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Full-Text Articles in Medicine and Health Sciences
Scaling Up Family Planning In Zambia—Part 2: The Cost Of Scaling Up Family Planning Services, David Collins, Colin Gilmartin
Scaling Up Family Planning In Zambia—Part 2: The Cost Of Scaling Up Family Planning Services, David Collins, Colin Gilmartin
Reproductive Health
This costing study is Part 2 of a broader implementation research study designed to establish the feasibility of integrating successful interventions and lessons from the Scaling Up Family Planning (SUFP) project into Zambia’s health system at the conclusion of the project, and to contribute to the global learning on scaling up family planning services. The main contribution of the costing study was to examine the cost implications in determining the scope and pace of scale up. Challenges experienced during the project reportedly included lack of equipment and limited space in some facilities, government staff shortages, and irregular access to supplies …
Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee
Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee
Reproductive Health
To support the Government of Zambia in addressing its reproductive health challenges and in meeting its goals for 2020, the United Kingdom Department for International Development funded a four-year effort to support public sector contraceptive expansion under the Scaling Up Family Planning (SUFP) Project, led by Abt Associates. Launched in 2012, and with a focus on hard-to-reach areas and youth and expanding access to long-acting reversible contraceptives, SUFP was a technical assistance program designed to strengthen the ability of the public sector to provide services to meet the country’s FP2020 goals. SUFP focused on capacity building, infrastructure strengthening, behavior change …
Standard Days Method Of Contraception: Evidence On Use, Implementation, And Scale Up, Kelsey Wright, Hiba Iqteit, Karen Hardee
Standard Days Method Of Contraception: Evidence On Use, Implementation, And Scale Up, Kelsey Wright, Hiba Iqteit, Karen Hardee
Reproductive Health
In 2002, an article in Contraception reported on a trial for a new method of contraception, the Standard Days Method (SDM). SDM is a fertility awareness-based family planning (FP) method that identifies the eighth through nineteenth days of a woman’s menstrual cycle as the fertile window. SDM users abstain or use barrier methods during their fertile periods to prevent pregnancy. The trial established a first-year method failure rate of 5 per 100 woman years with correct use, and 12 per 100 women for typical use. Over the decade since the publication of the original efficacy trial, the Georgetown University Institute …
Research Gaps In Scale Up Of Family Planning And Reproductive Health Programming, The Evidence Project, E2a, Hpp, Measure Evaluation
Research Gaps In Scale Up Of Family Planning And Reproductive Health Programming, The Evidence Project, E2a, Hpp, Measure Evaluation
Reproductive Health
The Evidence Project, in collaboration with the Evidence to Action Project, the Health Policy Project, and MEASURE Evaluation convened a meeting to discuss research gaps related to scale-up. The meeting was held at the request of USAID’s Office of Population and Reproductive Health (OPRH) to help guide their research strategy. The meeting had four objectives: discuss scale-up experiences and the role of research and monitoring for strengthening program performance at scale; identify research gaps related to scale-up; prioritize the scale-up research gaps for OPRH; identify next steps for addressing these priority research gaps. This meeting generated a rich discussion about …
Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows
Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows
Reproductive Health
This document reports on the Government of Kenya’s Output-Based Aid (OBA) vouchers program—an affordable strategy to meet the international and national objectives for improved maternal and reproductive health. To help achieve the global Millennium Development Goals related to maternal and child health, the Kenyan government has launched several initiatives including this Vision 2030 flagship program which harmonizes global and national objectives by improving access and enhancing equity in health service delivery. The report finds that the three maternal health MDG indicators—maternal mortality rate, rate of institutional deliveries, and contraceptive prevalence—can all be improved substantially by scaling up the OBA program. …
Using Evidence-Based Recommendations For Guidance, Guidelines And Scale-Up Strategies, Ian Askew
Using Evidence-Based Recommendations For Guidance, Guidelines And Scale-Up Strategies, Ian Askew
Reproductive Health
No abstract provided.
Scaling Up The Integration Of Tuberculosis Screening Into Reproductive Health Services, Aphia Ii Or Project In Kenya
Scaling Up The Integration Of Tuberculosis Screening Into Reproductive Health Services, Aphia Ii Or Project In Kenya
Reproductive Health
The Population Council’s APHIA II Operations Research and Kenya’s Ministry of Health implemented a pilot project in five facilities across Nairobi Province in 2010 with the aim of improving access to care and treatment for tuberculosis (TB) for women during postnatal care (PNC) services. As tuberculosis persists in Kenya, integration of screening and referrals within postnatal care services will increase case detection and treatment for those infected. Integration of TB screening is likely to be scaled up throughout PNC and maternal and child health services in Kenya. Strong linkages between health services, training, and supervision, and simple provider tools will …
Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya
Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya
Reproductive Health
This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …
From Pilot To Program: Scaling Up The Kenya Adolescent Reproductive Health Project, Humphres Evelia, Japheth Nyambane, Harriet Birungi, Ian Askew, Rikka Trangsrud, Eva Muthuuri, Irene Chaami, Agnes Odawa, Lucy Musyoka, Susan Mutungi, Margaret Githuiya, Joan Omuruli
From Pilot To Program: Scaling Up The Kenya Adolescent Reproductive Health Project, Humphres Evelia, Japheth Nyambane, Harriet Birungi, Ian Askew, Rikka Trangsrud, Eva Muthuuri, Irene Chaami, Agnes Odawa, Lucy Musyoka, Susan Mutungi, Margaret Githuiya, Joan Omuruli
Reproductive Health
The Population Council’s Frontiers in Reproductive Health Program and the Program for Appropriate Technology in Heath collaborated with three Government of Kenya ministries—Education; Health; and Gender, Sports, Culture and Social Services—to design and implement the Kenya Adolescent Reproductive Health Project with the goals of: improving knowledge about reproductive health and encouraging a responsible and healthy attitude toward sexuality among adolescents, delaying the onset of sexual activity among younger adolescents, and decreasing risky behaviors among sexually active adolescents. Key findings from the pilot project showed that the three ministries could successfully implement these interventions with high participation among parents and youth. …
Using Systematic Screening To Integrate Health Services In India And Senegal: Pilot Study Versus Scale-Up Results, James R. Foreit
Using Systematic Screening To Integrate Health Services In India And Senegal: Pilot Study Versus Scale-Up Results, James R. Foreit
Reproductive Health
This study examines the effectiveness of using systematic screening to integrate health services in India and Senegal. First, a pilot study of relatively small-scale experiments was undertaken to determine if systematic screening for unmet needs for health services could increase the number of preventive care services clients receive at healthcare visits. FRONTIERS then participated in the scale-up to test the effect of different supervision and training strategies on the frequency of provider screening. Results show that systematic screening may have the potential to produce important increases in the number of services provided in many developing country settings at the pilot …
Creating The Conditions For Scaling Up The Integration Of Reproductive Health Services For Men In Health And Family Welfare Centers In Bangladesh, M.A. Mannan, Jafar Ahmad Hakim, Syeda Tazneen Waris, Ashraf Ali, Akm Nurul Hakim, Abdul Hannan, Sameena Chowdhury, Saria Tasnim, Saiful Islam, Aqm Rezaul Karim, Sharif M.I. Hossain, Ubaidur Rob, M.E. Khan
Creating The Conditions For Scaling Up The Integration Of Reproductive Health Services For Men In Health And Family Welfare Centers In Bangladesh, M.A. Mannan, Jafar Ahmad Hakim, Syeda Tazneen Waris, Ashraf Ali, Akm Nurul Hakim, Abdul Hannan, Sameena Chowdhury, Saria Tasnim, Saiful Islam, Aqm Rezaul Karim, Sharif M.I. Hossain, Ubaidur Rob, M.E. Khan
Reproductive Health
An operations research study, supported by the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, showed that reproductive health services for men could be feasibly and acceptably integrated within the Health and Family Welfare Centres in Bangladesh, which have been primarily women-centered health facilities. Given these findings, a follow-up study was implemented to create the conditions for scaling up the model through identifying and piloting the operational details to consider when taking the intervention to scale. The findings presented in this report suggest that this model of service delivery and training can be scaled up countrywide, preferably in stages. To …
Taking Critical Services To The Home: Scaling-Up Home-Based Maternal And Postnatal Care, Including Family Planning, Through Community Midwifery In Kenya, Annie Mwangi, Charlotte E. Warren
Taking Critical Services To The Home: Scaling-Up Home-Based Maternal And Postnatal Care, Including Family Planning, Through Community Midwifery In Kenya, Annie Mwangi, Charlotte E. Warren
Reproductive Health
With support from USAID, the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project supported the scaling up of a community-based model in Kenya that enabled women to give birth safely at home or be referred to a hospital when attended by a self-employed skilled midwife living in the community. To strengthen the sustainability of this approach FRONTIERS engaged a microfinance NGO to develop a training curriculum on basic business skills and financial literacy, and encouraged the community midwives (CMs) to form clusters or informal associations so that they could be trained in business skills. Following these interventions, CMs proved more …
Creating The Conditions For Scale-Up Of The Men In Maternity Intervention In India, Leila Caleb-Varkey, Anurag Mishra, M.E. Khan
Creating The Conditions For Scale-Up Of The Men In Maternity Intervention In India, Leila Caleb-Varkey, Anurag Mishra, M.E. Khan
Reproductive Health
The Frontiers in Reproductive Health (FRONTIERS) program conducted an operations research study, called the Men in Maternity (MiM) study, in collaboration with the Employees' State Insurance Corporation of India (ESIC), aimed at involving men in the antenatal and postpartum care of their partners to raise knowledge and use of postpartum contraception and preventive practices against sexually transmitted infections, as well as improving pregnancy outcomes. This report details the MiM scale-up process, which worked well in terms of ESIC assuming ownership of the training component of the program and being able to build capacity for training. However, to further scale up …
Sharing Experiences With Comprehensive Responses To Adolescent Reproductive Health Needs In Africa, Nafissatou J. Diop, Anta Fall Diagne
Sharing Experiences With Comprehensive Responses To Adolescent Reproductive Health Needs In Africa, Nafissatou J. Diop, Anta Fall Diagne
Reproductive Health
In 1999, the Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) project, began a three-year collaboration in Senegal on an adolescent reproductive health (ARH) pilot project that showed that a multisectoral, multidisciplinary approach can increase knowledge, enhance attitudes, and foster positive behaviors for reproductive health. Following requests from several neighboring countries, and given the long collaboration with WHO, FRONTIERS initiated efforts in 2007 to enable utilization of these findings in other African countries. The purpose of this report is to promote the utilization of multisectoral approaches for improving ARH programming by governments, donors, and national and international agencies in francophone …
Development Of A Quality Assurance Procedure For Reproductive Health Services For District Public Health Systems: Implementation And Scale-Up In The State Of Gujarat, M.E. Khan, Anurag Mishra, Vivek Sharma, Leila Caleb-Varkey
Development Of A Quality Assurance Procedure For Reproductive Health Services For District Public Health Systems: Implementation And Scale-Up In The State Of Gujarat, M.E. Khan, Anurag Mishra, Vivek Sharma, Leila Caleb-Varkey
Reproductive Health
This project was carried out in India, in two districts each in Gujarat and Maharashtra states. It confirmed that quality assurance (QA) checklists and an implementation manual, developed by the USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council in collaboration with UNFPA/India, are useful and effective tools that the Ministry of Health and Social Welfare (MOHFW) can use to monitor the quality of services provided by health facilities. It also demonstrated that this QA mechanism can be easily institutionalized at the district level management. One key lesson has been the critical role that the commitment of state …
From Pilots To Regional Programs: Expanding Contraceptive Choice And Improving Quality Of Care In Zambia's Copperbelt, Jill Keesbury
From Pilots To Regional Programs: Expanding Contraceptive Choice And Improving Quality Of Care In Zambia's Copperbelt, Jill Keesbury
Reproductive Health
Between 2002 and 2005, the Pilots to Regional Programs (PRP) initiative was implemented in eight rural and periurban districts of Zambia’s Copperbelt region. Implemented by the Zambian Ministry of Health/Central Board of Health in collaboration with the Copperbelt Provincial Health Office and with technical assistance from the Population Council, the PRP initiative had two objectives: to expand contraceptive choice and increase the availability of high-quality reproductive health services, and to field-test a model for scaling up reproductive health interventions. The resulting project was structured around three activities: (1) expanding the method mix, (2) training healthcare workers, and (3) linking the …
Kenya: Multisectoral Engagement Increases Support For Adolescent Reproductive Health, Frontiers In Reproductive Health
Kenya: Multisectoral Engagement Increases Support For Adolescent Reproductive Health, Frontiers In Reproductive Health
Reproductive Health
In 1999, FRONTIERS launched the Kenya Adolescent Reproductive Health Project (KARHP), testing a multisectoral approach to improving young people’s reproductive health knowledge and behavior at community, school, and health-facility levels in two pilot districts in the Western Province. The intervention involved three key government ministries—Education, Science and Technology, Health, and Gender, Sports, Culture, and Social Services—with input from community leaders, parents, and youth. Positive findings from the study convinced the three ministries and USAID to institutionalize and scale up selected elements from the pilot project. In 2003, FRONTIERS and PATH began providing technical assistance aimed at mainstreaming and expanding cost-effective …
How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit
How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit
Reproductive Health
Most service-delivery interventions begin as pilot projects. When a pilot study of an intervention is successful, managers begin to think about scaling up the project to new areas. Cost is a critical factor influencing the extent and pace of scale-up. This brief explains how to adapt and modify cost information obtained from a pilot project to estimate scale-up costs. The brief shows why the costs of a pilot project alone are not sufficient to predict costs of scale-up and gives examples of how costs are influenced by factors like economies and diseconomies of scale, resource substitution, and intervention modification. The …
Transferring Ghana's System Of Evidence-Based Health Program Development: Program For An Initial Exchange With Sierra Leone And Burkina Faso, Frontiers In Reproductive Health
Transferring Ghana's System Of Evidence-Based Health Program Development: Program For An Initial Exchange With Sierra Leone And Burkina Faso, Frontiers In Reproductive Health
Reproductive Health
Ghana’s Community-based Health Planning and Services (CHPS) experiment demonstrated that mobilizing community volunteerism, in combination with retraining and redeploying nurses to village-based locations reduced childhood mortality rates in that country. Thus, CHPS has become the government’s primary strategy for realizing universal access to health care. This report provides a description of an initial exchange organized by the Ghana Health Service, the Navrongo Health Research Centre, and the Population Council to explore ways of transferring and adapting these evidence-based strategies to other countries in the region. The exchange included representatives from the Sierra Leone Ministry of Health and Sanitation and the …
Systematic Screening To Integrate Reproductive Health Services In India, N.P. Das, Urvi Shah, Varsha Chitania, Pratibha Patel, M.E. Khan, Anurag Mishra, James R. Foreit
Systematic Screening To Integrate Reproductive Health Services In India, N.P. Das, Urvi Shah, Varsha Chitania, Pratibha Patel, M.E. Khan, Anurag Mishra, James R. Foreit
Reproductive Health
This study, conducted in large public clinics and small health posts in the city of Vadodara, India, tested the effectiveness of a systematic screening technique in integrating reproductive health services at the provider level. The objective was to determine if women screened during clinic visits received more services, appointments, and referrals per visit than women who were not screened. Results show that in experimental group clinics the number of services per visit increased while control clinics experienced a slight decrease; the effect of systematic screening was smaller in health posts than in clinics. In experimental posts, services per visit increased …
Scaling Up A Successful Counseling Model In Guatemala, Guatemalan Association Of Female Physicians (Agmm)
Scaling Up A Successful Counseling Model In Guatemala, Guatemalan Association Of Female Physicians (Agmm)
Reproductive Health
This project aimed to improve clients’ ability to make an informed choice of contraceptive methods by scaling up the use of the balanced counseling strategy in public service delivery institutions in Guatemala. To reach this end, the project provided technical assistance to Calidad en Salud (Quality in Health), the leading reproductive health project in Guatemala, to train service providers in public institutions about the counseling methodology. The project successfully introduced the balanced counseling strategy in Guatemala and, as a result, has improved the informed choice of contraceptives in the country.
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
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 …