising costs. Girls are more likely than boys to drop out of school prematurely and are less likely to do well on the primary school leaving exams that come at the end of grade eight. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 36 primary schools in which those adolescents reside, this paper investigates the effect of school quality on the likelihood of dropping out from primary school in three districts of Kenya. In …

On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

Demographers have known since the 1940s that standard measures of period fertility, such as the widely used total fertility rate, are distorted by changes in the timing of childbearing. Period fertility rates are depressed during years in which women delay childbearing and inflated in years when childbearing is accelerated. This problem is usually ignored because there has been no generally accepted method for solving it. This study proposes a method for removing the tempo distortions from the total fertility rate. The key assumption of the method is that period effects, rather than cohorts effects, are the primary force in fertility …

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 …

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 …

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 …

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 …

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 …

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 …

Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain

Reproductive Health

The project "Involving Private Medical Practitioners (PMPs) in Family Planning Services" is an innovative initiative to involve PMPs in protecting the reproductive health (RH) of couples, attract private investment in the family planning (FP) sector, and eventually reduce the increasing financial pressure on the government. The project was implemented in two phases. In phase I, qualified PMPs from urban areas were given training on FP. In phase II, nonqualified PMPs were given training on FP. PIACT Bangladesh, a local NGO, conducted two pilot projects to involve the PMPs in FP. The first one was to involve qualified PMPs in urban …

Management Support For Postabortion Operations Research At The Egyptian Fertility Care Society, Population Council

Reproductive Health

The ANE OR/TA Project started its first five-year phase in 1991 addressing increased choice and accessibility of contraceptive use, promoting quality of family planning (FP) services in Asia and the Near East, and promoting the use of operations research (OR) to solve service-delivery problems. The first phase emphasized human resource development. During the years leading up to the 1994 International Conference on Population and Development, there was increased global attention to issues related to reproductive health (RH), and in particular the adverse health implications of harmful RH practices, including unsafe abortion. OR was being called upon to help implement this …

Follow-Up Household Survey In Agra District, Jayanti Tuladhar, R.B. Gupta, V.S. Sridhar, Tilak Mukherjee

Reproductive Health

This follow-up household survey in Agra District, India, was conducted with funding from USAID under the Population Council’s Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. The main objective of this study, as noted in this report, is to assess changes in the program indicators of family welfare activities, including some of the selected reproductive health indicators, from 1995 (before method-specific targets were withdrawn) and 1997 (30 months after targets were withdrawn). The study’s objectives are to detect changes in FP knowledge and use among currently married women in rural areas; detect changes in level of …