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Articles 1 - 30 of 34
Full-Text Articles in Medicine and Health Sciences
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 …
L’Introduction De L’Identification Systématique Pour Réduire Les Besoins Non Satisfaits En Santé : Manuel Du Manager, Ricardo Vernon, James R. Foreit, Emma Ottolenghi
L’Introduction De L’Identification Systématique Pour Réduire Les Besoins Non Satisfaits En Santé : Manuel Du Manager, Ricardo Vernon, James R. Foreit, Emma Ottolenghi
Reproductive Health
Ce manuel est conçu pour aider les décideurs, les gestionnaires, les superviseurs et les prestataires de programmes à introduire le dépistage systématique dans leurs services de santé. Le dépistage systématique peut améliorer la santé des femmes en répondant à de multiples besoins non satisfaits en matière de services de santé reproductive et autres. Ce manuel fournit : les activités nécessaires à la mise en œuvre du dépistage systématique ; comment sélectionner les installations, les services à dépister et qui sera dépisté ; l'élaboration, l'adaptation et le prétest systématiques d'une liste de contrôle de dépistage ; des conseils pour les agents …
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Reproductive Health
In 1998, the nongovernmental organization Tostan implemented a village empowerment program in southern and western Senegal to help communities, especially women, improve living and health conditions in their villages, and to mobilize villages to hold public declarations supporting abandonment of harmful practices, particularly female genital mutilation/cutting (FGM/C) and child marriage. The program included modules on hygiene, literacy and numeracy, human rights, and children’s and women’s health. The Tostan approach has since been implemented more broadly in Senegal and in Burkina Faso, Guinea, and Sudan. In 2005–06, FRONTIERS evaluated the long-term impact of the program, focusing on the abandonment of FGM/C …
Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council
Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council
Reproductive Health
In 2004, FRONTIERS collaborated with UNICEF on a study of female genital mutilation/cutting (FGM/C) in Kenya’s Somali community and on ways of managing maternal care for cut women. The study showed that the health-care system in North Eastern Province, where many Somalis live, is ill prepared to deal with women who have been cut, particularly infibulated women who are pregnant or delivering. The study recommended improving providers’ ability to counsel and treat pregnant cut women as part of an overall improvement of maternal care, and strengthening providers’ role as behavior change agents within communities. In 2005, FRONTIERS launched an intervention …
Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council
Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council
Reproductive Health
The World Health Organization recommends that women receive information on family planning (FP) during antenatal care (ANC), immediately after birth, and during postpartum and well-baby care. However, few studies have assessed the effect of information during each of these stages on women’s use of contraceptive methods. Data collected by FRONTIERS in the Dominican Republic, Haiti, and Nicaragua have been analyzed to answer this question. Use of maternal care services, exposure to FP information, and use of postpartum contraception varies among countries. All women interviewed in the Dominican Republic attended ANC services and delivered in a facility; ANC use and institutional …
Africa Regional Sexual And Gender-Based Violence Network Consultation: Technical Exchange And Planning Meeting, Population Council
Africa Regional Sexual And Gender-Based Violence Network Consultation: Technical Exchange And Planning Meeting, Population Council
Reproductive Health
In March 2008, the Population Council brought together members of the Africa Regional Sexual and Gender Based Violence (SGBV) Network for a South-South technical exchange meeting. The objectives were to identify best practices from existing programs, provide an evidence base for new programming, and develop mechanisms for South-South technical assistance. As detailed in this report, discussions covered the medical, legal, and psychosocial issues associated with SGBV prevention and response activities. Participants identified the following: Protocols and guidance documents are essential for ensuring comprehensive, quality response at all levels. Enabling access and utilization of the full range of medical services remains …
Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)
Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)
Reproductive Health
The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to the hospital. PAIMAN is compiling data from three data sources and making efforts to improve the functioning of these Health Information Systems (HISs) for efficient management of health services at the district level through generation of quality data and their …
Kenya And Ethiopia: Community And Religious Leaders Are Effective Advocates For Hiv Testing For Young Couples, Population Council
Kenya And Ethiopia: Community And Religious Leaders Are Effective Advocates For Hiv Testing For Young Couples, Population Council
Reproductive Health
Early marriage is common for girls in much of sub-Saharan Africa. A common belief is that marriage protects them from HIV, but studies show that married girls are at much higher risk from HIV and from maternal morbidity and mortality. FRONTIERS conducted operations research in Ethiopia and Kenya to assess the acceptability and feasibility of community-based interventions to raise awareness of the HIV risks of early marriage and promote the use of HIV counseling and testing (C&T) services by couples. The studies were an initial phase in a planned four-year intervention; this brief reports on the feasibility of the approach. …
Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon
Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon
Reproductive Health
The first days, weeks, and months after a delivery represent a period of substantial information and service needs for both mother and child, including treatment of hemorrhage and infections, breastfeeding information and support, nutritional complements and micronutrients, immunizations for children and mothers, counseling for managing intimate partner violence and depression, and, most importantly, contraception. In areas of high HIV prevalence, contraceptives and antiretroviral therapy are especially critical elements of postpartum care. Yet despite its strategic importance, few organizations have made it a priority to address women's reproductive health and fertility needs during the year following delivery. The situation is compounded …
Dominican Republic, Haiti, Nicaragua: Women Living With Hiv Have Unmet Family Planning Needs, Population Council
Dominican Republic, Haiti, Nicaragua: Women Living With Hiv Have Unmet Family Planning Needs, Population Council
Reproductive Health
Women living with HIV in the Dominican Republic, Haiti, and Nicaragua are marginalized in many ways, including their access to family planning (FP) services. Making FP services accessible to persons living with HIV (PLWH) is one of four key strategies that WHO promotes in its comprehensive approach to prevent HIV infections in infants and young children. This strategy also increases the coverage and quality of FP services among a population commonly underserved and at high risk of unplanned pregnancy. Expanded access to antiretroviral therapy in many developing countries has improved the life expectancies and health of many PLWH who are …
Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia
Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia
Reproductive Health
As in many developing countries, young people in Kenya and Senegal (aged 10–20) account for about 25 percent of the population. To ensure their future contribution to their countries, it is of vital strategic importance to safeguard their welfare. Rapid social change in both countries exposes youth to sexual and reproductive health (RH) risks, including unintended pregnancy, sexually transmitted infections including HIV, and sexual violence. Beginning in 1999, the Population Council’s FRONTIERS program conducted operations research studies that tested the feasibility, acceptability, and cost of a public-sector, multisectoral intervention to enhance young people’s RH knowledge and behavior. Study findings showed …
Profile Of Abortion Seekers In Ghana And Their Decision-Making Processes, Philomena Nyarko, Cletus Adohinzin, Saumya Ramarao, Placide Tapsoba, Ayorinde Ajayi
Profile Of Abortion Seekers In Ghana And Their Decision-Making Processes, Philomena Nyarko, Cletus Adohinzin, Saumya Ramarao, Placide Tapsoba, Ayorinde Ajayi
Reproductive Health
In 2006, a consortium of agencies, including the Population Council, came together to provide technical and financial support to the Government of Ghana in the rollout of comprehensive abortion care (CAC) services. The consortium collaborated with the government in expanding women’s access to modern family planning and CAC. The consortium’s program, Reducing Maternal Mortality and Morbidity (R3M), aims to reduce unwanted pregnancy and severe complications and deaths caused by unsafe abortion. The formative research in this report was undertaken to provide a profile of beneficiaries, their needs for information and services, their decision-making process in seeking care, and the quality …
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Reproductive Health
In 2006, FRONTIERS collaborated with the National Committee Against the Practice of FGM/C on an analysis of recent trends in female genital mutilation/circumcision (FGM/C) in rural and urban Burkina Faso. The study, conducted to help develop policies and programs for FGM/C abandonment in Burkina Faso and more widely in Africa, had three components: a description of the institutional, political, and programmatic environment in Burkina; a secondary analysis of data from existing studies; and an assessment of the community’s perceptions and behavior regarding FGM/C, as well as the factors that contribute to abandonment or continuation of the practice. For the policy …
Increasing Women's Use Of The Iud For Family Planning, Ricardo Vernon
Increasing Women's Use Of The Iud For Family Planning, Ricardo Vernon
Reproductive Health
The intrauterine device (IUD) is highly effective, easy to use, and has few side effects. The device costs the provider about US$2 and offers a duration of protection that makes it the most cost-effective of the temporary methods if used for two years or more. The IUD's many advantages also make it a good alternative for reducing unmet need for long-term contraception around the world. Between 5 and 17 percent of all married women of reproductive age in 53 less developed countries do not want to have more children but are not using a contraceptive method. Because the IUD can …
Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi
Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi
Reproductive Health
In 2001, the World Health Organization issued guidance on a new model of antenatal care (ANC) called goal-oriented or focused antenatal care (FANC), for implementation in developing countries. The new model reduces the number of required antenatal visits to four, and provides focused services shown to improve maternal outcomes. FANC emphasizes helping women maintain normal pregnancies by identifying existing health conditions, detecting emerging complications, promoting health, preparing for a healthy birth, and educating clients on postpartum care including nutrition, breastfeeding, and family planning. Trials conducted in Argentina, Cuba, Saudi Arabia, and Thailand proved that FANC was safe and was a …
Dissocier Les Mutilations Génitales Féminines De L'Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi
Dissocier Les Mutilations Génitales Féminines De L'Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi
Reproductive Health
Les mutilations ou excisions génitales féminines (MGF/E) sont pratiquées dans au moins 28 pays d'Afrique subsaharienne, quelques pays du Moyen-Orient et d'Asie, et parmi les populations immigrées de ces pays en Europe, en Amérique du Nord et en Australie. Dans le monde, on estime que 100 à 140 millions de filles et de femmes ont subi cette pratique, et au moins trois millions de filles sont à risque chaque année. La communauté ethnique somalienne au Kenya ainsi qu'en Somalie, à Djibouti et en Éthiopie pratique l'excision depuis des siècles et la pratique semble être restée largement inchangée. Le programme FRONTIERS …
Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)
Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)
Reproductive Health
The World Health Organization estimates that 585,000 women die from pregnancy-related conditions each year. Pregnancy-related conditions, including dysfunctional labor, hemorrhage, infection, toxemia, and unsafe abortion, are the leading cause of death among women of reproductive age in many developing countries. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan, through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to …
Institutionalization Of Quality Assurance Within District Health Management: Experiences From Maharashtra And Karnataka, M.E. Khan, Anurag Mishra, Vivek Sharma, Jaleel Ahmad, Jose Joseph, Venkatesh Srinivasan, K.M. Sathyanarayana, Viji Vargees, K.D. Maiti, Rashmi Sharma
Institutionalization Of Quality Assurance Within District Health Management: Experiences From Maharashtra And Karnataka, M.E. Khan, Anurag Mishra, Vivek Sharma, Jaleel Ahmad, Jose Joseph, Venkatesh Srinivasan, K.M. Sathyanarayana, Viji Vargees, K.D. Maiti, Rashmi Sharma
Reproductive Health
The Population Council, with financial support from UNFPA, provided technical assistance to the states of Maharashtra and Karnataka, India in implementing a quality assurance (QA) program and helped its institutionalization in the district level of health management. An analysis of all the facilities covered as of December 2007 revealed substantial gaps in the infrastructure and human resources available to provide good-quality services, as well as adherence to standards for providing the services. To build the capacity to undertake QA visits, the Population Council and state authorities organized a series of events to orient and train state and district officials, facility-level …
Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu
Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu
Reproductive Health
In Uganda, HIV/AIDS treatment, care and support programs are still organized around either adult or pediatric care and fail to adequately address the needs of adolescents, specifically perinatally-infected adolescents. This study, implemented jointly by the Population Council's Frontiers in Reproductive Health (FRONTIERS) program and the AIDS Support Organization (TASO), aimed to better understand the reproductive health and sexuality of this population group, and to identify anxieties or fears they have around entering social stages of adulthood. This study confirms that wide programmatic gaps exist in addressing the sexual and reproductive health needs of young people perinatally infected with HIV who …
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Reproductive Health
A program to operationalize and institutionalize a gender perspective in reproductive health services in Bolivia resulted in a significant reduction in unmet need for contraception, increased client satisfaction, and improved communication between partners. Bolivia’s Integral Health Coordination Program (PROCOSI) encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their RH programs. In 2005, FRONTIERS collaborated with PROCOSI to test the feasibility and costs of a system for certifying that its member organizations provided gender-sensitive RH services. The two-year project followed a 2000 intervention to incorporate gender perspectives in PROCOSI clinics that led …
Family Planning And Comprehensive Abortion Care Handbook For Medical Students And House Officers, Population Council
Family Planning And Comprehensive Abortion Care Handbook For Medical Students And House Officers, Population Council
Reproductive Health
The persistently high maternal mortality and morbidity in Ghana is partly due to high rates of unwanted fertility, unsafe abortion, and relatively low use of modern contraception. In 2006, a consortium of agencies, including the Population Council, initiated the Reducing Maternal Mortality and Morbidity program. The program provides financial and technical resources that will enable the government to significantly expand women's access to modern family planning, contraception, and comprehensive abortion care (CAC) to reduce maternal mortality in Ghana. This handbook on FP and CAC was developed as part of the program. It updates a previous document produced more than ten …
Introducing Systematic Screening To Reduce Unmet Health Needs: A Manager's Manual, Ricardo Vernon, James R. Foreit, Emma Ottolenghi
Introducing Systematic Screening To Reduce Unmet Health Needs: A Manager's Manual, Ricardo Vernon, James R. Foreit, Emma Ottolenghi
Reproductive Health
This manual is designed to help program decision-makers, managers, supervisors, and providers introduce systematic screening in their health services. Systematic screening can improve women’s health by addressing multiple unmet needs for reproductive and other health services. This manual provides: activities necessary to implement systematic screening; how to select facilities, services to screen for, and who will screen; systematic screening checklist development, adaptation, and pretesting; advice for training screeners/providers and supervisors and an outline of a generic training agenda. The manual’s contents may be adapted to reflect local, national, or programmatic health priorities and resources as well as to promote the …
South Africa: Integrated Approach Improves Quality Of Post-Rape Care, Population Council
South Africa: Integrated Approach Improves Quality Of Post-Rape Care, Population Council
Reproductive Health
In South Africa, an integrated model for post-rape care by nurses in a rural district hospital, which included a designated room for medical management and guidelines for providing reproductive health and HIV services, improved the quality of care provided. However, nurses remained reluctant to collect forensic evidence that could be used for prosecuting perpetrators. South Africa has developed a strong policy framework outlining medical management of rape survivors, which includes provision of HIV testing and post-exposure prophylaxis and emergency contraception, ideally within 72 hours. However, implementation has been hampered by numerous obstacles, both in health care infrastructure and policy, and …
Kenya: Islamic Scholars Find No Religious Justification For Fgm/C, Population Council
Kenya: Islamic Scholars Find No Religious Justification For Fgm/C, Population Council
Reproductive Health
In 2004, FRONTIERS undertook a study on the cultural basis of female genital mutilation and cutting (FGM/C) in Kenya’s Somali community. The study showed universal support for FGM/C, and indicated that one of the major justifications is the perception that Islam requires female as well as male genital cutting. Interviews with informants showed that belief in the religious justification overrides arguments about the health and human rights aspects and the knowledge that it is illegal in Kenya. In 2005, FRONTIERS launched an intervention to engage the community in discussions about FGM/C to clarify the religious position. FRONTIERS arranged symposia involving …
India: Quality Assurance Procedure Monitors And Improves Quality Of Services, Population Council
India: Quality Assurance Procedure Monitors And Improves Quality Of Services, Population Council
Reproductive Health
A quality assurance (QA) procedure was pilot-tested and subsequently scaled up throughout the state of Gujarat, India, after demonstrating that a 65-item checklist is an efficient tool for identifying and remedying gaps in service delivery. From 2004–06, FRONTIERS developed and tested a standardized QA procedure. The State Ministry of Health and Family Welfare (MOHFW) used the procedure to assess health-care services in rural clinics in two pilot districts each in the states of Gujarat and Maharashtra. Based on positive results, the State MOHFW expanded the QA procedure in a phased manner throughout all 25 districts of Gujarat. The model is …
Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council
Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council
Reproductive Health
Kenya and Malawi have developed national policies to prevent malaria in pregnancy. Measures to prevent malaria among antenatal clients were shown to be sustainable several years after pilot interventions ended. In Malawi, the approach has been expanded nationwide. In most malaria-endemic areas of Africa, women in their first and second pregnancies have the highest risk of acquiring malaria and, consequently, of malaria-associated anemia and low birth-weight. Two USAID-funded interventions aimed at strengthening the prevention and management of malaria in pregnancy were pilot-tested at the district level in Kenya (1998–2002) and Malawi (1998–2004). As noted in this brief, the goal was …
Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council
Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council
Reproductive Health
The Kenyan government’s reproductive health policy highlights service integration and quality of care. While integrating counseling and testing (C&T) for HIV into family planning (FP) can potentially increase the range of services to clients at risk from sexually transmitted infections (STIs) including HIV, few studies have documented the feasibility, effects, or costs of such integration. From 2005–07, the Population Council worked with the Kenyan Ministry of Health to test the feasibility of two models for integrating C&T into existing FP services. Both models featured client education on HIV prevention during FP visits. Providers were trained to routinely use the Balanced …
Operations Research For Managers Of Reproductive Health Programs, James R. Foreit, M.E. Khan
Operations Research For Managers Of Reproductive Health Programs, James R. Foreit, M.E. Khan
Reproductive Health
The course presented in this publication defines operations research (OR) as the study of factors under the control of health program managers and other decision-makers. The purpose of OR is to improve programs and provide information for management decision-making. Successful OR is characterized by a close collaboration between program managers and researchers throughout the study. The course focuses on OR as a branch of the behavioral sciences and deals with formative research and field experiments. It concentrates on improving the research knowledge of managers who have had little or no training in research. The focus of this interactive course is …
Financial Capacity Building For Ngo Sustainability, John H. Bratt, Rick Homan, Barbara Janowitz, James R. Foreit
Financial Capacity Building For Ngo Sustainability, John H. Bratt, Rick Homan, Barbara Janowitz, James R. Foreit
Reproductive Health
While demand for family planning and reproductive health services is increasing worldwide, a number of recent trends threaten the financial sustainability of donor-supported NGOs that provide these services. First, the U.S. Agency for International Development has seen its funding for population assistance decline since 1995. A second reason is the growth of government-funded programs that provide these services for low-income clients, which reduced the need for NGOs to focus programs entirely on the poor. Health-sector reform has created opportunities for NGOs via public–private partnerships in some countries, but sustained public-sector support is unlikely given limited economic growth in domestic economies …
Assessing Integration Methodology (Aim): A Handbook For Measuring And Assessing The Integration Of Family Planning And Other Reproductive Health Services, M. Estela Rivero-Fuentes, Saumya Ramarao, Ricardo Estrada, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Harriet Birungi, John Townsend, Susana Medina
Assessing Integration Methodology (Aim): A Handbook For Measuring And Assessing The Integration Of Family Planning And Other Reproductive Health Services, M. Estela Rivero-Fuentes, Saumya Ramarao, Ricardo Estrada, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Harriet Birungi, John Townsend, Susana Medina
Reproductive Health
Several international statements over the past two decades have endorsed the integration of family planning (FP) services with other reproductive health (RH) services as a means of expanding availability and access for potential users. Many rationales underlie the move toward integrating FP with other services. First is that it provides benefits to the client and the program. Moreover, there is the expectation that the costs to the health system of configuring two or more services will cost less than providing them independently. However, there is still little empirical evidence available about integration of services. Over time, a number of methodologies …