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Guía Operativa Para Programas De Educación Sexual Y Servicios De Salud Reproductiva Para Jóvenes, Ofelia Aguilar, Lorena Santos, Marisa Diaz Infante, Rocio Mejia, Ricardo Vernon, Antonieta Martin

Reproductive Health

El presente libro tiene como fin poner al alcance de personas y organizaciones interesadas en establecer políticas y programas de servicios y educación sexual para los jóvenes, una guía basada en el Programa Gente Joven que implementa la Fundación Mexicana para la Planeación Familiar, A.C. (MEXFAM). Consideramos que los componentes y las actividades de este programa pueden ser adaptados en otras latitudes y así enriquecer proyectos orientados al trabajo con jóvenes.

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The purpose of this book is to make available, to people and organizations interested in establishing policies and programs on sexual education and services for young people, a …

Lutte Contre La Pratique De L'Excision Au Mali: De L'Approche Santé À L'Approche Basée Sur Les Droits De L'Enfant-Rapport D'Evaluation Du Programme Du Centre Djoliba, Anta Fall Diagne

Reproductive Health

Depuis les années 1980, Save the Children Suède soutient des activités visant à éliminer la pratique de l'excision organisées par le Centre Djoliba au Mali. Le but de cette évaluation est d'examiner l'impact du programme du Centre Djoliba sur la vie de communautés sélectionnées et en utilisant une approche basée sur les droits de l'homme et de l'enfant, pour examiner les changements majeurs dans les communautés cibles. Cette approche a conduit à une meilleure compréhension de ces droits et à la volonté des communautés d’essayer d’intégrer les connaissances acquises sur ces droits dans leur vie quotidienne. Cependant, l'environnement socioéconomique défavorable …

Evaluation Of The Long-Term Impact Of The Tostan Programme On The Abandonment Of Fgm/C And Early Marriage: Results From A Qualitative Study In Senegal, Nafissatou J. Diop, Amadou Moreau, Helene Benga

Reproductive Health

In 1998–99, a village empowerment program was implemented in the Thiès/Fatick and Kolda regions of Senegal by the nongovernmental organization Tostan, to mobilize communities to hold public declarations in support of abandoning harmful traditional practices, including female genital mutilation/cutting (FGM/C) and child marriage. The information presented in this report indicates that many did end the practices following a public declaration, however, the lack of follow-up in the field and the absence of support mechanisms pose a large obstacle. Nevertheless, the program achieved significant results: knowledge of life skills resulting in positive changes and a shift in the perception of FGM/C …

Analysis Of The Evolution Of The Practice Of Female Genital Mutilation/Cutting In Burkina Faso, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini

Reproductive Health

This study was undertaken as a collaboration between the Population Council’s Frontiers in Reproductive Health program and the Comité National de Lutte contre la Pratique de l’Excision (CNLPE) within the Ministry of Social Action and National Solidarity in Burkina Faso. The creation of a favorable environment for the campaign against excision in Burkina Faso has facilitated various anti-cutting activities over the past two decades and enabled the achievement of gains, both in terms of awareness and behavior change. However some of the strategies need further readjustment: among the reasons why excision still continues in Burkina Faso is a certain view …

Institutionalization Of Quality Assurance Within District Health Management: Experiences From Maharashtra And Karnataka, M.E. Khan, Anurag Mishra, Vivek Sharma, Jaleel Ahmad, Jose Joseph, Venkatesh Srinivasan, K.M. Sathyanarayana, Viji Vargees, K.D. Maiti, Rashmi Sharma

Reproductive Health

The Population Council, with financial support from UNFPA, provided technical assistance to the states of Maharashtra and Karnataka, India in implementing a quality assurance (QA) program and helped its institutionalization in the district level of health management. An analysis of all the facilities covered as of December 2007 revealed substantial gaps in the infrastructure and human resources available to provide good-quality services, as well as adherence to standards for providing the services. To build the capacity to undertake QA visits, the Population Council and state authorities organized a series of events to orient and train state and district officials, facility-level …

Using Systematic Screening To Integrate Health Services In India And Senegal: Pilot Study Versus Scale-Up Results, James R. Foreit

Reproductive Health

This study examines the effectiveness of using systematic screening to integrate health services in India and Senegal. First, a pilot study of relatively small-scale experiments was undertaken to determine if systematic screening for unmet needs for health services could increase the number of preventive care services clients receive at healthcare visits. FRONTIERS then participated in the scale-up to test the effect of different supervision and training strategies on the frequency of provider screening. Results show that systematic screening may have the potential to produce important increases in the number of services provided in many developing country settings at the pilot …

From Pilot To Program: Scaling Up The Kenya Adolescent Reproductive Health Project, Humphres Evelia, Japheth Nyambane, Harriet Birungi, Ian Askew, Rikka Trangsrud, Eva Muthuuri, Irene Chaami, Agnes Odawa, Lucy Musyoka, Susan Mutungi, Margaret Githuiya, Joan Omuruli

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program and the Program for Appropriate Technology in Heath collaborated with three Government of Kenya ministries—Education; Health; and Gender, Sports, Culture and Social Services—to design and implement the Kenya Adolescent Reproductive Health Project with the goals of: improving knowledge about reproductive health and encouraging a responsible and healthy attitude toward sexuality among adolescents, delaying the onset of sexual activity among younger adolescents, and decreasing risky behaviors among sexually active adolescents. Key findings from the pilot project showed that the three ministries could successfully implement these interventions with high participation among parents and youth. …

The Potential For Sustainability Of Malaria In Pregnancy Initiatives In East And Southern Africa: Kenya And Malawi, Washington Onyango-Ouma, Sam Agatre Okuonzi, Doreen Ali, Harriet Birungi, Annie Mwangi

Reproductive Health

This study assesses the sustainability of initiatives to improve maternal and child health survival by preventing and treating illness from malaria, and documents best practices for promoting sustainability and lessons for replication in countries where malaria is endemic. The study applied the Child Survival Sustainability Assessment framework to initiatives in Kenya and Malawi to analyze progress toward sustainability, including not only a biomedical perspective but also the human, social, and organizational processes that influence sustainability of health projects. The report concludes that Malaria in Pregnancy (MIP) interventions were sustained within and beyond the project districts in both countries. Furthermore, both …

Integrating Tuberculosis Case Finding And Treatment Into Focused Antenatal Care In Kenya, Charlotte E. Warren, Annie Mwangi

Reproductive Health

The Population Council/FRONTIERS program, in collaboration with the National Leprosy and Tuberculosis Programme, the Division of Reproductive Health, and the Provincial Health Management Team in Western Province, Kenya, received PEPFAR funding to improve screening for tuberculosis (TB) for pregnant women, including HIV-positive pregnant women. An intervention was tested to strengthen TB case detection to ensure that maternal and child health providers, in addition to providing antenatal care and PMTCT services, also screen and assess the client’s need for TB services and refer for further management. The effectiveness of this approach was demonstrated by the increased number of pregnant women who …

Technical Assistance To The Interagency Coordination Group Seeking To Reduce Female Genital Mutilation/Cutting, Nafissatou J. Diop

Reproductive Health

This report documents technical assistance provided by FRONTIERS to the Interagency Coordination Group seeking to reduce female genital mutilation/cutting (FGM/C) in sub-Saharan Africa. In particular, staff assisted the group in networking, learning to talk to each other, setting up an operational way of functioning, and influencing key international policy and programmatic documents. Lessons learned through operations research on FGM/C were disseminated widely through the group’s activities and FRONTIERS technical assistance influenced several plans of action and implementation programs. The report notes that in addition to better networking for presenting a common regional vision during the development of policy and programmatic …

Creating The Conditions For Scaling Up The Integration Of Reproductive Health Services For Men In Health And Family Welfare Centers In Bangladesh, M.A. Mannan, Jafar Ahmad Hakim, Syeda Tazneen Waris, Ashraf Ali, Akm Nurul Hakim, Abdul Hannan, Sameena Chowdhury, Saria Tasnim, Saiful Islam, Aqm Rezaul Karim, Sharif M.I. Hossain, Ubaidur Rob, M.E. Khan

Reproductive Health

An operations research study, supported by the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, showed that reproductive health services for men could be feasibly and acceptably integrated within the Health and Family Welfare Centres in Bangladesh, which have been primarily women-centered health facilities. Given these findings, a follow-up study was implemented to create the conditions for scaling up the model through identifying and piloting the operational details to consider when taking the intervention to scale. The findings presented in this report suggest that this model of service delivery and training can be scaled up countrywide, preferably in stages. To …

Strengthening The Financial Sustainability Of Two Population Services And Training Center (Pstc) Clinics (Bangladesh), Population Services And Training Center (Pstc), Frontiers In Reproductive Health

Reproductive Health

The Population Services and Training Center of Bangladesh (PSTC) operates 15 clinics and 150 satellite posts that provide an Essential Services Package (ESP) to the poor, consisting of child health, family planning, maternal health, communicable disease treatment, and limited curative care. The objective of this study was to conduct an operations research study to determine the feasibility of improving cost recovery in two clinics by raising prices. It appears that the study design was too ambitious for PSTC, a service delivery organization with no prior research experience. Lack of experience was compounded by the resignation of all three PSTC research …

Strengthening Emergency Contraception In Nepal, Mahendra Pd. Shrestha, Sharif M.I. Hossain, M.E. Khan

Reproductive Health

A national workshop on emergency contraception was organized in Nepal by the Family Health Division within the Ministry of Health in 2004, with technical assistance provided by the FRONTIERS program of the Population Council. Among many conclusions from the workshop, one recommendation was that emergency contraceptive pills (ECP) should be introduced through the government family planning program to assist in reducing unwanted pregnancies. Based on the Population Council’s past experiences with introducing and mainstreaming ECP services in Bangladesh and India, a phase-wise introduction of ECP in Nepal was recommended. The project findings suggest that Nepalese women continue to face an …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In The Dominican Republic, Gisela Quiterio, Maritza Molina, Marija Miric, Ricardo Vernon, M. Estela Rivero-Fuentes

Reproductive Health

A diagnostic study of the provision and use of contraception in postpartum, postabortion, and prevention of mother-to-child transmission (PMTCT) programs in the Dominican Republic was conducted with funding from USAID. The objectives of the study were to assess the contraceptive knowledge, attitudes, and behaviors of providers and clients; the degree to which information, counseling, and delivery are implemented in postpartum, postabortion, and PMTCT services; the quality of these services; and the readiness of postpartum, postabortion, and PMTCT services to offer contraceptive services. The report finds that family planning services are linked to antenatal, delivery, and postpartum care in most of …

Helping Egyptian Women Achieve Optimal Birth Spacing Intervals Through Fostering Linkages Between Family Planning And Maternal/Child Health Services, Nahla G. Abdel-Tawab, Sarah Loza, Amal Zaki

Reproductive Health

The Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Egyptian Ministry of Health and Population and the NGO Social Planning, Analysis and Administration Consultants, conducted an operations research study to measure the acceptability and effectiveness of two birth spacing message models in Upper Egypt. Overall, the study found that providing birth spacing messages to low-parity women during antenatal and postpartum care and also to husbands through community awareness activities was feasible and acceptable. As a result, birth spacing messages have been integrated into service delivery guidelines for antenatal and postpartum care, and IEC materials on …

Comparing The Effectiveness And Costs Of Alternative Strategies For Improving Access To Information And Services For The Iud In Ghana, Ivy Osei, Gertrude Voetagbe, Moses Aikins, John Gyapong, Philomena Nyarko, Harriet Birungi, Gloria Quansah Asare, Henrietta Odoi-Agyarko, Olivia Aglah

Reproductive Health

The Ghana Health Service (GHS) was prompted to explore ways of increasing interest in the IUD through increasing awareness of this and other long-acting and permanent methods via interpersonal channels and by intensifying campaigns to dispel rumors about the method. The Health Research Unit of the GHS, EngenderHealth’s Quality Health Partners project, and the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project collaborated with the GHS to test innovative approaches to increase awareness of the IUD and to improve access to the method. The study examined the general and method-specific knowledge of long-acting family planning methods among clients and providers, …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In Haiti, M. Estela Rivero-Fuentes, Ricardo Vernon, Michaelle Boulos, Louis-Marie Boulos

Reproductive Health

This report presents the results of a situation analysis of the provision and use of contraception in postpartum, postabortion, and Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in Haiti. FRONTIERS provided the Centre d’Évaluation et de Recherche Appliqueé (Center for Evaluation and Applied Research or CERA) with technical assistance for the data collection, cleaning, and entry processes. The study found that there is a substantial unmet need for family planning services among postpartum women and many missed opportunities to provide these services during the pregnancy-extended postpartum period continuum. Most outpatient services have adequately implemented HIV counseling for pregnant women, …

Promoting Healthy Timing And Spacing Of Births In India Through A Community-Based Approach, M.E. Khan, Mary Philip Sebastian, Usha Sharma, Rukma Idnani, Kaushal Kumari, Bharati Maheshwari, Shahid Ashraf

Reproductive Health

The Indian Family Welfare Program, though successful in increasing contraceptive use among couples who have achieved their desired family size, has failed in educating people about the importance and need of using contraceptive methods for spacing births. With its Indian collaborators, the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program undertook a study to test a model to increase use of postpartum contraception among young pregnant women with a parity of 0 or 1. The study showed that the Behavior Change Communication (BCC) model developed to promote Healthy Timing and Spacing of Pregnancy (HTSP) was effective in promoting the lactational …

Increasing The Accessibility, Acceptability And Use Of The Iud In Gujarat, India, M.E. Khan, Sitanshu Sekhar Kar, Vikas Kishor Desai, Pratibha Patel, B.P. Itare, Sandhya Barge

Reproductive Health

The USAID-funded FRONTIERS Program of the Population Council, in collaboration with the Department of Health & Family Welfare, Government of Gujarat, and the Center for Operations Research and Training, Vadodara, conducted an operations research study in India to test the hypothesis that by improving the demand for the IUD and simultaneously strengthening the technical competencies and counseling skills of the providers, use of the IUD use would increase. The findings show that demand-generation activities and provision of good-quality IUD services, together with a supportive programmatic environment, when carried out simultaneously showed increased acceptance of the IUD. The intervention could be …

Creating The Conditions For Scale-Up Of The Men In Maternity Intervention In India, Leila Caleb-Varkey, Anurag Mishra, M.E. Khan

Reproductive Health

The Frontiers in Reproductive Health (FRONTIERS) program conducted an operations research study, called the Men in Maternity (MiM) study, in collaboration with the Employees' State Insurance Corporation of India (ESIC), aimed at involving men in the antenatal and postpartum care of their partners to raise knowledge and use of postpartum contraception and preventive practices against sexually transmitted infections, as well as improving pregnancy outcomes. This report details the MiM scale-up process, which worked well in terms of ESIC assuming ownership of the training component of the program and being able to build capacity for training. However, to further scale up …

Development Of A Quality Assurance Procedure For Reproductive Health Services For District Public Health Systems: Implementation And Scale-Up In The State Of Gujarat, M.E. Khan, Anurag Mishra, Vivek Sharma, Leila Caleb-Varkey

Reproductive Health

This project was carried out in India, in two districts each in Gujarat and Maharashtra states. It confirmed that quality assurance (QA) checklists and an implementation manual, developed by the USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council in collaboration with UNFPA/India, are useful and effective tools that the Ministry of Health and Social Welfare (MOHFW) can use to monitor the quality of services provided by health facilities. It also demonstrated that this QA mechanism can be easily institutionalized at the district level management. One key lesson has been the critical role that the commitment of state …

Taking Critical Services To The Home: Scaling-Up Home-Based Maternal And Postnatal Care, Including Family Planning, Through Community Midwifery In Kenya, Annie Mwangi, Charlotte E. Warren

Reproductive Health

With support from USAID, the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project supported the scaling up of a community-based model in Kenya that enabled women to give birth safely at home or be referred to a hospital when attended by a self-employed skilled midwife living in the community. To strengthen the sustainability of this approach FRONTIERS engaged a microfinance NGO to develop a training curriculum on basic business skills and financial literacy, and encouraged the community midwives (CMs) to form clusters or informal associations so that they could be trained in business skills. Following these interventions, CMs proved more …

Strengthening Postnatal Care Services Including Postpartum Family Planning In Kenya, Annie Mwangi, Charlotte E. Warren, Nancy Koskei, Holly Blanchard

Reproductive Health

The objectives of this study were to develop and introduce a strengthened postnatal care package into one hospital and four health centers in one district in Kenya, to document the feasibility, acceptability, and quality of care of the strengthened postnatal care, and to evaluate the effectiveness of the postnatal package on women’s reproductive health behaviors. The study was implemented jointly by the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project and by Jhpiego’s ACCESS-FP project, both funded by USAID. A postnatal care–family planning orientation package for providers was developed that incorporated relevant maternal and newborn healthcare services in the postnatal …

Assessing The Need And Opportunities For Improved Linkages Between Conditional Cash Transfers And Reproductive Health Programs In Latin America And The Caribbean, Ricardo Vernon, M. Estela Rivero-Fuentes

Reproductive Health

The objective of this project was to document the structure and functioning of conditional cash transfer (CCT) programs in Latin America and the Caribbean, to assess opportunities for improved linkages between CCTs and reproductive health programs, and to explore the role that operations research may have in the improvement of CCT programs. Activities were conducted in the Dominican Republic, El Salvador, Honduras, Jamaica, Nicaragua, and Peru. Operational problems identified by CCT programs included the targeting and selection of beneficiaries, monitoring compliance with conditions for receiving cash transfers, the systems used to provide the transfers, and management weaknesses. Recommendations are made …

Regional Workshop To Use The Findings From Operations Research To Increase The Access, Quality And Integration Of Contraceptive Services In Latin America And The Caribbean, M. Estela Rivero-Fuentes, Antonieta Martin

Reproductive Health

In October 2007, the Frontiers in Reproductive Health (FRONTIERS) program held a three-day regional workshop in La Antigua, Guatemala, to disseminate results of its operations research projects. During the workshop, participants received contraceptive technology updates, and learned about effective strategies tested by FRONTIERS to increase access to the IUD and vasectomy; and about integration of family planning with postpartum, postabortion, and PMTCT. Researchers discussed study results, program managers explained how they were used, and practitioners talked about implementing the interventions—a combination of perspectives that successfully transmitted the message that the interventions were not difficult to apply, could have a great …

Introduction Of Emergency Contraceptive Pills In The Public Health System Of Pakistan: A South-To-South Collaboration, M.E. Khan, Gul Rashida, Sharif M.I. Hossain, Ali M. Mir, Ubaidur Rob

Reproductive Health

This report describes a south-to-south collaboration to assist the Ministry of Health of Pakistan to introduce emergency contraception (EC) into its family planning program, supported by the Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) program. The collaboration consisted of a three-day visit by senior managers from the Pakistani health authorities to Bangladesh to familiarize them with the EC program in that country, followed by a two-day consultative meeting in Islamabad to draw up concrete plans for introduction of the method into the Pakistan system. Participants at the consultation developed plans to introduce EC into both community-based distribution and clinical …

Improving Communication Between Parents And Adolescents On Reproductive Health And Hiv/Aids, Nafissatou J. Diop, Alioune Diagne

Reproductive Health

Cette recherche opérationnelle avait pour but d’évaluer la fonctionnalité et l’efficacité d’un modèle d’intervention destiné à prendre en charge les besoins d’informations des adolescent(e)s en matière de santé de la reproduction et cela à travers le renforcement et l’amélioration de la communication entre les parents et les enfants/adolescent(e)s. Les résultats ont montré la faisabilité de mettre en place un programme qui est spécifiquement destiné à améliorer le niveau et la qualité de la communication entre les parents/tuteurs et les adolescent(e)s sur les questions de SR/VIH/SIDA et cela malgré le caractère encore sensible de cette question dans le contexte socioculturel sénégalais. …

Enhancing Utilization Of The Findings From The Youth Reproductive Health Project In Senegal, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

This operations research (OR) study focused on providing information appropriate to the cultural context of Senegalese adolescents on a variety of reproductive health issues including: knowledge of the human body; puberty; sexuality; gender roles; different cultural, familial, and peer values regarding sexual and reproductive behavior; contraception; responsible parenthood; STIs and AIDS; and sources of help and services. The study was undertaken in three urban communities in northern Senegal and had an overall positive result on young people's reproductive health knowledge, enhanced community understanding of youth reproductive health needs, and showed that a multisectoral approach is vital to supporting young people’s …

Developing Comprehensive And Evidence-Based Policy And Guidelines For Antenatal And Postnatal Care In Kwazulu-Natal, Prudence Ditlopo, Mantshi Menziwa, Saiqa Mullick, Saumya Ramarao, Janet Dalton, Dolly Nyasulu, Mags Beksinska, Busi Kunene

Reproductive Health

In May 2004, the Maternal Child and Women’s Health department of Kwazulu-Natal (KZN), South Africa requested technical assistance from the Population Council’s USAID-funded FRONTIERS project for developing standardized and comprehensive antenatal and postnatal (ANC/PNC) care policies and guidelines and supportive training and educational materials. The aims and objectives of this project were to: support the development of a comprehensive evidence-based antenatal and postnatal care program in KZN; consolidate lessons learned and evidence around delivery of comprehensive ANC and PNC; revise provincial guidelines to enable comprehensive ANC and PNC services that address PMTCT, partner involvement, syphilis screening, focused visits, and antiretrovirals; …

Feasibility, Acceptability, Effectiveness And Cost Of Models Of Integrating Hiv Prevention And Counseling And Testing For Hiv Within Family Planning Services In North West Province, South Africa, Saiqa Mullick, Mantshi Menziwa, Nzwakie Mosery, Doctor Khoza, Edwin Maroga

Reproductive Health

The Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program, in collaboration with the National Department of Health and the North West Provincial Department of Health and with support from PEPFAR, initiated a two-phased operations research study to test the acceptability, feasibility, and cost of two different models of integration of counseling and testing for HIV into family planning services in South Africa and to evaluate their effectiveness against standard practice. Based on the studies findings, the report concludes that the integration of HIV prevention activities, including education about prevention, dual protection, and counseling and testing within FP services in …