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Integration Of Reproductive Health Service For Men In Health And Family Welfare Centers In Bangladesh, Ahmed Al-Sabir, Mohammed Ahsanul Alam, Sharif M.I. Hossain, Ubaidur Rob, M.E. Khan Jan 2003

Integration Of Reproductive Health Service For Men In Health And Family Welfare Centers In Bangladesh, Ahmed Al-Sabir, Mohammed Ahsanul Alam, Sharif M.I. Hossain, Ubaidur Rob, M.E. Khan

Reproductive Health

Over the last 30 years, Bangladesh’s national family planning (FP) program has mainly concentrated its promotional efforts on women’s adoption of FP. While the government policy has been effective in influencing women to accept contraceptive methods, men’s role in FP has been completely neglected. Similarly, male RH services are hardly available at Health and Family Welfare Centres (HFWCs). This report describes a project aimed at integrating male RH services within the existing government female-focused health-care-delivery system. The study was implemented by NIPORT in collaboration with the Directorate of Family Planning and the Population Council. Interventions resulted in a substantial rise …

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Misoprostol And Teratogenicity: Reviewing The Evidence, Neena Philip, Caitlin S. Shannon, Beverly Winikoff Jan 2003

Misoprostol And Teratogenicity: Reviewing The Evidence, Neena Philip, Caitlin S. Shannon, Beverly Winikoff

Reproductive Health

Misoprostol, a prostaglandin E1 analog marketed as Cytotec® for the prevention and treatment of gastric ulcers, is inexpensive and registered for use in over 80 countries. Many scientific articles show the preparation to be safe and effective for various reproductive health indications, including cervical softening and early pregnancy termination. Owing to the extensive body of published literature on these indications, misoprostol is now widely used for several reproductive health indications. The abortifacient properties of misoprostol are well known to medical professionals and frequently to the public. As noted in this meeting report, because the drug is available at low cost, …

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Bangladesh: Link Adolescent Reproductive Health Resources To Increase Access, Frontiers In Reproductive Health Jan 2003

Bangladesh: Link Adolescent Reproductive Health Resources To Increase Access, Frontiers In Reproductive Health

Reproductive Health

Adolescents, who make up about 25 percent of the population of Bangladesh, have limited access to reproductive health (RH) information and services. With age at marriage increasing, young people are vulnerable to a variety of RH risks, including unwanted pregnancy and sexually transmitted infections (STIs). In 1999, FRONTIERS tested the feasibility, impact, and cost of several interventions to improve the RH of adolescents. The intervention took place in two experimental urban sites, while a third control site received prevailing services. Both sites received the community intervention, which involved sensitization and outreach to community stakeholders to encourage local support. Out-of-school adolescents …

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Senegal: Involve Community Networks In Adolescent Reproductive Health, Frontiers In Reproductive Health Jan 2003

Senegal: Involve Community Networks In Adolescent Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

Senegal is undergoing rapid urbanization, leading to changes in traditional social and family structure. With these changes there is a rise in early sexual activity among young adults, and increased exposure to unwanted pregnancy and sexually transmitted infections (STIs). In Senegal, where 28 percent of the population is 10–19 years of age, a renewed focus on reproductive health (RH) services appears timely. In 1999, FRONTIERS began testing the feasibility, effectiveness, and cost of several interventions to improve the RH of youth. The study took place in three urban communities in northern Senegal. Two served as intervention sites where community- and …

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Mexico: Strengthen Education On Adolescent Reproductive Health, Frontiers In Reproductive Health Jan 2003

Mexico: Strengthen Education On Adolescent Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

Unprotected sex among Mexico’s young people often leads to unplanned pregnancy and unwanted births as well as risk of sexually transmitted infections (STIs) including HIV. From 1999 to 2002, FRONTIERS worked with the nongovernmental organization MEXFAM to test the feasibility, effectiveness, and cost of community-, clinic-, and school-based interventions to improve the reproductive health (RH) of youth aged 10–19. Eight cities were selected as intervention sites, and four as control sites. In the intervention sites, researchers worked with coordinators and “multipliers”—local community members such as teachers, community leaders, health-care providers, and peer educators—who taught courses on adolescent RH. In the …

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Cameroon: Peer Education And Youth-Friendly Media Reduce Risky Sexual Behavior, Frontiers In Reproductive Health Jan 2003

Cameroon: Peer Education And Youth-Friendly Media Reduce Risky Sexual Behavior, Frontiers In Reproductive Health

Reproductive Health

Cameroonian researchers at the Institute of Behavioral Studies and Research (IRESCO), with support from FRONTIERS, conducted an operations research project between 2000 and 2002 to assess strategies to encourage abstinence, increase contraceptive use, and reduce sexually transmitted infection (STI) rates among sexually active youth. The intervention combined peer-education strategies with media campaigns to promote healthy behavior among youth in the Mokolo neighborhood of Yaoundé. IRESCO trained 49 peer educators aged 19–25 in reproductive health (RH) communication strategies. The team coordinated educational talks, counseling sessions, conferences, and cultural and athletic events; produced comic books and brochures; and sold French and English …

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Philippines: Mobilize Policy Champion Teams To Foster Utilization Of Management Tools, Frontiers In Reproductive Health Jan 2003

Philippines: Mobilize Policy Champion Teams To Foster Utilization Of Management Tools, Frontiers In Reproductive Health

Reproductive Health

In September 2000, the Population Council launched a nine-month project to test the effectiveness of teams of “policy champions” to increase the utilization of operations research (OR) findings in reproductive health (RH) policy and programs in the Philippines. The team members, chosen from government, nongovernment, academic, and media institutions, received three days of orientation to become policy champions. The strategy was built upon evidence that local decision-makers in decentralized health systems often have little knowledge of RH, and rarely use research findings in their decision-making. The effort focused on using a research-tested community-based monitoring and information system to help providers …

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Enhancing Quality For Clients: The Balanced Counseling Strategy, Federico R. Leon, Alex Rios, Adriana Zumaran, Marisela De La Cruz, Carlos Brambila, John H. Bratt Jan 2003

Enhancing Quality For Clients: The Balanced Counseling Strategy, Federico R. Leon, Alex Rios, Adriana Zumaran, Marisela De La Cruz, Carlos Brambila, John H. Bratt

Reproductive Health

A central focus of high-quality family-planning care is the interaction between clients and the providers who serve them. In the ideal client-provider interaction, the provider treats all clients respectfully, responds to their reproductive needs and intentions, helps in the selection of the most appropriate family planning method, and offers sufficient information to use the method safely and effectively. To improve the quality of the client-provider interaction, Population Council staff developed a “Balanced Counseling Strategy,” a type of algorithm or decision tree, to be used in combination with several job aids, or visual memory aids. The Balanced Counseling Strategy structures the …

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Improving The Quality Of Reproductive Health Care: How Much Does It Cost?, Laura Raney, Stephanie Joyce, John Townsend Jan 2003

Improving The Quality Of Reproductive Health Care: How Much Does It Cost?, Laura Raney, Stephanie Joyce, John Townsend

Reproductive Health

Quality care for clients should be the focus of a family planning and reproductive health program, but can programs afford it? There is no simple answer. The multiple dimensions of quality of care make it more difficult to identify and measure affordable improvements in service delivery. Calculating program costs is challenging, and different methods can lead to widely varying estimates. Determining how much quality costs is a challenge, but it is both possible and important for programs’ sustainability. This brief focuses on various aspects of costs and examines information about the cost of improving quality (as opposed to the cost …

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Improving The Quality Of Reproductive Health Care For Young People, Liz C. Creel, Rebecca J. Perry Jan 2003

Improving The Quality Of Reproductive Health Care For Young People, Liz C. Creel, Rebecca J. Perry

Reproductive Health

Nearly 1.7 billion people, about one-third of the world’s total population, are between the ages of 10 and 24, with the vast majority living in developing countries. As they mature, young people are increasingly exposed to reproductive health (RH) risks such as sexually transmitted infections (STIs), unintended or early pregnancies, and complications from pregnancy and childbirth. Improving young people’s RH care is key to improving the world’s future economic and social well-being, but young people’s RH needs are often overlooked or viewed through a lens of cultural values that limit care. During the past decade, in part as a result …

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Traditional Birth Attendants In Maternal Health Programmes, Population Council Jan 2003

Traditional Birth Attendants In Maternal Health Programmes, Population Council

Reproductive Health

Despite the tremendous resources invested in training Traditional Birth Attendants (TBAs) over the past two decades, scientific evidence from around the world has shown that training TBAs has not reduced maternal mortality. Any improvement observed when TBA training programs have been introduced was because of the associated supervision and referral systems, and the quality of essential obstetric services available at first referral level. Conversely, evidence has shown reduced maternal and perinatal morbidity and mortality when women have a “Skilled Attendant” (a qualified health care provider who has midwifery or obstetric skills) present at every birth. Thus, national safe motherhood programs, …

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Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand Jan 2003

Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand

Reproductive Health

The Population Council has been providing technical assistance and conducting Operations Research (OR) studies in family planning and reproductive health for over two decades. These studies are designed to identify problems and test strategies to resolve those problems, providing program managers, administrators, and policymakers with the information they need to improve service-delivery systems. The ultimate goal is that strategies tested through OR will be adopted, leading to changes in policy or operational procedures at institutional, national, or international levels. These changes are what we refer to as impact. The purpose of the new approach to evaluation described in this Evaluation …

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"Ex Africa Semper Aliquid Novi", Ecafrique Jan 2003

"Ex Africa Semper Aliquid Novi", Ecafrique

Reproductive Health

Newsletter published by ECafrique, an Africa-wide forum dedicated to introducing, delivering, and mainstreaming quality emergency contraception services in Africa. This edition is written in English and French.

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The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig Jan 2003

The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig

Reproductive Health

This project provides convincing empirical evidence on the impact of quality of care on contraceptive use and fertility behavior through analysis of a unique longitudinal data set from rural Bangladesh. The findings from this project add important new and methodologically rigorous evidence to the emerging literature on the implications of service quality on contraceptive behavior. The results reaffirm the importance of female fieldworker outreach—both in terms of quality and the number of visits—on contraceptive use dynamics in rural Bangladesh. In addition to these substantive findings, the study makes important methodological contributions in assessing the impact of programmatic variables—especially quality of …

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Testing A Model For The Delivery Of Emergency Obstetric Care And Family Planning Services In The Bolivian Public Health System, Deborah L. Billings, Eliana Del Pozo, Hugo Arevalo Jan 2003

Testing A Model For The Delivery Of Emergency Obstetric Care And Family Planning Services In The Bolivian Public Health System, Deborah L. Billings, Eliana Del Pozo, Hugo Arevalo

Reproductive Health

Unsafe abortion is a serious public health problem in Bolivia, accounting for up to 25 percent of maternal mortality. Postabortion care (PAC) was recognized as a priority public health action in Bolivia in 1994 and the operations research project summarized in this report was undertaken at the request of the Ministry of Health to help guide the improvement of PAC services in the country’s revised health plan. Improvements were made in the following areas: informing women of their health status after the uterine evacuation procedure; elements of the procedure itself (instrument to be used, pain control, possible risks); and informing …

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An Assessment Of Trends In The Use Of The Iud In Ghana, John Gyapong, Gifty Addico, Ivy Osei, Mercy Abbey, Dominic Atweam Kobinah, Henrietta Odoi-Agyarko, Gloria Quansah Asare, Harriet Birungi, Ian Askew Jan 2003

An Assessment Of Trends In The Use Of The Iud In Ghana, John Gyapong, Gifty Addico, Ivy Osei, Mercy Abbey, Dominic Atweam Kobinah, Henrietta Odoi-Agyarko, Gloria Quansah Asare, Harriet Birungi, Ian Askew

Reproductive Health

Use of the IUD in relation to other contraceptive methods is reported to have either stagnated or declined in a number of countries including Ghana. The overall aim of this study was to inform the Ghana Health Service, USAID, and other partners on future directions for contraceptive promotion and supply. The stagnating demand for the IUD as a family planning method can be attributed to several factors, including perceptions and rumors about the method. The study recommends: intensified marketing of the IUD through the Ghana Life Choices Program; IUD-focused training and creation of a critical mass of trained IUD providers; …

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Testing Balanced Counseling To Improve Provider-Client Interaction In Guatemala's Moh Clinics, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Julio Garcia Colindres, Benedicto Vasquez, Carlos Morales Jan 2003

Testing Balanced Counseling To Improve Provider-Client Interaction In Guatemala's Moh Clinics, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Julio Garcia Colindres, Benedicto Vasquez, Carlos Morales

Reproductive Health

The job aids–assisted Balanced Counseling Strategy adopted by Guatemala’s Ministry of Health required specific instructions for use by nonprofessional providers and an intervention that assured provider compliance with the behavioral requirements of the new paradigm. Results show that the trained providers outperformed the controls in quality of care at each level of session length, but used nine extra minutes per session on average. Nonprofessional providers can take advantage of the job aids–assisted Balanced Counseling Algorithm and substantially improve their quality of care. Extra time invested in counseling new family planning clients will be easily absorbed insofar as they continue to …

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Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena Jan 2003

Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena

Reproductive Health

The purpose of this study was to identify the reasons for the low use of the IUD in Guatemala and to explore the reasons why other reversible methods are selected more frequently than IUDs. The study aimed to determine the availability and acceptability of IUDs as a contraceptive option within the Ministry of Health, the Guatemalan Social Security Institute, and APROFAM. Results indicated that service providers do not take into consideration women’s reproductive needs or intentions when they provide family planning counseling. There are several demand-side factors that affect the use of the IUD, including lack of knowledge about the …

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One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo Jan 2003

One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo

Reproductive Health

This report presents a one-year assessment of quality-of-care improvements in Peru, following provider training on the job aids–assisted Balanced Counseling Strategy. Results showed significant enhancement of quality of care, an increase in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) …

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Policy And Program Implications Of The Matching Grants Program In The Philippines, Marilou Palabrica-Costello, Nimfa Ogena, Alejandro N. Herrin Jan 2003

Policy And Program Implications Of The Matching Grants Program In The Philippines, Marilou Palabrica-Costello, Nimfa Ogena, Alejandro N. Herrin

Reproductive Health

In 1999, the Philippines Department of Health, with support from USAID and technical assistance from Management Sciences for Health (MSH), implemented the matching grants program (MGP) as a component of the local government performance program. The MGP aims to improve the capability of municipalities and component cities to expand service delivery, and to achieve significant increases in rates of fully immunized children, vitamin A supplementation, tetanus toxoid immunization for women, as well as in the use of family planning methods, especially modern methods. Upon the request of the USAID Mission, the Frontiers in Reproductive Health program worked closely with MSH …

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Postabortion Family Planning Operations Research Study In Perm, Russia, Irina Savelieva, John M. Pile, Inna Sacci, Ratha Loganathan Jan 2003

Postabortion Family Planning Operations Research Study In Perm, Russia, Irina Savelieva, John M. Pile, Inna Sacci, Ratha Loganathan

Reproductive Health

EngenderHealth, the Population Council’s FRONTIERS program, and the Research Center of Obstetrics, Gynecology, and Perinatology of the Russian Academy of Medical Sciences, with support from the Perm Health Departments, undertook an operations research study to test models for increasing contraceptive use and reducing the repeat abortion rate among abortion clients in Perm, Russia. The study also assessed the direct and indirect costs of abortion and contraceptive use incurred by women in the year following their index abortion (the abortion which took place the day of entry into the study). The findings of the study were significant for the training interventions …

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Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth Jan 2003

Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth

Reproductive Health

EngenderHealth, in collaboration with the Ministry of Health, conducted an operations research project to examine the feasibility of introducing an integrated three-element model of postabortion care (PAC) services in secondary- and primary-level sites in two predominantly rural regions in Senegal. The intervention provided health personnel with: 1) training to improve clinical competence, counseling, infection prevention, and general care; 2) technical assistance, materials, and support to aid in overcoming challenges; and 3) ongoing monitoring and supervision. The project findings attest to the benefits of expanding existing PAC programs in rural settings and suggest that the advantages of such an expansion outweigh …

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Improving Quality Of Care For Family Planning Services In Uganda, Joel Okullo, Quinto Okello, Harriet Birungi, Ian Askew, Barbara Janowitz, Carmen Cuthbertson, Florence Ebanyat Jan 2003

Improving Quality Of Care For Family Planning Services In Uganda, Joel Okullo, Quinto Okello, Harriet Birungi, Ian Askew, Barbara Janowitz, Carmen Cuthbertson, Florence Ebanyat

Reproductive Health

The Regional Centre for Quality of Health Care at Makerere University, Uganda in collaboration with the Delivery of Improved Services for Health II Project, the Ministry of Health (MOH), and the Population Council’s FRONTIERS Program, conducted an operations research project to help the MOH improve the quality of family planning services with the aim of helping couples better attain their reproductive goals. The study developed a package of interventions (the Yellow Star Programme—YSP) that sought to increase the readiness of clinics to offer basic family planning services, to improve provider motivation, and to empower clients to request quality services. The …

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Creation Of A Unified Management Information System For Three Ngos In The West Bank And Gaza, Health, Development, Information And Policy Institute Jan 2003

Creation Of A Unified Management Information System For Three Ngos In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

The goal of the Pilot Health Project (PHP) has been to improve the health status of Palestinian women and children. To further this goal, the Health, Development, Information and Policy Institute (HDIP) was given the responsibility to develop a management information system (MIS) for the collection, storage, processing, and dissemination of information for PHP clinics. In cooperation with the Palestinian Ministry of Health (MOH) and various healthcare providers and MIS professionals, HDIP worked through a carefully organized and highly participatory process to design and develop the MIS for the PHP. This report reviews that process and presents the features of …

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Assessment Of Pilot Health Project Outcome Indicators: West Bank/Gaza, Laila Nawar, Dale Huntington, Ibrahim Kharboush, Nancy Ali, Mahmoud Shaheen Jan 2003

Assessment Of Pilot Health Project Outcome Indicators: West Bank/Gaza, Laila Nawar, Dale Huntington, Ibrahim Kharboush, Nancy Ali, Mahmoud Shaheen

Reproductive Health

The Pilot Health Project (PHP) was designed to address Palestinian women’s most pressing reproductive health needs. This report presents results from a single cross-sectional study that was conducted by the Health, Development, Information and Policy Institute (HDIP) between May and August 2000 in order to determine the baseline measures for the PHP’s key outcome indicators among healthcare providers and clients in the PHP clinics. Based on the findings reflected by the study, a number of recommendations were made that need to be followed up and implemented by the Improved Village and Community Health Services Project. These include the need for …

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Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health Jan 2003

Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health

Reproductive Health

Many public, NGO, and private-sector service-delivery systems are suitably matched to the requirements of providing injectable contraceptives in India, including the ability to ensure choice and service delivery quality. This operations research study was designed to demonstrate the feasibility of providing injectable contraceptives in private medical practices and to contribute to the body of scientific literature on the acceptability of this method in India. DKT India and EngenderHealth formed a partnership with the Population Council’s Frontiers in Reproductive Health program to conduct this study in Gujarat. The ability to generate recommendations is limited, however, by the special characteristics of the …

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Replication Of The Tostan Programme In Burkina Faso: How 23 Villages Participated In A Human Rights-Based Education Programme And Abandoned The Practice Of Female Genital Cutting In Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching Jan 2003

Replication Of The Tostan Programme In Burkina Faso: How 23 Villages Participated In A Human Rights-Based Education Programme And Abandoned The Practice Of Female Genital Cutting In Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

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Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert Jan 2003

Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert

Reproductive Health

This paper presents the results of an extensive review of the literature pertaining to the relationship between vaginal lubrication and the acceptability of microbicides, spermicides, and male and female condoms. The review highlights the need for research that better elucidates norms, preferences, and practices regarding lubrication during sex within and across countries. The second part of the report presents the results of the first phase of a qualitative study on lubrication during sex showing that diverse personal and cultural factors shape preferences and practices and may ultimately affect the acceptability of microbicides. The immediate challenge is to provide women with …

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Non-Consensual Sexual Experiences Of Young People: A Review Of The Evidence From Developing Countries, Shireen J. Jejeebhoy, Sarah Bott Jan 2003

Non-Consensual Sexual Experiences Of Young People: A Review Of The Evidence From Developing Countries, Shireen J. Jejeebhoy, Sarah Bott

Reproductive Health

Although there is increasing evidence of risky consensual sex among young people in developing countries, non-consensual sexual experiences among them have rarely been studied and few interventions have been designed to protect them from the risks of such experiences. However, what is available suggests that coercion and unwantedness may play a considerable role in the sexual relations of young people—girls and young women but also boys and young men. The implications of non-consensual sexual experiences for young people’s rights, their health and development and the risks they pose in the transition to adulthood are enormous. This review collates what is …

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Changing Family Planning Scenario In India: An Overview Of Recent Evidence, K.G. Santhya Jan 2003

Changing Family Planning Scenario In India: An Overview Of Recent Evidence, K.G. Santhya

Reproductive Health

Over the decades, there has been a substantial increase in contraceptive use in India. The direction, emphasis and strategies of the Family Welfare Programme have changed over time. However, meeting the contraceptive needs of considerable proportions of women and men and improving the quality of family planning services continue to be a challenge. The 1990s witnessed a growing recognition of this, and several innovative policy and programme initiatives have been launched to address these issues. This paper reviews and synthesises evidence from surveys and studies conducted in the 1990s and thereafter on contraceptive use dynamics and the unmet need for …

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