Medicine and Health Sciences Commons^™

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

The Impact Of Population, Health, And Environment Projects: A Synthesis Of Evidence, Rachel Winnik Yavinsky, Carolyn Lamere, Kristen P. Patterson, Jason Bremner

Reproductive Health

This working paper synthesizes the existing research and results from projects that integrate family planning with environment, livelihoods, natural-resource management, and other non-health development sectors. The report synthesizes the published and gray literature on current and past integrated projects and the experiences of implementers to generate a summary of the state of knowledge on integrated family planning and environment projects. Specifically, this synthesis documents what is being measured by integrated projects, the proven benefits of integration, and gaps in the evidence base. Based on this analysis, the synthesis highlights and discusses successes and challenges for documenting the impact of integrating …

Low Use And High Discontinuation Of Modern Contraceptives In Pakistan: Reasons And Policy Recommendations, Population Council

Reproductive Health

According to the latest Pakistan Demographic and Health Survey, 20 percent of married women of reproductive age have unmet need for contraception. Moreover, the country’s contraceptive prevalence rate (CPR), for modern and traditional methods combined, is only 35 percent—one of the lowest CPRs in the region. In addition to the problem of nonuse, the country is finding it difficult to keep current contraceptive users onboard: compared to other developing countries, Pakistan has the highest rate of discontinuation of contraceptive use. Thus, while there has been an overall increase in the use of contraceptives—modern and traditional—there is a large difference between …

The Effect Of Integrating Hiv Services On Quality Of Postnatal Care, Integra Initiative

Reproductive Health

Addressing the postnatal needs of new mothers is a neglected area of care throughout sub-Saharan Africa. Unintended pregnancies during the first 12 months following delivery, and vertical transmission of HIV during labor and delivery, are some of the challenges faced by women during the extended postpartum period. Many women want to delay or avoid another pregnancy, but are not using a modern contraceptive method. Few developing countries ensure that mothers and newborns are assessed early and monitored during the initial six-week period as recommended by WHO, which contributes to discontinuity of services received during pregnancy and delivery and limits linkages …

Expanding Young People's Access To Integrated Services In Malawi, Integra Initiative

Reproductive Health

In sub-Saharan Africa, uptake of sexual and reproductive health (SRH) services among young people remains low, placing millions of young people at risk of poor reproductive health outcomes and sexually transmitted infections, including HIV. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London School of Hygiene & Tropical Medicine and the Population Council. Issue 7 of the series focuses on expanding young people’s access to integrated services in Malawi. Conclusions include: improving the quality …

Reducing Maternal And Child Mortality In Punjab: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Punjab’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 45 percent of maternal deaths, 26 percent of infant deaths, and 76 percent of young child deaths. FP’s wider health …

Delivering Contraceptive Vaginal Rings—Task Sharing In The Delivery Of Family Planning Programs: Experiences From Senegal, Babacar Mane, Nafissatou Diop, Saumya Ramarao

Reproductive Health

The Population Council is conducting activities to facilitate the introduction of vaginal rings in sub-Saharan Africa. This report notes that the first ring to be introduced will be the Council’s Progesterone Contraceptive Vaginal Ring (PCVR), which is relevant in contexts where women practice prolonged lactation. The PCVR will also address the high unmet need for family planning (FP), especially for postpartum women. The Council aims to expand the availability and affordability of vaginal rings in Kenya, Nigeria, and Senegal. One of the challenges is the lack of skilled providers. To design plans for involving mid- and lower-level health workers in …

Health Facility Guidelines And Management Benchmarks: Improving Workplace Health Services And Health Management In Factories, Farms And Other Workplaces In Low- And Middle-Income Countries, David Wofford, Marat Yu, Lauren Shields, Maria Pontes

Reproductive Health

This document contains a set of voluntary health and management guidelines for corporations and their supply chains to promote continual improvement and application of good practices, better access to men’s and women’s health services, and more effective use of health resources at workplaces in the developing world. It is focused on both quality of health services provided at the workplace and adequacy of company policies and management systems to ensure that workers have access to health services. The main goals of the guidelines are to: 1) help enterprises—multinational companies and their supplier or subsidiary companies in developing countries—improve the management …

Family Planning Vouchers To Improve Delivery And Uptake Of Contraception In Low And Middle Income Countries: A Systematic Review, Benjamin Bellows, Ashish Bajracharya, Carol Bulaya, Sophie Inambwae

Reproductive Health

Family planning vouchers have provided accessible and quality reproductive health services to the poor and have been critical to countries in making progress in achieving Millennium Development Goal 5. Increased utilization of contraception allows for birth spacing, decreases unintended pregnancy, and results in healthier mothers and families. Strategies to improve utilization through targeted subsidies in low- and middle income countries (LMICs) have not been fully documented in a systematic review of the literature. This study report summarizes the effect of voucher systems for contraceptive services on socioeconomic and demographic indicators in LMICs. A systematic review of unpublished reports and published …

Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend

Reproductive Health

Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …

Expanding Access To Education For Teenage Mothers In Homa Bay County: What ‘Might’ Work, Chi-Chi Undie

Reproductive Health

No abstract provided.

Respectful Maternity Care Resource Package, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

The Respectful Maternity Care Resource Package is a set of manuals, tools, and resources to ensure high-quality, respectful maternal and newborn health services. The resources help program managers, health workers, and technical advisors set up workshops and trainings for facility-based providers and community health workers. The workshops provide practical, low-cost, and easily adaptable strategies to improve respectful care.

The Respectful Maternity Care Resource Package was developed by the Heshima project as part of the USAID Translating Research into Action (TRAction) project.

Training facility-based health providers

• Facilitator’s guide
• Orientation slide deck
• Participant’s guide

Training community health workers

• Facilitator’s guide
• Orientation slide …

Anneau Vaginal À Progestérone: Évite Les Grossesses, Population Council

Reproductive Health

Cette fiche de renseignements fournit des informations sur l’utilisation de l’anneau contraceptif vaginal à la progestérone pour prévenir la grossesse. L'anneau vaginal à progestérone (AVP) offre une nouvelle manière de fournir un moyen de contraception. Il a été prouvé qu'il s'agit d'une méthode contraceptive sûre et efficace pour les femmes qui allaitent. Utilisé par ces femmes, l'AVP évite les grossesses en inhibant la croissance folliculaire et, par conséquent, empêchant l'ovulation; renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation; étendant l'aménorrhée post-partum; et épaississant la glaire cervicale, et donc en empêchant les spermatozoïdes d'atteindre l'ovule. L'AVP donc étend la gamme …

Delivering Contraceptive Vaginal Rings, Population Council

Reproductive Health

To bolster sustainable contraceptive delivery and use, USAID recently proposed a renewed focus, articulating five key areas to address unmet need for family planning: Method Choice, Total Market Approach, Family Planning Workforce, Social and Behavior Communication Change, and Strengthened Supply Systems. In its Delivering Contraceptive Vaginal Rings project, the Population Council has entered into a cooperative agreement with USAID to introduce two new modern contraceptive methods in developing markets: the progesterone contraceptive vaginal ring (PCVR), a three-month ring designed specifically for spacing while breastfeeding, and an investigational one-year contraceptive vaginal ring—the Nestorone®/EthinylEstradiol contraceptive vaginal ring (NES/EE CVR)—that can be used …

Marie Stopes International's Sifpo Project—Strengthening International Family Planning Organizations, October 2010–September 2015, Population Council

Reproductive Health

The Population Council was a partner in the Strengthening International Family Planning Organizations (SIFPO) project implemented by Marie Stopes International. SIFPO’s mandate was to increase use of voluntary family planning (FP) services globally by strengthening selected international FP organizations with global reach and an extensive, multicountry network of FP clinics for achieving maximum program impact and synergies. This report outlines the Council’s role within the project: evaluate effectiveness of MSI’s FP programs to identify successful best practices and approaches; assist MSI to disseminate the findings of some or all evaluations; strengthen MSI’s internal research and metrics capacity with thematic workshops …

Union Health And Family Welfare Centers In Chittagong And Munshiganj: Are They Ready To Provide 24-Hour Normal Delivery Services? (Brief), Population Council

Reproductive Health

To date, the Directorate General of Family Planning (DGFP) of Bangladesh’s Ministry of Health and Family Welfare has established approximately 3,900 Union Health and Family Welfare Centers (UHFWCs) in rural areas providing: family planning; menstrual regulation; vaccinations; and general, reproductive, and maternal health services six days a week. About 1,500 UHFWCs have been upgraded with the necessary staff and equipment to provide normal delivery services round-the-clock in rural areas. In rural areas, public-sector health facilities, including UHFWCs, contribute to only 12 percent of institutional deliveries. Until now, Family Welfare Visitors (FWVs) posted at UHFWCs performed only 0.3 percent of deliveries. …

Progesterone Vaginal Ring: Prevents Pregnancy, Population Council

Reproductive Health

This fact sheet provides information about how the progesterone vaginal contraceptive ring works to prevent pregnancy. The progesterone vaginal ring (PVR) offers a novel way of delivering safe and effective contraceptives for lactating women. When used by such women it prevents pregnancy by inhibiting follicular growth, hence preventing ovulation; reinforcing the inhibitory effect of breastfeeding on ovulation; extending postpartum amenorrhea; and thickening the cervical mucus, thus inhibiting sperm from meeting the egg. The PVR expands the range of contraceptives available to lactating women and has the potential to contribute to improving maternal and infant health.

Progesterone Vaginal Ring: Safe For Mothers And Babies, Population Council

Reproductive Health

This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding on ovulation and extending postpartum amenorrhea. The PVR is an effective and safe contraceptive for mothers, their babies, and their sexual partners. This method vastly expands the range of contraceptive choices available for nursing women.

Progesterone Vaginal Ring: Beneficial Role In Birth Spacing, Population Council

Reproductive Health

As a result of growing urbanization and changing social norms concerning the role of women in developing countries, the duration of exclusive breastfeeding and its impact as a contraceptive strategy has been reduced. This has given rise to the need for a contraceptive method that can extend the infertile period following delivery, especially in countries where access to other contraceptives is limited and where longer duration of breastfeeding is a social norm and a major benefit to infant health. This project brief provides information on the progesterone vaginal ring (PVR), which can enhance the effect of breastfeeding on birth spacing. …

Union Health And Family Welfare Centers In Chittagong And Munshiganj: Are They Ready To Provide 24-Hour Normal Delivery Services?, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Shongkour Roy, Afsana Fatema Noor

Reproductive Health

To date, the Directorate General of Family Planning (DGFP) of Bangladesh’s Ministry of Health and Family Welfare has established approximately 3,900 Union Health and Family Welfare Centers (UHFWCs) in rural areas providing: family planning; menstrual regulation; vaccinations; and general, reproductive, and maternal health services six days a week. About 1,500 UHFWCs have been upgraded with the necessary staff and equipment to provide normal delivery services round-the-clock in rural areas. Yet, Family Welfare Visitors (FWVs) posted at UHFWCs perform only 0.3 percent of deliveries. This means that UHFWCs and FWVs are not optimally utilized to increase the rate of institutional deliveries. …

Introduction Of Dmpa In Public Health Facilities Of Uttar Pradesh And Rajasthan: An Evaluation, M.E. Khan, Anvita Dixit, Jaleel Ahmad, G. Pillai

Reproductive Health

India is committed to achieving the goals of FP2020, which, besides substantially increasing new contraceptive users, also demands adopting a rights-based approach and ensuring easy access, choice, and good quality services. The contraceptive method mix in India has been dominated by female sterilization for a long time. No new contraceptive method has been added to the national family welfare program for decades. Use of injectable contraceptives was approved in 1994 in the private sector, but is still not part of the national program. Recently some initiatives have been taken to make Depo Medroxyprogesterone Acetate (DMPA) available through the public sector …

Reasons For Low Modern Contraceptive Use—Insights From Pakistan And Neighboring Countries, Batool Zaidi, Sabahat Hussain

Reproductive Health

This literature review forms part of an extensive research project to determine why, despite evident demand, contraceptive prevalence remains so low in Pakistan, especially for modern methods. The research has been conducted by the Population Council with the support of the Research and Advocacy Fund (RAF) and comprises four component studies: review of relevant academic, program, and policy literature; qualitative study of perspectives of men, women, and service providers in the country on family planning; situation analysis of contraceptive quality, supply, and access factors at health facilities; and examination of supply-chain issues affecting the availability of contraceptives. This review presents …

Willingness To Pay For Contraceptive Vaginal Rings In Nigeria, Salisu Mohammed Ishaku, Ayodeji Oginni, Godwin Unumeri, Deepa Rajamani

Reproductive Health

During the last two decades, Nigeria’s contraceptive prevalence rate (CPR) for modern methods remained at 10 percent, one of the lowest rates in sub-Saharan Africa. Following the renewed global commitments culminating in the 2012 London Summit on Family Planning with promises to reach an additional 120 million new users of modern contraceptives worldwide, Nigeria’s Federal Ministry of Health set a new target of raising Nigeria’s CPR to 36 percent by 2018. One way to accomplish this is by meeting the contraceptive needs of women in the immediate postpartum period and beyond. Attention is being focused on making proven contraceptive methods …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Mmr In Punjab, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

Pakistan is one of the six countries that account for more than 50 percent of the world’s maternal deaths. Each year, there are nearly 14,000 pregnancy-related deaths. Although maternal mortality has fallen from 533 per 100,000 live births in 1990–91 to 276 in 2006–07, Pakistan has not been able to achieve its Millennium Development Goal target of reducing maternal mortality to 140 per 100,000 live births by 2015. Planners require a method that can provide reliable subnational estimates easily, cost effectively. and with greater regularity. The Research and Advocacy Fund offered support to the Government of Pakistan to assess the …

Investigating The Low Patterns Of Modern Contraceptive Use In Pakistan, Iram Kamran, Zeba Tasneem, Tahira Parveen, Yasmin Zehra Zaidi

Reproductive Health

This report documents the study “Investigating the Low Patterns of Modern Contraceptive Use in Pakistan” conducted by the Population Council Pakistan in 2014 as part of an extensive research project to determine why use of modern contraceptives in the country remains so low despite large unmet need. The family planning (FP) scenario in Pakistan has changed significantly in recent years, and it is now recognized that the reasons most often cited for unmet need require reappraisal, with qualitative research required for a deeper understanding of the attributes, experiences, reservations, and preferences that women, men, and service providers associate with specific …

Knowledge And Provision Practices Of Misoprostol Among Pharmacies In Senegal, Ramatoulaye Ndao, Nafissatou Diop, Kate Reiss, Eva Burke

Reproductive Health

Marie Stopes International and the Population Council conducted a study on the knowledge and practice of misoprostol provision among pharmacy workers in Senegal, as part of the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) research program. This study helped guide strategies for expanding provision and proper delivery in pharmacies of misoprostol, a drug which is highly effective and acceptable for treating postpartum hemorrhage and post-abortion complications. Amplified communication about the product can contribute to an increase in demand from providers in all sectors. However, as demand for the product increases, the supply chain must be strengthened to respond …

Community Opinion Leaders In Ghana Speak Out On Adolescent Sexuality: What Are The Issues?, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew

Reproductive Health

This policy brief reports on a study that is a component of a larger study that assessed the sexual and reproductive health (SRH) needs of adolescents in four slums in two regions of Ghana. The study’s focus on this perspective stems from the fact that there is a lack of evidence surrounding the outlook of community opinion leaders on adolescent reproductive health in this setting. Understanding what adults think about major adolescent SRH issues in their communities (including the SRH rights of adolescents, adult–adolescent communication about SRH issues, and service-seeking and sexual behavior outcomes) provides insight into how adults perceive …

Are Parents Talking To Adolescents About Sexuality? Evidence From Four Slums In Ghana, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew

Reproductive Health

This evidence brief summarizes the essential information from a part of a larger study that assessed the sexual and reproductive health (SRH) needs of adolescents in four slums in two regions of Ghana. The objective of this brief is to provide evidence to support and facilitate the improvement of parent–adolescent communication on sexuality. This study echoes several other studies by providing evidence that a majority of parents are not opposed to in-school sex education for their children and welcome the idea of empowering themselves (parents) to have productive discussions with their children. Nevertheless, there is a mismatch between the proportion …

What Are The Sexual And Reproductive Health Needs Of Adolescents In Ghana’S Slums?, Selina F. Esantsi, Gloria Quansah Asare, Placide Tapsoba

Reproductive Health

To address the need for quality evidence on the sexual and reproductive health (SRH) needs of adolescents in slums, the STEP UP project conducted a study in four slum settings in Ghana. This policy brief highlights key points, including the need for a well-designed, comprehensive sex education curriculum; interventions that address sexual coercion and violence as an integral component of current adolescent reproductive health programs; and the need to involve all stakeholders including parents/guardians and community leaders in addressing adolescent SRH needs. Evidence from the study can be used to improve ASRH programming so that it better meets the needs …