Public Health Commons^™

Breaking The Silence: Learning About Youth Sexual And Reproductive Health In Egypt [Arabic], Nahla G. Abdel-Tawab, Sally Saher, Nora El Nawawi

Poverty, Gender, and Youth

This collection of research (supported by the Ford Foundation office in Cairo) documents the Population Council’s efforts to build the capacity of young Egyptian researchers to study youth sexual and reproductive health. Understanding the needs of young Egyptians, including their sexual and reproductive health needs, is crucial for developing policies and programs that can help bring about desired changes and improve their health and well-being. Young people must be given accurate information and access to services to protect their sexual and reproductive health and to prepare them for taking on family responsibilities as they get older. This report sets the …

Assessment Of The Effectiveness Of An Innovative Screening Colonoscopy Protocol In Producing High Quality Performance And Outcomes By Trained Primary Care Physicians, Yi Jhen Li

Theses and Dissertations

Colorectal cancer (CRC) is the 3rd most prevalent cancer and 2nd leading cause of cancer death in the U.S. Colonoscopies have been recommended as the preferred screening method to prevent cancer by removing polyps before they transform into cancer. Although colonoscopy every 10 years is considered to be the preferred screening method, it is not perfect mainly owing to the variable quality of screening colonoscopy under community-based practice conditions. Although the effectiveness of colonoscopy in preventing CRC is documented, screening colonoscopy coverage in the US population remains low. This is partly due to low colonoscopy capacity due to a shortage …

Associations Between The Perceived And Built Food Environment, Timothy L. Barnes

Theses and Dissertations

Neighborhood food environments have been associated with dietary intake and obesity. Measures of the food environment have typically been characterized with geographic information systems (GIS)-based measures, however, the use of perception-based measures of the food environment have increased in frequency. Few studies have fully examined the relationship between perceptions and GIS-based measures of the food environment, especially considering the congruency between perceived and GIS-based presence of specific retail food outlets, nor the relationship between food outlets and perceived availability of healthy foods or fast food opportunities.

Telephone survey data from 705 residents in an eight-county region of South Carolina were …

Evaluation Of Mass Media Campaigns To Change Smokers' Knowledge, Attitudes, And Behaviors In China And Taiwan, Li-Ling Huang

Theses and Dissertations

Research in high income countries (HICs) suggest that anti-smoking television advertisements are most effective if they contain emotionally evocative graphic messages or personal testimonials that depict serious consequences from smoking. The ability to effectively translate these messaging strategies to low- and middle-income (LMICs) countries outside of Western cultures remains understudied. It is critical to determine which smoking cessation messages work best in LMICs because they increasingly bear the global burden of tobacco-related disease. To date there is limited evidence on the efficacy of tobacco control mass media campaigns and the relative effectiveness of different tobacco control messaging strategies in China …

Urban Adventure Racing: Using Grounded Theory To Assess Motives, Eddie Hill, Edwin Gómez, Brandi Brinkley, Marni Goldenberg

Human Movement Studies & Special Education Faculty Publications

Although urban adventure races (ARs) have grown in popularity, little research exists on the reasons for the rising interest. Typically, adventure races are defined as a series of outdoor tasks completed within a given course or timeframe that are meant to challenge individuals, both mentally and physically. ARs borrow much from adventure programming. Aspects of AR programming may include goal-setting, problem-solving activities, and processing, and is often theoretically driven. This study used Grounded Theory as a basis for exploring why participants choose ARs, and if motives vary by gender. Of the 60 questionnaires collected, 40 were suitable for data analysis. …

Examining The Role Of Electronic Medical Record Generated Provider Reminders On Provider Offering Of Breast Cancer Screening Services, Charles Beverley, Jr.

Theses and Dissertations

Introduction:Breast cancer affects the lives of millions of women each year in the United States. Early detection by mammography screening can reduce the risk for advanced stages of breast cancer and improve the probability of long-term survival in women. Electronic medical records (EMRs) have been identified as a successful approach for increasing the offering of preventive care in breast cancer. This study examines the impact of EMR usage, and EMR generated provider reminders on physician ordering or providing of mammography screenings.

Methods:This study used survey data from the 2008-2010 National Ambulatory Medical Care Survey (NAMCS). Our sample included non-federal office-based …

Shaping Demand And Practices To Improve Family Health Outcomes: Findings From A Quantitative Survey, Volume 3: Bihar, M.E. Khan, France Donnay, Usha Kiran Tarigopula, Kumudha Aruldas

Reproductive Health

This report provides findings of a study undertaken to generate comprehensive information on eight target behaviors that have direct bearing on family health in rural Bihar. Behaviors include: 1) Increasing the proportion of deliveries that occur in a facility and mothers who have access to basic emergency obstetric care; 2) Increasing the proportion of safe deliveries at home; 3) Increasing the uptake of preventive postnatal-care services for newborns and mothers; 4) Increasing the practice of skin-to-skin care/Kangaroo Mother Care for newborns; 5) Increasing the practice of early and exclusive breastfeeding of infants during the first six months of life; 6) …

Fp2020: A Research Roadmap, Population Council

Reproductive Health

The global community came together in July 2012 in pursuit of an ambitious yet essential goal: ensuring that 120 million additional women and girls have access to effective family planning information and services by 2020. National governments, civil society, and the private sector resolved to tackle the numerous supply and demand barriers that prevent many women from using contraceptives. Donors committed $2.6 billion in new funding to support these efforts, matched by pledges from many developing-country governments. To reap the benefits of family planning, clients must have easy access to a wide range of affordable contraceptive methods through multiple service …

Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu

Reproductive Health

In late 2006, the Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The initiative included a core set of activities aimed at improving overall awareness of EC across the country and strengthening the quality of EC services in both the public and private sectors. It was intended to serve as a model for other countries interested in improving access to EC, and to generate in-depth knowledge on EC program strategies and utilization characteristics in sub-Saharan Africa. The MOH drew lessons and experiences from the initiative …

The Unfinished Agenda To Meet Fp2020 Goals: 12 Actions To Fill Critical Evidence Gaps, Ian Askew, Martha Brady

Reproductive Health

More than 200 million women in the developing world who want to avoid pregnancy are not using a modern contraceptive method. The international community convened at the London Family Planning Summit in July 2012 and strengthened their resolve to address unmet need. National governments, civil society, and the private sector committed US$2.6 billion toward the goal of making contraceptive information, services, and supplies available to an additional 120 million women and girls by 2020. This book elaborates on one of two influential publications disseminated by the Population Council that assess the situation: Reviewing the Evidence and Identifying Gaps in Family …

Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar

Reproductive Health

Maternal mortality in Ethiopia remains among the highest in the world. A UN Commission Report in 2012 identified 13 life-saving commodities—defined as medicines, medical devices, and health supplies—that effectively address avoidable causes of death during pregnancy and childbirth that, if more widely accessed and properly used, could significantly reduce preventable deaths among women. This assessment, conducted by the Population Council, evaluates the availability of these life-saving commodities that are essential for basic emergency obstetric and neonatal care, and safe and clean delivery services within primary health care in Ethiopia. The report concludes that Ethiopia’s pharmaceutical procurement and supply system is …

Day Of Dialogue: Mainstreaming Emergency Contraception In The National Family Welfare Program, Population Council

Reproductive Health

The Population Council, in collaboration with the Family Planning Association of India, hosted a Day of Dialogue which addressed issues related to access, availability and use of emergency contraception pills (ECP). Some of the key issues addressed in this consultation included: provider knowledge on mechanism of action and attitudes toward easy access to ECP and its link to premarital sex and promiscuity, repeated use of ECP, and lack of information about ECP among potential users. The Population Council shared key findings of a recent study on knowledge, attitudes, and opinions of gynecologists and pharmacists on ECP use. The one-day consultation …

Challenges In Impact Evaluation, Anrudh K. Jain

Reproductive Health

These notes are for a presentation given at the Consultation on Social and Behavioral Change Interventions for Enhancing Child Survival in South Asia organized by UNICEF, USAID, and Population Council in New Delhi, India. The slides identify challenges for conducting impact evaluations by describing the anticipated process for behavior change communication using women’s support groups, issues encountered in the process, and evaluation designs. Examples from the Population PAIMAN project are used to illustrate ways to address these challenges.

Day Of Dialogue: Expanding Opportunities For Increased Access To Emergency Contraception (Ec) In Nigeria, Population Council

Reproductive Health

In order to create a supportive policy and service delivery environment for emergency contraception (EC) and improve uptake in Nigeria, the Population Council conducted a survey of service providers’ knowledge, attitudes, and practices regarding EC, supplemented by in-depth interviews with key opinion leaders regarding their perceptions. This study revealed gaps that have implications for policy and programming. In collaboration with the International Consortium for Emergency Contraception, the Population Council convened a “Day of Dialogue” on EC to discuss the key research findings and to recommend strategic considerations for repositioning EC within the country's family planning program. This report describes the …

Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab

Reproductive Health

These slides present results from a Population Council study conducted in Egypt aimed at identifying factors that prevent Egyptian couples from attainment of their reproductive goals using a rights-based, gender-sensitive analysis of family planning service demand and supply. The analysis focused on six aspects of clients’ rights: clinic/provider readiness, accessibility and affordability, privacy and confidentiality, choice and autonomy, informed decisionmaking, and the right to complain. The presentation concludes with recommendations for closing gaps that exist with regard to protection of clients’ rights to autonomy, choice, informed decisionmaking, privacy, and confidentiality.

Demographic Dividend, A Window Of Opportunity For Development: Implications For South-South Cooperation, Selina F. Esantsi

Reproductive Health

At the Inter-Ministerial Conference on “South-South Cooperation in Post ICPD and MDGs” held in Beijing in 2013, this presentation defined the demographic dividend and noted implications and potential benefits of this opportunity. Two case studies were presented—South Korean and Ghana—followed by suggestions for governments on how to harness this dividend. Suggestions include investing in child survival and health programs, building human capital, stabilizing the financial sector, and improving transparency and governance. The presentation concludes with specific ways for south–south collaboration to enhance this opportunity.

Effectiveness Of A Comprehensive Sexual And Gender-Based Violence Prevention Project For In-School Girls In Swaziland, Swaziland Action Group Against Abuse (Swagaa)

Reproductive Health

Swaziland is one of the sub-Saharan African countries affected by sexual and gender-based violence (SGBV) and HIV and AIDS, with women facing greater risk compared to men. In response to increasing reports of violence against women and children in the country, the Swaziland Action Group Against Abuse launched a Girls’ Empowerment Clubs (GEC) program in primary and secondary schools in order prevent SGBV cases. Due to limitations of the program (such as being led by teachers and reliance on volunteers), an intervention study was carried out by the Population Council to test the effectiveness of an enhanced version, “GEC-Plus,” that …

Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew

Reproductive Health

This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …

Journee De Dialogue Sur La Contraception D'Urgence (Cu), Population Council, International Consortium For Emergency Contraception

Reproductive Health

Le Population Council en collaboration avec le Consortium International sur la Contraception d’Urgence, a organisé, une journée de dialogue sur la contraception d’urgence (CU) au Sénégal, en partenariat avec le Ministère de la Femme, de l’Enfant et de l’Entreprenariat Féminin; le Ministère de la Santé et de l’Action Sociale; et le Ministère de la Jeunesse, de l’Emploi et de la Promotion des Valeurs Civiques. L’objectif principal de la journée était de développer un plan d’actions pour la création d’un environnement politique et juridique plus favorable à l’offre de CU, et pour la vulgarisation de la CU auprès des communautés. Suite …

Mitigating The Consequences Of Sexual Violence In Zambia By Decentralizing Emergency Medical Responses To Police Victim Support Units: Report On The Feasibility Of Police Provision Of Post-Exposure Prophylaxis For Hiv (Pep) In Zambia, Mary Zama, Mardieh Dennis, Jessica Price, Stephanie M. Topp, Jonathan Kaunda Mwansa, Jill Keesbury

Reproductive Health

The Zambian Ministry of Home Affairs (housing the Zambia Police Service); the Ministry of Health, the Ministry of Community Development, Mother and Child Health; and the Population Council collaborated on operations research studies to increase provision of emergency medical care to survivors of sexual violence via the Zambia Police Services (ZP). Recognizing the need to strengthen linkages between the police and the health sector and following up on the lessons learned from earlier models of police delivery of emergency contraception, this feasibility study was designed to: determine if victim support unit (VSU) officers could be trained to safely and effectively …

Gender-Based Violence: A Qualitative Exploration Of Norms, Experiences And Positive Deviance, Shireen J. Jejeebhoy, K.G. Santhya, Shagun Sabarwal

Reproductive Health

This report presents the findings of formative research the Population Council conducted, with support from UK aid, in the district of Patna, India that aimed to better understand the context of violence—physical, emotional, and sexual—against women and girls, and notably, the prevailing norms about men’s entitlement and women’s acquiescence to violence. Findings suggest that violence against women and girls is widespread and widely justified, that women are perceived as having few options but to tolerate violence, and that the most common response to violence is silence. At the same time, many women and some positive deviant men recognize the injustice …

Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu

Reproductive Health

Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The specific objectives of the initiative were to: increase knowledge, awareness, and use of EC among Kenyan women; increase knowledge and awareness of EC among health providers; and strengthen EC provision in both the private and public sectors. This policy brief describes a toolkit designed for policymakers and service providers which draws on the achievements, lessons learned, and experiences from this project.

Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community

Reproductive Health

The East, Central and Southern Africa (ECSA) Health Community, which prioritizes gender-based violence and child sexual abuse as regional health concerns, partnered with the Population Council to convene a pre-conference Expert Committee meeting of the Research, Information and Advocacy Programme. The conference marked a major milestone in the ECSA Health Community’s commitment to promote and support region-wide sharing and utilization of health research and policy information among its member states. This report summarizes the deliberations of the two-day workshop and the recommendations for implementing an advocacy plan to address this important facet of the region’s development agenda.

Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes

Reproductive Health

Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …

Reviewing The Evidence And Identifying Gaps In Family Planning Research: The Unfinished Agenda To Meet Fp2020 Goals, Ian Askew, Martha Brady

Reproductive Health

The Population Council produced this paper to help guide discussions and considerations regarding the key evidence gaps and research investments needed to achieve the FP2020 goal and objectives. The paper focuses primarily on the social science, implementation, and operations research that will be needed to achieve the first three objectives. Research shows that through high-quality voluntary family planning (FP) programs, governments can reduce fertility and generate substantial improvements in health, wealth, human rights, and education. Family planning programs for the 21st century will require thoughtful design—engaging both public and private sectors—to meet the growing need for safe and effective FP …

Approaches That Will Yield Greater Success When Implementing Self-Administered Electronic Data Capture Ict Systems In The Developing World With An Illiterate Or Semi-Literate Population, Stanley J. Mierzwa, Samir Souidi, Irene Friedland, Sarah A. Littlefield, Lauren L. Katzen, Craig Savel, Deborah Boccio, Saumya Ramarao

Reproductive Health

The Information Technology (IT) Group at the Population Council responded to a need for a technology solution that would help researchers obtain more accurate responses to survey questions that concerned subject matter of a sensitive nature. The IT Group had three goals: (1) to enhance research by obtaining the best data possible, (2) to operate successfully in the local environment and be welcomed by the local populations, and (3) to increase the efficiency and cost-effectiveness of the survey process. This paper outlines approaches to consider when designing and implementing self-administered information and communications technology (ICT) questionnaires in developing countries, and …

Using Evidence-Based Recommendations For Guidance, Guidelines And Scale-Up Strategies, Ian Askew

Reproductive Health

No abstract provided.

Access To Emergency Contraception And Safe Abortion Services For Survivors Of Rape And Defilement In Sub-Saharan Africa: A Regional Overview, Jill Thompson, Chi-Chi Undie, Ian Askew

Reproductive Health

No abstract provided.

Adapting The Who Tool On Sexual And Reproductive Health And Human Rights: Experiences In Four Countries, Ian Askew, Kaila Clarke, Fauzia Akhter Huda, Joyce Mumah, Mary Philip Sebastian

Reproductive Health

No abstract provided.

Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows

Reproductive Health

This document reports on the Government of Kenya’s Output-Based Aid (OBA) vouchers program—an affordable strategy to meet the international and national objectives for improved maternal and reproductive health. To help achieve the global Millennium Development Goals related to maternal and child health, the Kenyan government has launched several initiatives including this Vision 2030 flagship program which harmonizes global and national objectives by improving access and enhancing equity in health service delivery. The report finds that the three maternal health MDG indicators—maternal mortality rate, rate of institutional deliveries, and contraceptive prevalence—can all be improved substantially by scaling up the OBA program. …