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Articles 421 - 450 of 540
Full-Text Articles in Public Health
The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain
The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain
Poverty, Gender, and Youth
Since 1982, the Maternal and Child Health and Family Planning Extension Project has compiled longitudinal panel data on rural women’s contact with household service providers who visit homes to discuss family planning and offer services to women on request. This study tests the hypothesis that home-based services reinforce customs of purdah (female seclusion) by sustaining the dependency and isolation of the women served by the program. Results show that household services improve women’s status. This effect is largely attributable to the impact of outreach on effective fertility regulation. Findings do not support the hypothesis that household service delivery is detrimental …
Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline
Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline
Poverty, Gender, and Youth
Theories of the fertility transition now routinely reserve a place for diffusion effects. Two fundamental behavioral mechanisms account for such effects: social learning and social influence. Social learning refers to the acquisition of information from others. The information might have to do with a new technology or with the health, social, and economic consequences of decisions. In the case of fertility, individuals might learn from others about the availability of a new contraceptive, or about health side effects of certain contraceptives, or about the apparent gains and losses from having fewer children and investing in their schooling. Social influence refers …
Continuing The Strengthening Of Situation Analysis Methodology: An Africa-Focused Approach, Robert A. Miller
Continuing The Strengthening Of Situation Analysis Methodology: An Africa-Focused Approach, Robert A. Miller
Reproductive Health
In 1995, the Population Council’s Africa OR/TA Project II proposed a three-year subproject to organize and strengthen the Situation Analysis methodology that had been developed by the first Africa OR/TA Project in 1989. This subproject proposed to concentrate on three areas of continuing importance in the African context: wider use of the established database to explore program issues in reproductive health (RH); synthesis of the knowledge that has been collected about African family planning (FP) programs into a monograph analyzing program issues, patterns of services, and their implications; and continued assistance in training and data processing on field studies. These …
El Método Cope Para Mejorar El Cuidado De La Atención: La Experiencia De La Asociación Para La Planificación Familiar De Kenia, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
El Método Cope Para Mejorar El Cuidado De La Atención: La Experiencia De La Asociación Para La Planificación Familiar De Kenia, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Poverty, Gender, and Youth
Esta es la primera de varias ediciones de Quality/Calidad/Qualité que describen métodos concebidos para ayudar tanto a los directores como al personal de los programas de planificación familiar a efectuar una evaluación propia de la calidad de los servicios que prestan. Estas herramientas dan a los patrocinadores de los programas la oportunidad de identificar las deficiencias en su entorno de servicio y proponer soluciones. El informe examina la experiencia de la Asociación Nacional de Planificación Familiar de Kenia, proporciona algunas lecciones aprendidas y demuestra que estos ejercicios de autoevaluación están, de hecho, dando como resultado una mejora de la calidad …
On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney
On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney
Poverty, Gender, and Youth
Demographers have known since the 1940s that standard measures of period fertility, such as the widely used total fertility rate, are distorted by changes in the timing of childbearing. Period fertility rates are depressed during years in which women delay childbearing and inflated in years when childbearing is accelerated. This problem is usually ignored because there has been no generally accepted method for solving it. This study proposes a method for removing the tempo distortions from the total fertility rate. The key assumption of the method is that period effects, rather than cohorts effects, are the primary force in fertility …
Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll
Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll
Poverty, Gender, and Youth
Five categories of possible government influence on a nation’s fertility are explored: (1) through publicly funded programs that explicitly seek to affect family-size outcomes (2) through the legal order and system of public administration (3) through measures that affect economic opportunity, social mobility, and gender relations; (4) through public-sector expenditures and transfer payments keyed to age or family status; and (5) through the state’s supplanting of local beliefs and traditions with the symbols of national identity and through the parallel expansion of cultural frames of reference. Aside from the first of these, intentions to influence fertility are either incidental or …
Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Poverty, Gender, and Youth
This is the first of several editions of Quality/Calidad/Qualité that describe methodologies designed to assist family planning program managers and staff to self-assess the quality of services they are providing. These tools give program sponsors an opportunity to identify shortfalls in their service environment and propose solutions. This issue focuses on AVSC International's COPE (client-oriented, provider-efficient) methodology, a self-assessment tool that has now been used in 35 countries around the world. The report examines the experience of the National Family Planning Association of Kenya, provides some lessons learned, and demonstrates that these self-assessment exercises are, in fact, resulting in system-wide …
Clinic-Based Family Planning And Reproductive Health Services In Africa: Findings From Situation Analysis Studies, Kate Miller, Robert A. Miller, Ian Askew, Marjorie C. Horn, Lewis Ndhlovu
Clinic-Based Family Planning And Reproductive Health Services In Africa: Findings From Situation Analysis Studies, Kate Miller, Robert A. Miller, Ian Askew, Marjorie C. Horn, Lewis Ndhlovu
Reproductive Health
The United States Agency for International Development (USAID) supported publication of “Clinic-Based Family Planning and Reproductive Health Services in Africa: Findings from Situation Analysis Studies.” The book reflects USAID's commitment to improving quality of reproductive health (RH) care and expanding access for underserved groups. Nowhere are these efforts more important than in Africa, where use of family planning (FP) and other measures of RH status are lowest among the world’s regions. Providing high-quality health services that meet couples' reproductive needs is a socially just and humane goal in itself. Moreover, higher-quality services can be expected to result in better outcomes …
Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council
Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council
Reproductive Health
Much literature has been written about improving the quality of reproductive health (RH) care at service delivery points (SDPs) because women deserve quality services, and as a means of increasing use of family planning (FP) and other RH services. There are six fundamental dimensions of quality of care: choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to encourage continuity, and an appropriate constellation of services. Improving these elements is thought to increase client satisfaction, resulting in an increase in contraceptive use and eventually fertility decline. Existing research has not convincingly demonstrated this link between quality of …
Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller
Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller
Reproductive Health
The Planned Parenthood Association of Ghana (PPAG) is one of the most active nongovernmental organizations delivering reproductive health (RH) services in Ghana, focusing particularly on youth issues and services. USAID suggested to the Population Council’s Africa OR/TA Project II staff that PPAG might benefit from technical assistance. A large and well-funded IPPF program to promote sexual health among youth of the Volta Region offered a good opportunity to begin OR work. Earlier, the program was envisioned as a demonstration educational program of five years duration. Further discussions suggested that this program was unlikely to be duplicated anywhere, because of its …
Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob
Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob
Reproductive Health
The national family planning and maternal child health (FP-MCH) program in Bangladesh has raised FP acceptance among couples of reproductive age significantly. A major challenge still facing the program, however, is strengthening its reproductive health (RH) component. The Population Council launched a pilot project to examine the feasibility of strengthening comprehensive reproductive tract infection (RTI) and sexually transmitted disease (STD) services at the Health and Family Welfare Center level. The project had three phases. First, a needs assessment was conducted. Then the components of the intervention were identified, designed, and implemented. And at the third phase, an evaluation was carried …
Strengthening The Utilization Of Family Planning Operations Research: Findings From Case Studies In Africa, Julie Solo, Annamaria Cerulli, Robert A. Miller, Ian Askew, Elizabeth Pearlman
Strengthening The Utilization Of Family Planning Operations Research: Findings From Case Studies In Africa, Julie Solo, Annamaria Cerulli, Robert A. Miller, Ian Askew, Elizabeth Pearlman
Reproductive Health
The goal of undertaking operations research (OR) on family planning (FP) and reproductive health (RH) services is to strengthen the ability of programs and policies to maximize access to and quality of these services. This report addresses the need for a greater understanding of how information from OR studies is utilized. The Africa OR/TA Project II undertook a study to assess the extent to which information from OR studies conducted under the Africa OR/TA Project I (1988–1993) was utilized. The study also examined the factors influencing how study results were utilized. Case studies of several OR projects were undertaken to …
Increasing Demand For Reproductive Health Services In A Peruvian Clinic, Federico R. Leon, Anibal Velasquez, Lissette Jimenez, Alicia Calderon
Increasing Demand For Reproductive Health Services In A Peruvian Clinic, Federico R. Leon, Anibal Velasquez, Lissette Jimenez, Alicia Calderon
Reproductive Health
Over the past few years, well-established family planning (FP) organizations in developing countries, such as INPPARES, the IPPF affiliate in Peru, have strived to implement the Cairo Agenda. In the process of including reproductive health (RH) in FP care, they have dedicated human resources and infrastructure to provide RH services seldom offered in the past. The problem these organizations now face is to increase use of the newly available RH care. Currently, clients seeking FP services may leave clinics unaware of the other RH care provided. At a time when international donors are phasing out financial assistance, the partially idle …
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Reproductive Health
Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …
Factors Affecting The Outputs And Costs Of Community-Based Distribution Of Family Planning Services In Tanzania, Jane Chege, Naomi Rutenberg, Barbara Janowitz, Andrew Thompson
Factors Affecting The Outputs And Costs Of Community-Based Distribution Of Family Planning Services In Tanzania, Jane Chege, Naomi Rutenberg, Barbara Janowitz, Andrew Thompson
Reproductive Health
This study assesses the cost-effectiveness of reimbursement schemes for community-based distribution (CBD) programs in Tanzania, and answers whether agents who receive monetary incentives perform better and are more cost-effective than those that receive nonmonetary incentives. Fieldwork was undertaken in April and May 1997, and data forming the basis of the analysis was collected from four CBD programs. These programs vary in their remuneration schemes and status of their CBD agents, size, and geographical coverage; the range of activities undertaken by the agents; and supervision and management structures. As noted in this report, CBD agents who receive monetary remuneration see more …
Youth Talk About Sexuality: A Participatory Assessment Of Adolescent Sexual And Reproductive Health In Lusaka, Zambia, Tamara Fetters, Evans Mupela, Naomi Rutenberg
Youth Talk About Sexuality: A Participatory Assessment Of Adolescent Sexual And Reproductive Health In Lusaka, Zambia, Tamara Fetters, Evans Mupela, Naomi Rutenberg
Reproductive Health
Thirty-six percent of Zambia’s 9 million inhabitants are between 10 and 19 years of age, and most adolescents are sexually active by their mid-teens. Pregnant teenagers have an elevated risk of maternal mortality and complications related to birth. In 1990, at Lusaka’s University Teaching Hospital, self-induced abortion accounted for up to 30 percent of maternal mortality, and one-quarter of these deaths occurred in women under 18 years. Sexually transmitted infections (STIs) are a major health problem for adolescents, yet only a small proportion protect themselves from pregnancy and STIs. There are many barriers to improving the situation, including opposition by …
Getting Men Involved In Family Planning: Experiences From An Innovative Program, Directorate Of Family Planning, National Institute Of Population Research And Training, Population Council
Getting Men Involved In Family Planning: Experiences From An Innovative Program, Directorate Of Family Planning, National Institute Of Population Research And Training, Population Council
Reproductive Health
This study was designed to determine the effect of interventions on accelerated proactive male involvement in family planning (FP) and factors influencing acceptance of male contraceptive methods. It was observed that a program can be successful if management cadres can be motivated and involved in the process. Other findings suggest the importance of education and communication materials, supply of information, orientation of fieldworkers, and mobilization of resources including hands-on refresher training. Misconceptions about male contraception (particularly vasectomy) are rampant in traditional Bangladeshi society, thus ideas should be positively expressed through visual aids. Among the various communications materials, at least one …
Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain
Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain
Reproductive Health
The project "Involving Private Medical Practitioners (PMPs) in Family Planning Services" is an innovative initiative to involve PMPs in protecting the reproductive health (RH) of couples, attract private investment in the family planning (FP) sector, and eventually reduce the increasing financial pressure on the government. The project was implemented in two phases. In phase I, qualified PMPs from urban areas were given training on FP. In phase II, nonqualified PMPs were given training on FP. PIACT Bangladesh, a local NGO, conducted two pilot projects to involve the PMPs in FP. The first one was to involve qualified PMPs in urban …
Family Planning Operations Research: A Book Of Readings, James R. Foreit, Tomas Frejka
Family Planning Operations Research: A Book Of Readings, James R. Foreit, Tomas Frejka
Reproductive Health
For as long as there have been family planning programs, there has been family planning research. At the theoretical level, researchers examine the effect of fertility on health and socioeconomic development and study the determinants of fertility for individuals and populations. At the policy level, studies explore the role of family planning programs in modifying fertility and health. The development of new contraceptives is accompanied by clinical and pre-introductory trials in program settings. Surveys measure changes in contraceptive use and fertility, and the results are used to make decisions affecting programs. Finally, programs themselves carry out operations research (OR) to …
Do Population Policies Matter? Fertility And Politics In Egypt, India, Kenya, And Mexico, Anrudh K. Jain
Do Population Policies Matter? Fertility And Politics In Egypt, India, Kenya, And Mexico, Anrudh K. Jain
Reproductive Health
How are effective population policies articulated and implemented? Have international agencies played a strong role in prompting developing-country governments to adopt and implement strong population policies? How has the international debate influenced deliberations on population issues in developing countries? The impetus for the four country studies presented in this book was provided by a desire to better understand some of these issues within specific contexts. Egypt, India, Kenya, and Mexico were selected because of their demographic weight, a long history of population policies and programs, and evidence of fertility decline. The four country studies examine the influence of many forces …
Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi
Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi
Reproductive Health
Family planning (FP) and maternal and child health (MCH) in Bangladesh have achieved commendable success in the recent past, mostly through a large-scale government service-delivery system supported by donors and nongovernmental organizations. Although encouraged by this success, there was concern about programmatic, financial, and social sustainability of the program, including quality of services. It is now believed that most of these concerns will be taken care of if effective community participation can be ensured. A pilot project was initiated in 1997 in Anowara, a low-FP-performing area in rural Chittagong, with assistance from the Population Council. The main objective of the …
Management Support For Postabortion Operations Research At The Egyptian Fertility Care Society, Population Council
Management Support For Postabortion Operations Research At The Egyptian Fertility Care Society, Population Council
Reproductive Health
The ANE OR/TA Project started its first five-year phase in 1991 addressing increased choice and accessibility of contraceptive use, promoting quality of family planning (FP) services in Asia and the Near East, and promoting the use of operations research (OR) to solve service-delivery problems. The first phase emphasized human resource development. During the years leading up to the 1994 International Conference on Population and Development, there was increased global attention to issues related to reproductive health (RH), and in particular the adverse health implications of harmful RH practices, including unsafe abortion. OR was being called upon to help implement this …
Follow-Up Household Survey In Agra District, Jayanti Tuladhar, R.B. Gupta, V.S. Sridhar, Tilak Mukherjee
Follow-Up Household Survey In Agra District, Jayanti Tuladhar, R.B. Gupta, V.S. Sridhar, Tilak Mukherjee
Reproductive Health
This follow-up household survey in Agra District, India, was conducted with funding from USAID under the Population Council’s Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. The main objective of this study, as noted in this report, is to assess changes in the program indicators of family welfare activities, including some of the selected reproductive health indicators, from 1995 (before method-specific targets were withdrawn) and 1997 (30 months after targets were withdrawn). The study’s objectives are to detect changes in FP knowledge and use among currently married women in rural areas; detect changes in level of …
Follow-Up Household Survey In Sitapur District, Jayanti Tuladhar, R.B. Gupta, B.P. Thiagrajan, Tausif Alam Khan, Hemlata Sadhwani
Follow-Up Household Survey In Sitapur District, Jayanti Tuladhar, R.B. Gupta, B.P. Thiagrajan, Tausif Alam Khan, Hemlata Sadhwani
Reproductive Health
This follow-up household survey in Sitapur, India, was conducted with funding from USAID under the Population Council's Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. The main objective of the study, as noted in this report, is to assess changes in the program indicators of family welfare activities, including some of the selected reproductive health indicators, from 1994–95 (before the method-specific targets were withdrawn) and 1997 (30 months after the targets were withdrawn). The study has the following immediate objectives: detect changes in family planning (FP) knowledge and use among currently married women in rural areas; …
Observations From A Study Tour Of Bangladesh And Indonesia On Their Family Welfare Programme, M.E. Khan, Jayanti Tuladhar, R.B. Gupta, Ubaidur Rob, Meiwita B. Iskandar
Observations From A Study Tour Of Bangladesh And Indonesia On Their Family Welfare Programme, M.E. Khan, Jayanti Tuladhar, R.B. Gupta, Ubaidur Rob, Meiwita B. Iskandar
Reproductive Health
Bangladesh has a successful family planning (FP) program and has succeeded in bringing about a demographic transition at a much faster rate than many of its neighboring countries. The contraceptive prevalence rate in Bangladesh increased from 3 percent in 1971 to 45 percent in 1993, and the fertility rate decreased from 7.0 to 3.4 births per woman during the same period. This reflects the effort that the Government of Bangladesh, with the help of international agencies, has made to educate couples about FP and increase access and choice of contraceptive methods, even in remote areas. Another predominantly Muslim country that …
Monitoring Of Macro-Level Family Planning Quality Of Care Indicators, Meiwita B. Iskandar
Monitoring Of Macro-Level Family Planning Quality Of Care Indicators, Meiwita B. Iskandar
Reproductive Health
The success of population development in Indonesia can be seen partly from success in reducing population growth. Population growth has declined from 2.32 percent (1971–80) to 1.98 percent (1980–90), and then to 1.66 percent (1990–95). The continued slowing of population growth is expected to bring expanded opportunities for economic development and improved quality of life. The success of family planning (FP) programs cannot be judged solely on reduction of population growth but should also be judged in terms of quality of care (QOC) and success in helping women achieve their reproductive goals. The Indonesian National Family Planning Coordinating Board (BKKBN) …
Technical Assistance To Enhance The Institutionalization Of Operations Research Within The Philippines Family Planning Program, Population Council
Technical Assistance To Enhance The Institutionalization Of Operations Research Within The Philippines Family Planning Program, Population Council
Reproductive Health
This technical assistance project supports the goal of the Asia Near East Operations Research and Technical Assistance (ANE OR/TA) project of helping strengthen family planning (FP)/reproductive health (RH) operations research (OR) capabilities in the Philippines. During the extension period of the ANE OR/TA project, four OR studies were implemented in the Philippines dealing with cross-cutting issues, including a study to assess the feasibility of integrating RTI management within FP/MCH programs; an intervention study dealing with improving quality of care via expanded FP counseling; an intervention to address high unmet need in Pangasinan Province; and an intervention study to increase male …
Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez
Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez
Reproductive Health
Recent years have been characterized by an increasing consensus that, in order to support women's goals and aspirations, health programs directed to the improvement of women's and children's health must consider men's perspectives. Although family planning (FP) is often viewed as the woman's responsibility, men have an important role in decisions of whether FP will be practiced and which method will be used. Even though gender relations in the Philippines are often characterized as being relatively egalitarian, there are several reasons for believing that male involvement in FP is highly relevant for this country. Studies indicate that not only are …
Improving Quality Of Care In Fp/Rh Of Selected Communities Of Pangasinan Province: An Intervention Study, Zelda C. Zablan, Josefina V. Cabigon, Luzviminda Muego, Marilou P. Costello, Chona R. Echavez
Improving Quality Of Care In Fp/Rh Of Selected Communities Of Pangasinan Province: An Intervention Study, Zelda C. Zablan, Josefina V. Cabigon, Luzviminda Muego, Marilou P. Costello, Chona R. Echavez
Reproductive Health
This intervention study was designed to improve the quality of family planning (FP) services within the Integrated Family Planning and Maternal Health Program of the Pangasinan Population and Family Planning Program in the Philippines. It addresses high unmet need and studies the feasibility of enhancing quality of services by training service providers in fixed clinics and orienting outreach workers on the method of identifying women who have unmet need for FP. Four municipalities were chosen from the 47 municipalities comprising the province of Pangasinan and randomly assigned to experimental and control groups. Four indicators were used to match the chosen …
Dual Protection In An Integrated Community-Based Program: A Case Study Of Tanzania Family Health/Ministry Of Health Project In Mbeya, Grace Mbekem, Jane Chege
Dual Protection In An Integrated Community-Based Program: A Case Study Of Tanzania Family Health/Ministry Of Health Project In Mbeya, Grace Mbekem, Jane Chege
Reproductive Health
One of the most pressing challenges for health programs in most sub-Saharan African countries is effectively addressing the increasing prevalence of HIV/AIDS. Recent evidence suggests that controlling sexually transmitted diseases (STDs) through undertaking preventive measures, early diagnosis, and treatment significantly slows the spread of HIV/AIDS. In regard to STI/HIV, Maternal and Child Health (MCH) and Family Planning (FP) clients are described as “low risk” groups. However, in a number of sub-Saharan African countries, the reported levels of STDs are significantly high enough to justify use of limited resources to target this group for STD services. MCH/FP programs have begun to …