Medicine and Health Sciences Commons^™

Engaging Men For Effective Family Planning Through Couple Communication: An Assessment Of Two Mcsp Couple Communication Approaches In Togo, Natacha Stevanovic-Fenn, Bethany Arnold, Sanyukta Mathur, Catherine Tier, Anne Pfitzer, Rebecka Lundgren

Reproductive Health

On behalf of Breakthrough RESEARCH, the Institute for Reproductive Health of Georgetown University, in collaboration with the Population Council, assessed two of three couple's communication approaches for family planning being implemented by Maternal and Child Survival Program in Togo’s Kloto district: in home couple's counseling (either individual in home counseling or with the couple together) and group discussions. IRH’s overall goal was to assess the benefits and feasibility of these two approaches as well as to determine which elements of each are best suited for roll-out on a broader scale. The two models—home-based couple counseling and group discussions—were implemented in …

An Assessment Of Human Resources For Health Hiring, Deployment And Retention, Procedures And Practices In Cross River And Bauchi States, Nigeria, Osasuyi Dirisu, Akinwumi Akinola, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril, George I. Eluwa

Reproductive Health

Primary health care (PHC) is the first contact in a healthcare system and, at its core, includes access to basic interventions that address health needs at the community level. These basic interventions are provided by key frontline health workers—nurses, midwives, and community health extension workers—critical for facilitating immediate access to maternal, newborn, and child health services at PHC facilities. Despite the critical roles of these healthworker cadres, their distribution is uneven and skewed—geographic and within levels of care and governments, in addition to poor distribution of skills—compounded by high attrition due to poor human resources for health (HRH) management and …

Assessment Of In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers In Bauchi And Cross River States, Nigeria, Ekechi Okereke, Iliyasu Zubairu, Udoh Nsekpong, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

Training contributes tremendously to the development and sustenance of health workers’ competencies for quality healthcare services. Although Nigeria has a higher stock of human resources for health compared to other African countries, the World Health Organization argues that its distribution is highly skewed toward urban areas. Building and maintaining staff capacities requires continuing professional development through in-service training (IST) and continuing education (CE). This study assesses current IST and CE for health workers in Bauchi and Cross River states to provide evidence to inform policy and planning and improve implementation of capacity-building for health workers in Nigeria.

Collaboration With The University Of Calabar For Human Resources For Health Management Training For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

A pool of knowledgeable staff is required within middle and senior management for long-term human resources for health (HRH) planning and effective management at all levels of the health system—federal, state, and local. This brief reports on the training by the Population Council, in partnership with the World Health Organization in Nigeria, of 105 key personnel on HRH planning, management, policy dialogue, advocacy, and resourcing for the HRH project “Enhancing the Ability of Frontline Health Workers to Improve Health in Nigeria.” Critical HRH-related capacities were built among key Nigerian health system personnel and managers, most significantly in the states of …

Health Financing And Family Planning In The Context Of Universal Health Care: Connecting The Discourse, Gabrielle Appleford, Saumya Ramarao

Reproductive Health

Financing is a major challenge and concern for the future of family planning (FP) programs. As countries commit to increasing access to and quality of FP services and to universal health care (UHC), it is crucial that UHC schemes include FP and other reproductive health services. While the importance of financing is recognized in relation to quality, the “how” of financing FP within the context of UHC is not well understood. This brief targets the “bridge” constituency that is coalescing between the health financing and FP communities of practice around a shared interest in making access to health services universal. …

Health Financing And Family Planning In The Context Of Universal Health Care: Connecting The Discourse In Kenya, Gabrielle Appleford, Saumya Ramarao

Reproductive Health

Financing is a major challenge and concern for the future of family planning (FP) programs. As countries commit to increasing access to and quality of FP services and to universal health care (UHC), it is crucial that UHC schemes include FP and other reproductive health services. This brief aims to: 1) document trends in UHC and health financing, drawing out implications for policymakers and programmers; and 2) identify opportunities for the FP community of practice to advocate for the inclusion of quality FP services within UHC and health financing discussions. With this brief, we aim to highlight experiences in Kenya, …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Uganda, Justus Barageine, Charity Ndwiga, Hassan Kanakulya, Pooja Sripad

Reproductive Health

The Population Council, in collaboration with Fistula Care Plus and EngenderHealth, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing fistula screening, diagnosis, and treatment in Uganda. Following a baseline assessment, researchers implemented a multi-pronged intervention utilizing a mobile hotline, transport voucher, and mass media tools to increase community awareness. This brief provides key messages and recommendations for overcoming barriers hindering access to fistula care services. Health systems and external stakeholder support are essential for sustaining trends.

Strengthening Bauchi State College Of Nursing And Midwifery By Updating Its Training Curricula, Procedure Manuals And Student Handbooks, Ekechi Okereke, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

Many of Nigeria’s Nursing and Midwifery schools and colleges encounter challenges that include outdated training curricula, which can lead, in some cases, to loss of accreditation. In Bauchi state, a state College of Nursing and Midwifery was formally established in 2013. The Population Council engaged a curriculum expert who had worked with the Nursing and Midwifery Council of Nigeria (which stipulates minimum standards of compliance for accreditation) to assess the school’s training documents, including its training curriculum, procedure manual, and student handbook. The school is expected to secure full accreditation in 2019. The Population Council also supported the strengthening of …

Strengthening Cross River State Schools Of Nursing And Midwifery By Updating Their Training Curricula, Procedure Manuals And Student Handbooks, Ekechi Okereke, Godwin Unumeri, Aisha Jibril

Reproductive Health

Many of Nigeria’s Nursing and Midwifery schools and colleges encounter challenges that include outdated training curricula, which can lead, in some cases, to loss of accreditation. In Cross River state, in 2014 only one health training institution was accredited—provisionally. Five other institutions had lost their accreditations from the Nursing and Midwifery Council of Nigeria (NMCN) which stipulates minimum standards of compliance for accreditation. An assessment team led by the Director of Nursing of Calabar’s Ministry of Health visited the Cross River schools to determine the best ways of addressing the gaps in the accreditation team’s report. Through the HRH project …

Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya—Brief, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan

Reproductive Health

This policy brief summarizes key findings from a study that examined whether there are shifts in norms and practices related to FGM/C among communities in Narok (predominantly inhabited by Maasai) and Kisii (predominantly inhabited by Abagusii) counties in Kenya. Although Kisii and Narok are FGM/C hotspots, practicing communities in these counties are reassessing norms and traditions in light of the current social and legal climate. These changes may provide a useful starting point for intervention programs that seek to create dialogue and critical reflection on the practice of FGM/C in an effort to accelerate its abandonment. Programmatic recommendations include: engaging …

Using Demographic And Health Surveys In The Campaign To End Fgm/C: A Kenyan Example, Dennis Matanda, Caroline W. Kabiru

Reproductive Health

In order to design effective interventions to end female genital mutilation/cutting (FGM/C), we need to map where FGM/C is practiced and what factors influence it. Data from the Demographic and Health Surveys (DHS), nationally representative surveys conducted in low- and middle-income countries every five years, give us the opportunity to explore how FGM/C is influenced by both individual and community-level factors. Where FGM/C prevalence is not uniform, various research and analysis techniques can be used to improve estimates and draw further information from DHS data. This brief shares insights from two studies carried out in Kenya using DHS data collected …

Reference Guide For Data Collection: Qualitative Social Network Interviews, Bettina Shell-Duncan, Amadou Moreau, Sarah Smith, Holly B. Shakya

Reproductive Health

The purpose of this document is to guide researchers who plan to use qualitative social network methods drawing on our experiences implementing a qualitative study entitled, “The End of Female Genital Mutilation/Cutting in Senegal: Tracing Social Networks, Investigating the Role of Gender and Intergenerational Influence.” Qualitative fieldwork was carried out in two contrasting settings in Senegal: 1) a region with a low prevalence of female genital mutilation/cutting (FGM/C) characterized by ethnic heterogeneity, and 2) a region with a high prevalence of FGM/C characterized by relative ethnic homogeneity. The goal of this research was to investigate the ways in which social …

Strengthening In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

This brief details Council efforts to develop effective, and costed, in-service training and continuing education modules for frontline health workers in Bauchi and Cross River states in Nigeria. This project was funded by WHO to aid the training and development of Nigeria's public health worker sector.

Population Council's Support For Nigeria's Third National Human Resources For Health Conference And Efforts To Institutionalize Hrh Conferences In Nigeria, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

This project brief describes the Population Council's partnership efforts with public health stakeholders in Nigeria to plan and host a third national conference for provision of necessary and relevant information on critical health issues to health staff and stakeholders throughout Nigeria.

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Nigeria, Pooja Sripad, Charity Ndwiga, Charlotte E. Warren

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically subordinate women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

Practice-Based Learning: Integrating Sgbv Screening Into Health Facilities In Refugee Contexts, Chi-Chi Undie, Josephine Ngebeh, Joanina Karugaba, Harriet Birungi, Michael Mbizvo

Reproductive Health

Sexual and gender-based violence (SGBV) “screening” refers to the standardized assessment of clients for SGBV incidents, regardless of reasons for presenting at a health facility. This practice has been shown to be feasible and effective in various countries and contexts in the East and Southern African region, resulting in proactive identification of female survivors, and their successful referrals for comprehensive SGBV care. In the last decade, health facilities in the region have been increasingly eager to incorporate such screening within the normal protocols of their health-care providers. In collaboration with the Population Council-led Africa Regional SGBV Network, the UNHCR East, …

Grammatical Error Types Using A Picture Description Task In English And Spanish With Young Children, Lisa Valles

Open Access Theses & Dissertations

Purpose: The current study was part of a larger project examining diagnostic accuracy of various assessment tools for bilingual children living in a border community. The purpose of this project was to examine language sample measures in young children using a picture description task (Eisenberg & Guo, 2013) by answering the following questions:

1. What were the frequent types of errors exhibited by young children in English and Spanish?

2. Were there distinct types of grammatical errors across languages in bilingual children?

Methods: Participants were recruited from a large city on the US/Mexico border. There were 47 participants in the …

Does Education Improve Health In Low- And Middle Income Countries? Results From A Systematic Review, Stephanie Psaki, Barbara Mensch, Erica Chuang, Andrea J. Melnikas

Poverty, Gender, and Youth

Despite enormous progress in expanding school enrollment globally, improvements in health have not always followed, raising important questions: Does education, in fact, enable women, men and their families to be healthier? And if so, how? To fill this gap in knowledge, the GIRL Center conducted a systematic review of the evidence for the effects of education on health in low- and middle-income countries.

Delivering Results In Girls' Education: How To Evaluate What Works, What Doesn't, And What We Don't Know, Stephanie Psaki

Poverty, Gender, and Youth

Girls around the world face daunting challenges when it comes to enrolling in primary school, completing secondary school, and gaining the basic knowledge and skills they need to be empowered, healthy, and productive adults. Many governments and organizations have risen to meet that challenge through policies and programs designed to remove common barriers to girls’ education. But as the number of actors in this space grows, and resources to address these challenges remain scarce, it is essential to ensure that investments are targeted toward the most effective policies and programs. This brief lays out the basics of program evaluation. The …

Exploring The Association Between Female Genital Mutilation/Cutting And Fistula, Evidence To End Fgm/C Programme Consortium

Reproductive Health

Policymakers and advocates often cite fistula—a hole between the vagina and rectum or bladder that leaves a woman leaking urine or excrement or both—among the many adverse health conditions thought to be related to female genital mutilation/cutting (FGM/C). But high-quality research supporting a connection between the two conditions is limited. Health workers, program managers, and health advocates need a clear understanding of the evidence linking FGM/C and fistula and more accurate information on the dynamics between them. To fill this gap, the Evidence to End FGM/C program examined the association between FGM/C and fistula. This brief highlights the program’s findings …

Exploring The Association Between Female Genital Mutilation/Cutting And Hiv, Evidence To End Fgm/C Programme Consortium

Reproductive Health

Female genital mutilation/cutting (FGM/C) threatens the health and well-being of girls in a variety of ways. Some experts have suggested that human immunodeficiency virus (HIV) may be among the practice’s adverse health outcomes. They theorize that because women with FGM/C risk genital trauma and bleeding during intercourse, their chances of acquiring HIV from an infected male partner are increased. While evidence that FGM/C increases susceptibility to HIV could bolster FGM/C eradication efforts, this connection has received limited research attention. This brief highlights the Evidence to End FGM/C program’s findings on the current state of evidence on the association between FGM/C …

A Reference Guide: Six Practical Tips For Understanding Data On Female Genital Mutilation/Cutting (Fgm/C), Charlotte Greenbaum, Reshma Naik

Reproductive Health

The Population Reference Bureau (PRB) was a core partner on the Population Council’s Evidence to End FGM/C: Research to Help Girls and Women Thrive—a UKAID-funded research program to help end female genital mutilation/cutting (FGM/C) within one generation. Their role was to build the consortium’s capacity for research utilization and to develop innovative tools and products to improve how researchers communicate their findings about FGM/C to key decisionmakers.
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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) …

Addressing Stigma And Gender Inequities To Strengthen Hiv And Aids Programming: A Focus On Key Populations, Population Council

HIV and AIDS

Over the past 20 years, the Population Council has generated evidence around the types of stigma experienced by key populations at higher risk for HIV, and has designed and tested strategies aimed at reducing stigma and improving HIV programs and outcomes. Key populations (KPs), such as female sex workers, men who have sex with men, transgender individuals, and people who use drugs, often face multiple stigmas that reinforce one another. Evidence generated by the Population Council has shown that addressing and reducing stigma faced by KPs is a crucial step toward improving HIV prevention and treatment outcomes. This brief summarizes …

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 …

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 …

Benchmark Assessment Of Orphaned And Vulnerable Children In Areas Of The Zambia Family (Zamfam) Project—Brief, Michael Mbizvo, Paul C. Hewett

HIV and AIDS

The US Agency for International Development and US President’s Emergency Plan for AIDS Relief (PEPFAR) are supporting the Zambia Family (ZAMFAM) project to strengthen comprehensive, integrated service delivery and support to children living with, affected by, or vulnerable to HIV/AIDS (OVC) in the Lusaka, Copperbelt, Southern, and Central Provinces of Zambia. To inform that effort, Project SOAR conducted a benchmark survey among beneficiaries in the four provinces of the ZAMFAM program. The benchmark survey measured the status and conditions of OVC and their families. This brief provides a summary of the findings outlined in the final report on the needs …

Benchmark Assessment Of Orphaned And Vulnerable Children In Areas Of The Zambia Family (Zamfam) Project, Michael Mbizvo, Paul C. Hewett, Nkomba Kayeyi, Lyson Phiri, Saziso N. Mulenga, Bwalya Mushiki, Mwelwa Chibuye

HIV and AIDS

The US Agency for International Development and US President’s Emergency Plan for AIDS Relief (PEPFAR) are supporting the Zambia Family (ZAMFAM) project to strengthen comprehensive, integrated service delivery and support to children living with, affected by, or vulnerable to HIV/AIDS (OVC) in the Lusaka, Copperbelt, Southern, and Central Provinces of Zambia. To inform that effort, Project SOAR conducted a benchmark survey among beneficiaries in the four provinces of the ZAMFAM program. The benchmark survey measured the status and conditions of OVC and their families. The findings provide a deeper understanding of the needs of OVC families and the gaps in …

Can Depression Screening Be Integrated Into Busy Hiv Clinics In Malawi? Early Results Demonstrate Its Feasibility And Acceptability, Project Soar—Malawi Mental Health

HIV and AIDS

Integration of depression screening and treatment into HIV care may prove critical to achievement of the 90–90–90 goals in Malawi and elsewhere in the region. Project SOAR has partnered with the Malawi Ministry of Health to implement and evaluate the integration of a depression management program into HIV care in Malawi. This brief focuses on initial results from the screening phase, which show that more than 90 percent of patients have been appropriately screened for depression. Based on a first round of qualitative interviews, the program has been well received by clinic staff and patients. The brief lists key lessons …

Characterizing The Unmet Hiv Prevention Needs And Hiv Risk Vulnerabilities Of Adolescent Girls And Young Women In Ethiopia, Project Soar

HIV and AIDS

Adolescent girls and young women (AGYW) in Ethiopia, as well as across Eastern and Southern Africa, experience a disproportionate level of new HIV infections. AGYW who are out of school face a particular set of vulnerabilities, especially those living away from parents. Unfortunately, data characterizing unmet HIV prevention needs and risk vulnerabilities among AGYW, especially out-of-school AGYW, are lacking given the challenges in reaching and studying this population. To address this gap, Project SOAR is conducting an integrated HIV biobehavioral survey focused on out-of-school AGYW in three high HIV prevalence settings of Ethiopia. Study findings will inform HIV prevention and …