Public Health Commons^™

Increasing Institutional Delivery And Access To Emergency Obstetric Care Services In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative in rural Uttar Pradesh (UP), India to determine the impact of the Janani Suraksha Yojana (JSY) scheme on the current status of institutional delivery in the region, to understand the facilitating factors and barriers in delivering in a health facility, and to identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of institutional delivery. JSY was launched as an intervention to address the barriers to institutional delivery, through the introduction of community-based women volunteers. The study shows that with the introduction of the JSY the rate of institutional delivery jumped …

Referral Mechanism Improves Uptake Of Art Services For Hiv+ Fp Clients, Population Council

Reproductive Health

An operations research intervention by the Population Council in Kenya aimed to design a referral framework for linking HIV‐positive family planning (FP) clients to treatment and care in selected health facilities. The project also assessed the acceptability and effectiveness in increasing the number of eligible HIV‐positive FP clients receiving HIV care and treatment services. This summary details the effort to improve the linkage between FP services and comprehensive care centers that led to a dramatic increase in the proportions of HIV-positive clients in FP clinics who go on to receive HIV/AIDS treatment and care services at the same facility. Recommendations …

Maternal And Neonatal Health Services In Sudan: Results Of A Situation Analysis, Nahla G. Abdel-Tawab, Maha El-Rabbat

Reproductive Health

This project brief is based on the results of a situation analysis (SA) study that was done collaboratively by the Population Council and Sudan Ministry of Health (MOH) with funds from UNFPA, UNICEF, and Packard Foundation. The analysis showed an uneven distribution of reproductive health (RH) staff across Sudan, and nurses and nurse midwives are the key in RH services. There was also limited access to family planning services. Antenatal care was limited, and pregnant women in the study seldom received counseling on birth spacing or birth preparedness. Birth attendants also lacked adequate knowledge and skills. Emergency obstetric care was …

Epigenetics: Blurring The Line Between Nature And Nurture, Elizabeth H. Rose

CMC Senior Theses

This long-standing nature versus nurture debate is cited in behavioral and physical expressions of disease dysfunctions, resiliencies, and recovery. Their purposes are noted both in scientific pursuits as well as literature. This discourse has been particularly intense in the fields of psychology, psychiatry, and biology where there is a long history of scientists’ attempts to disprove or discredit others’ intellectual and professional measures. Interestingly, recent advances in the neurosciences and genetic technologies have brought these fields closer together with a new focus – the interactional relationship between nature and nurture – epigenetics.

Transition To Marriage And Parenthood Among Youth In India, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

This Population Council policy brief documents the magnitude of early marriage and early childbearing in India and sheds light on young people’s marriage-related planning and preparedness for married life, and the nature of married life. While child marriage is particularly evident among young women, it is notable that significant proportions of young men too have married below the legal minimum age at marriage for males. Findings call for multi-pronged efforts to eliminate the practice of early marriage among young men and women, and to support newlywed young women. Ensuring that these programs reach young people and the influential adults in …

Building Programs To Address Child Marriage: The Berhane Hewan Experience In Ethiopia, Eunice N. Muthengi, Annabel Erulkar

Poverty, Gender, and Youth

The development of a context-appropriate program to delay marriage in rural Ethiopia took place over many years and in stages. The program that ultimately became known as “Berhane Hewan” was developed by building an evidence base of understanding on the populations being served and developing partnerships between the Population Council and like-minded agencies with complementary expertise. The Berhane Hewan pilot demonstrated that significant impacts can be made on the social, educational, and health status of adolescent girls in a short period of time, through well designed and implemented support programs. However, high levels of exposure to all project components, make …

Kishor-Kishorider Jonno Ortho Sikkha [Financial Education For Adolescents], Sigma Ainul, Marzina Khatun, Najneen Mahbooba

Poverty, Gender, and Youth

No abstract provided.

Youth In India: Situation And Needs 2006-2007—Executive Summary, Andhra Pradesh, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

This study, implemented by the International Institute for Population Sciences, Mumbai and the Population Council, New Delhi is the first-ever subnationally representative study conducted to identify key transitions experienced by married and unmarried youth in India. In recognition of the importance of investing in young people, several national policies and programs formulated since 2000 have underscored a commitment to addressing the multiple needs of this group in India. Effective implementation of policies and programs, however, has been handicapped by lack of evidence on young people’s situation and needs. This study focused on married and unmarried young women and unmarried young …

Youth In India: Situation And Needs 2006–2007, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

This report is the result of a subnational study undertaken by the International Institute for Population Sciences, Mumbai and the Population Council, New Delhi as part of a project to collect information on key transitions experienced by youth in India. The project was implemented in six states of India, namely, Andhra Pradesh, Bihar, Jharkhand, Maharashtra, Rajasthan, and Tamil Nadu. The report offers a roadmap for programs and priorities that aim to address young people’s needs. More than 50,000 young people were interviewed in the study, providing a robust picture of youth in India and a wealth of evidence on almost …

Summary Of Findings Health Status Of Children Entering Kindergarten: Results Of The 2009-2010 (Year Two) Nevada Kindergarten Health Survey, Nevada Institute For Children's Research And Policy Reports

Nevada Institute for Children's Research and Policy Reports

Academic achievement for children is vital to their success in life. Those that do well in school have greater opportunities for post-secondary education, and later have better prospects for employment. One of the major factors that can affect a child’s academic achievement is his or her health status. Academic outcomes and health conditions are consistently linked in the literature (Taras & Potts-Datema, 2005). Children with poor health status, and especially those with common chronic health conditions, have increased numbers of school absences and more academic deficiencies (Taras & Potts-Datema, 2005). In a study concerning excused versus unexcused absences, children with …

Acceptance, Communication Mode And Use Of Audio Computer- Assisted Self Interview Using Touchscreen To Identify Risk Factors Among Pregnant Minority Women, Jutta S. Thornberry, Kennan B. Murray, M. Nabil El-Khorazaty, Michele Kiely

Publications and Research

This paper evaluates the acceptability, communication mode and use of audio computer-assisted self-interview (A-CASI) among minority pregnant women receiving prenatal care in six Washington, DC sites. A total of 2,913 women were screened for demographic eligibility (18+ years old,gestation, Black/African-American or Hispanic) and risk (smoking, environmental tobacco smoke exposure, depression, intimate partner violence). Questions were displayed on touch screen laptop monitors and heard through earphones. The mean length of time to complete the screener was almost 6 minutes.

A-CASI experience, which included difficulty in using the computer, acceptability (enjoyment), and preferred communication mode, was compared across sites, the eligibility and …

Kishor-Kishorider Jonno Ortho Sikkha: Shikkhok Shahayika [Financial Education For Adolescents: Teacher's Manual], Sigma Ainul, Marzina Khatun, Najneen Mahbooba

Poverty, Gender, and Youth

No abstract provided.

L'Adolescence Des Filles Au Burkina Faso: Une Clé De Voûte Pour Le Changement Social, Martha Brady, Lydia Saloucou, Erica Chong

Poverty, Gender, and Youth

Although a number of innovative programs have been created to meet their needs, Burkinabé adolescent girls continue to face many threats to their well-being. They still need considerable support and opportunities to improve their social and economic status and health status. This report, using a number of data sources, including Population Council studies and programs, and the Demographic and Health Survey of Burkina Faso, aims to provide a general overview of these young girls’ adolescence—the realities of life and the policy and program initiatives designed for them. The Population Council hopes that this report will make a significant contribution to …

Poverty, Marriage Timing, And Transitions To Adulthood In Nepal: A Longitudinal Analysis Using The Nepal Living Standards Survey, Ashish Bajracharya, Sajeda Amin

Poverty, Gender, and Youth

This working paper examines the influence of household poverty experienced during early childhood on early marriage and outcomes in schooling and workforce participation during adolescence for girls in Nepal. Much of the evidence concerning these relationships is drawn from cross-sectional data that cannot be used, and has not been able, to address causality. This Population Council study uses longitudinal data from the Nepal Living Standards Survey (NLSS), a two-wave panel in which the waves were conducted eight years apart to address these questions. Analyzing the data by household-wealth quintiles reveals surprisingly nonlinear results indicating that these associations are largest for …

Life Skills: Psychosocial And Interpersonal Skills For Adolescent Girls In Urban Ghana—Mentor's Guide, Population Council

Poverty, Gender, and Youth

School dropout is common among urban adolescent girls in Ghana, leading to increased social isolation and high rates of teenage pregnancy. The curriculum described in this mentor’s guide is one component of the Population Council’s “Safe Spaces” asset-building program for vulnerable adolescent girls in urban Ghana. The curriculum consists of 20 Life Skills sessions, which each take 90 minutes to complete. The program approach used is based on giving girls a safe, girls-only space where they can meet friends and learn about important topics under the guidance of a female mentor. The number of sessions completed per week or per …

Youth In India: Situation And Needs 2006-2007—Executive Summary, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

This executive summary presents, in brief, findings from the Youth in India: Situation and Needs study, a subnational study undertaken by the International Institute for Population Sciences, Mumbai and the Population Council, New Delhi to collect information on key transitions experienced by youth in India, including those related to education, workforce participation, sexual activity, marriage, health, and civic participation. The magnitude and patterns of young people’s sexual and reproductive practices before, within, and outside of marriage, as well as related knowledge, decisionmaking, and attitudes, is also assessed. The project was implemented in six states of India, namely, Andhra Pradesh, Bihar, …

Kishor-Kishorider Jonno Ortho Sikkha: Dishari Shohayika [Financial Education For Adolescents: Mentor's Manual], Sigma Ainul, Marzina Khatun, Najneen Mahbooba

Poverty, Gender, and Youth

No abstract provided.

The Nature Of Mothers' Work And Children's Schooling In Nepal: The Influence Of Income And Time Effects, Ashish Bajracharya

Poverty, Gender, and Youth

Using nationally representative cross-sectional data from the Nepal Living Standards Survey, this Population Council working paper examines the influence of the nature of mothers’ work on Nepali children’s schooling outcomes. It analyses whether the engagement of mothers (and fathers) in nonagricultural work has significant consequences for their children’s school attendance and grade attainment, compared with these consequences when parents’ work is in traditional subsistence agriculture. Results indicate that children of parents who both work in the nonagriculture sector are significantly more likely to have attended or currently be attending school and have higher grade attainment, compared with children whose parents …

Planning And Implementing An Essential Package Of Sexual And Reproductive Health Services: Guidance For Integrating Family Planning And Sti/Rti With Other Reproductive Health And Primary Health Services, Katherine Williams, Charlotte E. Warren, Ian Askew

Reproductive Health

The second goal of the United Nations Population Fund’s (UNFPA’s) 2008–11 Strategic Plan is “Universal access to reproductive health by 2015 and universal access to comprehensive HIV prevention by 2010 for improved quality of life.” UNFPA identified a number of outcomes that will contribute to achieving this goal. Through an extensive search of the published literature and collation of unpublished literature on programmatic experiences with developing and implementing integrated packages of SRH services, the Population Council gathered a body of evidence from which this guidance for UNFPA staff and national counterparts has been developed. UNFPA identified two priority areas: integrating …

Manual On Financial Mechanism For The Health Facilities: Introducing Pay-For-Performance Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Laila Rahman, Dipak Kumar Shil, Md. Mamun-Or Rashid, Ismat Ara Hena, Md. Noorunnabi Talukder, Farhana Akter, Anup Kumar Dey, Ripa Ali, Joynal Abedin, Mursheda Rahman, Md. Ataur Rahman, Md. Julkarnayeen, Arifur Rahman, Md. Abdur Rab Sardar

Reproductive Health

The Population Council initiated an operations research study to test two Pay-for-Performance (P4P) strategies to improve maternal, newborn, and child health (MNCH) services in Bangladesh in 2010. The P4P study is being implemented as part of the two ongoing MNCH and maternal and newborn health (MNH) projects of the United Nations Children’s Fund (UNICEF) implemented by the Directorate General of Health Services, Government of Bangladesh. The study has been testing two strategies. The first introduces incentives tied with performance for motivating service providers to improve the quantity as well as quality of services, and enable poor pregnant women, and mothers …

Facility Assessment Report: Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena, Farhana Akter, Mohammad Ataur Rahman, Md. Julkarnayeen, Md. Akteruzzaman, Md. Sohel Rana, Ripa Ali

Reproductive Health

Under the leadership of the Directorate General of Health Services, the Population Council in collaboration with James P. Grant School of Public Health, BRAC University and with support from UNICEF is testing an innovative service delivery model to provide financial incentives to institutions to enhance their performance on maternal, newborn, and child health (MNCH) services in three districts of Bangladesh as part of GOB-UNICEF’s ongoing MNCH/MNH projects. A comparative analysis on the availability and condition of physical and human assets across 16 health facilities will inform what is needed in a facility in terms of inputs and processes. This report …

Future Of Family Planning Program In Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan

Reproductive Health

Bangladesh experienced large population growth in the past, but due to a successful family planning program, the total fertility rate (TFR) declined rapidly until the mid-nineties. Over the last decade, the country experienced a slow pace in fertility decline with a small increase in the contraceptive prevalence rate (CPR). This slow pace in fertility decline is causing serious concern for reaching replacement level fertility by 2015. CPR increased seven-fold from 1975 to 2000, but there was no significant increase from 2000-09, demonstrating the weakness of present program efforts. This raises concern among researchers, policymakers, and program managers about the prospect …

Urban Family Planning Program Of Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan

Reproductive Health

Extremely inadequate government primary health care (PHC) structure exists in cities in Bangladesh. Nongovernmental organizations (NGOs) play an important role in providing basic health and family planning services to a limited proportion of the urban population. However, NGO programs are time-bound and subject to the availability of development assistance. Bangladesh has one of the highest rates of growth of urban populations among developing countries. For this teeming urban population, there is no structured family planning service. To ensure continuous family planning services in urban areas it is critical to develop a sustainable primary health care structure with the thrust on …

Workshop Report: Introducing Pay-For-Performance (P4p) Approach And Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Ismat Ara Hena, Farhana Akter, Mohammad Ataur Rahman, Md. Julkarnayeen

Reproductive Health

In Bangladesh, improving skilled birth attendance at delivery and access to facility-based obstetric and newborn care are vital to improving maternal and neonatal health. The health system in Bangladesh faces a critical challenge on the supply side: unavailability of quality services at public health facilities, due to inadequately motivated providers, vacant positions, and provider absenteeism. As well, salaries of public-sector providers do not depend on quality of work or quantity of services provided. Paying an incentive to facilities based on a performance benchmark has the potential of increasing the quantity and quality of maternal, neonatal, and child health (MNCH) care. …

Brief Report: Activities And Achievements Of The P4p Project—Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Population Council

Reproductive Health

A pilot study was initiated in Bangladesh for testing Pay-for-Performance for providers and clients in improving maternal, newborn, and child health (MNCH) services by addressing supply and demand-side barriers. With funding from UNICEF, the Population Council provided technical assistance for the operations research study implemented by the Directorate General of Health Services, Ministry of Health and Family Welfare of the Government of Bangladesh. Necessary and key human resource placement and training on integrated management of childhood illness, emergency operations centers, newborn care, infection prevention, and waste management are important for better performance in all facilities. In spite of existing barriers, …

Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef

Reproductive Health

The Population Council launched a pilot study to test two Pay-for-Performance (P4P) strategies to improve MNCH services in Bangladesh. This document presents guidelines for offering incentives to providers, distributing coupons, and forming P4P and/or Coupon Committees and Quality Assurance Groups. The guidelines were developed over the course of five policy-level and consensus-building workshops with national and local-level program managers and service providers, organized under the leadership of the DGHS, in consideration of the local context and sustainability in case of nationwide replication in the country. These guidelines will come into effect upon receiving approval from the DGHS, Ministry of Health …

Public Expenditure On Health Care In Orissa: Focus On Reproductive And Child Health Services, Sarit Kumar Rout

Reproductive Health

In view of the importance of public financing in influencing health outcomes and the paucity of studies that have explored patterns of resource allocation on reproductive and child health services, a study was undertaken in Orissa, India to examine the pattern of and trends in public expenditure on health care with a special focus on expenditure on reproductive and child health services. The study was part of the Population Council, India’s Health and Population Innovation Fellowship program. Findings indicate that major policy issues such as the transfer of power to panchayati raj institutions and those involving health administration and management, …

Increasing Appropriate Complementary Feeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to determine current complementary feeding practices among children aged 6–23 months; understand the facilitating factors and barriers in adopting appropriate complementary feeding practices; and identify programmatic and behavior change communication (BCC) initiatives that could promote the adoption of appropriate complementary feeding practices. The qualitative study shows that women and family members did not feed a measured quantity of food to their children. A lack of knowledge and lack of communication created barriers to initiating complementary feeding. The policy brief recognized education and antenatal care as facilitating factors and …

Increasing Early And Exclusive Breastfeeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to determine the current status of early and exclusive breastfeeding, understand the facilitating factors and barriers in adopting the desired breastfeeding practices, and identify programmatic and behavior change communication (BCC) initiatives to promote the practice. Findings indicate that efforts by Primary Health Centre staff to counsel and encourage women to breastfeed early could significantly increase adoption of this practice. The policy brief identifies barriers that reflect a lack of knowledge and misperceptions about breastfeeding, but finds that education, supportive family members, and knowledgeable health workers can facilitate breastfeeding. …

Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …