Public Health Commons^™

Paidar: Private Sector Allied For Inclusive Delivery Of Accessible Reproductive Health, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Pakistan continues to face critical challenges in increasing contraceptive use and reducing the unmet need for family planning (FP). While public-sector facilities remain key providers, a substantial proportion of healthcare seekers rely on private family physicians as their initial point of contact.

Recognizing this strategic opportunity, the PAIDAR study was designed to strengthen the role of private- sector male family physicians in FP service delivery. Implemented across six diverse districts of Punjab, supported by Health Care Commission Punjab and Department of Health and Population Punjab, the intervention enhanced providers' capacity to deliver quality FP counselling, contraceptive services, structured referrals, and …

Making Better Use Of Data For Improved Health Service Delivery In Punjab: Transforming Data Into Action Evidence, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Strong health systems depend not only on collecting data, but on using it effectively for planning, monitoring, and decision-making. To strengthen evidence-based management across Punjab's health sector, the Population Council partnered with the Health and Population Department, Punjab, particularly the Health Information and Service Delivery Unit (HISDU), to improve the utilization of routine health information. This brief summarizes the collaboration's focus on three complementary areas: (1) Development of the ASET (Analytics for Service Efficiency and Tracking) platform to transform routine data into actionable information; (2) Strengthening the Capacity of Data Users through specialized training in data analytics, visualization, and use …

From Evidence To Action: Case For Further Investment In Family Planning For Faster Fertility Decline, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

For over three decades, the Population Council Pakistan has generated evidence and supported governments in designing innovative approaches to address population and reproductive health challenges. Building on evidence around fertility transition, reproductive health, and the nationally endorsed Tawazun (balance) narrative, the Population Council supported the Government of Punjab through the FCDO-funded Delivering Accelerated Family Planning in Pakistan (DAFPAK) initiative and other strategic partnerships to implement scalable solutions for strengthening family planning services. This brief outlines five high-impact, proven interventions ready for institutional scale-up and provides an actionable path forward to transform routine health encounters into sustainable health system reforms.

Voucher Model For Family Planning: Empowering Poor Women And Expanding Access To Family Planning Services In Punjab, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Pakistan continues to face significant inequalities in access to family planning (FP) services, with the poorest women bearing a disproportionate burden of unmet need. Financial constraints, transportation costs, limited mobility, restricted decision-making power, and inadequate access to quality services often prevent women from obtaining the family planning services they need.

To address these barriers, the Population Council, in partnership with the Benazir Income Support Programme (BISP) and the Punjab Population Innovation Fund (PPIF), designed and rigorously evaluated an innovative Family Planning Voucher Scheme.

The model linked social protection with reproductive health services, enabling poor women from Rahim Yar Khan (RYK) …

Trends In Family Planning Uptake In Tanzania: An Analysis Of National Survey Data 2021-2022, Harun Yussuf Ayoub, Sabarinah Prasetyo

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

The purpose of this study is to uncover the socioeconomic and demographic factors that influence the usage of contraceptives by analysing trends and patterns in Tanzania's family planning uptake using data from national surveys. The results show that while Tanzania has made progress in increasing contraceptive prevalence from 27% in 2010 to 39% in 2021-22, disparities persist across socioeconomic and demographic lines. Women in urban areas, from higher wealth quintiles, and with higher educational attainment have significantly higher contraceptive prevalence rates compared to their counterparts. The study also reveals that the majority of women are aware of family planning methods, …

Pattern And Determinants Of Contraceptive Use Among The Muslim Women In Wajir And Lamu Counties In Kenya: A Cross-Sectional Study., Batula Abdi, Jerry Okal, Gamal Serour, Vincent Were, Marleen Temmerman, Peter Gichangi

Centre of Excellence in Women and Child Health

Background; Improving access to family planning (FP) is associated with positive health benefits that includes averting nearly a third of all maternal deaths and 10% of childhood deaths. Kenya has made great strides in improving access to family planning services. However, amid this considerable progress, regional variation has been noted which begs the need for a clearer understanding of the the patterns and determinants that drive these inconsistencies.

Methods; We conducted a cross-sectional study that involved 663 Muslim women of reproductive age (15–49 years) from Wajir and Lamu counties in Kenya between March and October 2018.The objective of this study …

A Community-Based Distribution Intervention For Family Planning Among Women In Northern Nigeria, Joy Matau Garba

Walden Dissertations and Doctoral Studies

In Northern Nigeria, inadequate information on family planning contributes to high mortality and morbidity rates in women of reproductive age due to multiple childbirths yearly. This study aimed to examine the relationship between the community-based distribution (CBD) strategy, religion, and attitudes toward family planning methods. Rosenstock’s health belief model, which can be an instrumental anchor for health promotion programs, was the theoretical framework for the quantitative cross-sectional study design. The data source was survey questionnaires administered by the U.S. Agency for International Development to 809 reproductive-age Nigerian women after implementing a CBD intervention. A multinomial logistics regression analysis showed that …

Factors Related To Contraceptive Use And Family Planning Decision-Making In The South Asian Community Residing In New York City, Nandini Shroff

Dissertations and Theses

Introduction: Currently, there are approximately 5.4 million South Asians residing in the United States (U.S.). The limited literature illustrates that contraceptive use is underutilized among Asians and Asian sub-groups, including South Asian Americans, compared to other racial and ethnic groups. Using Los Angeles County Health survey data, one study found that 22% of Asian Americans reported always using condom in the past 12 months compared to 37% of African Americans, 27% of Whites, and 27% of Hispanics. A study among New Jersey women revealed that compared to non-South Asian women, South Asians (SAs) were less likely to have used ever …

Identification Des Changements Les Plus Significatifs Sur La Communication Intergénérationnelle Et La Santé Des Jeunes En Matière De Planification Familiale Et De Santé De Reproduction : Évaluation Qualitative De La Campagne Médiatique « Merci Mon Héros » Au Niger Et En Côte D’Ivoire, Martha Silva, Sethson Kassegne, Robert-Hugues Yaovi Nagbe, Rebecca Ezouatchi, Lorimpo Babogou, Farida Moussa

Sexual and Reproductive Health, Rights, and Choices

No abstract provided.

Understanding Community Health Volunteer Incentive Preferences In Kenya, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

In Kenya, community health services are implemented through community health units. Community health volunteers (CHVs) who serve these units are chosen by the community and trained by community health extension workers. This brief summarizes qualitative and quantitative findings from the Frontline Health project’s discrete choice experiment study in Kenya, which aimed to understand incentive preferences of CHVs with the aim of improving motivation, performance, and retention of CHVs.

Identifying Factors That Support Community Health Worker Motivation, Job Satisfaction, And Retention In Haiti, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) play a critical role in Haiti’s health system, by connecting communities—particularly rural and hard-to-reach populations—to healthcare services. The Frontline Health project conducted a study to better understand the types of incentive structures that can best support the CHWs in Haiti and this brief summarizes those findings.

Women's Perceptions On The Effects Of Covid-19 On Access And Use Of Private Sector Family Planning Services In Nigeria: The Integrate Project, The Integrate Project

Reproductive Health

In Nigeria, Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of care for many common illnesses. Although CPs and PPMVs are not formally recognized as family planning (FP) service providers, 22% of modern contraceptive users report receiving their last method from a PPMV and 12% from a private pharmacy. PPMVs are popular for FP because of their widespread availability, consistent drug stocks, extended hours, personable interactions, and lack of separate fees for consultations. As in many places, the COVID-19 pandemic poses unprecedented challenges to health services in Nigeria. By limiting person-to-person contact, especially during …

Integrate Project Results: Family Planning Knowledge And Quality Of Care Received From Community Pharmacists And Patent And Proprietary Medicine Vendors, The Integrate Project

Reproductive Health

In Nigeria, Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of care for many common illnesses. Although CPs and PPMVs are not formally recognized as family planning (FP) service providers, 22% of modern contraceptive users report receiving their last method from a PPMV and 12% from a private pharmacy. PPMVs are popular for FP because of their widespread availability, consistent drug stocks, extended hours, personable interactions, and lack of separate fees for consultations. As the Federal Ministry of Health explores expanding its task sharing policy to include CPs and PPMVs, evidence is needed on …

Using Social Listening To Inform Integrated Social And Behavior Change Programs In Burkina Faso, Nrupa Jani, Leanne Dougherty, Martha Silva

Reproductive Health

No abstract provided.

Health And Ideations Of Married Female Adolescents, Breakthrough Research

Reproductive Health

This brief provides rigorous evidence-based insights to implementers and researchers of social and behavior change (SBC) programs that seek to improve knowledge, attitudes, norms, and behaviors of married female adolescents. The brief focuses on married adolescents’ uptake of services and health knowledge in Kebbi, Sokoto, and Zamfara states in northwestern Nigeria using a subset of data from a household survey of married women ages 15–49 years. It is one of a series of briefs that present findings from a Breakthrough RESEARCH study that uniquely captures data on a wide range of psychosocial drivers of behavioral outcomes in the areas of …

Preferred Incentives For Improving Community Health Worker Satisfaction And Retention In Bangladesh, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) are critical actors within community health systems, providing a range of reproductive, maternal, child, and primary health information, counseling, and services. To better understand factors that influence CHWs’ work motivation and satisfaction in Bangladesh, the Frontline Health project, implemented with collaborators from Johns Hopkins Bloomberg School of Public Health, and supported by the government of Bangladesh’s Directorate General of Health Services and the Directorate General of Family Planning, conducted a discrete choice experiment (DCE) study. This brief presents key qualitative findings from the DCE study in Bangladesh and implications for program and policy stakeholders.

The Ways In Which Women’S Suffrage Affected Healthcare, Madison M. Weber

The Review: A Journal of Undergraduate Student Research

The 19th Amendment had and continues to have a major impact on women’s healthcare in the United States. Prior to suffrage, women had little to no ability to voice their thoughts on and change policies that regarded their own health. This essay addresses the way in which the vote both directly and indirectly impacted healthcare; including workplace conditions, maternal and reproductive rights, racial disparities, political advocacy and healthcare, the different waves of feminism, and how this has all affected modern healthcare for women. From progressive articles being published in women's magazines, to the establishment of marital rape, to the availability …

Issues For Consideration In The Scale-Up Of The Inclusion Of Family Planning In The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Ghana is working toward achieving universal health coverage (UHC). This is driven, in part, by the Sustainable Development Goals (SDGs), specifically SDG 3—Good Health and Well-Being, which seeks to ensure healthy lives and promote well-being for all at all ages. Achieving this feat will improve equity of access as people, especially the poor can access quality health services without financial hardships. Ensuring equitable access to family planning (FP) is essential to securing the well-being of women and supporting the health and development of communities. One pathway to ensuring equity is the inclusion of FP in affordable insurance. While the inclusion …

Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana: A Health Facility Assessment, Population Council, Ministry Of Health, Ghana Health Service, National Health Insurance Authority, Marie Stopes International Ghana

Reproductive Health

In Ghana, National Health Insurance Act 852 of 2012 ensures that health-care benefits include family planning (FP) services, however people continue to pay for FP services because the policy is yet to be implemented in practice. Under the leadership of the Ministry of Health, the National Health Insurance Authority in collaboration with the Ghana Health Service, Marie Stopes International-Ghana and the Population Council implemented a pilot project to remove FP service out-of-pocket costs. All modern clinical FP methods were added to national health insurance and expensed by health facilities through the national health insurance claims process. The intervention significantly increased …

Diet Diversity Among Pregnant Women And Young Children—Insights For Improving Malaria, Family Planning, And Maternal And Child Health Outcomes In Northwestern Nigeria Through Social And Behavior Change Programming, Breakthrough Research

Reproductive Health

This research brief provides rigorous, evidence-based insights to policy-makers, implementers, and researchers of social and behavior change (SBC) programs on maternal and child nutrition during the 1,000-day period between a woman’s pregnancy and her child’s second birthday. It is one of a series of briefs presenting findings from a Breakthrough RESEARCH study that uniquely captures data on a wide range of psychosocial drivers of behavioral outcomes in family planning, malaria, and maternal, newborn and child health and nutrition (MNCH+N) in the three northwestern states of Nigeria.

Monitoring The Quality Assurance Branding Campaign Confiance Totale In Côte D’Ivoire, Martha Silva, Edan Komlan, Leanne Dougherty

Sexual and Reproductive Health, Rights, and Choices

Breakthrough RESEARCH has conducted a study to monitor the family planning (FP) quality assurance branding campaign in Côte d’Ivoire called Confiance Totale. Implemented by Breakthrough ACTION, Confiance Totale (French for Complete Trust) aims to increase demand for and use of quality FP services in Francophone West Africa. The promotional campaign, developed in early 2020, theorizes that promotion of safe and effective FP within a supportive social context will lead to an increase in demand for FP services, following the theory that mass media influence not only individual FP skills and knowledge but also environmental supports, constraints, and ideational factors …

Findings From The Merci Mon Héros Social Listening Endline Report, Breakthrough Research

Reproductive Health

No abstract provided.

Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Contraceptive use in Ghana has remained low despite annual increases since 2012. Having a high unmet need for family planning (FP) suggests that there may be barriers to access and uptake. Over time, several policies, including Ghana’s Costed Implementation Plan from 2015–20, have suggested FP initiatives to improve contraceptive use yet they have not been entirely implemented. Further, although FP was included in the health insurance act passed in 2003, amended in 2008, and revised in 2012, which indicated that health-care benefits include FP, people continue to pay out of pocket for services at National Health Insurance Authority facilities because …

Best Bets: Vouchers For Rights-Based, Voluntary Family Planning—International Evidence On Financing Of Family Planning, Benjamin Bellows, Moazzam Ali, Ali M. Mir

Reproductive Health

To meet the FP2020 and Sustainable Development Goals (SDGs), significant investments are required by countries and donors in priority areas, including sustainable financing, reaching all adolescents, expanding availability of services to the poorest and hard-to-reach populations, and improving the quality and increasing the range of methods available. Studies show that vouchers can substantially contribute to SDG goals by expanding contraceptive access and choice among underserved populations. Vouchers can be an effective financing tool to enhance equity, increase access, and improve the quality of FP services available to underserved populations within Pakistan.

Improving Reproductive Health And Family Planning Outcomes Among Out-Of-School Adolescents And Youth In The Philippines, Breakthrough Research, De La Salle University

Poverty, Gender, and Youth

Breakthrough RESEARCH, in collaboration with De La Salle University’s Social Development Research Center (DLSU-SDRC) in Manila, conducted a targeted qualitative research study to facilitate social and behavior change approaches for out-of-school ages 15 to 19 for positive reproductive health and family planning behavior change. Research in three regions of the Philippines generated evidence for the design of intervention approaches to be most effective for four priority behaviors: delay of sexual debut, use of modern contraceptive methods, care-seeking in the first trimester for pregnant youth, and birth spacing of three to five years to prevent short birth intervals.

Modeling The Impact Of Inclusion Of Family Planning Services In Ghana's National Health Insurance Scheme, Justin Archer, Gillian Eva, Augustine Ankomah, Saumya Ramarao, Kamil Fuseini, Anne Coolen, Stephen Duku, Benjamin Bellows

Reproductive Health

While access to and uptake of modern family planning (FP) in Ghana has steadily risen over the last decade, the modern Contraceptive Prevalence Rate (mCPR) among all women reached only 22% in 2019 with 30% of women still reporting unmet need. To increase FP uptake via mitigation of cost barriers among women with unmet need, the Government of Ghana is seeking to integrate claims-based FP services into the National Health Insurance Scheme benefits package. The impact of these activities has the potential to be significant with the proportion of women accessing modern FP shifting dramatically to public facilities over the …

Documenting Lessons From An Integrated Social And Behavior Change Program Linked To Integrated Health Services In Zambia, Breakthrough Research

Reproductive Health

This program brief documents lessons for social and behavior change programmers implementing multi-health, community-based programs with integrated health services. An iterative process by Breakthrough ACTION Zambia, from October 2018 through March 2019, identified four design concepts with strong feasibility and potential for impact and expansion. These four concepts were refined in Breakthrough ACTION Zambia provinces and districts in collaboration with implementing partners and the Ministry of Health Department of Health Promotion, with final intervention design and implementation processes determined in close collaboration with the Ministry.

Best Bets For Accelerating Family Planning In Pakistan: The Case For Engaging Family Physicians And The For-Profit Private Sector, Ashfaq Rehman, Anam Malkani

Reproductive Health

Many women in the developing world already rely on private sector providers for various types of treatment, as well as for family planning (FP) services, due to ease of access, shorter waiting times, and a perception of better service. Drug shops and pharmacies are also important for improving access and basic information about contraceptive products. Private pharmacies and shops are key when public sector facilities face frequent shortages and stock outs.

Best Bets For Accelerating Family Planning In Pakistan: Inducting Men, Sharing Responsibility, Kiren Khan, Zeba Sathar

Reproductive Health

Pakistan's family planning (FP) program remains more or less exclusively aimed at women, yet evidence from both international as well as programming from within Pakistan suggests that including men in FP could improve results. Given the large youth cohort entering reproductive life in Pakistan, there are compelling grounds for also including younger men and adolescent boys, especially those about to wed, within the country's reproductive health (RH) and FP strategies.

Best Bets: Additional Funding For Family Planning—International Evidence On Financing Of Family Planning, Zeba Sathar

Reproductive Health

Additional financing for family planning (FP) in Pakistan is strongly justified, not only to increase contraceptive prevalence, reduce unmet FP need, and avert millions of unwanted pregnancies, but also to reduce maternal mortality and effect improvements in other spheres of development. As a safeguard against unintended fertility, FP contributes to national savings in multiple ways, and additional annual funding of $93 million—or 40 cents per capita—is a relatively minor investment that promises huge dividends.