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Full-Text Articles in Public Health
Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes
Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes
Reproductive Health
Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …
Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru
Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru
Reproductive Health
This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …
A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland
A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland
HIV and AIDS
No standardized process exists for developing a set of agreed upon terms, definitions, and translations in local languages that ensures participants understand both technical and nontechnical terms used in a clinical trial context. HIV prevention trials deal with a disease that is stigmatized and with sexual behaviors that may not be openly discussed, thus care must be taken in the selection of words to ensure terms are appropriate for use in the context of a clinical trial and understandable but not offensive. The lack of a standardized process can make it difficult for researchers to decide which words to use, …
Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed
Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed
Reproductive Health
The Population Council Bangladesh, in collaboration with the Directorate General of Family Planning and Marie Stopes Bangladesh, with funding from the World Health Organization and the DFID-supported STEP UP project, conducted an 18-month operations research study from January 2012 to June 2013. This operations research tested the feasibility of introducing menstrual regulation with medication (MRM) in Bangladesh and assessed accessibility of the combination regimen of mifepristone and misoprostol in urban and rural health facilities. Based on this study’s results, the feasibility of introducing MRM services in Bangladesh is clear, and women receiving MRM were satisfied with their overall quality of …
Challenges In Impact Evaluation, Anrudh K. Jain
Challenges In Impact Evaluation, Anrudh K. Jain
Reproductive Health
These notes are for a presentation given at the Consultation on Social and Behavioral Change Interventions for Enhancing Child Survival in South Asia organized by UNICEF, USAID, and Population Council in New Delhi, India. The slides identify challenges for conducting impact evaluations by describing the anticipated process for behavior change communication using women’s support groups, issues encountered in the process, and evaluation designs. Examples from the Population PAIMAN project are used to illustrate ways to address these challenges.
Gender-Based Violence: A Qualitative Exploration Of Norms, Experiences And Positive Deviance, Shireen J. Jejeebhoy, K.G. Santhya, Shagun Sabarwal
Gender-Based Violence: A Qualitative Exploration Of Norms, Experiences And Positive Deviance, Shireen J. Jejeebhoy, K.G. Santhya, Shagun Sabarwal
Reproductive Health
This report presents the findings of formative research the Population Council conducted, with support from UK aid, in the district of Patna, India that aimed to better understand the context of violence—physical, emotional, and sexual—against women and girls, and notably, the prevailing norms about men’s entitlement and women’s acquiescence to violence. Findings suggest that violence against women and girls is widespread and widely justified, that women are perceived as having few options but to tolerate violence, and that the most common response to violence is silence. At the same time, many women and some positive deviant men recognize the injustice …
Follow-Up Study Of Migrant Adolescent Girls In Domestic Service Who Participated In The First Cohort Of The Filles Éveillées ("Girls Awakened") Program, Sarah Engebretsen
Follow-Up Study Of Migrant Adolescent Girls In Domestic Service Who Participated In The First Cohort Of The Filles Éveillées ("Girls Awakened") Program, Sarah Engebretsen
Poverty, Gender, and Youth
Circular migration (from rural to urban areas and back) among adolescents is common throughout West Africa, with the principle motivation being the search for economic opportunities, including domestic work. The evidence base on adolescent migration and domestic work is fairly thin. Evidence on programmatic effectiveness generally ends at program completion and does not follow adolescents over time. The current study follows a subsample of migrant adolescent girls in domestic service in urban Burkina Faso who participated in the first cohort of the Filles Éveillées (Girls Awakened) pilot program. Filles Éveillées was designed to provide migrant girls in domestic service with …
Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland
Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland
Reproductive Health
Results presented in this STEP UP Research Report show that over half of women having unmet need for family planning in Senegal did not intend to use family planning in the future and this was consistent across all population strata. Reasons for non-use confirm the existence of widespread opposition to the use of modern contraception. Unfamiliarity and lack of information is likely to be a reason for such opposition; initial suspicion of contraception has also been documented. Thus a first policy priority, and one that is relatively easy to achieve, is to increase knowledge through the mass media and localized …
The Adolescent Girls Empowerment Program: Lessons Learned From The Pilot Test Program, Karen Austrian, Natalie Jackson Hachonda, Paul C. Hewett
The Adolescent Girls Empowerment Program: Lessons Learned From The Pilot Test Program, Karen Austrian, Natalie Jackson Hachonda, Paul C. Hewett
Poverty, Gender, and Youth
Adolescent girls in Zambia face a range of risks and vulnerabilities that compromise their healthy development into young women, and lack the social, health, and economic assets to mitigate these risks. The issues that girls are confronted with include high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, and lack of agency and participation. The Adolescent Girls Empowerment Program (AGEP) has three major components: safe spaces groups in which girls meet once a week over the course of two years for training …
Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar
Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar
Poverty, Gender, and Youth
This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …
Policy Brief: Adolescent Girls And Migration In The Developing World, Population Council
Policy Brief: Adolescent Girls And Migration In The Developing World, Population Council
Poverty, Gender, and Youth
When a migrant girl is successful, she creates a ripple effect through generations: families and future children will be better off because of her ability to finish school, get a job, and stay healthy. Despite the positive potential of migration for adolescent girls, migrant girls are largely ignored in policy and programs designed to reach migrants and adolescents. Because of their age and gender, migrant girls are especially vulnerable to risks such as exploitative employment. If these girls arrive at their destination and settle in safely, their diligence can enable them to capitalize on new opportunities and become productive, contributing …
Girls On The Move: Adolescent Girls & Migration In The Developing World, Miriam Temin, Mark R. Montgomery, Sarah Engebretsen, Kathryn M. Barker
Girls On The Move: Adolescent Girls & Migration In The Developing World, Miriam Temin, Mark R. Montgomery, Sarah Engebretsen, Kathryn M. Barker
Poverty, Gender, and Youth
Adolescent girls in developing countries are migrating to urban areas in ever greater numbers. While migration can be risky, for the majority of girls, migration can increase opportunities and economic stability and provide them with the autonomy to make decisions about their lives. Preventing the worst outcomes and helping girls succeed are essential to unlocking the benefits of migration. When migrant girls can take advantage of the benefits, they can be a powerful force for change in the developing world—improving lives and reducing poverty in their communities and countries. This Girls Count report examines the social and economic determinants of …
Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga
Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga
HIV and AIDS
This study by the Population Council and the Zambia-Led Prevention Initiative was designed to examine the motivations of individuals volunteering as STEPS-OVC caregivers; to explore their experiences in service, including perceived barriers to carrying out their volunteer work and if, and how, their expectations for volunteering had been met or not; to assess individuals’ intent to continue caregiving; and to ascertain factors associated with volunteer productivity. Two main findings stand out from this study: that communitarian and religious helping values were virtually universal in the study population, and that a majority of the volunteers indicated economic and material interests and …
Evaluation Of Filles Eveillees ("Girls Awakened"): A Pilot Program For Migrant Adolescent Girls In Domestic Service, Sarah Engebretsen
Evaluation Of Filles Eveillees ("Girls Awakened"): A Pilot Program For Migrant Adolescent Girls In Domestic Service, Sarah Engebretsen
Poverty, Gender, and Youth
The Filles Éveillées (Girls Awakened) program was designed to increase social networks and skill building among migrant adolescent girls in domestic service in urban Burkina Faso. The program was piloted over two cycles: 2011–2012 in Bobo Dioulasso, and 2012–2013 in Ouagadougou and Bobo Dioulasso. According to this evaluation report, process evaluation was conducted between the two cycles to assess program effectiveness and suggest improvements for program structure, implementation, and content before launching the second cohort. Changes resulting from this process evaluation included simplifying the sexual and reproductive health program content; reordering the modules and introducing financial capabilities earlier so that …
Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi
Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi
Poverty, Gender, and Youth
The decision to engage in the development of girl-friendly savings accounts was made as part of the Population Council’s work with adolescent girls in Kenya. In June 2008 the Council and MicroSave Consulting started the Safe and Smart Savings Products for Vulnerable Adolescent Girls. Based on the market research and prior experience with developing programs for adolescent girls, a product concept for a group-based savings account was developed, in which the group model was used to address the legal constraints of minors not being able to hold individual accounts. In Kenya and Uganda, two financial institutions were identified, and the …
Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu
Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu
Reproductive Health
In late 2006, the Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The initiative included a core set of activities aimed at improving overall awareness of EC across the country and strengthening the quality of EC services in both the public and private sectors. It was intended to serve as a model for other countries interested in improving access to EC, and to generate in-depth knowledge on EC program strategies and utilization characteristics in sub-Saharan Africa. The MOH drew lessons and experiences from the initiative …
Reviewing The Evidence And Identifying Gaps In Family Planning Research: The Unfinished Agenda To Meet Fp2020 Goals, Ian Askew, Martha Brady
Reviewing The Evidence And Identifying Gaps In Family Planning Research: The Unfinished Agenda To Meet Fp2020 Goals, Ian Askew, Martha Brady
Reproductive Health
The Population Council produced this paper to help guide discussions and considerations regarding the key evidence gaps and research investments needed to achieve the FP2020 goal and objectives. The paper focuses primarily on the social science, implementation, and operations research that will be needed to achieve the first three objectives. Research shows that through high-quality voluntary family planning (FP) programs, governments can reduce fertility and generate substantial improvements in health, wealth, human rights, and education. Family planning programs for the 21st century will require thoughtful design—engaging both public and private sectors—to meet the growing need for safe and effective FP …
From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit
From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit
HIV and AIDS
HIV treatment, care, and support, and PMTCT programs are most effective when based on the best available research evidence. This is the fundamental premise of evidence-based medicine. Equally well known is the dilemma of transforming evidence into practice, which is the subject of knowledge translation and implementation science. Even when the findings of clinical trials make their way into international and national program guidelines, they run up against competing priorities within public health and community programs, resource constraints, and institutional and human inertia. Understanding how to effectively change the approach used in program operations requires understanding how programs work in …
Hivcore Operations Research Workshop Summary Report, Nrupa Jani
Hivcore Operations Research Workshop Summary Report, Nrupa Jani
HIV and AIDS
Over the past decade, unprecedented progress has been made in the scale-up of HIV treatment, care, and support, yet substantial coverage gaps remain. Targeted operations research and program evaluation can play a significant role in ensuring efficient and effective service delivery, scaling up to reach more clients and on a broader geographical scope, enhancing quality of care, and improving the health status and health systems in developing country settings. With funding from USAID, the Population Council and partners are responding to these critical service delivery issues through HIVCore. HIVCore improves the efficiency, effectiveness, scale, and quality of HIV and AIDS …
Assessing Retention And Motivation Of Public Health-Care Providers (Particularly Female Providers) In Rural Pakistan, Ali M. Mir, Gul Rashida Shaikh, Saleem Shaikh, Neha Mankani, Anushe Hassan, Maqsood Sadiq
Assessing Retention And Motivation Of Public Health-Care Providers (Particularly Female Providers) In Rural Pakistan, Ali M. Mir, Gul Rashida Shaikh, Saleem Shaikh, Neha Mankani, Anushe Hassan, Maqsood Sadiq
Reproductive Health
The main objectives of this project in Pakistan were to explore the core issue of availability of health providers, especially female providers who are required for provision of maternal and neonatal healthcare, and to determine the range of factors that either constrain or motivate providers to serve in key positions in public facilities in rural areas. The study, conducted by the Population Council with funding from the Maternal and Newborn Health Programme ‐ Research and Advocacy Fund, identifies a number of problems faced by healthcare providers working in the public healthcare system in Pakistan and makes the following recommendations for …
Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu
Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu
Reproductive Health
Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The specific objectives of the initiative were to: increase knowledge, awareness, and use of EC among Kenyan women; increase knowledge and awareness of EC among health providers; and strengthen EC provision in both the private and public sectors. This policy brief describes a toolkit designed for policymakers and service providers which draws on the achievements, lessons learned, and experiences from this project.
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Reproductive Health
Prevention of unintended pregnancy is often considered the key outcome of reducing unmet need; it is the basic right of women and couples to become pregnant only when intended. This paper explores this relationship by reviewing the definition and measurement of unintended pregnancy, identifying key trends in its distribution within and between populations, and analyzing the relationship between unintended pregnancy, demand for family planning, and family planning program performance. The determinants and consequences of unintended pregnancy are reviewed to further understand the implications of using it as a policy and programming goal. The paper concludes by reviewing the broader policy …
Availability, Use And Quality Of Care For Medical Abortion Services—Preliminary Results Of Two Components: Kiis And The Pharmacy Study, Wilson Liambila, Harriet Birungi, Francis Onyango, Brian Mdawida, Vitalis Akora, Thoai Ngo, Kate Reiss
Availability, Use And Quality Of Care For Medical Abortion Services—Preliminary Results Of Two Components: Kiis And The Pharmacy Study, Wilson Liambila, Harriet Birungi, Francis Onyango, Brian Mdawida, Vitalis Akora, Thoai Ngo, Kate Reiss
Reproductive Health
No abstract provided.
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew
Reproductive Health
No abstract provided.
Access To Emergency Contraception And Safe Abortion Services For Survivors Of Rape And Defilement In Sub-Saharan Africa: A Regional Overview, Jill Thompson, Chi-Chi Undie, Ian Askew
Access To Emergency Contraception And Safe Abortion Services For Survivors Of Rape And Defilement In Sub-Saharan Africa: A Regional Overview, Jill Thompson, Chi-Chi Undie, Ian Askew
Reproductive Health
No abstract provided.
Day Of Dialogue: Mainstreaming Emergency Contraception In The National Family Welfare Program, Population Council
Day Of Dialogue: Mainstreaming Emergency Contraception In The National Family Welfare Program, Population Council
Reproductive Health
The Population Council, in collaboration with the Family Planning Association of India, hosted a Day of Dialogue which addressed issues related to access, availability and use of emergency contraception pills (ECP). Some of the key issues addressed in this consultation included: provider knowledge on mechanism of action and attitudes toward easy access to ECP and its link to premarital sex and promiscuity, repeated use of ECP, and lack of information about ECP among potential users. The Population Council shared key findings of a recent study on knowledge, attitudes, and opinions of gynecologists and pharmacists on ECP use. The one-day consultation …
Effectiveness Of A Comprehensive Sexual And Gender-Based Violence Prevention Project For In-School Girls In Swaziland, Swaziland Action Group Against Abuse (Swagaa)
Effectiveness Of A Comprehensive Sexual And Gender-Based Violence Prevention Project For In-School Girls In Swaziland, Swaziland Action Group Against Abuse (Swagaa)
Reproductive Health
Swaziland is one of the sub-Saharan African countries affected by sexual and gender-based violence (SGBV) and HIV and AIDS, with women facing greater risk compared to men. In response to increasing reports of violence against women and children in the country, the Swaziland Action Group Against Abuse launched a Girls’ Empowerment Clubs (GEC) program in primary and secondary schools in order prevent SGBV cases. Due to limitations of the program (such as being led by teachers and reliance on volunteers), an intervention study was carried out by the Population Council to test the effectiveness of an enhanced version, “GEC-Plus,” that …
Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew
Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew
Reproductive Health
This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …
Mitigating The Consequences Of Sexual Violence In Zambia By Decentralizing Emergency Medical Responses To Police Victim Support Units: Report On The Feasibility Of Police Provision Of Post-Exposure Prophylaxis For Hiv (Pep) In Zambia, Mary Zama, Mardieh Dennis, Jessica Price, Stephanie M. Topp, Jonathan Kaunda Mwansa, Jill Keesbury
Mitigating The Consequences Of Sexual Violence In Zambia By Decentralizing Emergency Medical Responses To Police Victim Support Units: Report On The Feasibility Of Police Provision Of Post-Exposure Prophylaxis For Hiv (Pep) In Zambia, Mary Zama, Mardieh Dennis, Jessica Price, Stephanie M. Topp, Jonathan Kaunda Mwansa, Jill Keesbury
Reproductive Health
The Zambian Ministry of Home Affairs (housing the Zambia Police Service); the Ministry of Health, the Ministry of Community Development, Mother and Child Health; and the Population Council collaborated on operations research studies to increase provision of emergency medical care to survivors of sexual violence via the Zambia Police Services (ZP). Recognizing the need to strengthen linkages between the police and the health sector and following up on the lessons learned from earlier models of police delivery of emergency contraception, this feasibility study was designed to: determine if victim support unit (VSU) officers could be trained to safely and effectively …
Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai
Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai
Reproductive Health
The objectives of this Population Council study were twofold: first to collect information on prevailing practices of abortion and post‐abortion care in Pakistan and, second, to gauge changes in the magnitude and quality of abortion‐related complications and care during the last decade (since the 2002 national study of “Unwanted Pregnancy and Post‐abortion Complications in Pakistan”). The study found that the level of post‐abortion family planning (FP) counseling in both public and private health facilities offering PAC services was inadequate. There has been no improvement over the decade in the level of counseling reported, and, even more disappointingly, only half of …