Public Health Commons^™

Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee

Reproductive Health

To support the Government of Zambia in addressing its reproductive health challenges and in meeting its goals for 2020, the United Kingdom Department for International Development funded a four-year effort to support public sector contraceptive expansion under the Scaling Up Family Planning (SUFP) Project, led by Abt Associates. Launched in 2012, and with a focus on hard-to-reach areas and youth and expanding access to long-acting reversible contraceptives, SUFP was a technical assistance program designed to strengthen the ability of the public sector to provide services to meet the country’s FP2020 goals. SUFP focused on capacity building, infrastructure strengthening, behavior change …

Scaling Up Family Planning In Zambia—Part 2: The Cost Of Scaling Up Family Planning Services, David Collins, Colin Gilmartin

Reproductive Health

This costing study is Part 2 of a broader implementation research study designed to establish the feasibility of integrating successful interventions and lessons from the Scaling Up Family Planning (SUFP) project into Zambia’s health system at the conclusion of the project, and to contribute to the global learning on scaling up family planning services. The main contribution of the costing study was to examine the cost implications in determining the scope and pace of scale up. Challenges experienced during the project reportedly included lack of equipment and limited space in some facilities, government staff shortages, and irregular access to supplies …

Situational Analysis Of The Private Sector In The Delivery Of Family Planning Services In Egypt: Current Status And Potential For Increased Involvement, Nahla G. Abdel-Tawab, Doaa Oraby, Benjamin Bellows

Reproductive Health

The recent increase in Egypt’s total fertility rate, along with stalling contraceptive rates and persistent unmet need for family planning (FP), highlights a need to explore new venues for providing FP services. The specific objectives of this study are to determine the size, scope, and scale of private-sector FP providers (private physicians, nongovernmental organization clinics, and private pharmacies); examine the policy and regulatory environment for private provision of FP products and services; and assess business, financing, and training needs of the private health sector and the potential for expanding its role in FP service provision. To improve current trends in …

The Private Sector As A Provider Of Family Planning Services In Egypt: Challenges And Opportunities, Nahla G. Abdel-Tawab, Doaa Oraby, Benjamin Bellows

Reproductive Health

The recent increase in Egypt’s fertility rate, following decades of progress in lowering fertility levels, highlights the need for renewed attention to the country’s family planning program. The Ministry of Health is currently the largest provider of family planning in Egypt, serving a diverse population of women, many of whom may not need the free public service. Expanding the role of the private sector in the provision of family planning services and supplies holds great potential to more effectively meet the current and future family planning needs of millions of Egyptian women. This brief examines the role of the private …

The Private Sector As A Provider Of Family Planning Services In Egypt: Challenges And Opportunities [Arabic], Nahla G. Abdel-Tawab, Doaa Oraby, Benjamin Bellows

Reproductive Health

[In Arabic] The recent increase in Egypt’s fertility rate, following decades of progress in lowering fertility levels, highlights the need for renewed attention to the country’s family planning program. The Ministry of Health is currently the largest provider of family planning in Egypt, serving a diverse population of women, many of whom may not need the free public service. Expanding the role of the private sector in the provision of family planning services and supplies holds great potential to more effectively meet the current and future family planning needs of millions of Egyptian women. This brief examines the role of …

Understanding Demand For Family Planning And Reproductive Health Services Through The Indian National Health Insurance Scheme In Uttar Pradesh, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

The Indian National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), was launched by the Ministry of Labour and Employment in 2008 to promote equitable access to health services through the private and public sectors. This scheme is intended to offer economically disadvantaged families living below the poverty line in urban and rural areas access to a pre-specified package of health services including: general surgery, general medical care, pediatric care, gynecological care, family planning (FP) and other reproductive health (RH) services, dental, ophthalmology, urology, neurosurgery, and oncology. Almost eight years into the program, this is an opportune time to examine …

Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

In 2008, the Government of India launched the National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in both urban and rural areas to access a range of private health services. The available evidence suggests several limitations and barriers that may affect the utilization of RSBY services and warrants a more in-depth examination of the contexts of family planning/reproductive health (FP/RH) services. The Population Council, under the Evidence project, conducted a study among the urban poor to: 1) determine RSBY awareness and barriers to enrollment; 2) identify barriers and facilitating factors to …

Delivering Contraceptive Vaginal Rings To Breastfeeding Women, Population Council

Reproductive Health

The Progesterone Vaginal Ring (PVR) is a user-controlled contraceptive that helps breastfeeding women safely and effectively space, delay, or limit their next pregnancy. The Population Council and partners developed the PVR to help address the unmet need for contraception among breastfeeding women. The ring provides a convenient option that adds choices for new mothers and promotes optimal infant nutrition and health. This two-page brief provides fast facts for advancing nutrition and infant health with the PVR.

Building A National Pro-Choice Alliance In Mexico: Evaluation Of The Alliance Media Campaign To Promote Access To Safe, Free, And Legal Abortion Services, Population Council

Reproductive Health

The Population Council and Alliance partners designed a legal abortion media campaign aimed at informing women in Mexico City of their legal right to a safe, free elective abortion during the first 12 weeks of pregnancy. The impetus for the campaign was the apparent lack of knowledge regarding the legality of abortion in Mexico City among low-income, marginalized women of reproductive age combined with the inadequate number of Mexico City Ministry of Health facilities equipped to provide services to women living in an expansive metropolitan area such as Mexico City. This brief presents results of an evaluation that show that …

Evaluating The Impact Of Integrated Microfinance And Reproductive (Mf/Rh) Services On Household Wellbeing And Reproductive Health Behaviors Of Women In Nigeria, Population Council

Reproductive Health

A growing body of studies attempts to show that microfinance institutions are capable of contributing to improvements in women’s reproductive health (RH) status by integrating information that leads to behavioral change. In Nigeria, there is little evidence documenting the impact and health outcomes among beneficiaries of integrated microfinance and reproductive health (MF/RH) service. The integrated MF/RH program, funded by The David & Lucile Packard Foundation and implemented by Partners for Development, provided an opportunity to test the impact of integrating RH messaging and support for service provision into a microcredit scheme. The objective of this integrated approach was to improve …

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Evaluation Of The Impact Of Strengthening Union Health And Family Welfare Centers For Providing 24/7 Normal Delivery Services In Bangladesh, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan, Mohammed Sharif, Forhana Rahman Noor, Surojit Kundu, Shongkour Roy, Afsana Fatema Noor, Ubaidur Rob

Reproductive Health

In Bangladesh, the majority of the infant deliveries in rural areas take place at homes where there is a higher risk of morbidity and mortality. Most Union Health and Family Welfare Centers (UHFWCs) are unable to provide 24-hour normal delivery services in close proximity to most rural women. With this point of view, the Population Council has provided technical assistance to the Directorate General of Family Planning to implement an operations research (OR) study in 24 UHFWCs to test the effectiveness of a model to strengthen UHFWCs so that they can provide such services. This report presents the findings of, …

Landscape Analysis Of The Family Planning Situation In Pakistan: Brief Summary Of Findings, Population Council

Reproductive Health

This brief provides a summary of the Landscape Analysis of the Family Planning Situation in Pakistan carried out by the Population Council with the support of the Bill & Melinda Gates Foundation in 2015–16. The analysis provides a comprehensive assessment of consumer demand, contraceptive service provision, and contraceptive supply, and the provincial policy environment based on primary data collection in eight districts in Punjab, Sindh, and Khyber Pakhtunkhwa. Its aim is to identify investment opportunities to catalyze an escalation in contraceptive prevalence, enabling Pakistan to meet its FP2020 goals.

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Faisalabad, Population Council

Reproductive Health

This district profile of Faisalabad is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities, pharmacies, and lady health workers; distribution of public static and private facilities by cadre;, provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning. The analysis, conducted by the Population Council, was supported by …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Hyderabad, Population Council

Reproductive Health

This district profile of Hyderabad is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of family planning, including other socioeconomic indicators, and consumers’ perspectives on barriers to use of family planning. While it notes the lack of information among men; it also finds limited access to public health facilities compounded by poverty—a hurdle for the urban poor. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Landscape Analysis Of The Family Planning Situation In Pakistan, Population Council

Reproductive Health

Pakistan faces a number of challenges to increasing modern contraceptive use. Although there are encouraging signs, such as improved male participation, the addition of about four million current FP users, from 2007 to 2013, and a responsive policy environment with demonstrated political and financial commitment to meeting the country’s FP2020 goals, the task that lies ahead is still huge. This report presents the findings of a landscape analysis of family planning (FP) in Pakistan by the Population Council in 2015 and 2016, with support from the Bill & Melinda Gates Foundation. This landscape analysis assesses both demand and supply side …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Karachi, Population Council

Reproductive Health

This district profile of Karachi is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of family planning; use of antenatal and delivery care services; other socioeconomic indicators; availability of health facilities and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning. The analysis, conducted by the Population Council, was supported by the …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Peshawar, Population Council

Reproductive Health

This district profile of Peshawar is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of antenatal and delivery care services; other socioeconomic indicators; availability of health facilities, pharmacies, and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Rawalpindi, Population Council

Reproductive Health

This district profile of Rawalpindi is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of family planning and other socioeconomic indicators. It covers consumers’ perspectives on barriers to use of family planning noting the lack of information among men and women, especially migrants; problems of access among poor rural women; and difficulty in affording services, among poor couples. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Understanding Married Women's Vulnerability To Hiv Infection In Egypt: An Exploratory Study, Doaa Oraby, Nahla G. Abdel-Tawab

Reproductive Health

This study examines the behavioral, sociocultural, economic, programmatic, and legal factors that aggravate Egyptian women’s vulnerabilities to HIV/AIDS. The study concludes that in low-prevalence settings like Egypt, targeted interventions are the most strategic and cost-effective: for example, HIV awareness-raising with a special focus on the preventive role of consistent, correct condom use, and creating a cadre of peers that could provide psychosocial support and HIV counseling to migrant workers. Furthermore, premarital and antenatal care programs should include HIV awareness-raising and provider-initiated counseling and testing after screening of women to identify those at risk for HIV infection. Concurrently, efforts should be …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Districts Haripur And Nowshera, Khyber Pakhtunkhwa, Population Council

Reproductive Health

Through its Reproductive Maternal and Neonatal Child Health project, GIZ Pakistan is assisting the Government of Pakistan in strengthening its health system’s capacities for ensuring effective, efficient, client-oriented, and affordable reproductive, maternal, newborn, and adolescent health care. GIZ engaged with senior national and provincial government officials who indicated their interest in applying the innovative Made-In/Made-For (Maternal Death, from Informants/Maternal Death, Follow On Review) methodology, a cost-effective alternative for generating reliable estimates of maternal mortality through community-based informant networks. This Population Council study in two pilot districts identified specific areas that need strong policy and programmatic interventions to improve maternal health …

Using The Community Informant-Based (Made-In And Made-For) Methodology To Estimate The Neonatal Mortality Rate (Nmr) In Nowshera, Khyber Pakhtunkhwa: A Feasibility Study, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, Rehan M. Niazi

Reproductive Health

Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

Space-Time Modelling Of Emerging Infectious Diseases: Assessing Leptospirosis Risk In Sri Lanka, Cameron C F Plouffe

Theses and Dissertations (Comprehensive)

In this research, models were developed to analyze leptospirosis incidence in Sri Lanka and its relation to rainfall. Before any leptospirosis risk models were developed, rainfall data were evaluated from an agro-ecological monitoring network for producing maps of total monthly rainfall in Sri Lanka. Four spatial interpolation techniques were compared: inverse distance weighting, thin-plate splines, ordinary kriging, and Bayesian kriging. Error metrics were used to validate interpolations against independent data. Satellite data were used to assess the spatial pattern of rainfall. Results indicated that Bayesian kriging and splines performed best in low and high rainfall, respectively. Rainfall maps generated from …

Demand And Supply Factors Affecting Maternal Healthcare Utilization Pattern In Nigeria, Dumbiri Joy Powell

Theses and Dissertations

Given poor maternal services utilization and associated high maternal mortality risk in Nigeria, we document policy-amenable supply and demand factors impacting women’ use of skilled ANC and institutional delivery services. Using a cross-sectional design, we analyzed data from the Nigeria State Health Investment Project health facility and household surveys on 418 health facilities and 3,726 women with a pregnancy within 24 months prior to survey living in 241 geographic wards of two states. Logistic regression was used to study associations of women’s use of each maternal service with ward facilities’ ANC outpatient satisfaction, healthcare staff job satisfaction, surveyorverified facility infrastructure, …

Across The States: Do Long Term Services & Supports Policies Affect The Number Of Nursing Home Residents With Low-Care Needs?, Mary Otis

MPA/MPP/MPFM Capstone Projects

Long term care for the elderly has been steadily gaining salience in the public policy realm for many years. The federal government has been vigorously studying and exploring solutions, including the Centers for Medicare and Medicaid Services’ (CMS) efforts to expand access to home and community-based services (HCBS) in order to reduce dependence on institutional care. These federal efforts include various incentive programs and policies recently offered under the Affordable Care Act. However, data on the strength of each state’s long term services and supports system has not been easily accessible until recently. The report “Raising Expectations: A State Scorecard …

Predictors Of Sun Protection Behaviours And Sunburn Among Australian Adolescents, Simone Pettigrew, Michelle Jongenelis, Mark Strickland, Carolyn Minto, Terry Slevin, Geoffrey Jalleh, Chad Lin

Research outputs 2014 to 2021

Background

Excessive sun exposure and sunburn increase individuals’ risk of skin cancer. It is especially important to prevent sunburn in childhood due to the higher relative risk of skin cancer across the life span compared to risk associated with sunburn episodes experienced later in life. This study examined demographic and attitudinal factors associated with engagement in a range of sun protection behaviours (wearing a hat, wearing protective clothing, staying in the shade, and staying indoors during the middle of the day) and the frequency of sunburn among Western Australian adolescents to provide insights of relevance for future sun protection campaigns. …

Low Self-Esteem Leads To Depression Among Elderly: Case Study Of Nursing Home, Savera Aziz Ali, Nadir Suhail, Sumera Aziz Ali

School of Nursing & Midwifery

Background: Self-esteem is defined as “how we value our self”; it affects our trust and relationships in every part of life. Person with low self-esteem may feel powerless and incompetent about himself/herself. Moreover, low self-esteem operates as a risk factor for depression, which is most common disorder among elderly people both in developed and developing countries, causing multiple behavioral changes as well as may increase the chances of depression and suicide among the elderly people. Objective: The objective of this case study was to understand the problems faced by elderly people in the nursing home and to relate the self-esteem …

Fruit And Vegetable Consumption, Body Mass Index, And Dieting Behaviors Among Florida Middle And High School Youth, Corinne A. Labyak, Tammie M. Johnson, Claudia Sealey-Potts, Judy E. Perkin

Florida Public Health Review

The purpose of this study was to examine fruit and vegetable consumption reported by Florida middle school and high school students and to determine if consumption was associated with: (1) demographic characteristics; (2) body mass index (BMI); and/or (3) weight loss behaviors. Data from the 2009 Florida YRBS and the MSHBS were used. Both surveys used a two-stage cluster sample design, producing a representative sample of students. In addition to socio- demographic variables, independent variables included engaging in weight loss behaviors. Dependent variables were adequate fruit and adequate vegetable consumption. Descriptive, chi-square and logistic regression analyses were performed. Results indicated …

Fruit, Vegetable And Beverage Consumption In Duval County Middle School Students: Youth Risk Behavior Survey 2009-2013, Corinne A. Labyak, Alireza Jahan-Mihan, Richard Patterson, Judith Rodriguez, Janice J. Seabrooks-Blackmore, Karen Patterson, Zhiping Yu, Catherine Christie, Claudia Sealey-Potts

Florida Public Health Review

Public health professionals have the opportunity to impact middle school students’ dietary behaviors to combat childhood obesity. The purpose of this study was to investigate the dietary behavior results from the YRBS taken by middle school students in Duval County in 2009, 2011 and 2013. A two-stage cluster design was used and the survey was completed by 6th through 8th grade students following parent notification. Compared to other health zones, Health Zone 1 had the lowest intake of fruits and vegetables in 2009 (2.66 ±1.65) and 2011 (2.77 ± 1.60) and the second lowest intake in 2013 (2.92 ± 1.70). …