Health Services Research Commons^™

Unsafe Abortion In Kenya: Findings From Eight Studies, Khama Rogo, Ann Leonard

Reproductive Health

One of the most topical areas in reproductive health today is the consequences of induced and often unsafe abortion. Safe motherhood initiatives continue to highlight the contribution of unsafe abortion to the persistent high rates of maternal mortality and morbidity in sub-Saharan Africa. In some countries, unsafe abortion is responsible for up to half of all maternal mortality and morbidity, with adolescents constituting a significant proportion of those procuring unsafe abortions. In Kenya, concern about the problem of incomplete and septic abortion has increased, particularly on the part of service providers who must treat women suffering from the complications of …

Learning About Sexuality: A Practical Beginning, Sondra Zeidenstein, Kirsten Moore

Poverty, Gender, and Youth

“Learning About Sexuality: A Practical Beginning” is divided into three main parts. The first includes approaches that program staff, activists, and researchers are taking to understand people’s experiences of sexuality. The second explores the explicit and implicit links among health-seeking behavior, contraceptive practice, reproductive health, and sexuality. The chapters in part three focus on activities that challenge entrenched attitudes and behavior about sexuality that have real and potentially harmful effects on women’s and men’s reproductive health. The book features program and research work in all regions of the world with women, men, girls, and boys. The chapters are written by …

Inopal Ii Final Report, Population Council

Reproductive Health

The goal of the Population Council's “Investigación Operacional en Planificación Familiar y Atención Materno-Infantil para América Latina y el Caribe” (INOPAL) program was to conduct operations research and provide technical assistance to improve the coverage, quality, and sustainability of family planning (FP) services in Latin America and the Caribbean. INOPAL II was the successor to INOPAL I (1984–1989). Like its predecessor, INOPAL II was supported by a contract from the USAID Office of Population, when it was replaced by a new USAID-funded project, INOPAL III. INOPAL II objectives included: expanding access to FP services, improving the operations of programs by …

Indonesia: Utilization Of Completed Operations Research Studies, Meiwita B. Iskandar, Subadra Indrawati

Reproductive Health

In the past eight years, many operations research (OR) programs were implemented in Indonesia to increase the availability, accessibility, and acceptability of services desired by family planning (FP) users. OR has also been employed to improve quality and sustainability by studying the performance, efficiency, and effectiveness of services delivered by providers. Nonetheless, relatively little is known about the true effects of OR studies in identifying and solving program problems in order to support the planning and coordinating of a particular program. Measuring utilization of OR results is not simple. In 1989, USAID signed its last bilateral assistance agreement with the …

Proceedings Of The Operations Research Training Workshop: Mainstreaming Nfp In The Public Sector, August 15-18, 1996, Family Planning Service, Philippine Federation For Natural Family Planning, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This report summarizes the proceedings of the “Operations Research Training Workshop: Mainstreaming Natural Family Planning in the Public Sector,” held August 15-18, 1996, in Boracay, Aklan, Philippines. The workshop was sponsored by the Philippine Federation for Natural Family Planning (NFP), the Family Planning Service of the Department of Health, and the Family Planning Operations Research and Training (FPORT) Program of the Population Council, Manila. Program managers and health officials were trained in operations research (OR) to enhance their understanding and appreciation of OR and its role in integrating NFP technology in the public health sector. Results of several diagnostic and …

Dmpa Injectable Use: Findings From The 21-Month Dmpa Monitoring Study, Population Council

Reproductive Health

This report presents the results of the DMPA Monitoring Study undertaken by the Population Council, Manila, as a technical assistance project for the DMPA Reintroduction Program of the Department of Health. The primary objective is to provide data on DMPA utilization and continuation rates to project the logistical needs of the program during the next three years. Data on availability of DMPA supplies and IEC (information, education, and communication) materials relating to DMPA were also monitored to provide some measure of effectiveness of the program's distribution system. The study covers a 21-month observation period from April 1994 to December 1995 …

Proceedings Of The Operations Research Workshop For Lgu Health And Population Officials And Researchers, August 9-13, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This report summarizes the results of the training workshop for health and population officials and researchers who gathered in Boracay, Aklan, Philippines, on August 9-13, 1996, to discuss the tenets and applications of operations research (OR). This workshop was co-sponsored by the Family Planning Service of the Department of Health (DOH) and the Family Planning Operations Research and Training Program of the Population Council, Manila. Fourteen local government units (LGUs) were represented in the workshop: Benguet, Cagayan, Ilocos Sur, Tarlac, Quezon City, Capiz, Negros Oriental, Bacolod, Misamis Oriental, Davao del Sur, Davao City, Maguindanao, North Cotabato, and South Cotabato. They …

The Dmpa Service Provider: Profile, Problems And Prospects—Philippines, Maria Carmela Patron, Marilou P. Costello

Reproductive Health

This report presents the results of interviews conducted with 60 trained DMPA service providers from seven of the ten local government units (LGUs) covered by Phase I of the Philippine Department of Health's DMPA Reintroduction Program. DMPA, or Depot-medroxyprogesterone acetate, is an injectable contraceptive commonly known as Depo-Provera. The interviews were undertaken as part of the DMPA Monitoring and Follow-up Studies sponsored by the Population Council under the Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. While the monitoring study and the follow-up survey focused on DMPA users and dropouts, this study centered on the service …

A Model Of Costs Of A Cbd Programme, Saumya Ramarao, John Townsend, M.E. Khan

Reproductive Health

This study is a collaborative effort of the Population Council, New Delhi, and the Centre for Development and Population Activities, New Delhi. Cost analysis is an analytical tool that provides program managers and planners with information about existing and potential programs. Existing programs can be evaluated for efficiency and effectiveness, while the resource requirements of future programs can be estimated. In the context of family planning (FP) programs, cost analysis provides policymakers and program managers with sufficient data on efficient ways to meet the demand for FP services with available resources. As FP programs mature and requirements for the resources …

Development Of Approaches To Community Based Family Planning Outreach In Egypt: Assessment Of Raidats Rifiats Program, Population Council

Reproductive Health

Egypt’s family planning program officially began in 1965. Impressive gains in contraceptive use have been made since 1980, and the contraceptive prevalence rate increased from 24 percent in 1980 to 47 percent in 1992. Egypt’s National Population Policy addresses the nation’s population growth through multiple interventions designed to reduce fertility, including family planning (FP) services. FP accessibility is promoted through a network of public and NG0 FP clinics. A number of years ago, the Egyptian Family Planning Program began using the Raidats Rifiats program to extend services into rural communities. There is concern regarding the program’s ability to recruit women …

Experience With The Dmpa Injectable Contraceptive: Findings From A Survey Of Dmpa Acceptors, Maria Carmela Patron, Marilou P. Costello

Reproductive Health

This report presents the results of a survey of 899 DMPA acceptors who availed of injectable contraceptive services from public health facilities under the Philippine Department of Health's (DOH) DMPA Reintroduction Program. The survey is part of the DMPA Monitoring and Follow-up Studies sponsored by the Population Council’s Manila office in response to a request by the DOH to provide operations research support to the program. Depot-medroxyprogesterone acetate (DMPA), commonly known as Depo-Provera, is a three-month injectable contraceptive. It was recently officially endorsed as a family planning (FP) program method by the DOH, following its approval by the Philippine Bureau …

Report On Norplant® Implants In Indonesia, Andrew A. Fisher, Soledad Diaz, Alejandro N. Herrin, Joedo Prihartono

Reproductive Health

At the request of the Indonesian National Family Planning Coordinating Board, the Population Council’s consultant team reviewed issues related to Norplant® implant service delivery in Indonesia and recommended specific areas for new initiatives, improvements, and further research. The team reviewed secondary sources on the subject and visited Indonesia from April 17–28, 1995. They talked with family planning (FP) officials and observers and made field visits to West Java and Yogyakarta. This report reviews important issues facing the national FP program, particularly regarding Norplant insertions and removals. Program approaches are included, as are an outline for a national assessment study that …

Dmpa Monitoring Study: Findings On Use And Continuation Rates, Population Council

Reproductive Health

This report presents the results of the DMPA Monitoring Study undertaken by Population Council, Manila, as a technical assistance project for the DMPA Reintroduction Program of the Department of Health. The primary objective of the study is to provide data on DMPA (injectable contraceptive) utilization and continuation rates that may be used to project the logistical needs of the program for the next four years (1995–1998). Availability of DMPA supplies, and information, education, and communication (IEC) materials on DMPA in the facilities were also monitored to provide some measure of the effectiveness of the distribution system. The study covers a …

Improving The Counseling And Medical Care Of Postabortion Patients In Egypt, Population Council, Egyptian Fertility Care Society

Reproductive Health

This pilot study conducted in Cairo and Minya examined the effects of improving the medical care and counseling of post-abortion patients in Egypt. A pre-test/post-test, no control group study design was used to measure the effects of an intervention that upgraded physicians' clinical and interpersonal communication skills for the care of post-abortion patients, including counseling and family planning (FP). The study's surveys utilized direct interviews with staff working in the OB/GYN wards, structured observations of treatment procedures and counseling of post-abortion patients, and interviews with patients prior to discharge. Changes in the clinical management of post-abortion patients were introduced through …

An Exploratory Study Of The Psycho-Social Stress Associated With Abortions In Egypt, Dale Huntington, Laila Nawar, Dalia Abdel Hady

Reproductive Health

An operations research study was conducted to investigate the concerns of postabortion patients in Egypt to improve counseling that women receive. A corollary use of the study results is the development of sensitive survey research questions for measuring incidence of induced abortion. This study utilized qualitative research methods by conducting in-depth interviews with postabortion patients in El Galaa and El Menia University Hospitals and focus group discussions with family planning clients and noncontracepting women. For all types of postabortion patients the most salient issue was physical survival of an extremely painful experience. All postabortion patients were acutely concerned about their …

Improving Community Based Family Planning Services And The Potential For Increasing Contraceptive Prevalence In Bangladesh, Amy Gale Dunston, Peter C. Miller

Reproductive Health

This report contains descriptions of 13 family planning (FP) projects recently implemented in Bangladesh. The results in terms of the contraceptive prevalence rate (CPR) are analyzed to investigate the degree to which improved FP service delivery in Bangladesh can increase contraceptive use in the present status of demand, investigate the programmatic factors most associated with increased prevalence, and make these projects more widely known. Criteria for inclusion included coverage of a geographic area where household distribution of contraceptive supplies was available, and where at least one measurement of CPR has been made through credible survey efforts since July 1988. The …

Support For Research, Dissemination, Utilization, And Policy In Bangladesh, Ubaidur Rob, Donna Nager

Reproductive Health

Through the initiative of the Family Planning Fortnight: Meeting the Future Challenges, held in December 1993, the Government of Bangladesh made a policy statement about the critical importance of dealing with the nation's population problem. The Fortnight provided the strategic framework for developing actions to strengthen the National Family Planning Program that would meet the country's population challenges. To initiate rapid action, the Family Planning Fortnight Steering Committee, under the chairmanship of the Secretary, Ministry of Health and Family Welfare, formed a working group to prepare a report that would capitalize on all earlier efforts and lay out a plan …

Knowledge, Attitudes And Practice Of The Dmpa Injectable Contraceptive: Data From Focus Group Discussions, Maria Carmela Patron, Marilou P. Costello

Reproductive Health

This report is based on data from 12 focus group discussions conducted throughout the Philippines as part of the DMPA Monitoring and Follow-up Studies. The DMPA Monitoring and Follow-up Studies are part of a technical assistance project undertaken by the Population Council in support of the Department of Health’s DMPA Reintroduction Program. The project provides data on DMPA (depot-medroxyprogesterone acetate) acceptance and continuation rates as well profiles of DMPA users and dropouts to serve as bases for decisions and policies that will ensure quality services. The project draws information from several sources including a 15-month monitoring of DMPA acceptors; surveys …

Current Experiences With Community-Based Distribution Of Family Planning In Kenya: A Review Prepared For Usaid/Kenya, Population Council

Reproductive Health

Kenya has been one of the leading countries worldwide in developing and implementing community-based distribution (CBD) programs as part of the national family planning (FP) program. CBD activities in Kenya are coordinated by the National Council for Population and Development, with support from USAID and other donor agencies. Kenya’s CBD program has been widely publicized because of its success in improving access to FP information and services, and its diversity of organizational structures. USAID would like to review the current situation and possible future directions before designing its CBD strategy for the next five-year bilateral project. The Africa OR/TA II …

Quality Of Care In Family Planning Service Delivery In Kenya: Clients' And Providers' Perspectives, Lewis Ndhlovu

Reproductive Health

In recent years, the increasing number of organizations that have studied quality of care in international family planning (FP) programs demonstrates the importance the topic has acquired. To define quality of care in FP, the Bruce–Jain framework of six elements of care (choice of methods, information given to clients, technical competence, interpersonal relations, continuity and follow up, and appropriate constellation of services) have been used as the standard. However, what has been overlooked in this approach is the clients' perspectives of service quality. This study sought to narrow the gap in knowledge about the comparability and consistency in views between …

Quantitative Economic Evaluations Of Hiv-Related Prevention And Treatment Services: A Review, David R. Holtgrave, Ronald O. Valdiserri, Gary A. West

RISK: Health, Safety & Environment (1990-2002)

Dr. Holtgrave and colleagues at the CDC set forth an extensive taxonomy of HIV prevention and treatment services and review reports of efforts to subject some of those services to formal economic evaluation. They find few services thus far to have been so evaluated, no evaluation to have focused solely upon behavioral outcomes and most economic evaluations to lack formal quantitative analyses.

Factors That Contribute To The Varying Performance Of Bspos And Bhws In The Delivery Of Family Planning Services In Iloilo City, Fely David, Fely Chin

Reproductive Health

In 1992, the Population Council established the Family Planning Operations Research and Training (FPORT) Program in the Philippines. It brought together program managers and regional researchers to identify problem areas that might benefit from operations research. From Western Visayas (Region VI), the City Population Office (CPO) of Iloilo City in collaboration with the Social Science Research Institute of the Central Philippine University, identified a problem concerning the poor performance of volunteer family planning (FP) workers and undertook to study it. The study focused on the Barangay Service Point Officers (BSPOs) who assist in the delivery of FP services under the …

Planning Services In Iloilo City: A Diagnostic Study Of The Implementation Of The Department Of Health Training Courses For Family Planning Providers In Region Ii And Cordillera Administrative Region, Steven Rood, Marcelo Raquepo, Mary Ann Ladia

Reproductive Health

This research project is one of several being undertaken in the Philippines under the Family Planning Operations Research and Training (FPORT) Program of the Department of Health (DOH) and the Population Council. The general aim of FPORT is to train researchers to provide information to family planning (FP) practitioners that will be of value in the operation of FP programs. It was decided that researchers in northern Luzon would focus on FP trainings undertaken by the Department of Health. Several meetings among researchers and health personnel were held to shape research questions that would be of use to the DOH …

Could Distance Be A Proxy For Severity-Of-Illness? A Comparison Of Hospital Costs In Distant And Local Patients., H G. Welch, E B. Larson, W P. Welch

Dartmouth Scholarship

We test the hypothesis that hospital costs, after adjusting for DRG mix, are higher in distant patients than in local patients. Data were obtained from the Washington State Commission Hospital Abstract Reporting System (CHARS) and included all patients discharged from 15 metropolitan hospitals in the state of Washington during fiscal year 1987 (N = 181,072).

Family Planning And Population: A Compendium Of International Statistics, John A. Ross, W. Parker Mauldin, Vincent C. Miller

Poverty, Gender, and Youth

This volume provides statistics on all large-scale family planning (FP) programs in the developing world, together with selected demographic and socioeconomic statistics. Time trends are given for some indicators, and data are arranged for comparative analysis across countries. Where available, time trends go back to the mid-1980s. This volume’s predecessor, published in 1992, should be consulted for earlier demographic and socioeconomic data, and for tables on maternal and child health indicators that are not repeated here. The data on FP programs come from a series of three questionnaires sent since 1987 to 100 developing countries, which have generally been kept …

Manual Para El Diseño De Investigación Operativa En Planificación Familiar, Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

El Manual para el diseño de investigación operativa en planificación familiar, publicado por primera vez en inglés por el Population Council en 1983, se basó en las experiencias de los autores en investigaciones operativas en Asia. Esta segunda edición contiene secciones revisadas y aumentadas. En su caso, se han agregado ejemplos de América Latina y África. En la Introducción se hace una revisión completa y actualizada del desarrollo de la investigación operativa (IO) en salud y planificación familiar. Se han agregado nuevos capítulos sobre la selección de la intervención a ser probada en un investigación operativa sobre la descripción de …

Handbook For Family Planning Operations Research Design, Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

The Handbook for Family Planning Operations Research Design, first published in English by the Population Council in 1983, was based on field research studies in Asia. This second edition contains revised and expanded sections. Where appropriate, examples from Latin America and Africa have been added. The introductory section contains a current statement on the process of health and family planning operations research (OR). New chapters have been included on selecting an appropriate intervention to test in an OR study, and on describing the main elements of the study intervention. The chapter on information dissemination has been expanded and a new …

Handbook For Family Planning Operations Research Design [Arabic], Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

"The Handbook for Family Planning Operations Research Design," first published in English by the Population Council in 1983, was based on field research studies in Asia. This second edition contains revised and expanded sections. Where appropriate, examples from Latin America and Africa have been added. The introductory section contains a current statement on the process of health and family planning operations research (OR). New chapters have been included on selecting an appropriate intervention to test in an OR study, and on describing the main elements of the study intervention. The chapter on information dissemination has been expanded and a new …

Trends In Hospital And Nursing Home Care Expenditures, Maine, 1982 To 1986, Maine Department Of Human Services

Maine Collection

Trends in Hospital and Nursing Home Care Expenditures, Maine, 1982 to 1986

Maine Department of Human Services - Office of Data, Research, and Vital Statistics

John R. McKernan, Jr., Governor, Rollin Ives, Commissioner, Brenda Smith, Planning and Research Associate, May, 1989.

"This report produced under Appropriation No. 1310-4010."

Contents: Introduction / Hospital Care Expenditures / Nursing Home Care Expenditures / Comparison of Hospital and Nursing Home Care Expenditure Trends / Concluding Remarks / References

Acute Care Bed Need In Maine: General Use Acute Care Facilities In Maine : Utilization, Occupancy Rates, And Bed Need Projected To 1990 And 1995, Stephen Greenberg

Maine Collection

Acute Care Bed Need in Maine: General Use Acute Care Facilities in Maine : Utilization, Occupancy Rates, and Bed Need Projected to 1990 and 1995

by Stephen Greenberg, Planning and Research Associate, Office of Data, Research, and Vital Statistics.

Prepared at the request of the Division of Planning, Bureau of Health, Maine Department of Human Services.

Produced under Appropriations 1310.4, 1305.1065 and 2210.2950 (November, 1988).

Contents: Overview and Discussion of Findings / Using the Data: An Example / List of Detailed Tables / Appendices