Medicine and Health Sciences Commons^™

Lessons From A Five-Year Research Programme On Fgm/C And Their Relevance For Policy And Programmes In Kenya, Dennis Matanda, Agnes K. Meroka-Mutua, Samuel Kimani

Reproductive Health

The Sustainable Development Goals target the elimination of all forms of harmful practices, including female genital mutilation/cutting (FGM/C) by 2030. Kenya has made progress in addressing the elimination of FGM/C through ratification of global instruments and enactment of the Prohibition of FGM Act in 2011 and other supportive laws. The Act created the foundation for the establishment of the Anti-FGM Board, which provides policy leadership and coordination of anti-FGM/C programs in Kenya. More recently, the President of Kenya issued a decree for accelerated elimination of FGM/C by 2022. This synthesis report highlights how evidence generated over the last five years …

Breastfeeding: Insights For Improving Malaria, Family Planning, And Maternal And Child Health Outcomes In Northwestern Nigeria Through Social And Behavior Change Research, Breakthrough Research

Reproductive Health

This brief provides evidence for implementers and researchers of social and behavior change programs designed to improve community knowledge, attitudes, norms and behaviors for pregnant and postpartum women's health. The brief focuses on key behaviors including early breastfeeding initiation within one hour of birth and exclusive breastfeeding for the first six months of life, while also discussing breastfeeding barriers and facilitators. This is one of a series of briefs that present findings from a Breakthrough RESEARCH study that captured data on a wide range of psychosocial factors of behavioral outcomes for family planning, malaria, and maternal, newborn and child health, …

Building Assets For Humanitarian Settings, Women's Refugee Commission, Population Council

Poverty, Gender, and Youth

This document is the Women’s Refugee Commission and the Population Council’s adaptation of the Building Assets Toolkit and its core activity, the Asset Exercise, for use in humanitarian contexts. An asset-building exercise is a thoughtful way to build intentional program content for girls to determine what assets they need in order to survive and thrive. This is particularly important for programs intended to reach the poorest girls in the poorest communities based on sound evidence on the reality of their lives. The Council’s Building Assets Toolkit is rooted in this exercise, helping practitioners, policymakers, and advocates build tailored, meaningful, …

Female Genital Mutilation/Cutting: A Review Of Laws And Policies In Kenya And Nigeria, Samuel Kimani, Otibho Obianwu

Reproductive Health

Female genital mutilation/cutting (FGM/C) is a cultural practice that has health and human rights impacts on girls and women. The health sector has responsibility for prevention and response to provision of care services to women/girls with FGM/C-related complications. The mandate for the health sector response to FGM/C is anchored in nationwide or sector-specific legal/policy instruments. Kenya and Nigeria have ratified global legal/policy instruments and adopted WHO guidelines/tools for the prevention and management of FGM/C. The extent to which existing legal/policy documents in these two countries address prevention and response to management of FGM/C has been unclear. A desk review was …

Appendices—Female Genital Mutilation/Cutting: A Review Of Laws And Policies In Kenya And Nigeria, Samuel Kimani, Otibho Obianwu

Reproductive Health

This document contains Appendices to “Female Genital Mutilation/Cutting: A Review of Laws and Policies in Kenya and Nigeria.” Appendix 1 contains two tables: “Components of Kenyan Laws Related to FGM/C Prevention and Management,” and “Components of Nigerian Laws Related to FGM/C Prevention and Management.” Appendix 2 contains seven tables: “Components Relevant to Health Sector Response to Prevention and Management of FGM/C in Kenyan Policies,” “Components Relevant to Health Sector Response to Prevention and Management of FGM/C in Nigerian Policies,” “Components Relevant to Health Sector Response to Prevention and Management of FGM/C in the Kenyan Plans of Action,” “Components Relevant to …

Creative Assets And Program Content Guide: To Build Social And Emotional Learning And Promote Trauma Mitigation And Healing, Adolescent Girl And Creativity Network

Poverty, Gender, and Youth

In 2016, the Adolescent Girl and Creativity Network was commissioned by the Population Council’s Community of Practice to utilize their wealth of knowledge and field experience to critically examine, adapt, and expand the Council’s Building Assets Toolkit^© and complementary Asset Exercise. The question explored was: What are the essential assets pertinent to the most-at-risk girls and how can they be built through creative techniques/activities? This guide is the result of that activity—13 creative assets and 50 activities (program content) to build social and emotional learning, mitigate and manage trauma, and promote healing. The 50 creative program content activities to …

Bangladesh: Covid-19 Knowledge, Attitudes, Practices And Needs—Responses From The First Round Of Data Collection Among Adolescent Girls In Five Districts, Population Council

Poverty, Gender, and Youth

The Population Council Bangladesh conducted the first round of a series of rapid phone-based surveys on COVID-19 knowledge, attitudes, and practices and the social and economic impacts of COVID-19 on adolescent girls. The first COVID-19 positive patient in Bangladesh was reported on March 8, 2020. The advent of COVID-19 triggered the closure of all educational institutions. A nationwide “holiday” was declared on March 26, 2020, and a ban was implemented on all passenger travel by water, rail, and air. These restrictions have been partially relaxed, but the disease is spreading rapidly with 28,511 positive cases and 408 deaths as of …

Domestic Work, Sexual Abuse, And Exploitation In Tanzania, James K. Matheka, Elizabeth Shayo, Annabel Erulkar

Poverty, Gender, and Youth

Domestic work is characterized by excessive working hours, extremely low pay or no pay at all, and conditions that make the profession exploitive in many cases. Evidence is emerging that domestic work is a feeder profession for sex work. One study of more than 2,000 commercial sex workers in Ethiopia found that 42 percent were former domestic workers. However, little is known about transitions to commercial sex work or commercial sexual exploitation in Tanzania. The objective of the research detailed in this brief was to expand the understanding of child domestic workers and commercial sex workers/girls who are commercially sexually …

Reducing Hiv Risk Among Young Women And Their Partners: Highlights From The Dreams Implementation Science Research Portfolio, Population Council

HIV and AIDS

The Population Council, with funding from the Bill & Melinda Gates Foundation and the U.S. Agency for International Development through Project SOAR, led a set of implementation science studies to capture multiple perspectives that reflect the innovative aspects of DREAMS. These mixed-method studies conducted across seven countries (Eswatini, Kenya, Malawi, South Africa, Tanzania, Uganda, and Zambia) provide critical evidence that fill knowledge gaps on how to reduce HIV risk among AGYW and their male partners. This brief presents key findings grouped around four areas of inquiry: 1) HIV vulnerability and risk; 2) social drivers of HIV risk; 3) effects of …

Behavioral Sentinel Surveillance Survey In Nigeria: Baseline Technical Report, Emily White Johansson, Paul Hutchinson, Elizabeth Omoluabi, Akanni Akinyemi, Andrea Smith, J. Clint Welty, Udochisom Anaba, Dominique Meekers, Alejandra Leyton, Dele Abegunde, Paul C. Hewett

Poverty, Gender, and Youth

This technical report presents results of the baseline Behavioral Sentinel Surveillance survey by Breakthrough RESEARCH in Nigeria in September and October 2019. From 2019 to 2021, baseline, midline, and endline surveys will assess the effectiveness of Breakthrough ACTION integrated social and behavior change activities for malaria, family planning, and maternal, newborn and child health plus nutrition in Kebbi and Sokoto in comparison to Breakthrough ACTION's exclusively malaria activities in Zamfara state. Malaria activities were initiated in Zamfara in October 2019. This technical report presents detailed baseline results, including comparisons of results for the Breakthrough ACTION integrated and malaria-exclusive program areas. …

Gender Integration In Social And Behavior Change: What Does It Take?, University Research Co., Breakthrough Research

Poverty, Gender, and Youth

This document pulls from a recent review of social and behavior change (SBC)-focused literature and highlights eight promising practices regarding how to integrate gender considerations in health and non-health SBC interventions. The practices are operationalized at different levels of the Socio-Ecological Model for Change and are mutually reinforcing. The purpose of this document is to share these promising practices with SBC partners to strengthen gender integration and mainstreaming efforts in SBC programming.

Nairobi Informal Settlements: Covid-19 Perceptions, Prevention Practices And Impact—Round 3, Population Council

Poverty, Gender, and Youth

This presentation provides an overview from the third round of data collection from a phone survey conducted May 10–11, 2020, in five informal settlements in Nairobi (Kibera, Huruma, Kariobangi, Dandora, and Mathare). Total number of interviews completed was 1,750 (87 percent of Round 1); 37 percent of participants were male, 63 percent were female. Almost all resided in the same location as in the previous interview three weeks prior. The presentation covered myths and misconceptions on COVID-1; risk of being infected; what individuals would do if they had symptoms of COVID-19; testing; stigma; movement outside the home; handwashing behavior; use …

Kenya: Covid-19 Perceptions, Prevention Practices, And Impact—Responses From Third Round Of Data Collection In Five Nairobi Informal Settlements (Kibera, Huruma, Kariobangi, Dandora, And Mathare), Population Council

Poverty, Gender, and Youth

This brief presents findings from Round 3 of data collection in five Nairobi informal settlements (Kibera, Huruma, Kariobangi, Dandora, and Mathare). On May 10–11, 2020, phone interviews were completed with 1,750 adults, representing 87% of the original COVID-19 KAPstudy cohort. The average age of respondents was 36 years, and 63 percent were female. Almost all resided in the same location as in the previous interview three weeks prior. Overall, most participants are impacted economically and socially by the COVID-19 pandemic and associated social distancing and lockdown policies. Many report losing their source of income while also reporting increased costs of …

A Diagnostic Assessment Of The Health System's Response To Fgm/C Management And Prevention In Nigeria, Osasuyi Dirisu, Adetayo Adetunji, Mayokun Adediran, Otibho Obianwu

Reproductive Health

In Africa, it is estimated that 27 million, 24 million, and 20 million girls and women have undergone FGM/C in Egypt, Ethiopia, and Nigeria, respectively, making them the countries with the highest absolute numbers of women and girls living with FGM/C in the continent. Despite the existence of laws, policies, and plans of action that should drive the health system’s response, the practice persists at a substantial level in Nigeria. The goal of the study, detailed in this working paper, was to contribute to a reduction in the prevalence and ultimately the abandonment of FGM/C through a diagnostic assessment of …

When And How The Law Is Effective In Reducing The Practice Of Fgm/C: A Cross-Border Study In Burkina Faso And Mali, Josephine Wouango, Susan L. Ostermann, Daniel Mwanga

Reproductive Health

Female genital mutilation/cutting (FGM/C) is recognized globally for being associated with risks to both the physical and psychological health of girls and women; it is also considered to be a violation of human rights. At present, an estimated 200 million girls and women in 30 countries have undergone FGM/C and as many as 30 million under-15 girls are at risk. A common policy response to FGM/C is to enact laws and enforce criminal prohibitions. This policy brief summarizes key findings from a cross-border study of two neighboring countries: Burkina Faso, which has a strong FGM/C law, and Mali, which has …

Adolescent Girls Initiative–Kenya: Endline Evaluation Report, Karen Austrian, Erica Soler-Hampejsek, Beth Kangwana, Nicole Maddox, Yohannes Dibaba Wado, Benta Abuya, Valsa Shah, John A. Maluccio

Poverty, Gender, and Youth

Early pregnancy is a challenge for girls in Kenya that often has immediate effects on their educational opportunities, future implications for their social, health, and economic outcomes, and negative impacts on their children. For girls to achieve well-being in early and late adolescence, no single-sector intervention—whether education, health, wealth creation, or prevention of violence—will be adequate. The Adolescent Girls Initiative–Kenya (AGI-K) delivered multisectoral interventions to over 6,000 girls aged 11–15 in two marginalized areas of Kenya: the Kibera informal settlement in Nairobi and Wajir County in Northeastern Kenya. These interventions were carried out for two years (2015–17) and comprised a …

Guatemala Indigenous Municipalities: Covid-19 Knowledge, Attitudes, And Practices, Population Council

Poverty, Gender, and Youth

This presentation recounts findings on COVID-19 knowledge, attitudes, and practices in Guatemala’s indigenous municipalities. A total of 144 phone-based key informant interviews were conducted from April 14–18, 2020, in ten municipalities. Key informants included indigenous women, heads of households, teachers, community leaders, municipal officers, and frontline health workers. Recommendations include: 1) intensifying government efforts to deliver accurate information on the prevention of COVID-19 to indigenous communities with a focus on developing a COVID-19 roadmap for community action after the first case is identified in a given municipality, and considering alternatives for self-isolation for the poorest households; 2) conveying tailored, actionable …

Bangladesh: Covid-19 Knowledge, Attitudes, Practices And Needs, Population Council

Poverty, Gender, and Youth

No abstract provided.

Covid-19-Related Knowledge, Attitudes, And Practices Among Adolescent Girls In Bangladesh: Concept Note, Sajeda Amin

Poverty, Gender, and Youth

The Population Council COVID-19 study team is implementing rapid phone-based surveys of a representative sample of girls living in the catchment area of two skills-building programs. The two programs (one with UNFPA, the Ministry of Women and Children Affairs; and the second with UNICEF and the Ministry of Education/DSHE) are affiliated with the UNFPA-UNICEF Global Programme to Accelerate Action to End Child Marriage. The overall goal of the programs is to prevent child marriage. The rapid assessment will explore how the pandemic and associated lockdown is changing girls' experience of schooling, time use, care responsibilities and household scarcity as mediating …

Guatemala: Covid-19 Knowledge, Attitudes And Practices—Perspectives From 144 Key Informants In 10 Indigenous Municipalities, Population Council

Poverty, Gender, and Youth

NOTE: This brief represents research in progress. Content has not been peer reviewed, and this version may be updated with additional analyses in subsequent publications.

---

The Population Council has a longstanding partnership with indigenous communities through the Abriendo Oportunidades program. Our experience working in indigenous settings has allowed us to witness a lack of indigenous inclusion in government activities. To better understand indigenous knowledge, perspectives, and needs related to the COVID-19 pandemic in Guatemala, we conducted 144 key informant interviews using mobile phones in ten municipalities from April 14–18, 2020. This brief describes highlights of the key informant interviews; …

Adapting The Asset Exercise For Humanitarian Contexts, Women's Refugee Commission, Population Council

Poverty, Gender, and Youth

As a guiding program theory, asset-building centers on the idea that skills, knowledge, relationships, and concrete resources can all constitute assets, or “stores of value,” that girls can, in turn, mobilize to make healthy choices, seek support, navigate institutions, and access entitlements. This approach is inherently multisectoral, rooted in a commitment to prioritize understanding of and respond to the diversity of girls’ needs, capacities, and experiences. The Asset Exercise operationalizes the concept of “asset-building” into concrete terms. The exercise consists of a deck of 100 “asset cards,” and eight “age cards.” Asset cards reflect both intrinsic qualities, concrete knowledge, and …

Fertility Preferences And Behaviors Among Younger Cohorts In Egypt: Recent Trends, Correlates, And Prospects For Change, Nahla G. Abdel-Tawab, Shadia Attia, Nourhan Bader, Rania Roushdy, Shatha El-Nakib, Doaa Oraby

Reproductive Health

After years of steady decline, Egypt experienced an increase in the total fertility rate (TFR) from 3.0 births per woman in 2008 to 3.5 in 2014, which was coupled with an increase in desired family size among young people. To better understand this increase in fertility as well as prospects for change, the Evidence Project/Population Council conducted secondary analyses of quantitative data from the Egypt Demographic and Health Survey (EDHS) and the Survey of Young People in Egypt (SYPE) and collected qualitative data from young people and key informants. This report examines the changes in fertility preferences and behaviors among …

The Community Health System In Mali: An Overview, Frontline Health Project

Reproductive Health

This brief provides an overview of the community health system in Mali. The system is decentralized and operates across five levels: national, regional, district, health area, and community. It relies on two cadres of community health workers to deliver health-care services, primarily to rural populations: agents de santé communautaire (ASCs) and relais communautaire. The National Implementation Guide for Essential Community Health Care is the main document that outlines responsibilities of community health providers and processes for organization, management, and delivery of health services. Although Mali’s maternal, child (under five years), and infant mortality rates have fallen over the past two …

The Community Health System In The Drc: An Overview, Frontline Health Project

Reproductive Health

This brief provides an overview of the community health system in the Democratic Republic of the Congo (DRC). The community health system is decentralized and operates across five levels: national, provincial, health zone, health area, and community. Various policy documents guide DRC’s community health system, including The National Health Development Plan 2016–2020. Relais communautaire (RECOs) are the main cadre of community health workers operating in the DRC. They are volunteers who provide a minimum package of reproductive, maternal, newborn, and child health services, including the provision of family planning; integrated community case management for malaria, diarrhea, and respiratory diseases; nutrition …

When And How Does Law Effectively Reduce The Practice Of Female Genital Mutilation/Cutting?, Josephine Wouango, Susan L. Ostermann, Daniel Mwanga

Reproductive Health

Female genital mutilation/cutting (FGM/C) is recognized globally as carrying risks to both the physical and psychological health of girls and women and is widely considered a violation of human rights. An estimated 200 million girls and women in 30 countries have undergone FGM/C and as many as 30 million girls younger than 15 years of age are at risk. A common policy response to FGM/C is to call for the enactment and enforcement of criminal prohibitions on the practice. Yet, compliance with laws is complex: it can be motivated and undercut by moral, social, religious, and incentive-based factors. The study …

Measurement Of Female Genital Mutilation/Cutting Status: Perspectives From Healthcare Providers, Policymakers, Programme Implementers, And Researchers, Dennis Matanda

Reproductive Health

Among practicing communities, female genital mutilation/cutting (FGM/C) is a highly sensitive and emotionally charged issue, and open discussion is often considered taboo. Not only may it be difficult to motivate people to discuss the topic, but the validity of their responses may be questionable. These factors make research on FGM/C challenging and hence the need for careful consideration of research methodologies. There is a need for proper documentation of the strengths and limitations of the various data-collection methodologies to assist in generating reliable data for programmatic efforts toward FGM/C abandonment. This working paper describes a study undertaken to highlight methodological …

Covid-19-Related Knowledge, Attitudes, And Practices Among Adolescents And Young People In Bihar And Uttar Pradesh, India: Study Description, Rajib Acharya, Mukta Gundi, Thoai Ngo, Neelanjana Pandey, Sangram Kishor Patel, Jessie Pinchoff, Shilpi Rampal, Niranjan Saggurti, K.G. Santhya, Corinne White, A.J. Francis Zavier

Poverty, Gender, and Youth

To control the spread of COVID-19 in India and to aid the efforts of the Ministry of Health and Family Welfare (MOHFW), the Population Council and other non-governmental organizations are conducting research to assess residents’ ability to follow sanitation and social distancing precautions under a countrywide lockdown. The Population Council COVID-19 study team is implementing rapid phone-based surveys to collect information on knowledge, attitudes and practices, as well as needs, among 2,041 young people (ages 19-23 years) and/or an adult household member, sampled from an existing prospective cohort study with a total sample size of 20,574 in Bihar (n=10,433) and …

Nairobi Informal Settlements: Covid-19 Knowledge, Attitudes, Practices And Needs—Round 2, Population Council

Poverty, Gender, and Youth

To control the spread of coronavirus, the Kenyan Ministry of Health COVID-19 Taskforce has implemented initial prevention and mitigation measures. Of concern are the densely overcrowded, poor urban slums where sanitation and social distancing measures are near impossible. COVID-19 would spread rapidly and be devastating under these conditions. To inform the Taskforce strategy, the Population Council COVID-19 study team utilizes rapid phone-based surveys to collection information on knowledge, attitudes and practices among ~2,000 heads of household sampled from existing prospective cohort studies across five Nairobi urban slums. Iterations of the survey will be conducted every 1-2 weeks. Baseline findings on …

Kenya: Covid-19 Knowledge, Attitudes, Practices And Needs—Responses From Second Round Of Data Collection In Five Nairobi Informal Settlements (Kibera, Huruma, Kariobangi, Dandora, Mathare), Population Council

Poverty, Gender, and Youth

To control the spread of coronavirus, the Kenyan Ministry of Health COVID-19 Taskforce has implemented initial prevention and mitigation measures. Of concern are the densely overcrowded, poor urban slums where sanitation and social distancing measures are near impossible. COVID-19 would spread rapidly and be devastating under these conditions. To inform the Taskforce strategy, the Population Council COVID-19 study team utilizes rapid phone-based surveys to collection information on knowledge, attitudes and practices among ~2,000 heads of household sampled from existing prospective cohort studies across five Nairobi urban slums. Iterations of the survey will be conducted every 1-2 weeks. Baseline findings on …

Migration And Covid-19: Uttar Pradesh And Bihar, Population Council Institute

Poverty, Gender, and Youth

To control the spread of COVID-19 in India and to aid the efforts of the Ministry of Health and Family Welfare, the Population Council and other nongovernmental organizations are conducting research to assess residents’ ability to follow sanitation and social distancing precautions under a countrywide lockdown. The Population Council COVID-19 study team is implementing rapid phone-based surveys to collect information on knowledge, attitudes, and practices, as well as needs, among 1,237 young people. As noted in this brief, Uttar Pradesh (UP) and Bihar are two of the highest out-migration states in India. Migration is mostly to metropolitan areas in Delhi, …