Public Health Commons^™

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

Reproductive Health

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

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria: Key Findings, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

This brief reports on a study in Nigeria to document provider attitudes, beliefs, and practices regarding emergency contraception (ECP), and to identify key opinion leaders’ opinions and insights pertaining to policy and programmatic issues in that country. Findings reveal that ECP is well known in urban Nigeria. Its provision is controlled mainly by the largely unregulated and unmonitored private sector. Government plays a distant role, thereby leaving family planning and ECP supply almost entirely in the hands of donor agencies. For wider availability and affordability of ECP products in both the private and public sectors, official policy action is required, …

The Africa Regional Sexual And Gender-Based Violence Network Annual Partners Meeting: June 26-27 2012, Mombasa, Kenya—Meeting Report, Population Council

Reproductive Health

The Population Council convened an annual partners meeting of its Africa Regional Sexual and Gender-Based Violence (SGBV) Network. Over 30 participants attended the meeting whose objectives were: 1) to facilitate South-South technical exchange and information-sharing on the changing landscape of violence among partners, donors, and other experts; and 2) to reflect on the ways in which research is translating into policy and practice. This report highlights the myriad ways in which activities conducted under this Network have influenced policy, practice, and funding considerations in the region, while detailing the progress of Network partners on their projects, built around several key …

Critical Issues For Integrating Srh And Hiv/Aids Services To Provide Dual Protection Against Unintended Pregnancy And Hiv/Sti Acquisition, Population Council

Reproductive Health

This document reports on a one-day symposium that was held by the STEP UP (Strengthening Evidence for Programming on Unintended Pregnancy) Research Program Consortium, coordinated by the Population Council. STEP UP generates policy-relevant research to promote an evidence-based approach for improving access to family planning and safe abortion in Bangladesh, Ghana, India, Kenya, and Senegal. The symposium’s objectives were to review and discuss critical and emerging issues around integrating SRH and HIV and AIDS services to enable dual protection, including new directions in dual protection technology and behaviour change interventions. The meeting also provided an opportunity to discuss the programmatic …

Replication Of The Community Mobilization For Postabortion Care (Commpac) Model In Naivasha District, Rift Valley Province, Kenya: An Evaluation Report, Chi-Chi Undie, Francis Obare, Saumya Ramarao

Reproductive Health

The Population Council’s RESPOND project worked with districts and communities in Kenya to: strengthen service delivery points to provide postabortion care (PAC) services; conduct community mobilization to improve involvement in and knowledge of the prevention and treatment of postabortion complications; build community capacity to address needs related to PAC; and encourage involvement in community action of those most marginalized and most affected by postabortion complications. The program succeeded at increasing knowledge of critical danger signs; enabling providers to effectively offer PAC services; and raising awareness of PAC, among other goals. The intervention was less successful in increasing FP knowledge, current …

Birth Spacing And Family Planning Uptake In Pakistan: Evidence From Falah, Arshad Mahmood

Reproductive Health

The Population Council was the lead implementing agency for the Family Advancement for Life and Health (FALAH) project in Pakistan. The project’s main objectives were to achieve a 10 percent increase in the use of moden contraceptives, to equip 80 service delivery points to provide family planning services, and to ensure birth-spacing understanding and ways to achieve it by three-quarters of the target population. The main conclusion of this research is that a sharp uptake of family planning is possible in a relatively short time, if certain investments are made to ensure better communication and greater access to quality family …

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

Reproductive Health

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

Country Mapping: Nigeria, Salisu Mohammed Ishaku, Saumya Ramarao

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

Defining Effective Voucher Management Information Systems: A Blueprint For Information Systems To Support Scalable Reproductive Health Voucher Programs, Based On System Evaluations With Programs In Bangladesh, Cambodia, Kenya, Uganda, And Tanzania, Mahad Ibrahim, Benjamin Bellows, Jaspal S. Sandhu

Reproductive Health

This document defines the key elements of information systems to support the development of effective, scalable voucher information systems. It is based on an engagement between the Gobee Group and the Population Council to strengthen information systems of reproductive health voucher programs in five countries in 2011–12. At the time of publication of this document, the Population Council was in the midst of a multiyear evaluation of five of the biggest reproductive health programs worldwide, an effort supported by the Bill & Melinda Gates Foundation. While the work supporting this report has been focused on reproductive health voucher programs—which provide …

Evaluation Of The Population-Level Impact Of The Maternal Health Voucher Program In Uganda, Reproductive Health Vouchers Evaluation Team

Reproductive Health

This report is based on an evaluation of the population-level impact of the maternal health voucher program in Uganda focusing on targeting of beneficiaries, health service utilization (four or more antenatal care visits, facility delivery, and postnatal care), out-of-pocket expenses, and equity. It further reviews the findings from an independent verification of the program that was conducted by PricewaterhouseCoopers Limited in 2010. The impact of the program on the outcomes considered is determined through a simple comparison of changes in proportions between intervention and comparison groups before and after the program started as well as estimation of multilevel random-intercept logit …

Population Level Impact Of Vouchers On Access In Uganda, Benjamin Bellows, Francis Obare, Reproductive Health Vouchers Evaluation Team

Reproductive Health

No abstract provided.

A Review And Evaluation Of Multi-Sectoral Response Services ('One-Stop Centers') For Gender-Based Violence In Kenya And Zambia, Jill Keesbury, Washington Onyango-Ouma, Chi-Chi Undie, Catherine Maternowska, Frederick Mugisha, Emmy Kageha, Ian Askew

Reproductive Health

An increasingly popular strategy for addressing sexual gender based violence (SGBV) is through the establishment of one-stop centers‘ (OSCs), which provide integrated, multi-disciplinary services in a single physical location. The goals of this assessment were two-fold: first, to assess the effectiveness of different OSC models in terms of health and legal outcomes for survivors, and the cost-effectiveness of these models; and second, to identify lessons learned in OSC implementation with recommendations for both start-up and scale-up. Findings from this study offer the first form of systematic evidence on the effectiveness of OSCs, which can guide national-level policymakers and program managers …

Rape Sentencing Study: A Review Of Statutory Sentencing Provisions For Rape, Defilement, And Sexual Assault In East, Central, And Southern Africa, Jill Thompson, Felly Nkweto Simmonds

Reproductive Health

Several countries in East, Central and Southern Africa have responded to the problem of violence against women and children by amending outdated criminal laws relating to rape and other forms of sexual and gender-based violence. This legislative review is Part I of a two-part desk review on sentencing of sexual offences and minimum sentences in the African and international context. It should be read in conjunction with Part II of the Rape Sentencing Study. The purpose of this review is to: 1) document the sentencing reforms made in selected countries in the East, Central and Southern African region since 1998; …

Report Of The Voucher And Accreditation Evaluation Project Meeting, Reproductive Health Vouchers Evaluation Team, Population Council

Reproductive Health

This is a report on a technical advisory meeting that brought together 45 participants from the five country programs being evaluated through the Reproductive Health Voucher and Accreditation (V&A) project, which is implemented by the Population Council with financial support from the Bill and Melinda Gates Foundation. This group met for the first time as a newly emerging “voucher community” to learn from the successes and challenges faced in this early growth phase of emerging V&A programs that deliver maternal and reproductive health services. In addition to standardizing the collection of performance and financing metrics, who would use such data …

Explaining Benefit Utilization Variability In Fmnp In Kentucky: An Application Of Pierre Bourdieu’S Theory, Stephanie M. Holcomb-Kreiner

Theses and Dissertations--Sociology

Research has demonstrated the crucial role fresh fruit and vegetable consumption plays in maintaining good health. However, most Americans do not consume adequate amounts, and low-income Americans consume the lowest quantities of fresh fruits and vegetables. The Farmers’ Market Nutrition Program (FMNP) and Senior Farmers’ Market Nutrition Program (SFMNP) attempts to rectify this situation by providing vouchers to low-income women, children, and elders that can be used only at farmers’ markets for the purchase of locally grown, fresh fruits and vegetables. Unfortunately, FMNP and SFMNP exhibit variable and often low benefit utilization. This variable and often low benefit utilization is …

School Program Planning To Increase Active Transport To School, Brenda Aguilar

McNair Poster Presentations

Studies have shown that active transport is known to increase physical activity of children, decrease traffic congestion and the production of greenhouse gasses. This study examines active transport to school (ATS) [walking, biking, or other self-powered wheels to school] among elementary students. Through the Nevada Moves Day program an increase proportion of elementary students who use ATS was expected.

This study was done at two elementary schools, one being the intervention school that participated in the Nevada Moves Day, and a control school, which did not participate. Data was collected over a three week period. Students using active transport and …

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

Psychology Faculty Articles and Research

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

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

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

Spina Bifida Subtypes And Sub-Phenotypes By Maternal Race/Ethnicity In The National Birth Defects Prevention Study, A J Agopian, Mark A Canfield, Richard S Olney, Philip J Lupo, Tunu Ramadhani, Laura E Mitchell, Gary M Shaw, Cynthia A Moore

Faculty, Staff and Student Publications

Spina bifida refers to a collection of neural tube defects, including myelomeningocele, meningocele, and myelocele (SB(M) ), as well as lipomyelomeningocele and lipomeningocele (SB(L) ). Maternal race/ethnicity has been associated with an increased risk for spina bifida among offspring. to better understand this relationship, we evaluated different spina bifida subtypes (SB(M) vs. SB(L) ) and sub-phenotypes (anatomic level or presence of additional malformations) by maternal race/ethnicity using data from the National Birth Defects Prevention Study. This study is a large, multisite, population-based study of nonsyndromic birth defects. Prevalence estimates were obtained using data from spina bifida cases (live births, fetal …

Intimate Partner Physical Violence Against Women In Saudi Arabian Primary Healthcare Clinics, Halah M. Eldoseri

Health Services Research Dissertations

Intimate partner violence against women (IPPVAW) is a serious public health concern. The Ecological Model provides a model to study several factors associated with IPPVAW. In Saudi Arabia, studies addressing IPPVAW are limited and do not cover the various aspects of the problem. The purpose of this study was to investigate the various factors associated with IPPVAW at the personal, interpersonal, community and societal levels. Methods: 200 ever-married women attending six PHC in Jeddah, Saudi Arabia were recruited via convenient sampling method. Women were interviewed on factors related to IPPVAW using an adapted version of WHO survey for violence against …

Formative Research And Community Resilience: A Case Of Under Addressed Youth Problem Gambling, Michea Caye

Antioch University Dissertations & Theses

The overarching research topic for this study is the issue of effectively engaging and informing community and government decision makers about health issues that can negatively impact a community's resilience. The question guiding this study is how can formative research engage and inform community and government decision makers about the under addressed issue of youth problem gambling (YPG) in Windham County, Vermont? The study has two aims: 1) to develop a formative research conceptual framework and evaluate its effectiveness in addressing the public health issue of youth problem gambling, and 2) to use the formative research methodology to develop a …

Alternative Medical Care And Livelihood In Latin America = 拉丁美洲另類醫療與人民生計實踐, Aleida Guevara

South South Forum 南南論壇

No abstract provided.

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Effect Of A Work Site Exercise Program On Selected Fitness And Psychological Parameters, Kristen Ann Christiansen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The increasing rates of obesity continue to threaten the vitality of our nation. Health care costs are soaring and chronic diseases are reaching even the youngest populations. Physical activity is an integral component in reversing the obesity epidemic and improving the health of today's workforce. The present study sought to determine the effect of a work site exercise program on select fitness and psychological parameters. Five female employees participated in a six-week exercise program utilizing HealthBeat(TM) outdoor exercise equipment in a circuit fashion for 30 minutes, 2 days per week. Eighty percent of participants were categorized as sedentary or low-active …

Evaluating The Impact Of Social Determinants On Pedestrian Injury In Clark County, Nevada, Jonathon Lavalley, Courtney Ann Coughenour, Michelle Chino

Health Sciences Graduate Research

In order to understand the social determinants which may impact pedestrian injury rates in an urban, sprawling, western community we conducted an ecologic investigation to compare pedestrian crash rates by social determinants available for census tracts in Clark County, NV.

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

Independent Study Project (ISP) Collection

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