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Full-Text Articles in Medicine and Health Sciences

Marriage And Sexual And Reproductive Health Of Rohingya Adolescents And Youth In Bangladesh: A Qualitative Study, Sigma Ainul, Iqbal Ehsan, Eashita Haque, Sajeda Amin, Ubaidur Rob, Andrea J. Melnikas, Joseph Falcone Jan 2018

Marriage And Sexual And Reproductive Health Of Rohingya Adolescents And Youth In Bangladesh: A Qualitative Study, Sigma Ainul, Iqbal Ehsan, Eashita Haque, Sajeda Amin, Ubaidur Rob, Andrea J. Melnikas, Joseph Falcone

Poverty, Gender, and Youth

This qualitative study focuses specifically on displaced Rohingya adolescents and youth (ages 14–24) and explores how the crisis has impacted their sexual and reproductive health (SRH), marriage practices, safety and security, and related attitudes and aspirations. This research aims to identify approaches to improve adolescents’ knowledge of SRH issues and their access to and uptake of services, and to identify gaps in programming knowledge and practice. Findings from this formative research and recommended actions will help the Government of Bangladesh, donors, and other relevant stakeholders to mobilize resources and deliver SRH services in a more organized and efficient way and …


Dynamics Of Oral Contraceptive Pill Use In India, The Evidence Project Jan 2018

Dynamics Of Oral Contraceptive Pill Use In India, The Evidence Project

Reproductive Health

The purpose of this brief is to provide evidence that can be used to strengthen the family planning program in India, particularly for community-based and facility-based distribution of oral contraceptive pills (OCPs), use of which remains low despite their availability. Understanding women’s interactions with frontline health workers while obtaining the method and during follow-up counseling can help the Government of India improve its National Family Planning Program. Based on its findings, the report recommends that all providers, especially frontline health workers, receive training focusing on four domains of quality of care: 1) respectful care, 2) counseling to enable appropriate method …


Fgm/C Decision-Making Process And The Role Of Gender Power Relations In Sudan, Ahmed Gamal Eldin, Suad Babiker, Majdi Sabahelzain, Muna Eltayeb Jan 2018

Fgm/C Decision-Making Process And The Role Of Gender Power Relations In Sudan, Ahmed Gamal Eldin, Suad Babiker, Majdi Sabahelzain, Muna Eltayeb

Reproductive Health

This study by the Population Council, Nairobi and partners aimed to contribute to a better understanding of female genital mutilation/cutting (FGM/C) in Sudan and the way different families perceive the practice and make FGM/C-related decisions. The ultimate goal was to inform interventions aimed at accelerating the pace of positive behavioral and social norm change and eventually promote the abandonment of all forms of FGM/C in Sudan. The findings indicate that although parents often make the final decision to cut or not cut their daughters, they do not act in isolation but are influenced by dominant social norms and by other …


Exploring Barriers And Opportunities For Pre-Eclampsia And Eclampsia Prevention And Management In Ethiopia, Pooja Sripad, Hussein Ismail, Amy Dempsey, Karen Kirk, Charlotte E. Warren Jan 2018

Exploring Barriers And Opportunities For Pre-Eclampsia And Eclampsia Prevention And Management In Ethiopia, Pooja Sripad, Hussein Ismail, Amy Dempsey, Karen Kirk, Charlotte E. Warren

Reproductive Health

The Ending Eclampsia Project is a five-year cooperative agreement between the United States Agency for International Development (USAID) and the Population Council, in partnership with the Federal Ministry of Health Ethiopia, which seeks to expand access to quality underutilized interventions and commodities for the prevention and treatment of pre-eclampsia/eclampsia (PE/E). This report presents qualitative findings from formative research conducted to: 1) assess the policy and health systems environment related to PE/E prevention and management, 2) identify potential bottlenecks in the supply chain, 3) investigate PE/E knowledge, attitudes, and practices at policy, health system, and community levels, 4) describe the barriers …


Adolescent Girls Empowerment Program (Agep): Nutrition, Paul C. Hewett, Amanda L. Willig, Jean Digitale, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Jere R. Behrman, Karen Austrian Jan 2018

Adolescent Girls Empowerment Program (Agep): Nutrition, Paul C. Hewett, Amanda L. Willig, Jean Digitale, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Jere R. Behrman, Karen Austrian

Poverty, Gender, and Youth

Adolescence is a critical period in the lives of young people and potentially a time to reap lasting benefits from interventions that improve general, sexual, nutritional, and maternal and child health. The government of Zambia is committed to improving the nutritional status of adolescents and pregnant women and their children. Nonetheless, adolescent girls in Zambia remain at risk for macro- and micro-nutrient deficiencies that have deleterious effects on growth, development, and maternal and child health. The Adolescent Girls Empowerment Program (AGEP) nutritional curriculum, developed in partnership with PATH, was tailored to provide age-appropriate information and covered six sessions on nutrition. …


Las Uniones Infantiles Forzadas: De La Reforma Legal A La Disrupción Social—Investigación Formativa En Cinco Comunidades En Chisec Alta Verapaz, Paola Broll, Cecilia Garcés Jan 2018

Las Uniones Infantiles Forzadas: De La Reforma Legal A La Disrupción Social—Investigación Formativa En Cinco Comunidades En Chisec Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

La evidencia ha demostrado que el matrimonio y las uniones infantiles forzadas (M/UIF) son nocivos a los derechos y el desarrollo de las niñas y adolescentes. También se ha demostrado que aumentar la edad mínima del matrimonio no es suficiente para erradicar este fenómeno que subyace en la práctica de las instituciones sociales a nivel comunitario. Se ha realizada esta investigación en el momento en que se aprobó la modificación al Código Civil, seguido de una modificación para aumentar la edad mínima para el matrimonio en Guatemala, con el propósito de identificar las normas, prácticas, y actitudes vigentes en la …


Migration And Child Domestic Work: Evidence From Ethiopia, Annabel Erulkar Jan 2018

Migration And Child Domestic Work: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

Domestic work is frequently the initial survival strategy for rural Ethiopian girls migrating to urban areas. Following migration from rural areas, most girls enter the workforce as domestic workers, because it is a readily available form of work requiring little or no education. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in urban and rural areas in six Ethiopian regions which demonstrated that this is a common phenomenon. Originating from poor rural areas and armed with little in the way of education, domestic workers receive low pay and frequently work in abusive situations, including sexual abuse. …


Community-Level Assessment Of Floods And Cyclones In Coastal Odisha, India: Impact, Resilience, And Implications, Sangram Kishor Patel Jan 2018

Community-Level Assessment Of Floods And Cyclones In Coastal Odisha, India: Impact, Resilience, And Implications, Sangram Kishor Patel

Poverty, Gender, and Youth

India is among the countries that have been severely affected by both floods and cyclones. In 2012, the Government of India estimated that nearly 12 percent of India’s land is prone to floods and river erosion. The Population Council conducted formative research in the state of Odisha to explore the people’s perceptions on impact and resilience to cyclones and floods, and to examine the state-level infrastructure and institutional initiatives to strengthen responses to these events. Findings reported in this brief indicate that flooding and cyclones have had a disproportionate affect on vulnerable groups, including women, children, the elderly, and disabled …


Expanding Access To Family Planning For Married Adolescent Girls In The Urban Slums Of Dhaka, Fauzia Akhter Huda, Nancy Termini Lachance Jan 2018

Expanding Access To Family Planning For Married Adolescent Girls In The Urban Slums Of Dhaka, Fauzia Akhter Huda, Nancy Termini Lachance

Reproductive Health

Early pregnancy is associated with adverse health, social, and economic consequences for girls, and Bangladesh has an adolescent fertility rate that is among the highest in the region. Poor, slum-dwelling girls are especially vulnerable. This policy brief outlines a project that icddr,b, a STEP UP project partner, initiated to test three innovative strategies aiming to support the unmet family planning needs of these girls. This brief concludes with government-level policy and program recommendations based on the evidence of this project for leveraging existing government health programs to better serve the needs of married adolescent girls and reduce their risks of …


Expanding Contraceptive Choice, Heather Clark, Saumya Ramarao, Catherine Unthank, Kazuyo Machiyama, Nandita Thatte Jan 2018

Expanding Contraceptive Choice, Heather Clark, Saumya Ramarao, Catherine Unthank, Kazuyo Machiyama, Nandita Thatte

Reproductive Health

Expanding the range of contraceptive options helps individuals to make choices appropriate to their needs and circumstances, allows them to switch from one method to another if desired, and reflects a program focus on quality and rights. This policy brief outlines policy and program considerations in order to establish and maintain well-functioning supply chains for an expanded choice of contraceptives: introducing new contraceptive technologies to satisfy the diverse preferences of women and their partners; overcoming access barriers to existing methods such as adverse economic and social circumstances, including gender norms; and maximizing the potential of expanded contraceptive choice by ensuring …


Are Services Meeting The Holistic Family Planning Needs Of Female Sex Workers Living With Hiv In Tanzania?, Project Soar Jan 2018

Are Services Meeting The Holistic Family Planning Needs Of Female Sex Workers Living With Hiv In Tanzania?, Project Soar

HIV and AIDS

Women of reproductive age living with HIV need access to comprehensive, voluntary family planning (FP) services to support their decisions about whether and when to have children. Contraceptive need is particularly acute among HIV-positive female sex workers who are often socially and economically disadvantaged. Furthermore, many HIV-positive female sex workers intend to have children some day, but may not be aware of strategies to minimize the risk of HIV transmission to infants and partners (i.e., “safer conception”). This activity brief describes a Project SOAR study in Tanzania that will contribute to the evidence base by conducting research that describes these …


Does A Community-Based, Hiv Service Delivery Model Improve Female Sex Workers’ Care And Treatment Outcomes In Tanzania?, Project Soar Jan 2018

Does A Community-Based, Hiv Service Delivery Model Improve Female Sex Workers’ Care And Treatment Outcomes In Tanzania?, Project Soar

HIV and AIDS

Female sex workers living (FSWs) with HIV face significant challenges in accessing HIV care and, once started on antiretroviral therapy (ART), remaining in care and adhering to treatment. These challenges include attending regular medical appointments because of time and cost constraints, providers’ stigmatizing attitudes, and poor service quality due to crowded ART clinics, long waiting times, and a lack of clinicians. This brief describes a community-based model of ART delivery THAT Project SOAR, Sauti, the National AIDS Control Programme, and the National Institute of Medical Research are designing, implementing, and evaluating, in order to help mitigate the barriers HIV-positive FSWs …


Engaging Male Partners Of Adolescent Girls And Young Women In Hiv Services In Malawi: Findings From Dreams Implementation Science Research, Project Soar Jan 2018

Engaging Male Partners Of Adolescent Girls And Young Women In Hiv Services In Malawi: Findings From Dreams Implementation Science Research, Project Soar

HIV and AIDS

Important contributors to adolescent girls' and young women's (AGYWs') vulnerability to HIV are the power differentials in their sexual relationships with male partners. Therefore, engaging male partners of AGYWs is important in reducing HIV incidence among these women. Project SOAR, in collaboration with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted qualitative research in the districts of Zomba and Machinga in Malawi to: 1) identify and locate the types of men who have sexual relationships with AGYW; 2) understand the challenges to and facilitators of accessing HIV services among AGYWs’ male partners; and 3) …


Evaluating A Multidisciplinary Integrated Management Team Intervention To Improve Maternal And Child Outcomes And Hiv Service Uptake And Retention In Lesotho, Project Soar Jan 2018

Evaluating A Multidisciplinary Integrated Management Team Intervention To Improve Maternal And Child Outcomes And Hiv Service Uptake And Retention In Lesotho, Project Soar

HIV and AIDS

Pregnant and postpartum HIV-positive women face a particularly complex set of barriers to prevention of mother-to-child transmission of HIV (PMTCT) uptake at the policy, health facility, community, and individual levels. They are vulnerable to poor retention in care and adherence to treatment, especially in the first three months after initiation of treatment and the postpartum period. In addition, counseling and support for primary prevention among HIV-negative pregnant women is almost nonexistent in PMTCT programs. This brief describes the IMPROVE study—a multidisciplinary integrated management team intervention to increase maternal and child health and HIV service uptake and retention—that Project SOAR is …


Female Sex Workers Living With Hiv In Tanzania Have Both A Need For Contraception And A Desire To Have Children In The Future, Project Soar Jan 2018

Female Sex Workers Living With Hiv In Tanzania Have Both A Need For Contraception And A Desire To Have Children In The Future, Project Soar

HIV and AIDS

HIV-positive women often have critical family planning (FP) needs in addition to HIV-related care, treatment, and prevention concerns. In sub-Saharan Africa, unintended pregnancy is common among HIV-positive women. At the same time, many women living with HIV want to have children some day, and there are various “safer conception” strategies available to help HIV-affected individuals and couples get pregnant while minimizing the risk of HIV transmission to seronegative partners and the baby. This brief describes the fertility-related needs and desires of female sex workers living with HIV in Tanzania, highlighting results indicating that health services should help women meet both …


How Are Educated Women In Ghana Regulating Fertility Without High Levels Of Modern Contraceptive Use?, Kazuyo Machiyama, Cicely Marston, Nancy Termini Lachance, Terence Adda-Balinia, Placide Tapsoba Jan 2018

How Are Educated Women In Ghana Regulating Fertility Without High Levels Of Modern Contraceptive Use?, Kazuyo Machiyama, Cicely Marston, Nancy Termini Lachance, Terence Adda-Balinia, Placide Tapsoba

Reproductive Health

While Ghana has made striking gains in enabling its women to use family planning to reduce family size—the total fertility rate shifted from 7.0 to 4.2 children per woman from the 1970s to the 2010s—the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) studies found that educated women in Ghana are achieving their fertility goals by limited use of highly effective contraceptive methods. Their fertility regulation strategies involve contraceptive method mosaics that have not been captured by the DHS. This evidence summary aggregates research from the STEP UP Research Programme Consortium along with other related evidence to explore this …


Exploring The Nigerian Health System's Response To Female Genital Mutilation/Cutting, Otibho Obianwu Jan 2018

Exploring The Nigerian Health System's Response To Female Genital Mutilation/Cutting, Otibho Obianwu

Reproductive Health

Although Nigeria has shown a steady long-term decline in female genital mutilation/cutting (FGM/C) prevalence, the practice remains widespread. This study brief outlines the Population Council’s Evidence to End FGM/C research program, which, in collaboration with the Federal Ministry of Health, will conduct a diagnostic assessment in order to: 1) examine how the healthcare sector supports the prevention of FGM/C; 2) determine the role of the healthcare sector in the management of FGM/C-related complications and the quality of care offered to clients; and 3) identify possible solutions for strengthening the healthcare system’s capacity to manage and prevent FGM/C. Findings are intended …


Understanding Medicalisation Of Female Genital Mutilation/Cutting (Fgm/C): A Qualitative Study Of Parents And Health Workers In Nigeria, Otibho Obianwu, Adetayo Adetunji, Osasuyi Dirisu Jan 2018

Understanding Medicalisation Of Female Genital Mutilation/Cutting (Fgm/C): A Qualitative Study Of Parents And Health Workers In Nigeria, Otibho Obianwu, Adetayo Adetunji, Osasuyi Dirisu

Reproductive Health

This community-based, cross-sectional qualitative study was conducted in four communities in Nigeria’s Delta, and was conceptualized to address gaps in our understanding of medicalization of female genital mutilation/cutting (FGM/C) and to provide critical evidence needed to effectively design abandonment interventions. The study findings reveal that the social norms driving FGM/C practice remain entrenched despite a shift to medicalization. They also reflect the tendency of parents and health workers to view FGM/C, whether traditional or medicalized, as a minor procedure with few complications and significant benefits that would positively impact a daughter’s future status as a wife and mother. Findings reveal …


Delivering Impact For Adolescent Girls: Emerging Findings From Population Council Research, Population Council Jan 2018

Delivering Impact For Adolescent Girls: Emerging Findings From Population Council Research, Population Council

Poverty, Gender, and Youth

Despite numerous global commitments to invest in improving the lives of adolescent girls, questions remain as to what package of interventions can deliver the best outcomes. This report synthesizes findings from nine recent Population Council impact evaluations, conducted around the world, which indicate that empowerment and asset-building interventions for adolescent girls can improve education, health, economic, social capital, gender-equitable attitude, and violence outcomes for girls. The report includes implications for programs and investment, and identifies open questions for further research and evaluation.


Assessing The Feasibility, Acceptability, And Costs Of Diagnosing Hiv At Birth In Lesotho And Rwanda, Michelle M. Gill, Heather Hoffman, Majoalane Mokone, Lynne Mofenson, Michel Tchuenche, Steven Forsythe Jan 2018

Assessing The Feasibility, Acceptability, And Costs Of Diagnosing Hiv At Birth In Lesotho And Rwanda, Michelle M. Gill, Heather Hoffman, Majoalane Mokone, Lynne Mofenson, Michel Tchuenche, Steven Forsythe

HIV and AIDS

Infant HIV diagnosis as early as possible in a child’s life followed by immediate antiretroviral treatment (ART) could stem the progressive rise in infant mortality among HIV-positive infants, particularly as several studies have suggested that an increased proportion of perinatal infections may occur in utero when maternal ART is received during pregnancy. This Project SOAR study leveraged two existing cohort studies to address some critical questions related to very early infant diagnosis. The objective was to determine the feasibility, acceptability, and costs associated with the addition of birth HIV testing to the routine testing algorithm for infants born to HIV-positive …


Early Results Demonstrate The Importance Of Early Treatment Of Hiv And The Feasibility And Acceptability Of Community-Based Antiretroviral Treatment Delivery For Female Sex Workers In Tanzania, Project Soar Jan 2018

Early Results Demonstrate The Importance Of Early Treatment Of Hiv And The Feasibility And Acceptability Of Community-Based Antiretroviral Treatment Delivery For Female Sex Workers In Tanzania, Project Soar

HIV and AIDS

Project SOAR in collaboration with the National AIDS Control Program of the government of Tanzania, National Institute of Medical Research, and Jhpiego’s Sauti Program, is conducting implementation science research to investigate the delivery of community-based antiretroviral treatment (ART) services to female sex workers (FSWs) in Tanzania. This brief summarizes key findings from a baseline survey administered to a cohort of FSWs enrolled in the study, qualitative interviews with FSWs conducted three months after the start of the community-based ART services, and routine monitoring data. Early findings support the feasibility and acceptability of Sauti’s community-based antiretroviral treatment model—important first steps in …


Feasibility And Acceptability Of Hiv Self-Testing Among Men Who Have Sex With Men In Nigeria, Population Council Jan 2018

Feasibility And Acceptability Of Hiv Self-Testing Among Men Who Have Sex With Men In Nigeria, Population Council

HIV and AIDS

HIV self-testing (HIVST) provides an alternative to facility-based HIV testing services, particularly for key populations such as men who have sex with men (MSM), who face barriers to testing due to stigma, discrimination, and criminalization. This brief reports on a study in Nigeria that demonstrates high acceptability for HIVST among MSM. Lessons learned from this study indicate that the scale-up of HIVST in Nigeria must include provision of adequate pre- and post-test counseling information, as well as the availability of helpline support to improve linkage to care for those who test positive. Future research should explore how HIV retesting can …


Male Partners Of Adolescent Girls And Young Women: Relationship Characteristics And Hiv Risk—Findings From Dreams Implementation Science Research, Population Council Jan 2018

Male Partners Of Adolescent Girls And Young Women: Relationship Characteristics And Hiv Risk—Findings From Dreams Implementation Science Research, Population Council

HIV and AIDS

Adolescent girls and young women (AGYW) in South Africa, as in many countries, are particularly vulnerable to HIV for a variety of reasons, including economic disadvantage and unequal power dynamics in sexual relationships with their male partners—many of whom are older and engage in high-risk behaviors. In an effort to learn more about men’s relationships with AGYW and how HIV services can better engage them, the Population Council is conducting implementation science research in KwaZulu-Natal Province. This brief reports findings from a 2017 baseline survey with nearly 1,000 men. An endline survey is planned for mid-late 2018, and will focus …


Optimizing Implementation Of Universal Hiv Treatment Coverage For People Living With Hiv In Senegal, Project Soar Jan 2018

Optimizing Implementation Of Universal Hiv Treatment Coverage For People Living With Hiv In Senegal, Project Soar

HIV and AIDS

Senegal plans a rapid scale up of HIV treatment for all people living with HIV (PLHIV), regardless of CD4 count or viral suppression. However, limited data exist on how to achieve sustained viral suppression among PLHIV in real world contexts where significant barriers to effective antiretroviral therapy (ART) delivery, uptake, and adherence persist. This brief describes a universal coverage ART intervention Project SOAR is conducting among PLHIV who are not virally suppressed. The findings from this study will inform the rollout of Senegal’s national test and treat strategy.


A Study Of Employment Outcomes Among Technical And Vocational Secondary Education Graduates In Egypt [Arabic], Salma Nasser, Ali Rashed Jan 2018

A Study Of Employment Outcomes Among Technical And Vocational Secondary Education Graduates In Egypt [Arabic], Salma Nasser, Ali Rashed

Poverty, Gender, and Youth

In Egypt, some 450,000 students graduate from technical and vocational schools each year. Yet just over 50 percent are employed immediately following their graduation. This brief explores the kinds of jobs that are available to these graduates, and the factors that affect the remaining 50 percent who do not join the work force. The report aims to understand the types of training that best prepare students for the available jobs, differences in opportunities for male and female graduates, and connections between work and the home and/or community circumstances that may hinder employment. The report offers recommendations for improving the education …


Pedaleando Hacia El Futuro: Una Oportunidad Para Incrementar Y Mantener La Asistencia Escolar De Niñas Adolescentes Encomunidades Indígeneas Del Árearural En Guatemala, Paola Broll Jan 2018

Pedaleando Hacia El Futuro: Una Oportunidad Para Incrementar Y Mantener La Asistencia Escolar De Niñas Adolescentes Encomunidades Indígeneas Del Árearural En Guatemala, Paola Broll

Poverty, Gender, and Youth

Population Council Guatemala, con el apoyo de UNFPA y otros donantes, desarrolló la estrategia de expansión y escala de Abriendo Oportunidades (AO) a través de conglomerados geográficos con abordaje ecológico. La provisión de 250 bicicletas fue un componente adicional de AO para probar su efectividad en el aumento de movilidad y la asistencia escolar en cuatro municipios guatemaltecos. Este reporte describe como el proyecto fue exitoso en el aumento de la movilidad, reinserción, y finalización del ciclo escolar 2017 de sus participantes. Los resultados muestran como la dotación de las bicicletas incrementó en 24% la reinserción escolar del ciclo 2016 …


Cesarean Section Deliveries In Egypt: Trends, Practices, Perceptions, And Cost, Nahla G. Abdel-Tawab, Doaa Oraby, Nevine Hassanein, Shatha El-Nakib Jan 2018

Cesarean Section Deliveries In Egypt: Trends, Practices, Perceptions, And Cost, Nahla G. Abdel-Tawab, Doaa Oraby, Nevine Hassanein, Shatha El-Nakib

Reproductive Health

In Egypt, the past decade has witnessed a sharp increase in the prevalence of cesarean section (CS) with the most recent Egypt Demographic and Health Survey documenting a CS rate of 52 percent, suggesting that cesarean delivery might be overused or used for inappropriate indications. This study aimed to explore trends, practices, and costs associated with CS deliveries to women, their families, and the health system, as well as factors that may contribute to increased use of CS in Egypt. Participating physicians and key informants unanimously agreed that the CS mode of delivery was over-used in Egypt. Perceived reasons underlying …


Ending Eclampsia: Phc Ph/E_Plus Model, Charlotte E. Warren Jan 2018

Ending Eclampsia: Phc Ph/E_Plus Model, Charlotte E. Warren

Reproductive Health

Pre-eclampsia and eclampsia (PE/E)—life-threatening high blood pressure and excess protein in the urine after 20 weeks gestation—is a leading cause of pregnancy-related deaths. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. The Population Council implemented a two-phase intervention involving training, mentoring, and supervising providers at secondary facilities on detection and management of PE/E patients (Phase 1), and training primary health care (PHC) providers to administer a modified loading dose of magnesium sulphate and refer women to secondary health facilities for monitoring (Phase 2). This brief describes the Population Council’s …


Shifts In Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Samuel Kimani, Caroline W. Kabiru Jan 2018

Shifts In Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Samuel Kimani, Caroline W. Kabiru

Reproductive Health

Despite compelling reasons and efforts to eradicate female genital mutilation/cutting (FGM/C) in Kenya, the practice has persisted, albeit with some changes. This study sought to understand the shifts in FGM/C among families and healthcare providers from selected Kenyan communities that practice FGM/C. Our findings highlight similarities and differences across three distinct Kenyan communities. FGM/C appears to persist through two models: first, shifts (changes) in the practice, notably cutting at a younger age, lesser cutting; and second, through stability and consistency with minimal change. The two diverse models appear to rely on and sustain social norms that support FGM/C in these …


Strengthening The Integration Of Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Brian Mdawida, Charlotte E. Warren, Melsa Lutomia, Jane Koech, Elizabeth Washika, Aparna Jain Jan 2018

Strengthening The Integration Of Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Brian Mdawida, Charlotte E. Warren, Melsa Lutomia, Jane Koech, Elizabeth Washika, Aparna Jain

Reproductive Health

Study findings reveal that many Kenyan women living with HIV are comfortable receiving family planning (FP) services from community health volunteers and with proper training and support, community health volunteers have the potential to provide integrated FP/HIV services. Community-based integrated FP/HIV services could help connect women living with HIV who want to prevent or postpone a pregnancy to contraceptive services, which can reduce unintended pregnancies and in turn maternal mortality and vertical transmission of HIV. This implementation research study offers evidence of the feasibility, quality of care, and acceptability of using community health volunteers to integrate family planning into HIV/AIDS …