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1999

Population Council

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Full-Text Articles in Medicine and Health Sciences

Strengthening The Evaluation And Research Unit Of The Zimbabwe Family Planning Council (1995–1998), Lewis Ndhlovu, Hazel M.B. Dube, Caroline S. Marangwanda Jan 1999

Strengthening The Evaluation And Research Unit Of The Zimbabwe Family Planning Council (1995–1998), Lewis Ndhlovu, Hazel M.B. Dube, Caroline S. Marangwanda

Reproductive Health

The Evaluation and Research Unit (ERU) plays a crucial role in supporting the research activities of the Zimbabwe National Family Planning Council (ZNFPC). Research activities are conducted in addition to analysis of service statistics and compilation of quarterly and annual reports. With a staff capacity of five and inadequate research skills existing in other units, the ERU finds it difficult to manage and monitor the diverse activities of the organization. To address these problems, a buy-in was signed between the Zimbabwe Government and USAID in May 1995. The objectives were to assist the ZNFPC in conducting operations research studies and …

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Assessing The Potential Demand For And Effectiveness Of Integrating Sti/Hiv Management Services With Zimbabwe National Family Planning Council's Clinic-Based Family Planning Services, Baker Ndugga Maggwa, Ian Askew, Hazel M.B. Dube, Caroline S. Marangwanda, Sithokozille Simba, Ahmed Latif Jan 1999

Assessing The Potential Demand For And Effectiveness Of Integrating Sti/Hiv Management Services With Zimbabwe National Family Planning Council's Clinic-Based Family Planning Services, Baker Ndugga Maggwa, Ian Askew, Hazel M.B. Dube, Caroline S. Marangwanda, Sithokozille Simba, Ahmed Latif

Reproductive Health

HIV/AIDS is a threat to individual lives and the national economies of many sub-Saharan African countries, despite efforts to contain its spread. The region also suffers from high levels of other reproductive tract infections (RTIs), some of which increase the risk of sexual transmission of HIV. The control of RTIs is therefore seen not only as an important reproductive health care strategy, but as a key strategy in reducing the spread of HIV/AIDS. Most national health care programs in the region are actively seeking cost-effective ways of implementing an RTI management program that would reduce and prevent RTIs and HIV. …

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Reproductive Health Indicators: Moving Forward, Kelly Blanchard, Batya Elul, Saumya Ramarao Jan 1999

Reproductive Health Indicators: Moving Forward, Kelly Blanchard, Batya Elul, Saumya Ramarao

Reproductive Health

This report is designed to help researchers, program managers, policymakers, and advocates sift through and evaluate which potential indicators might be useful in a particular programmatic context. It was initially prepared as a background manuscript for a Population Council meeting on reproductive health indicators held in Cairo in March 1998. The manuscript has since been modified to incorporate ideas and comments expressed at that meeting, as well as to include input from other Population Council colleagues.

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Mexico: Protecting Informed Consent, Elsa Santos, Silvia Elena Llaguno, Ricardo Vernon Jan 1999

Mexico: Protecting Informed Consent, Elsa Santos, Silvia Elena Llaguno, Ricardo Vernon

Reproductive Health

The objective of this three-month project in Mexico was to disseminate information among key audiences about: 1) the right of women to choose contraceptive methods in a free and informed manner; and 2) the laws and institutions available to help redress any violations of this right. Four publications on these topics, developed by a previous project funded by Population Council/INOPAL III, were reproduced and distributed to 2,750 people in the following target audiences: women of reproductive age; reproductive health service providers; national and state commissions of human rights, complaints offices in public hospitals, feminist and human rights organizations; and legal …

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Investigación Operativa En Planificación Familiar: Lecturas Selectas, James R. Foreit, Tomas Frejka Jan 1999

Investigación Operativa En Planificación Familiar: Lecturas Selectas, James R. Foreit, Tomas Frejka

Reproductive Health

Desde que existen los programas de planificación familiar existe la investigación sobre este tema. En el nivel teórico, los investigadores examinan el efecto de la fertilidad sobre la salud y el desarrollo socioeconómico y estudian los determinantes de la fecundidad para los individuos y la poblaciones. En el nivel de las políticas, los estudios exploran el papel que juegan los programas de planificación familiar en la modificación de la fecundidad y la salud. El desarrollo de nuevos anticonceptivos se acompaña de pruebas clínicas y pre-introductorias en el contexto de los programas. Se llevan a cabo encuestas para medir los cambios …

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Improving The Management Of Stis Among Mch/Fp Clients At The Nakuru Municipal Council Health Clinics, Julie Solo, Baker Ndugga Maggwa, James Kariba Wabaru, Bedan Kiare Kariuki, Gregory Maitha Jan 1999

Improving The Management Of Stis Among Mch/Fp Clients At The Nakuru Municipal Council Health Clinics, Julie Solo, Baker Ndugga Maggwa, James Kariba Wabaru, Bedan Kiare Kariuki, Gregory Maitha

Reproductive Health

In an effort to address the global crisis of HIV/AIDS and to reduce the spread of other sexually transmitted infections (STIs), maternal and child health/family planning (MCH/FP) programs have attempted to integrate the management of STIs into their services. This integration was endorsed at the 1994 International Conference on Population and Development in Cairo. However, as noted in this report, programs have encountered a number of difficulties as they try to effectively manage STIs in an MCH/FP setting. In particular, the effective detection and treatment of STIs has proven difficult among MCH/FP populations. This current study was developed to help …

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The Cost Of Health Services At The Facilities Level Of The Nakuru Municipal Council, Nakuru, Kenya, Andrew Thompson, Barbara Janowitz, Julie Solo Jan 1999

The Cost Of Health Services At The Facilities Level Of The Nakuru Municipal Council, Nakuru, Kenya, Andrew Thompson, Barbara Janowitz, Julie Solo

Reproductive Health

The Nakuru Municipal Council (NMC), in Kenya, is concerned with the financial sustainability of its services and is considering increasing prices. The Council is currently charging for services but these fees are not based on the cost of providing services. Before changing its prices, the NMC wanted information on its costs because another strategy to improve financial sustainability is to decrease the costs of producing various services. Information on current costs of services can also help the NMC to determine ways to reduce these costs. The NMC, in collaboration with the Africa OR/TA II project and Family Health International, conducted …

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Expanding Men's Participation In Reproductive Health In Kenya, Bolaji M. Fapohunda, Naomi Rutenberg Jan 1999

Expanding Men's Participation In Reproductive Health In Kenya, Bolaji M. Fapohunda, Naomi Rutenberg

Reproductive Health

To increase men’s participation in family planning (FP) and reproductive health (RH) both for their own well-being and as gatekeepers to women’s health, the African Population Policy Research Center and the Population Council’s OR/TA Project II launched a study designed to explore best practices for delivering services to men. The study examined men’s knowledge, perceptions, and concerns about RH issues, including FP, and the social context of their knowledge. In sub-Saharan Africa, FP and reproductive health-care research and interventions place a disproportionate emphasis on women and largely ignore the role of men. As a result, male participation in FP and …

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Testing Strategies To Improve Access To Emergency Contraception Pills: Prescription Vs. Prophylactic Distribution, John P. Skibiak, Yusuf Ahmed, M. Ketata Jan 1999

Testing Strategies To Improve Access To Emergency Contraception Pills: Prescription Vs. Prophylactic Distribution, John P. Skibiak, Yusuf Ahmed, M. Ketata

Reproductive Health

This report is the second in a series of research summaries produced in connection with the operations research project “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the project explores the many issues surrounding the introduction and delivery of emergency contraception services in a developing country context. The study described in this report compares two different approaches to overcoming barriers that prevent women from accessing emergency contraception during the 72-hour period when the first dosage of emergency contraception pills (ECPs) must be taken. In one approach, new family planning (FP) acceptors were …

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Comparing Alternative Products In The Provision Of Emergency Contraception, John P. Skibiak, Yusuf Ahmed, M. Ketata Jan 1999

Comparing Alternative Products In The Provision Of Emergency Contraception, John P. Skibiak, Yusuf Ahmed, M. Ketata

Reproductive Health

This report is the third in a series of summaries produced in connection with the operations research project “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the project explores the many issues surrounding the introduction and delivery of emergency contraception services in a developing country context. The study compares the introduction of two different emergency contraception pills—the combined oral contraceptive PC-4, introduced in Zambia in 1997, and the progestin-only contraceptive Postinor-2, introduced by this study in the following year. Client histories showed only minor differences in the attitudes of emergency contraception users …

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Zimbabwe: Les Méthodes De Dépistage Des Iar Chez Les Femmes Sont Chères Et Inefficaces, Population Council Jan 1999

Zimbabwe: Les Méthodes De Dépistage Des Iar Chez Les Femmes Sont Chères Et Inefficaces, Population Council

Reproductive Health

Les Infections de l’Appareil Reproductif (IAR) sont courantes au Zimbabwe. Beaucoup d’IAR augmentent le risque d’infection au Virus de l’Immunodéficience Humaine. En 1998, le Conseil National de Planification Familiale du Zimbabwe (ZNFPC) a entrepris une recherche opérationnelle afin d’évaluer la faisabilité de l’intégration du diagnostic des IAR et des services de traitement dans son menu de services. La population étudiée consistait en 1634 clientes de trois cliniques du ZNFPC. Chaque cliente a été interrogée sur les douleurs au bas ventre, les pertes vaginales et autres symptômes d’IAR. Elles ont ensuite été examinées pour des signes cliniques d’IAR, et ont subi …

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Reproductive Tract Infections: A Set Of Factsheets, Population Council Jan 1999

Reproductive Tract Infections: A Set Of Factsheets, Population Council

Reproductive Health

Reproductive tract infections (RTIs) are being increasingly recognized as a serious global health problem with impact on individual women and men, and their families and communities. RTIs can have severe consequences, including infertility, ectopic pregnancy, chronic pelvic pain, miscarriage, and increased risk of HIV transmission. For effective prevention and management of RTIs, accurate information is necessary and should be widely available. In addition to a brief introduction to RTIs, this document contains 13 factsheets addressing medical and social issues on a variety of topics related to RTIs. The document, produced by the Population Council with support from the Ford Foundation, …

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Zimbabwe: Los Métodos De Detección De Itr En Mujeres No Son Cost-Efectivos, Population Council Jan 1999

Zimbabwe: Los Métodos De Detección De Itr En Mujeres No Son Cost-Efectivos, Population Council

Reproductive Health

Las infecciones del tracto reproductivo (ITR) son frecuentes en Zimbabwe. Muchas de estas infecciones aumentan el riesgo de contraer el virus de inmunodeficiencia humana (VIH). En 1998, el Consejo Nacional de Planificación Familiar de Zimbabwe (en inglés, ZNFPC) realizó un estudio de IO para evaluar la viabilidad de integrar el diagnóstico y tratamiento de ITR en su oferta de servicios. La población estudiada estaba constituida por 1,634 clientas de tres clínicas de ZNFPC. Se preguntó a las usuarias si presentaban dolor en la región abdominal inferior, flujo vaginal y otros síntomas de ITR; asimismo, se les examinó para detectar la …

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Investing In Youth: Testing Community-Based Approaches For Improving Adolescent Sexual And Reproductive Health, Tamara Fetters, Fines Munkonze, Julie Solo Jan 1999

Investing In Youth: Testing Community-Based Approaches For Improving Adolescent Sexual And Reproductive Health, Tamara Fetters, Fines Munkonze, Julie Solo

Reproductive Health

The world is now sustaining the largest number of youth in human history; today there are nearly 900 million 10–19-year-olds and their health and livelihood issues are becoming increasingly important to policymakers worldwide. In Zambia, as in many other countries, young people face severe problems, including limited access to jobs, secondary education, and health care. The social, economic, and peer pressures that youth face often lead to high levels of sexual activity, often with subsequent negative impacts on their sexual and reproductive health. In spite of the magnitude of the reproductive health problems facing youth, they still have limited access …

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Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council Jan 1999

Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council

Reproductive Health

The health status of women, men, and children in sub-Saharan Africa remains the poorest in the world. Moreover, virtually every country in the region is suffering mediocre economic growth or economic decline, thereby reducing the ability of their health care systems to respond adequately, and increasing dependence on external donor assistance. In terms of reproductive health (RH), the region is faced with high levels of unwanted fertility; high levels of maternal, child, and infant morbidity and mortality; and an almost exponential growth in HIV prevalence. Access to and quality of RH services remains poor in most countries, thereby maintaining unmet …

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Integrating Sti And Mch/Fp Services, Population Council Jan 1999

Integrating Sti And Mch/Fp Services, Population Council

Reproductive Health

The integration of STI and HIV/AIDS information and services into existing MCH/FP programs has been strongly supported in recent years, following recommendations from the 1994 Cairo ICPD. Moreover, it is now widely accepted that early detection and management of STIs can reduce the incidence of HIV infection. Thus, there are powerful incentives to increase efforts to broaden the capacity of MCH/FP programs to provide STI prevention and management information and services for their clients, both as a comprehensive reproductive health service and as a preventive measure for reducing the transmission of HIV. As described in this brief, the Africa OR/TA …

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L'Approche De L'Analyse Situationnelle Pour L'Évaluation Des Services De Planification Familiale Et De Santé De La Reproduction: Manuel De Recherche, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba Jan 1999

L'Approche De L'Analyse Situationnelle Pour L'Évaluation Des Services De Planification Familiale Et De Santé De La Reproduction: Manuel De Recherche, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba

Reproductive Health

Une bonne prestation de services de planification familiale mettant l'accent à la fois sur l'accès et la qualité est la clé des objectifs interdépendants de satisfaction des besoins individuels et la réalisation du succès programmatique. L'analyse de situation (AS) fournit un lien nécessaire entre le responsable de programme et la cliente qu'il essaie de servir. Les données recueillies par l’AS offrent une image représentative du fonctionnement des composantes et permettent de «voir» l'expérience de la cliente. Les analyses situationnelles aident le responsable de programme à atteindre le plus grand but en termes de gestion—celui d’une administration efficace d'un service de …

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Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan Jan 1999

Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan

Reproductive Health

This book on family planning in India includes detailed empirical data and analysis of the various dimensions of quality of care in different regions of the country. Focus areas include: women’s perceptions of the care they receive; observations of provider-client interactions; barriers to quality of service delivery; existing interregional variations; contraceptive choice and interpersonal relations; technical quality of care; and the effect of the target system on the work style of outreach staff. All elements of the quality-of-care framework elaborated by Judith Bruce are well documented and their relationships to broader program constraints are clearly identified. The overall impression one …

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The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council Jan 1999

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

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Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda Jan 1999

Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda

Reproductive Health

This project was designed to disseminate, expand use, and promote institutionalization of a program to train healthcare professionals to address domestic violence. The program was developed and implemented by the Instituto Mexicano de Investigación de Familia y Población (IMIFAP), a nongovernmental organization that promotes reproductive health. IMIFAP designed an 18-hour workshop, entitled “Health Services Respond to Domestic Violence,” to sensitize health professionals to domestic violence issues and develop strategies for recognizing and managing cases of domestic violence. Following the workshop, strong and significant increases in knowledge about domestic violence and its management in primary healthcare services were found. Workshop participants …

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Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao Jan 1999

Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao

Poverty, Gender, and Youth

Despite ongoing declines in fertility in many countries, the population of the world is experiencing a period of rapid expansion, and its size is expected to exceed 10 billion by the end of the demographic transition. Three causes of this growth are identified and quantified: 1) fertility above the replacement level of two surviving children per woman, 2) continuing declines in mortality, and 3) population momentum resulting from a young age structure. A set of simple analytic expressions is proposed for estimating these factors from standard demographic indicators. Population momentum is shown to be the main cause of future growth …

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Measuring Living Standards With Proxy Variables, Mark R. Montgomery, Michele Gragnolati, Kathleen A. Burke, Edmundo Paredes Jan 1999

Measuring Living Standards With Proxy Variables, Mark R. Montgomery, Michele Gragnolati, Kathleen A. Burke, Edmundo Paredes

Poverty, Gender, and Youth

Very few demographic surveys in developing countries gather information on household income or consumption expenditure, despite the theoretical importance of these measures. Consequently, researchers have been forced to rely on ad hoc collections of proxy measures for living standards, and the properties of these proxies have not been systematically analyzed. In this research, we ask what hypotheses can be tested using proxy variables, and evaluate the performance of proxy measures in relation to consumption expenditures per adult, our preferred measure of living standards. We find that the proxy variables commonly employed in demographic research are very weak predictors of consumption …

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Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline Jan 1999

Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline

Poverty, Gender, and Youth

Fertility has declined substantially in developing countries in the period since 1960, primarily as the result of increases in contraceptive prevalence. Little dispute is found on this point, but considerable debate has arisen about the causes of the increase in contraceptive prevalence. One unresolved issue is the causal contribution of changes in fertility desires. The sources of increase in contraceptive prevalence are analyzed in 22 countries in Latin America, Asia, and Africa in the period from the 1970s to the 1990s, using World Fertility Surveys and Demographic and Health Surveys data. Through regression decomposition, change in prevalence is attributed to …

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The Decline Of Female Circumcision In Egypt: Evidence And Interpretation [Arabic], Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark Jan 1999

The Decline Of Female Circumcision In Egypt: Evidence And Interpretation [Arabic], Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than …

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The Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts Jan 1999

The Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts

Poverty, Gender, and Youth

This study examines the role of tempo effects in the fertility declines of developing countries. These effects temporarily inflate the total fertility rate (relative to the actual fertility of cohorts of women) during periods when the age at childbearing declines and they deflate it when childbearing is postponed. An analysis of data from the World Fertility Surveys and the Demographic and Health Surveys demonstrates that fertility trends observed in many developing countries are likely to be distorted by changes in the timing of childbearing. In most countries women are delaying childbearing, which implies that observed fertility is lower than it …

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Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar Jan 1999

Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar

Poverty, Gender, and Youth

Although an overall decline has occurred in adolescent fertility in Kenya, the proportion of births to teenagers that takes place prior to marriage is rising. At the same time that premarital sex and childbearing have increased, educational participation has expanded considerably, especially for girls. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 33 primary schools that the adolescents attended, this paper explores whether certain aspects of the school environment affect the likelihood of early and unprotected sex among adolescent girls and boys in three districts of Kenya. Because of the concern with “schoolgirl pregnancy” …

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Urban Growth In Developing Countries: A Review Of Projections And Predictions, Martin Brockerhoff Jan 1999

Urban Growth In Developing Countries: A Review Of Projections And Predictions, Martin Brockerhoff

Poverty, Gender, and Youth

Comparison of the United Nations’ earliest and most recent projections to the year 2000 suggests that urban and city growth in developing regions has occurred much more slowly than was anticipated as recently as 1980. A modified “urban population explosion” in developing countries since the 1970s conforms to explanatory models of urban growth developed by economists around 1980. Trends in productivity and terms of trade, in particular, have been highly favorable to agriculture as compared to manufacturing, presumably slowing migration to urban centers. Increases in national population growth rates have produced less than commensurate in rates of city growth, further …

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The Decline Of Female Circumcision In Egypt: Evidence And Interpretation, Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark Jan 1999

The Decline Of Female Circumcision In Egypt: Evidence And Interpretation, Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than …

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Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah Jan 1999

Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah

Reproductive Health

This report aims to explain the discrepancies in crisis-related research results in Indonesia, and to recommend methodologies to enhance future crisis-related monitoring and surveillance. The discussion aims to identify where the discrepancies are in the readily available data, and how these discrepancies can be explained. The report does not attempt to clarify the impact that the economic crisis is having on the health status of women and children in Indonesia. Recommendations are made to deal with the following findings: Aggregation of data may hide important crisis impacts; attribution of identified changes to the economic crisis may be misleading; differences in …

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Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon Jan 1999

Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon

Reproductive Health

The goal of this project was to inform physicians, pharmacists, and female factory workers about emergency contraception (EC) through mailings of booklets and posters. These materials were developed in a previous operations research project conducted by the Instituto Mexicano de Investigación de Familia y Población and supported by the Population Council INOPAL III project with funding from USAID. The study found that recipients generally liked the print materials and welcomed information about EC. Within three weeks of receiving the materials, many reported that they had taken immediate action to make EC available and/or to educate others about EC. This project …

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