International Public Health Commons^™

Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …

Country Mapping: Senegal, Babacar Mane, Nafissatou Diop, Nancy Termini Lachance, Saumya Ramarao, Heather Clark

Reproductive Health

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and its potential introduction. This technical report presents results from assessments undertaken to map the existing landscape of family planning programs and new contraceptive technologies in Senegal in an effort to identify national priorities and assess the level of interest in the PVR among stakeholders and to design appropriate preintroductory activities. This country mapping exercise confirms that Senegal is a promising context for the introduction of the PVR: the government is committed to repositioning family planning and …

An Assessment Of Individual And Institutional Research Utilization By Policy-Makers And Programme Managers At State And National Levels In Nigeria, National Agency For The Control Of Aids

HIV and AIDS

This report undertakes a systematic assessment of the need for evidence by decision-makers working on HIV and AIDS funding and policymaking, and implementing organizations at the national and subnational levels in Nigeria. The assessment identifies barriers and constraints to data use, identifies best practices, and offers recommendations for the design and prioritization of strategic approaches to address barriers and constraints in data use and production. Tools to monitor the adoption of evidence in policy and practice are also offered. The need for evidence-based practice in the national response to HIV and AIDS has been widely acknowledged and incorporated into policy …

Positive Action For Hiv In Schools In Kenya, Francis Obare, Harriet Birungi, Monica Wanjiru, Sheila Bayley, John Kiunjuri, Mary Omondi, Rob Burnet, Bridget Deacon

Reproductive Health

The objective of this study was to test the feasibility of using comic books, role models, and edutainment to communicate HIV and AIDS messages to in-school young people in Kenya, with a view to improving their knowledge about the epidemic, enhancing communication about it, and promoting positive attitudes and behavior among them. The study was implemented by the Population Council in eight secondary schools in Nairobi, as part of the APHIA II Operations Research Project in collaboration with the AIDS Control Unit in the Ministry of Education, Well Told Story, and the National AIDS/STI Control Programme. The study found that …

Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey

Reproductive Health

An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In India: Final Survey Report, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECPs) among providers in public and private facilities and pharmacies in India. This study’s objectives were: 1) to assess providers’ knowledge of ECP’s biological mechanism; 2) to understand providers’ knowledge and attitudes about ECP’s safety, effectiveness, and availability as an over-the-counter drug; and 3) to identify providers’ definitions of “repeated use” and profiling of women who are “repeated users” of ECP. The study recommends intervention programs and advocacy strategies to increase knowledge and access to ECP.

Critical Issues For Integrating Srh And Hiv/Aids Services To Provide Dual Protection Against Unintended Pregnancy And Hiv/Sti Acquisition, Population Council

Reproductive Health

This document reports on a one-day symposium that was held by the STEP UP (Strengthening Evidence for Programming on Unintended Pregnancy) Research Program Consortium, coordinated by the Population Council. STEP UP generates policy-relevant research to promote an evidence-based approach for improving access to family planning and safe abortion in Bangladesh, Ghana, India, Kenya, and Senegal. The symposium’s objectives were to review and discuss critical and emerging issues around integrating SRH and HIV and AIDS services to enable dual protection, including new directions in dual protection technology and behaviour change interventions. The meeting also provided an opportunity to discuss the programmatic …

Expanding Access To Comprehensive Reproductive Health And Hiv Information And Services For Married Adolescent Girls In Nyanza Province, Chi-Chi Undie, Harriet Birungi, Francis Obare, Ben Ochieng, Wilson Liambila, Erick Oweya, Ian Askew, Rob Burnet, Bridget Deacon, Aisha Mohamed

Reproductive Health

The objectives of this operations research study, conducted by the Population Council’s APHIA II Operations Research Project in Kenya, were to: 1) identify and design a set of interventions that promote the uptake of comprehensive reproductive health (RH)/family planning (FP) and HIV prevention services and information among married adolescent girls; and 2) expand access to comprehensive RH/FP and HIV prevention services and information among this population. The study demonstrated that the combined use of interactive media and community health worker visitation, health information provision, and referrals, is an effective means of reinforcing RH/FP and HIV messages, and of increasing access …

Evaluation Of The Population-Level Impact Of The Maternal Health Voucher Program In Uganda, Reproductive Health Vouchers Evaluation Team

Reproductive Health

This report is based on an evaluation of the population-level impact of the maternal health voucher program in Uganda focusing on targeting of beneficiaries, health service utilization (four or more antenatal care visits, facility delivery, and postnatal care), out-of-pocket expenses, and equity. It further reviews the findings from an independent verification of the program that was conducted by PricewaterhouseCoopers Limited in 2010. The impact of the program on the outcomes considered is determined through a simple comparison of changes in proportions between intervention and comparison groups before and after the program started as well as estimation of multilevel random-intercept logit …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Using Capture-Recapture Methodology For Enumerating Most-At-Risk Populations (Marps), Population Council

HIV and AIDS

Populations at higher risk for HIV infection are often the most difficult to reach and this is particularly true of men who have sex with men (MSM), injecting drug users, and female sex workers in sub-Saharan Africa. These subpopulations are frequently marginalized by society because of the illicit and/or illegal activities they engage in. Estimating the size of hard-to-reach populations is important to effectively plan, implement, monitor, and evaluate HIV and AIDS prevention and care programs. “Capture-recapture” is a method of estimating the prevalence of a trait in a population or more simply it’s a method that provides a good …

An Ethnographic Study Of Injecting Drug Users And Men Who Have Sex With Men In Selected States In Nigeria, Enhancing Nigeria's Hiv/Aids Response (Enr) Programme

HIV and AIDS

An ethnographic pre-assessment study of the behavioral dynamics of men who have sex with men (MSM) and injecting drug users (IDU) was conducted in 2009 as an integral part of the 2010 Integrated Biological and Behavioural Surveillance Survey (IBBSS). The study took place in Northern and Southern Nigeria and provided rich contextual information on the logistic and scientific factors that would aid successful conduct of the IBBSS and secure buy-in for it among study respondents. The study utilized a combination of rapid assessment procedures that were suitable to prevailing time exigencies and could foster preliminary understanding of the local contexts …

Executive Summary—Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

This document contains the executive summary of “Family Planning Programs for the 21st Century: Rationale and Design.” The first half of the book makes the case for why increased funding and support for voluntary family planning programs are needed. The second half explains how reinvigorated voluntary family planning programs can be structured to operate more effectively. Family planning is one of the most successful development interventions of the past 50 years. It is unique in its range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs, Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …

Filles Eveillées : Programme Pilote Pour Adolescentes Migrantes Employées De Maison Au Burkina Faso Urbain, Sarah Engebretsen, Gisele Kaboré, Leah Jarvis

Poverty, Gender, and Youth

Les jeunes Burkinabè n’ont guère de débouchés économiques, en particulier dans les milieux ruraux. En 2010, le Population Council a mené une recherche formative dans le but de mieux comprendre la situation des adolescentes migrantes employées de maison au Burkina Faso urbain. L’étude révèle qu’arrivées à la ville, ces filles vivent généralement chez leurs employeurs et travaillent de longues journées laborieuses. Il leur reste très peu de temps pour aller à l’école, développer des réseaux sociaux et acquérir les compétences nécessaires à la vie adulte. Il s’avère du reste que les programmes destinés à cette population interviennent en majorité après …

Évaluation De Processus : Programme Filles Eveillées Pour Adolescentes Migrantes Employées De Maison Au Burkina Faso Urbain 2012, Leah Jarvis, Gisele Kaboré

Poverty, Gender, and Youth

Le programme «Filles Éveillées» a été conçu pour apporter aux adolescentes migrantes employées de maison les compétences, les connaissances et le capital social qui leur permettent de réduire leurs vulnérabilités et de s’ouvrir de nouveaux débouchés. Les observations tirées de la collecte de données quantitatives et qualitatives ont révélé le succès considérable du programme: il est largement apprécié et a été bien reçu par les participantes, les mentors, les membres de la communauté et tous les autres intéressés. En sa qualité de programme pilote, les obstacles à une mise en œuvre sans incidents auraient été inévitables, mais par leur détermination …

A Life Course Perspective On Social Protection Among The Working Poor Of Egypt, Maia Sieverding

Poverty, Gender, and Youth

This paper employs a generational comparison to examine how increasing labor market informality has affected how poor households in Egypt gain access to and rely on social protection schemes. The results indicate that among the generation of Egyptians approaching retirement, the expansion of public employment and a policy allowing easy access to survivors’ benefits among female dependents served as important means of increasing social insurance coverage. However, many young households do not have even one member enrolled in the public pension system. Labor market instability and informality have also lowered the perceived value of social protection among this generation. The …

Le Consensus De Bellagio : Recommandations Pour Améliorer L'Accès Aux Méthodes De Contraception Efficaces, Réversibles À Longue Durée D'Action, Population Council

Reproductive Health

Ce communiqué et cette déclaration proposent des recommandations pour améliorer l'accès aux méthodes de contraception efficaces, réversibles à longue durée d'action (LARC) et accélérer les progrès vers la réalisation de l'Objectif du Millénaire pour le développement relatif à l'accès universel aux services de santé reproductive.

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This brief and statement offers recommendations for action to increase access to highly effective, long-acting, reversible contraception (LARCs) and accelerate progress toward meeting the Millennium Development Goal of universal access to reproductive health services.

Repositioning Community-Based Family Planning In Ghana: A Case Study Of Community-Based Health Planning And Services (Chps), Stephen Ntsua, Placide Tapsoba, Gloria Quansah Asare, Frank K. Nyonator

Reproductive Health

The Population Council conducted a diagnostic appraisal of delivering family planning services using the community-based health planning and services (CHPS model) in Ghana. This study’s results indicate that the CHPS program is well appreciated by rural communities where it is operational. However, the study identified several developments with implications for service delivery: increased community health officer (CHO) workloads and concomitant reductions in outreach services and home visits by community health visitors (CHVs) have weakened the CHO-CHV working relationship, leaving both cadres working in isolation. CHPS has significantly improved health indices but its contribution to increasing family planning is limited and …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria: Key Findings, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

This brief reports on a study in Nigeria to document provider attitudes, beliefs, and practices regarding emergency contraception (ECP), and to identify key opinion leaders’ opinions and insights pertaining to policy and programmatic issues in that country. Findings reveal that ECP is well known in urban Nigeria. Its provision is controlled mainly by the largely unregulated and unmonitored private sector. Government plays a distant role, thereby leaving family planning and ECP supply almost entirely in the hands of donor agencies. For wider availability and affordability of ECP products in both the private and public sectors, official policy action is required, …

Country Mapping: Kenya, Francis Obare, Wilson Liambila, Harriet Birungi, Eseoise Itombra, Heather Clark, Saumya Ramarao

Reproductive Health

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and to develop a strategic plan for its introduction. This technical report presents the findings of the assessments in Kenya with specific focus on: (1) the country’s demographic profile; (2) the health systems, health policy, and family planning program context; and (3) stakeholder perspectives regarding the PVR. The findings suggest that the introduction of the PVR would fill a gap in the family planning needs of breastfeeding women in Kenya, and there is strong support from stakeholders …

Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya: An Assessment Of Acceptability, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Harriet Birungi, Jill Keesbury, Ian Askew

Reproductive Health

Most research on intimate-partner violence (IPV) screening has been conducted in developed countries, so this study in Kenya serves as one of the first in a developing-country context to assess the acceptability of IPV screening from the perspective of providers and clients in public healthcare settings. The study conducted in Kenyatta National Hospital in Nairobi found that routine screening for IPV is acceptable to providers and clients at that location. However, to be effective as a routine service, the system needs to be reinforced in specific ways, including greater assurance of confidentiality, more positive provider attitudes, and higher respect for …

Defining Effective Voucher Management Information Systems: A Blueprint For Information Systems To Support Scalable Reproductive Health Voucher Programs, Based On System Evaluations With Programs In Bangladesh, Cambodia, Kenya, Uganda, And Tanzania, Mahad Ibrahim, Benjamin Bellows, Jaspal S. Sandhu

Reproductive Health

This document defines the key elements of information systems to support the development of effective, scalable voucher information systems. It is based on an engagement between the Gobee Group and the Population Council to strengthen information systems of reproductive health voucher programs in five countries in 2011–12. At the time of publication of this document, the Population Council was in the midst of a multiyear evaluation of five of the biggest reproductive health programs worldwide, an effort supported by the Bill & Melinda Gates Foundation. While the work supporting this report has been focused on reproductive health voucher programs—which provide …

Population Level Impact Of Vouchers On Access In Uganda, Benjamin Bellows, Francis Obare, Reproductive Health Vouchers Evaluation Team

Reproductive Health

No abstract provided.

Household Survey To Evaluate The Zambia-Led Prevention Initiative: Baseline Report, Zambia-Led Prevention Initiative

HIV and AIDS

With an estimated HIV prevalence of 14.3 percent among men and women age 15–49, Zambia is one of the sub-Saharan African countries most affected by the HIV and AIDS pandemic. The Zambia-led Prevention Initiative Program (ZPI) was developed by a consortium led by FHI360, with the Population Council as the evaluation partner. This study determined baseline levels of key indicators related to HIV, gender-based violence, and reproductive health. Additionally, the baseline findings provide critical insights into key areas for interventions in Zambia and highlights variability in the populations across provinces and between males and females that provide valuable guidance for …

The Reproductive Health Of Young People In Egypt, Nahla G. Abdel-Tawab, Noha Roushdy, Maia Sieverding

Poverty, Gender, and Youth

This Population Council brief presents results from the Survey of Young People in Egypt (SYPE) on reproductive health (RH). The SYPE results underscore the need for: the assessment of state and civil society initiatives to transmit RH information; a national, comprehensive, age-appropriate reproductive health module to be integrated into the educational program; a national campaign on HIV/AIDS and other sexually transmitted infections that targets young people of reproductive age; the integration of female circumcision into a broader approach to youth reproductive health and bodily rights; specialized reproductive health services for married adolescent girls; and further research on sexuality and reproductive …

Observations Initiales Et Finales De Filles Eveillées : Programme Pilote De Renforcement Des Compétences Des Adolescentes Migrantes Employées De Maison. Cohorte 1 (2011–2012), Bobo-Dioulasso, Sarah Engebretsen

Poverty, Gender, and Youth

Le Burkina Faso abrite la dixième population la plus jeune du monde, avec 45% de la population de moins de 15 ans. Les jeunes au Burkina Faso, en particulier les adolescentes, ont peu d'opportunités économiques, en particulier dans les zones rurales. Cela alimente la migration vers les milieux urbaines à la recherche de travail. Seules, les filles sont physiquement et économiquement vulnérables et beaucoup courent un risque élevé de violence sexiste. Le Population Council a mené une recherche formative en 2010 dans le but de mieux comprendre la situation des adolescentes migrantes employées de maison au Burkina Faso urbain, et …

Réseaux Sociaux Et Les Capacités Financières Des Filles Employées De Maison À Bobo-Dioulasso, Gisele Kaboré

Poverty, Gender, and Youth

Depuis plus d’une année, le Population Council assure la mise en œuvre du projet «Filles Éveillées» ciblant les travailleuses domestiques dans les zones urbaines au Burkina Faso. L’objectif de cette étude est d’avoir une meilleure connaissance des réseaux sociaux des filles—soit avec les personnes dans sa nouvelle communauté soit avec des personnes dans son village à travers la technologie—depuis leurs zones d’origine, sachant que la phase de transit n’est pas bien comprise mais que ça peut influencer le séjour de la fille en ville. Cette étude a pour objectif de cerner les capacités et les modes de gestion financières des …

De La Recherche À La Conception Programmatique Et À La Mise En Oeuvre : Programmation À L'Intention Des Filles Des Milieux Ruraux D'Éthiopie—Boîte À Outils Du Praticien, Annabel Erulkar

Poverty, Gender, and Youth

Cette boîte à outils décrit comment créer ou améliorer des programmes pour les filles de l’Éthiopie rurale, en vue d'accroître le nombre de programmes organisés à leur intention et de les rendre pertinents et mieux adaptés à leur contexte. La boîte à outils décrit un processus d’élaboration programmatique fermement ancré dans les faits. Les chapitres procèdent dès lors d’un point de départ axé sur la recherche pour identifier et décrire les filles, pour se concentrer ensuite sur le développement programmatique émanant des données, et aboutir enfin sur la mise en œuvre guidée par le suivi et l’évaluation permanents.

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This …

Female Disadvantage In The Egyptian Labor Market: A Youth Perspective, Maia Sieverding

Poverty, Gender, and Youth

In this brief, three aspects of female youth’s disadvantage in the labor market are analyzed: low labor force participation, high unemployment, and concentration in the public sector. These issues are closely interrelated and can be addressed through a set of policies that promote family-friendly employment conditions and the formalization of the private sector. The establishment of job search services for female youth is also critical to addressing the gender gap in unemployment.