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Scaling-Up Improved Postabortion Care In Egypt: Introduction To University And Ministry Of Health And Population Hospitals, Laila Nawar, Dale Huntington, Ezzeldin Osman Hassan, Hala Youssef, Nahla G. Abdel-Tawab

Reproductive Health

In Egypt, the legal, religious, and societal restrictions on abortion have constrained the provision of high-quality emergency health care services provided to postabortion patients, including links with family planning (FP) services. In 1994, a small-scale pilot study was conducted by the Egyptian Fertility Care Society and the Population Council's ANE OR/TA Project (1995) to improve postabortion care in Egypt. The study intervention included an intensive training program for physicians on the use of Manual Vacuum Aspiration instruments under local anesthesia. Physicians were also instructed in infection-control practices and counseling postabortion patients about their medical condition and FP. The study findings …

Male Involvement In Family Planning: A Kabp Study Of Agra District, Uttar Pradesh, M.E. Khan, Bella C. Patel

Reproductive Health

Although lack of male involvement in family planning has been a topic of research and discussion since the early 1980s, during the last five years it has become an important issue for women advocates, researchers, and many international agencies that are committed to reproductive health and gender equality. The large number of articles on this subject and growing number of conferences, research projects, and debates are testimonies to the importance of the issue, both from the programmatic point of view and as a process for bringing about a gender balance in men's and women's reproductive rights and responsibility. This paper …

Sexual Violence Within Marriage: A Case Study Of Rural Uttar Pradesh, M.E. Khan, John Townsend, Ranjana Sinha, Seema Lakhanpal

Reproductive Health

Until recently the study of sexual behavior, despite being a very important area of human behavior, has remained an untouchable subject. The sensitivity of the subject and difficulties collecting required information discouraged social scientists from venturing into this area of human behavior. However, the advent of AIDS and its rapid spread in India has changed the scenario. Today the study of sexual behavior is an important subject and both national and international agencies, as part of the AIDS control program, are encouraging research on the subject. This paper addresses a totally neglected area, which is sexual coercion within marriage. The …

Postabortion Case Load Study In Egyptian Public Sector Hospitals, Egyptian Fertility Care Society, Population Council

Reproductive Health

There is an absence of reliable data on the incidence of incomplete abortion in Egypt. A diagnostic, descriptive study that neither tests an experimental intervention nor evaluates in a comprehensive manner the quality of postabortion medical care was undertaken to address this issue. The study is a cross-sectional observation of the volume and nature of the postabortion case load in Egyptian public-sector hospitals, and it responds to the following objectives: 1) Accurately estimate the number of women who present for postabortion treatment in ob/gyn in-patient facilities as a percentage of ob/gyn admissions in a representative sample of Egyptian public-sector hospitals …

Utilization Of Operations Research In Egypt, Sahar Hegazi

Reproductive Health

This study aims to maximize the utilization of operations research (OR) findings in Egypt to strengthen research efforts contributing to the improvement of the family planning (FP) and reproductive health (RH) care program. To date, the field of OR in Egypt has not conducted a systematic review of the utilization of the OR studies completed over the last decade. The long-term objective of this study, as noted in this report, was to maximize the utilization of OR and strengthen future efforts contributing to the improvement of the FP and RH care program in Egypt. The study’s sample included selected studies …

Experience With Clinical Training In Postabortion Care In Egypt: Improving Medical And Interpersonal Skills, Sahar Hegazi, Dale Huntington

Reproductive Health

The Population Council’s Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project is collaborating with AVSC International to incorporate the addition of improved postabortion care procedures into the ongoing Safe Reproductive Health Care project. An element in the next phase of the program’s evolution was a two-day seminar held in Alexandria, Egypt. This seminar provided an opportunity for staff from ten hospitals that participated in the 1996–97 expansion program to present their own experience and impressions of the postabortion case-management procedures, and to discuss their strengths and weaknesses. This report presents an overview of this meeting’s presentations …

Implant Users: Over Five Years After Insertion (Further Analysis Of Previous Study Data), Jayanti Tuladhar, Joedo Prihartono

Reproductive Health

This secondary analysis report presents the characteristics of a subgroup of 235 women who are overdue in getting Norplant® implants removed after five years, factors related to the risk of nonremoval after five years, and issues related to accessing information about removal of implants. The main source of data for the present study is the “Norplant Implants® Assessment Study: Insertion, Use, and Removal” carried out in Indonesia in April 1996. This study consisted of a representative sample of 2,979 current and former Norplant users who had an insertion from April 1, 1987, to March 31, 1991, five or more years …

Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey

Reproductive Health

In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and …

Reproductive Behavior Among Muslims In Uttar Pradesh, M.E. Khan, Bella C. Patel

Reproductive Health

Muslims form the largest minority group in India, according to the 1991 census, constituting about 12 percent of the country's population. India has the second largest Muslim population in the world. The growth rate of the Muslim population in India during the last three decades is somewhat higher than the non-Muslim population. The present paper, based on a large sample survey carried out in Uttar Pradesh, India, compares the reproductive behavior of Hindus and Muslims. An attempt has been made to examine the determinants of their differential fertility and family planning behavior.

Dmpa Provision In Pss Clinics In Uttar Pradesh: Costs And Prices, Saumya Ramarao, John Townsend, Leila Caleb-Varkey, Sudha Tiwari, Sneh Vishwanath, Harbans Singh

Reproductive Health

The injectable contraceptive DMPA was introduced in the private sector in India in 1993, contingent on completion of a post-marketing surveillance study of users. The commercial price of a dose of DMPA is about Rs. 150-180, exclusive of the fees of the medical provider. This price puts it beyond the reach of most Parivar Seva Sanstha (PSS) clients in need of safe and effective family planning (FP) services in Uttar Pradesh. Since April 1996, an experiment has been underway with three PSS clinics in Uttar Pradesh to study the effect of price on demand for DMPA. The study seeks to …

The Situation Analysis Approach To Assessing Family Planning And Reproductive Health Services: A Handbook, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba

Reproductive Health

Good family planning service delivery emphasizing both access and quality is key to the related goals of satisfying individual needs and achieving programmatic success. Situation Analysis (SA) provides a needed link between the manager and the client he or she is trying to serve. The data marshaled for SA offer a representative picture of how subsystems are working and provide a way to “see” the client’s experience. Situation Analyses assist managers in achieving the broadest management goal—that of efficient administration of a vital health care service while keeping in view the ultimate goal—providing good care for those who seek it. …

Youth Centres In Kenya: Evaluation Of The Family Planning Association Of Kenya Programme, Annabel Erulkar, Barbara Mensch

Reproductive Health

Since 1987, the Family Planning Association of Kenya (FPAK) has operated two youth centers, one in Nairobi and the other in Mombasa. The centers target unmarried youth aged 10–24 and their primary objective is reduction in incidence of sexual and reproductive-health-related problems. These centers offer recreational and sports facilities, counseling services, including reproductive health (RH) information, limited RH services, and referrals. In 1996, FPAK undertook a systematic evaluation of its youth-center program including a situation analysis of the centers, a survey in their catchment areas, and an analysis of program costs. The main strength of the program was found to …

The Theater Of The Absurd In Europe And America: Sartre, Beckett, Pinter, Albee And Drama Criticism, Sheila O'Brien Mcguckin

Doctoral Dissertations

This study examines the significance of the post World War II Theater of the Absurd which explored new concepts of ontology and semiology and provided a vehicle for the dissemination of existentialist ideas. As a link between modernist and postmodernist drama, it also served as a catalyst for changes in drama criticism that anticipated some of the controversies of deconstructionism.

The first part of this work places the Theater of the Absurd in historical context by tracing elements of absurdity from the theater of ancient Greece into the twentieth century. Modern absurdism emerged in the 1930's as part of the …

Clinic-Based Investigation Of The Typology And Self-Reporting Of Fgm In Egypt, Population Council

Reproductive Health

This clinic-based study of female genital mutilation (FGM) was designed and carried out by the Egypt Fertility Care Society to gather detailed information on the types of FGM practiced in Egypt. The study involved interviews with clinic clients to elicit information about their experience and attitudes concerning FGM, and gynecological examinations by specially trained OB/GYN physicians. In all, 93% of the women in this study were found to have some type of FGM. The study's findings were incorporated in the final report of the 1995 Egyptian Demographic and Health Survey, with the aim of contributing to the scientific understanding of …

Reproductive Tract Infection—Lessons Learned From The Field: Where Do We Go From Here?, Jennifer Grant, Diana Measham

Reproductive Health

The Population Council convened a meeting about reproductive tract infections (RTIs) to examine how best to use available tools and information, learn about potential service delivery approaches, and examine the direction of research. The meeting began with an examination of what is known about the prevalence, distribution, determinants, characteristics, and consequences of RTIs, as well as the common elements of an intervention framework. General obstacles related to work in the area of RTIs include lack of awareness of the problem and the limited power of women in society. Priorities for future research and programming include: further research on the scope …

A Situation Analysis Of The Maternal And Child Health/Family Planning (Mch/Fp) Program In Botswana, Benjamin Baakile, Lucy Sejo Maribe, Baker Ndugga Maggwa, Robert A. Miller

Reproductive Health

Botswana has a rapid annual population growth rate and a high total fertility rate. It also has one of the highest levels of contraceptive use in sub-Saharan Africa. Infant and under-5 mortality rates have fallen, yet maternal mortality remains high. The Government of Botswana has developed an extensive network of health care facilities that provide services through an integrated approach. Family planning (FP) services are available at all three levels of the MOH system (hospitals, clinics, health posts). Services for managing sexually transmitted diseases (STDS) have recently undergone a substantial change with the introduction of the Syndromic Approach to STD …

Prospective Population Growth And Policy Options For India, 1991–2101, Leela Visaria, Pravin Visaria

Reproductive Health

India, the second most populous country in the world, experienced an accelerated decline in fertility during the 1980s. As a result, India’s total fertility rate (TFR) in 1993, 3.5 births per woman, is below the level presumed in the population projections of the United Nations and the World Bank. This favorable development has occurred as India is attempting to reorient its family planning program to focus on the reproductive health of women and the health and welfare of children. The method-specific targets for contraceptive acceptors assigned to every grassroots health worker were abandoned in April 1996. Against this backdrop, this …

Rapid Appraisal Of Ipp-Vi Training Of Anms In Uttar Pradesh, M.E. Khan, Saumya Ramarao, R.B. Gupta, Sulbha Swaroop, Leila Caleb-Varkey, Anoop K. Saxena, Anil Mishra

Reproductive Health

This report provides findings of a rapid appraisal of the Auxiliary Nurse Midwife (ANM) training program in Uttar Pradesh, India. The appraisal was undertaken by the Population Council and State Innovations in Family Planning Agency (SIFPSA). As SIFPSA is in the process of planning a training program to strengthen the technical skills and competence of ANMs and update their contraceptive knowledge, it was felt that a rapid appraisal of the training program would help in understanding the strengths and weaknesses of previous training efforts. The ANM training initiatives of SIFPSA would then build upon the experiences gained from earlier training …

Community Participation In Health, Family Planning And Development Activities: A Review Of International Experiences, Abbas Bhuiya, Fatima Yasmin, Farida Begum, Ubaidur Rob

Reproductive Health

The family planning (FP)/maternal and child health (MCH) program in Bangladesh has achieved success in the recent past, mostly through a large-scale government service-delivery system with support and cooperation from donors and nongovernmental organizations. There is concern about the financial and social sustainability of the program. Other issues include achievement of replacement-level fertility within a stipulated period and improvement of MCH-FP service quality. It is widely believed that most of the concerns will be taken care of with effective community participation. Before activating community initiatives, it is worth carrying out action research. A literature review was completed from July to …

Quality Of Family Planning Programme In India: A Review Of Public And Private Sector, Dileep V. Mavalankar

Reproductive Health

Increasing attention has been paid to quality of care (QOC) in family planning (FP) during the last few years, and there have been several initiatives to strengthen QOC in FP in the developing world. This paper reviews the quality of the FP program in India’s public and private sectors, and examines six elements: choice of methods, information given to clients, technical competence, interpersonal relations, continuity of care and follow-up, and appropriate constellation of services. Overall, the paper finds that not much attention has been paid to QOC and hence the level is quite low. Evidence and observations indicate that QOC …

Reintroducing Dmpa To The Philippine Family Planning Program: A Longitudinal Study Of Continuing Users And Drop-Outs, Population Council

Reproductive Health

In 1994, the Population Council, Manila, conducted an operations research (OR) project entitled “DMPA Monitoring and Follow-up Studies.” The activity was undertaken to provide accurate and timely support to the DMPA Reintroduction Program of the Department of Health. Commonly known as Depo-Provera, DMPA stands for Depo-Medroxy Progesterone Acetate, an extremely effective injectable contraceptive given every three months. This report focuses on the survey component of these studies which aims to comprehensively examine the influence on DMPA use of factors classified into the following eight major areas: socioeconomic and demographic characteristics; reproductive history; contraceptive history; adoption of DMPA; quality of care …

Proceedings Of The Operations Research Training Workshop For Program Managers And Researchers, January 15-21, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This document contains the proceedings of the training workshop on operations research (OR) for program managers and researchers held January 15-21, 1996, in Mindoro, Philippines. The workshop was co-sponsored by the Family Planning Service of the Department of Health and the Family Planning Operations Research and Training Program of the Population Council, Manila. Representatives from the health and population offices of ten local government units (LGUs) worked with a select group of researchers to evolve a list of relevant topics for operations research (OR) and develop a concept paper on a chosen OR topic. The LGUs represented in the workshop …

Unsafe Abortion In Kenya: Findings From Eight Studies, Khama Rogo, Ann Leonard

Reproductive Health

One of the most topical areas in reproductive health today is the consequences of induced and often unsafe abortion. Safe motherhood initiatives continue to highlight the contribution of unsafe abortion to the persistent high rates of maternal mortality and morbidity in sub-Saharan Africa. In some countries, unsafe abortion is responsible for up to half of all maternal mortality and morbidity, with adolescents constituting a significant proportion of those procuring unsafe abortions. In Kenya, concern about the problem of incomplete and septic abortion has increased, particularly on the part of service providers who must treat women suffering from the complications of …

Adolescent Family Life Education: Review Of Curriculum, Ladly Faiz, Hasina Banu, Devi Sharma

Poverty, Gender, and Youth

Adolescents, who are about 23 percent of the total population of Bangladesh, are entitled to grow up as healthy and responsible members of society. The Adolescent Life Education (ALE) program ensures the rights of this large section of the population and helps them develop as healthy and responsible members of their family and society. ALE is internationally known as Family Life Education, and its incorporation in Bangladesh’s education sphere is a recent phenomenon. Due to rapid social change worldwide, the young generation is presently facing an enormous problem coping with the erosion of traditional family, social life, and values. Adolescent …

Living On A Fault Line: Political Violence Against Women In Algeria, Leila Hessini

Poverty, Gender, and Youth

This study raises three questions to better comprehend the crisis women face in Algeria today: how are the state and the opposition groups addressing and defining women’s contemporary status, what is the link between women’s status and violence against them, and what are the tactics both of resistance and accommodation that Algerian women are using to survive in such a context? Throughout this study, the term “Islamic Fundamentalists” refers to movements and people in Algeria who use the “recovery” of early principles of the Ideal Muslim Community to develop their idea of a future Islamic “social order,” with the ultimate …

Components Of Kenya's Future Population Growth And Population Policy Implications, John Kekovole

Poverty, Gender, and Youth

The world’s population has grown rapidly from about 2.5 billion in 1950 to a current size of 5.8 billion. As noted in this report, most of the increase has been recorded in the developing countries of Africa, Asia, and Latin America due to continued high fertility in the face of reductions in levels of mortality. Kenya provides a unique opportunity to study the impact of various policy options on future population growth. The primary objective of this study is to measure the impact of different causes of continued population growth on Kenya’s future size and to formulate appropriate policy measures …

Out Of The Shadows: Homebased Workers Organize For International Recognition, Renana Jhabvala, Jane Tate

Poverty, Gender, and Youth

Home-based work is a vital and growing part of economic modernization, exponentially linked to the globalization of industry and the never-ending search for less costly sources of labor and more efficient means of production. As governments seek to attract industrial development, the availability of low-cost labor and labor stability is a valuable bargaining commodity. Furthermore, the income it produces is not supplementary but rather increasingly vital to families and nations alike. The women who embroider on the island of Madeira, Portugal, the home-based workers assembling electronic devices in Brazil, the Chinese women machine stitching garments at home in major cities …

Women's Perceptions Of Sexuality In Rural Giza, Hind Khattab

Poverty, Gender, and Youth

This study on sexuality among women in rural Giza, Egypt, is part of a broader project on women's health and reproductive morbidity conducted by the Population Council’s Reproductive Health Working Group. Reproductive tract infections (RTIs) and other ailments associated with reproduction among women in the rural community surveyed suggest that a heavy burden of disease is being borne by women living in underprivileged areas in this region. This research on sexuality has been conducted within a conceptual framework that uses a socio-cultural approach to health and illness. The investigation is an assessment of women's perception of and knowledge about sexuality …

Sources Of Future Population Growth In The Philippines And Implications For Public Policy, Alejandro N. Herrin, Marilou P. Costello

Poverty, Gender, and Youth

Rapid population growth, poor and uneven economic performance, and slow progress in health and education are interrelated phenomena. However, while there is strong support for public policies aimed at economic recovery and human resource development in the Philippines, there is still a lack of consensus on the need for public policy to moderate population growth and on the role of a government-sponsored family planning program in overall population and development activities. This paper examines alternative population projections and analyzes the contribution to future population growth of unwanted fertility, high desired family size, and population momentum. The aims are to highlight …

Learning About Sexuality: A Practical Beginning, Sondra Zeidenstein, Kirsten Moore

Poverty, Gender, and Youth

“Learning About Sexuality: A Practical Beginning” is divided into three main parts. The first includes approaches that program staff, activists, and researchers are taking to understand people’s experiences of sexuality. The second explores the explicit and implicit links among health-seeking behavior, contraceptive practice, reproductive health, and sexuality. The chapters in part three focus on activities that challenge entrenched attitudes and behavior about sexuality that have real and potentially harmful effects on women’s and men’s reproductive health. The book features program and research work in all regions of the world with women, men, girls, and boys. The chapters are written by …