Public Health Commons^™

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs, Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs [Arabic], Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …

Résumé Exécutif—Les Programmes De Planification Familiale Du Xxie Siècle: Fondement Et Conception, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Ce document contient le résumé exécutif de «Les programmes de planification familiale pour le XXIe siècle: Fondement et conception». La première moitié de l'ouvrage explique pourquoi un financement et un soutien accrus en faveur des programmes de planification familiale volontaire sont nécessaires. La seconde moitié explique comment les programmes renforcés de planification familiale volontaire peuvent être structurés de manière à fonctionner avec plus d’efficacité. La planification familiale est l'une des interventions les plus réussies de développement de ces 50 dernières années. Elle est unique en termes d’avantages potentiels, et englobe le développement économique, la santé maternelle et infantile, …

Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey

Reproductive Health

An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and …

Situation Analysis Of Behavior Change Communication Activities In Bihar: A Step Towards Developing A Comprehensive Bcc Strategy, M.E. Khan, Isha Bhatnagar, Avishek Hazra, Mukesh Kumar

Reproductive Health

A situation analysis undertaken by the Population Council in Bihar, India assessed a number of contributing factors to a behavior change communication (BCC) strategy. Social norms and practices can be changed if appropriate messages are delivered through a combination of communication channels including mass, mid-, and other media, coupled with improved interactions between frontline healthcare workers and target populations at family and community levels. The analysis notes that effective BCC strategy should be measured in terms of actual behavior change. Impact of BCC activities can be measured by immediate outputs and intermediate and final outcomes depending on implementation duration. The …

Repositioning Community-Based Family Planning In Ghana: A Case Study Of Community-Based Health Planning And Services (Chps), Stephen Ntsua, Placide Tapsoba, Gloria Quansah Asare, Frank K. Nyonator

Reproductive Health

The Population Council conducted a diagnostic appraisal of delivering family planning services using the community-based health planning and services (CHPS model) in Ghana. This study’s results indicate that the CHPS program is well appreciated by rural communities where it is operational. However, the study identified several developments with implications for service delivery: increased community health officer (CHO) workloads and concomitant reductions in outreach services and home visits by community health visitors (CHVs) have weakened the CHO-CHV working relationship, leaving both cadres working in isolation. CHPS has significantly improved health indices but its contribution to increasing family planning is limited and …

Country Mapping: Kenya, Francis Obare, Wilson Liambila, Harriet Birungi, Eseoise Itombra, Heather Clark, Saumya Ramarao

Reproductive Health

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and to develop a strategic plan for its introduction. This technical report presents the findings of the assessments in Kenya with specific focus on: (1) the country’s demographic profile; (2) the health systems, health policy, and family planning program context; and (3) stakeholder perspectives regarding the PVR. The findings suggest that the introduction of the PVR would fill a gap in the family planning needs of breastfeeding women in Kenya, and there is strong support from stakeholders …

Country Mapping: Nigeria, Salisu Mohammed Ishaku, Saumya Ramarao

Reproductive Health

The Population Council conducted a three-year acceptability study of the progesterone vaginal ring (PVR) in three sub-Saharan African countries. This technical report presents results from Nigeria, laying out the country’s demographics and high fertility rates; describing the family planning program and policy context; and, finally, revealing the stakeholder support thus far with a discussion on how best to proceed with introduction activities. This country mapping confirms the likelihood that the PVR would be well received in Nigeria and fill a large need in family planning. The PVR is a safe, long-acting, user-controlled product that can be easily inserted and removed …

Country Mapping: Senegal, Babacar Mane, Nafissatou Diop, Nancy Termini Lachance, Saumya Ramarao, Heather Clark

Reproductive Health

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and its potential introduction. This technical report presents results from assessments undertaken to map the existing landscape of family planning programs and new contraceptive technologies in Senegal in an effort to identify national priorities and assess the level of interest in the PVR among stakeholders and to design appropriate preintroductory activities. This country mapping exercise confirms that Senegal is a promising context for the introduction of the PVR: the government is committed to repositioning family planning and …

Integration Of Family Planning Into Other Health Services In Ghana: Performance Needs Assessment At Four Facilities In The Ashanti And Eastern Regions, Amos Laar

Reproductive Health

With support from the Population Council, the Reducing Maternal Morbidity and Mortality Program worked with the Ghana Health Service to conduct a performance needs assessment on family planning (FP) integration in four facilities in two of the country’s regions. The purpose of this endeavor was ultimately to pilot a project to develop and implement interventions that would improve clients’ access to FP at these facilities, based on the current and desired FP service provision levels, from the viewpoint of facility staff themselves, while taking into account client preferences. This midterm survey sought to assess the status of the integration process …

Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya: An Assessment Of Acceptability, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Harriet Birungi, Jill Keesbury, Ian Askew

Reproductive Health

Most research on intimate-partner violence (IPV) screening has been conducted in developed countries, so this study in Kenya serves as one of the first in a developing-country context to assess the acceptability of IPV screening from the perspective of providers and clients in public healthcare settings. The study conducted in Kenyatta National Hospital in Nairobi found that routine screening for IPV is acceptable to providers and clients at that location. However, to be effective as a routine service, the system needs to be reinforced in specific ways, including greater assurance of confidentiality, more positive provider attitudes, and higher respect for …

Positive Action For Hiv In Schools In Kenya, Francis Obare, Harriet Birungi, Monica Wanjiru, Sheila Bayley, John Kiunjuri, Mary Omondi, Rob Burnet, Bridget Deacon

Reproductive Health

The objective of this study was to test the feasibility of using comic books, role models, and edutainment to communicate HIV and AIDS messages to in-school young people in Kenya, with a view to improving their knowledge about the epidemic, enhancing communication about it, and promoting positive attitudes and behavior among them. The study was implemented by the Population Council in eight secondary schools in Nairobi, as part of the APHIA II Operations Research Project in collaboration with the AIDS Control Unit in the Ministry of Education, Well Told Story, and the National AIDS/STI Control Programme. The study found that …

Strengthening The Delivery Of Comprehensive Reproductive Health Services Through The Community Midwifery Model In Kenya, Wilson Liambila, Francis Obare, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Ruth Wayua Muia, Assumpta Matekwa

Reproductive Health

The overall objective of this project was to strengthen the delivery of family planning/reproductive health and HIV (FP/RH/HIV) services at the community level. The interventions included revision of existing guidelines and protocols for the community midwifery approach, training of providers, provision of equipment and supplies, and creating awareness on the use of community referral cards. In addition, cost analysis of community midwives’ services and willingness-to-pay assessments for various reproductive health services among current and potential users of community midwifery services were undertaken. The results showed that the community midwifery model improved clients’ access to a comprehensive package of RH/HIV including …

Increasing Parity Is Associated With Cumulative Effects On Memory, Laura M. Glynn

Psychology Faculty Articles and Research

BACKGROUND: The purpose of this investigation was to determine if reproductive experience is associated with cumulative effects on human memory performance during pregnancy and if these effects persist into the postpartum period.

METHODS: Verbal recall memory performance was assessed in 254 women four times during pregnancy and at 3 months postpartum. The relation between parity and memory function was evaluated with hierarchical linear modeling and analysis of covariance (ANCOVA).

RESULTS: The data indicate that the previously documented adverse effects of pregnancy on memory performance are compounded with successive pregnancies. During gestation and postpartum, multiparity was associated with poorer memory function, …

Economic Empowerment And Hiv Prevention Among Young Women And Girls In Kenya: Lessons From The Study Of Economic Empowerment Programs, Samantha Van Putten

Independent Study Project (ISP) Collection

One of the major issues facing Kenya is HIV/AIDS. With recognition by the global community that providing women with economic opportunities can help both those who are HIV positive, as well as in prevention for those who are not infected, programs combining microfinance and HIV education have started to emerge. While women in these programs 3 3 have shown preliminary signs of success, young girls did not respond as well in part due to lack of interest in the particular programs themselves. As such, this study examines two economic empowerment programs for girls and young mothers at the non-governmental organization …

The Perfect Storm: How Pro-Abortion Activists In The Netherlands Incite Social Change From International Waters, Julia Ellis‐Kahana

Independent Study Project (ISP) Collection

This project is a sociological ethnography of the Women on Waves foundation, founded in 1999 by Dr. Rebecca Gomperts. As an international non-profit organization, they employ a direct action method: sailing to countries where abortion is illegal and providing safe abortion access. Local women board the ship that then travels 12 miles to international waters, where Dutch law applies, and the abortion pill can be administered legally. Using a feminist perspective, I interviewed five of the women at the organization in addition to the ship’s captain in order to understand the ideological beliefs about the reproductive rights that have inspired …

Reproductive Realities: Fulani Women & Contraception, Corrina Regnier

Independent Study Project (ISP) Collection

This paper is the product of three weeks of research on contraception and the lives of married Fulani women in Ngaoundéré, Cameroon. Based on interviews with Fulani women, conducted both in French and in the Fulani language of Fulfulde with the aid of a French interpreter, I discuss the cultural and religious influences on women’s lives that impact their decisions or abilities to use contraception, as well as the ways these influences and realities have changed, are changing, and are expected to change in the future. I also look into the more practical concern of the availability and accessibility of …

Social Support For Young Carers An Analysis Of The Available Social Support For Children Caring For Aids-Sick And Other-Sick Caregivers In Emoyeni, South Africa., Flannery Mcardle

Independent Study Project (ISP) Collection

The dual epidemics of HIV/AIDS and non-communicable diseases in South Africa are the principal drivers of the worsening orphan epidemic in South Africa. As orphanhood is often far from a singular event but rather one preceded by months or even years of the parent or guardian’s declining health, many children will become the primary caregivers for a sick or dying adult. This study explores the lives of the young carers, specifically, the social support available for these children and how the support available for children caring for AIDS-sick caregivers may differ from that available for children caring for an adult …

Reproductive Health Education In The Kibera Slum: Developing A Slum-Specific Curriculum, Susanna Schneider Banks

Independent Study Project (ISP) Collection

The principal objective of this Independent Study Project is to make recommendations for a slum-specific reproductive health curriculum to be used in primary schools that serve the Kibera Slum in Nairobi, Kenya. In order to obtain data and form a credible basis for the recommendations, interviews were conducted with teachers, focus groups were facilitated with students, and questionnaires were distributed to parents. Additionally, observations were made about the current state of reproductive health education at each school. Data was collected at Kibera School for Girls, a private school in Kibera, and Olympic Primary School, a public school at the edge …

Il Faut Manger: A Study Of Women’S Body Image And Obesity In Mali, Jennifer Denike

Independent Study Project (ISP) Collection

Africa has long been a region of the world marked by the media as one of rail thin children with distended bellies and older men and women with cracked and wrinkled skin sagging off their bones. Media outlets like BBC, CNN, and the New York Times focus entire sections of their websites to special reports entitled ‘Famine in Africa’2, ‘Food Crisis in Niger’3, and ‘East Africa Famine 2011’4. Photos of children curled up on the ground, ribs and bones protruding at every angle grace the pages of nearly every magazine and newspaper. Nongovernmental organizations plead for donations and host fundraisers …

Migration, Vulnerability And Xenophobia: Central African Refugee And Asylum Seekers’ Access To Health Services In Durban, South Africa, Cathy Kaplan

Independent Study Project (ISP) Collection

In 1998, South Africa passed historic legislation that bridged international conventions on refugees and asylum seekers with the protections and rights defined in the South African Constitution and Bill of Rights. The 1998 refugees act defined specific rights that refugees and asylum seekers are entitled in South Africa, the most important of which include the provision of legal and immigration documentation, employment, adequate housing, and health and social services. When asylum seekers arrive in Durban, many are in the need of immediate health services as a result of long journeys, pre-existing conditions, pregnancy, or illnesses contracted in refugee camps throughout …

La Etnia Y Las Cesáreas En Los Partos En El Hospital Público De Arica, Chile, Marisa Westbrook

Independent Study Project (ISP) Collection

The principal objective of this project was to explore the relationship between ethnicity and the causes for Caesarean section in the regional public hospital in Arica, Chile. All births recorded in the maternity register (n=907) were analyzed over a 4-month period in 2011. The regional public hospital had a 27% caesarean section rate, higher than the WHO-recommended 15%. Last names were analyzed and deemed to be either of Aymara descent (n=275) or of European descent (n=632) based on criteria used from CONADI, the National Corporation for Indigenous Development. The overall rate of Caesarean section did not differ between Aymara and …

Cap Centre : L’Epicerie Sociale, Ana De Pina

Independent Study Project (ISP) Collection

Contrairement à autres study abroad programs, « The School of International Training (SIT) » donne les étudiants Américains une opportunité de découvrir la culture Française, d’apprendre la langue Française, et de s’intègre dans la société Française. Pendant notre séjour en France, nous avons fait de bénévolat dans une association que correspond à nos études aux États-Unis. Aux États-Unis j’étudie la sante publique. Je suis très intéressé pour l’administration des hôpitaux et autres institutions de santé et la relation entre la sécurité sociale et la bonne santé. Donc, pendant trois mois j’ai travaillé au CAP Centre, une épicerie sociale qui aide …

When Mountain Bellies Grow Round: Localized Knowledge And Behaviors Facilitating Pregnancy And Childbirth In Phaphlu, Nepal, Cailin Marsden

Independent Study Project (ISP) Collection

In attempts to gain a level of understanding of a community’s localized experiences, beliefs, practices, and roles around pregnancy and childbirth, ethnographic fieldwork was conducted with the mothers and fathers of Phaphlu in the Solukhumbu district of Nepal. Aimed at the validation of diverse and localized ways of knowing revealed during the fieldwork period, this paper applies anthropologist Bridgette Jordan’s theoretical framework of authoritative knowledge to the emergent themes of subjectively understood childbirth (knowledge acquisition and flow, role of the husband, and protective behavior.)

Perceived Parent-Child Relationship And High-Risk Behaviors Among Christian College Students, Karla G. Lavin Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Adolescents and young adults today are participating in high-risk behaviors such as dangerous sexual behaviors and drug and alcohol abuse at high rates. An increased incidence of negative effects associated with the aforementioned behaviors has led researchers to examine factors that influence and protect adolescents from certain devastating effects (Davis, Hendershot, George, Norris, & Heiman, 2007; Goldstein, Bamett, Pedlow, & Murphy, 2007; Hamilton, et al., 2007; Hingson, Heeren, & Winter, 2006; Hingson, Heeren, Winter, & Wechsler, 2003; Hingson, Heeren, Zakocs, Winter, & Wechsler, 2003; McCarty, et al., 2004; Mokdad, Marks, Stroup, & Gerberding, 2004; Mosher, Chandra, & Jones, 2005; …

Cultural Conceptions Of Health, Caroline Stephens

Independent Study Project (ISP) Collection

Healthcare is a complicated structure, influenced by multiple economic, social and cultural factors. It is problematic enough to determine how to administer healthcare in countries that rely only on the western healthcare system, but it is even more difficult in places such as Madagascar where multiple healthcare systems exist. Today the Malagasy have a culture that combines the many French practices with the traditional Malagasy beliefs, traditions and values. Many Malagasy chose to utilize allopathic medicine, but many others still prefer to go to a traditional healer. By gaining a better understanding of the average Malagasy person’s perceptions of proper …

The Benefits Of Having An Integrated Health Care System In Madagascar, Elizabeth Miller

Independent Study Project (ISP) Collection

For my individual research, I wanted to look into all the benefits that could be offered by collaborating allopathic and traditional healthcare systems and how such a system is accomplished in Madagascar, in order to weigh and to discover the feasibility of using integrated healthcare systems as sustainable development in other parts of the world. Furthermore, as Madagascar sets the example in my research this summer, the use of traditional and modern medicine as an integrated health care system best serves the majority of the Malagasy population for several important reasons.

How Do Religion And Belief Systems Influence Traditional Medicine And Health Care In Madagascar?, Whitney Franklin

Independent Study Project (ISP) Collection

Religion and beliefs consistently shape social structures, laws, and even medicine. In Madagascar, this is extremely evident when considering traditional medicine but also exists in modern medicine. Christianity and traditional beliefs are the two main systems that have shaped traditional medicine to what it has become today. These opposites function as a duality that becomes apparent when looking at certain events in Madagascar’s history and the examination of the evolution and rituals performed in the different types of traditional medicine. Through the methodology of interviewing traditional healers and gathering historical information from experts in lectures, I can make sure to …

Prenatal Smoking And Drinking Implications For Subsequent Child Maltreatment, Nicholas Alexander Adams

Sociology & Criminal Justice Theses & Dissertations

Prenatal smoking and drinking are very serious problems that have continued to plague society. They have multiple negative effects on the child both physically and cognitively. This study explored the relationship between prenatal abuse, i.e., prenatal smoking and prenatal drinking, and subsequent child physical abuse and official reports of child maltreatment. It was hypothesized that mothers who smoked or drank prenatally would be more likely to physically abuse their child postnatally and have official reports of child maltreatment. The sample included women participating in Wave III of the National Longitudinal Survey of Adolescent Health. N = 620 women who answered …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Gerontology Institute Publications

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …