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Full-Text Articles in Health Services Research

Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez Jan 1998

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 …


Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez Jan 1997

Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez

Reproductive Health

A Situation Analysis (SA) was conducted in seven local government health centers as part of a larger project studying the feasibility of integrating RTI services within the existing Family Planning/Reproductive Health Program of the Department of Health (DOH). The SA was part of a series of baseline activities conducted by the Family Planning Operations Research and Training Project as part of its study on Integrating RTI Management in Local Government Unit Health Centers. It was conducted by Population Council, Manila, for the DOH. Participating health centers were located in a large and highly urbanized community, a medium-sized city, and two …


Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings Jan 1997

Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings

Reproductive Health

In Kenya, as throughout the world, the health consequences of unsafe abortion for women of reproductive age are significant. Hospital-based studies in Nairobi have shown that unsafely induced abortion accounts for as much as 35 percent of pregnancy-related mortality and at least 50 percent of hospitals’ gynecological admissions. The concept of postabortion care (emergency treatment, postabortion family planning counseling and services, links between emergency abortion treatment services and comprehensive reproductive health care) has gained wide acceptance as one model of providing comprehensive care to women suffering from abortion complications. Integration of these three components is rarely found in public health …


Using A Rapid Assessment Approach To Evaluate The Quality Of Care In An Integrated Program: The Experience Of The Family Health Division, Ministry Of Health, Botswana, Lucy Sejo Maribe, Baker Ndugga Maggwa, Ian Askew, Kate Miller Jan 1997

Using A Rapid Assessment Approach To Evaluate The Quality Of Care In An Integrated Program: The Experience Of The Family Health Division, Ministry Of Health, Botswana, Lucy Sejo Maribe, Baker Ndugga Maggwa, Ian Askew, Kate Miller

Reproductive Health

To strengthen existing efforts by the Government of Botswana in responding to the HIV/AIDS epidemic, USAID provided financial and technical assistance through the Botswana Population Assistance (BOTSPA) project. BOTSPA’s goal was to improve the quality and availability of family planning (FP) and sexually transmitted infection (STI) services through designing, implementing, and monitoring activities that would lead to the eventual institutionalization and sustainability of high-quality FP and STI/HIV/AIDS services. The Ministry of Health requested assistance from the Africa OR/TA Project II to develop and test an approach for routinely measuring the quality of service delivery and assessing skills retention by staff …


Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew Jan 1997

Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew

Reproductive Health

Sub-Saharan Africa is confronting an HIV/AIDS epidemic and virtually all health programs in the region are seeking ways of preventing and reducing the spread of this virus. To compound the problem, the presence of certain sexually transmitted infections (STIs) is known to increase risk of the sexual transmission of HIV. The sub-Saharan region is believed to have some of the highest levels of STIs in the world, thus controlling STIs is not only an important reproductive health care strategy in itself but also a key strategy in reducing the spread of HIV. The strongest evidence to support this has come …


Traditional Family Planning In Bangladesh, Alan Gray, Jamil H. Chowdhury, Bruce Caldwell, Ahmed Al-Sabir Jan 1997

Traditional Family Planning In Bangladesh, Alan Gray, Jamil H. Chowdhury, Bruce Caldwell, Ahmed Al-Sabir

Reproductive Health

“Traditional” methods of family planning (FP) generally are methods such as withdrawal and periodic abstinence that do not require contraceptive substances or devices, or clinical procedures. In 1991, approximately 38 million couples worldwide relied on withdrawal to prevent pregnancy, and 30-35 million relied on periodic abstinence. Together, these constituted one-quarter of all users of temporary methods of FP worldwide. In Bangladesh, the proportion using periodic abstinence or withdrawal was more than 20 percent of users of temporary methods. The reasons for use of traditional methods have not been investigated in Bangladesh, because of overriding attention to modern methods. Given that …


Improved Reproductive Health And Std Services For Women Presenting To Family Planning Services In North Jakarta. Final Report Of Activities, Meiwita B. Iskandar, Catherine Vickers, Subadra Indrawati, Siti Nurul Qomariyah Jan 1997

Improved Reproductive Health And Std Services For Women Presenting To Family Planning Services In North Jakarta. Final Report Of Activities, Meiwita B. Iskandar, Catherine Vickers, Subadra Indrawati, Siti Nurul Qomariyah

Reproductive Health

The overall goal of this study was to develop an integrated program of reproductive tract infection/sexually transmitted disease (RTI/STD) clinical services within two family planning clinics in low-income neighborhoods in North Jakarta. Multiple training programs to introduce a standardized clinical evaluation for the detection, treatment, and management of RTI/STDs were conducted. Prior and subsequent to training, observations of health care provider (HCP) and client interactions were conducted to evaluate behavior changes among HCPs. Each consenting client received a standardized reproductive health history, a pelvic exam, and provided specimens for laboratory testing to detect RTIs. Through universal screening of the participants …


An Assessment Of Clinic Based Family Planning Services In Kenya: Results From The 1995 Situation Analysis Study, Lewis Ndhlovu, Julie Solo, Robert A. Miller, Kate Miller, Achola Ominde Jan 1997

An Assessment Of Clinic Based Family Planning Services In Kenya: Results From The 1995 Situation Analysis Study, Lewis Ndhlovu, Julie Solo, Robert A. Miller, Kate Miller, Achola Ominde

Reproductive Health

This study’s objective was to assist the Kenya Ministry of Health (MOH), the National Council for Population and Development (NCPD), NGOs, and donor agencies in planning the expansion and improvement of family planning (FP) and other reproductive health (RH) services provided in Kenya. Data on the functioning of program subsystems and the quality of care provided were collected in May 1995 from 254 maternal and child health/family planning (MCH/FP) facilities throughout the country using a situation analysis approach. The study sample included a representative sample of facilities from the MOH and NGO sectors. It also included a census of all …


Reproductive Behavior Among Muslims In Uttar Pradesh, M.E. Khan, Bella C. Patel Jan 1997

Reproductive Behavior Among Muslims In Uttar Pradesh, M.E. Khan, Bella C. Patel

Reproductive Health

Muslims form the largest minority group in India, according to the 1991 census, constituting about 12 percent of the country's population. India has the second largest Muslim population in the world. The growth rate of the Muslim population in India during the last three decades is somewhat higher than the non-Muslim population. The present paper, based on a large sample survey carried out in Uttar Pradesh, India, compares the reproductive behavior of Hindus and Muslims. An attempt has been made to examine the determinants of their differential fertility and family planning behavior.


Reintroducing Dmpa To The Philippine Family Planning Program: A Longitudinal Study Of Continuing Users And Drop-Outs, Population Council Jan 1996

Reintroducing Dmpa To The Philippine Family Planning Program: A Longitudinal Study Of Continuing Users And Drop-Outs, Population Council

Reproductive Health

In 1994, the Population Council, Manila, conducted an operations research (OR) project entitled “DMPA Monitoring and Follow-up Studies.” The activity was undertaken to provide accurate and timely support to the DMPA Reintroduction Program of the Department of Health. Commonly known as Depo-Provera, DMPA stands for Depo-Medroxy Progesterone Acetate, an extremely effective injectable contraceptive given every three months. This report focuses on the survey component of these studies which aims to comprehensively examine the influence on DMPA use of factors classified into the following eight major areas: socioeconomic and demographic characteristics; reproductive history; contraceptive history; adoption of DMPA; quality of care …


Proceedings Of The Operations Research Training Workshop For Program Managers And Researchers, January 15-21, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council Jan 1996

Proceedings Of The Operations Research Training Workshop For Program Managers And Researchers, January 15-21, 1996, Family Planning Service, The Family Planning Operations Research And Training (Fport) Program, Population Council

Reproductive Health

This document contains the proceedings of the training workshop on operations research (OR) for program managers and researchers held January 15-21, 1996, in Mindoro, Philippines. The workshop was co-sponsored by the Family Planning Service of the Department of Health and the Family Planning Operations Research and Training Program of the Population Council, Manila. Representatives from the health and population offices of ten local government units (LGUs) worked with a select group of researchers to evolve a list of relevant topics for operations research (OR) and develop a concept paper on a chosen OR topic. The LGUs represented in the workshop …


Profile Of Clients Of Different Providers Of Family Planning Services In Egypt [Arabic], Population Council, Spaac Jan 1996

Profile Of Clients Of Different Providers Of Family Planning Services In Egypt [Arabic], Population Council, Spaac

Reproductive Health

No abstract provided.


Inopal Ii Final Report, Population Council Jan 1996

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 Jan 1996

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 Jan 1996

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 …


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 Jan 1996

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 Aug 1995

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 Jan 1995

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 Jan 1995

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 Jan 1995

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 Jan 1995

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 …


Improving The Counseling And Medical Care Of Postabortion Patients In Egypt, Population Council, Egyptian Fertility Care Society Jan 1995

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 …


Improving Community Based Family Planning Services And The Potential For Increasing Contraceptive Prevalence In Bangladesh, Amy Gale Dunston, Peter C. Miller Jan 1995

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 Jan 1995

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 …


Current Experiences With Community-Based Distribution Of Family Planning In Kenya: A Review Prepared For Usaid/Kenya, Population Council Jan 1995

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 Jan 1995

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 …


Family Planning And Reproductive Health: Briefing Sheets For A Gender Analysis, Kirsten Moore, Debbie Rogow Jan 1994

Family Planning And Reproductive Health: Briefing Sheets For A Gender Analysis, Kirsten Moore, Debbie Rogow

Reproductive Health

This series of briefing sheets, developed by the Population Council, represents a starting point for the application of gender to the family planning (FP) and reproductive health (RH) arena. The information covers five key areas of RH: gender-based abuse, FP and gender issues among adolescents, sexuality and FP, men’s and women’s social and economic responsibilities for childrearing, and the complicated nexus between gender and FP/RH. In so doing, it provides a strong foundation for gender training. This concept was first developed to fulfill a need for gender training within the regional Operations Research/Technical Assistance Projects. To date, two such workshops …


Profile Of Clients Of Different Providers Of Family Planning Services In Egypt, Social Planning, Analysis & Administration Consultants (Spaac) Jan 1994

Profile Of Clients Of Different Providers Of Family Planning Services In Egypt, Social Planning, Analysis & Administration Consultants (Spaac)

Reproductive Health

The Government of Egypt launched its national family planning (FP) program in 1966. The early phase was mainly supply oriented and aimed at ensuring wide distribution of contraceptives primarily through pharmacies to meet rising demand. Between 1988 and 1992 a number of additional sources of FP services appeared, with an increase in clinic-based services through both the private and public sectors. In 1992 about one-fourth of users relied on pharmacies to get their FP supplies compared to about one-half in 1988. This change evolved through the influence of two forces: the initiation of a number of FP projects, and expanded …


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 Jan 1994

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 Jan 1994

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 …