International Public Health Commons^™

Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon

Reproductive Health

Using the results of a previous operations research study, the Ministry of Health of Honduras recently changed the National Women’s Health Service Delivery Guidelines to explicitly authorize nurse auxiliaries to insert IUDs, deliver Depo-Provera, and take Pap smears. These services are new to the rural communities served by rural health centers (RHCs). The objective of this project was to test whether the demand for these newly introduced services would increase if a promotional brochure was distributed in the surrounding communities by the RHC’s clients among potentially interested friends in these communities. The study found that the intervention that was tested …

An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz

Reproductive Health

Since its inception, the Zimbabwe National Family Planning Council’s (ZNFPC) community-based distribution (CBD) program has made significant and well-documented contributions to the demand for and use of family planning in Zimbabwe. Data from several studies have shown, however, a steady decline in this contribution and that the CBD agents spend more time resupplying existing clients than recruiting new acceptors. Moreover, the CBD program urgently needs to be able to address the AIDS crisis in the country. ZNFPC has undertaken this review to guide it in making appropriate decisions about the future direction of the program, allowing CBDs to have a …

Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi

HIV and AIDS

A growing body of scientific publications suggests that male circumcision is associated with reduced risk of HIV infection in sub-Saharan Africa. Thus, male circumcision is being considered as a potential intervention in the prevention of sexually transmitted HIV infection, even though this procedure has profound cultural implications and carries the risk of complications, and its benefits are realized only many years later. This report presents the findings of a meeting of international researchers, organized by the Horizons Project to explore the programmatic and research implications of the association between male circumcision and HIV prevention. Most studies on male circumcision and …

Burkina Faso: Mejorar La Atención Postaborto Beneficia A Pacientes Y Proveedores, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.

Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi

Reproductive Health

Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also …

Women Street Vendors: The Road To Recognition, Monique Cohen

Poverty, Gender, and Youth

This issue of SEEDS explores the experience of women working and organizing as urban street vendors at a time when both the volume of demand and the number of vendors are expected to grow. As municipalities seek to change laws that affect how street vendors ply their trade, it is clear that vendors must have a seat at the table. Local-level organizational efforts need to be consolidated at the national level to cement vendors’ hard-earned gains as rights in national laws and policy. A 1995 meeting in Bellagio conceived an international alliance of street vendors—StreetNet—which aims to promote the exchange …

Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health

Reproductive Health

At the request of the Family Health Directorate of the Ministry of Health in Burkina Faso, the Reproductive Health Research Network (CRESAR) conducted a study during 1996–98 to introduce emergency care for women with complications from miscarriage or unsafe abortion. With technical assistance from the Population Council and JHPIEGO, CRESAR trained staff at two large hospitals in Ouagadougou and Bobo-Dioulasso to provide postabortion care (PAC). Training for physicians, nurses, and midwives covered manual vacuum aspiration, family planning methods, infection prevention, and communication with patients. Staff also participated in the development of policies and standards for PAC services. To measure changes …

Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, and …

Senegal: Capacite A Más Proveedores En Atención Postaborto, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.

Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health

Reproductive Health

Since 1990, the Nakuru Municipal Council (Kenya) has implemented a multifaceted program to reduce the incidence of reproductive tract infections (RTIs), especially those that are sexually transmitted, including HIV/AIDS. Staff in the Council’s five health clinics use syndromic management guidelines, based on clients’ reported symptoms and clinical signs, to identify clients with RTIs. In 1998, the Population Council conducted a study to assess the accuracy of syndromic management and determine the best ways to integrate RTI management into existing antenatal (ANC) and family planning (FP) services. After an assessment of existing RTI services, 18 nurses from the five municipal clinics …

Kenia: La Identificación De Las Itr Sigue Siendo Un Problema: La Prevención Es Esencial, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.

Kenya: L'Identification Des Iar Demeure Hasardeuse: La Prévention Est Primordiale, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.

Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

The Population Council has supported a series of studies to improve the quality of postabortion care (PAC) in Egypt. A 1994 pilot study in two Egyptian hospitals showed that upgrading PAC and training physicians in manual vacuum aspiration (MVA), infection control, and counseling led to significant improvements in the care of postabortion patients. The 1997 study, conducted by the Egyptian Fertility Care Society with support from the Population Council, sought to institutionalize improved postabortion medical care and counseling procedures in ten hospitals. Five senior physicians from each hospital attended a five-day training course in MVA, infection control, and family planning …

Egypte: Développer L'Accès Aux Soins Après Avortement, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.

Mali: Fgc Excisors Persist Despite Entreaties, Frontiers In Reproductive Health

Reproductive Health

About 94 percent of Malian women aged 15–49 have experienced female genital cutting (FGC). In Mali, FGC is associated with serious gynecological and obstetric complications. In 1998, the National Center of Scientific and Technological Research of the Mali Ministry of Secondary and Higher Education and Scientific Research conducted an evaluation of programs to eradicate FGC. The study assessed the work of three national nongovernmental organizations working in Bamako and five regions of Mali. These NGOs had attempted to persuade traditional practitioners of FGC (“excisors”) to abandon the practice. All three NGOs employed outreach workers to educate excisors and community members …

Report On The International Symposium On Quality Of Care In China, Population Council

Reproductive Health

In 1995, China’s State Family Planning Commission (SFPC), the governmental agency charged with developing and implementing China’s population policy, issued an official call for the reorientation of the family planning program from a focus on demographic targets to meeting clients’ needs. In support of this reorientation effort, the SFPC selected six rural counties and five urban districts with comparatively good socioeconomic conditions as pilot sites for a quality-of-care experiment. This report provides a summary of an international symposium on quality of care held in Beijing from November 17–19, 1999. The symposium was sponsored by SFPC with the support of the …

An Assessment Of The Community Based Distribution Programs In Ghana, Jane Chege, Diouratie Sanogo, Ian Askew, Angela Bannerman, Steve Grey, Evam Kofi Glover, Francis Yankey, Joana Nerquaye-Tetteh

Reproductive Health

This study was carried out to describe the major NGO community-based distribution (CBD) programs in Ghana, and to assess in some detail the functioning, quality of care, and performance of the Planned Parenthood Association of Ghana (PPAG) program. The study showed that national coverage by the NGO programs is extensive—virtually all the 110 districts in the 10 regions have at least one program. However, coverage within districts is sparse, as each program covers only a few communities. The results have been communicated to the NGOs whose programs were included in the study and PPAG has already identified a number of …

Mali: Les Exciseuses Persistent Malgré Les Supplications, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.

Recidivism Among Jamaican Teenage Mothers : A Historical Cohort Study 1995-1998, Vonna Lou Caleb Drayton

Loma Linda University Electronic Theses, Dissertations & Projects

Pregnancy is the single most important reason why girls fail to complete secondary school in the Caribbean. The Women's Centre of Jamaica Foundation (WCJF) Program was established in 1978 to enable adolescent mothers 16 years and under to return to school, and to delay second pregnancies until completion of their education.

This historical cohort study assessed the effect of the WCJF Program on the incidence of repeat pregnancies over the period 1995-1998, and on the educational attainment of program participants. A random sample (n=260) of primiparous Jamaican adolescent mothers 12-16 years who gave birth in 1994 in the parishes of …

Literature Review: Challenging Hiv-Related Stigma And Discrimination In Southeast Asia: Past Successes And Future Priorities, Joanna Busza

HIV and AIDS

Pervasive stigma has surrounded HIV/AIDS since the beginning of the pandemic. In Southeast Asia, as elsewhere, it has been accompanied by discrimination, affecting transmission patterns and access to care and support. This paper describes the regional experience of stigma and discrimination and offers a review of community-based interventions that have attempted to reduce them. The evidence presented comes primarily from unpublished literature and anecdotal evidence gained through interviews with project staff throughout the region.

The Female Condom In Zimbabwe: The Interplay Of Research, Advocacy, And Government Action, Population Council

HIV and AIDS

During the past decade, a significant increase in reported cases of HIV/AIDS in Zimbabwe prompted the government, local organizations, and international donors to intensify prevention efforts. As part of this response, in November 1996 Zimbabwe’s National AIDS Coordinating Programme invited Population Services International to launch a social marketing program to promote the female condom, making this protective device widely available for the first time in Africa. After an acceptability study showed that Zimbabwean men and women liked using the female condom, leaders of these organizations encouraged public discussion and media attention, which helped pave the way to approval and introduction …

Reproductive Tract Infections: A Set Of Factsheets, Population Council

Reproductive Health

Reproductive tract infections (RTIs) are being increasingly recognized as a serious global health problem with impact on individual women and men, and their families and communities. RTIs can have severe consequences, including infertility, ectopic pregnancy, chronic pelvic pain, miscarriage, and increased risk of HIV transmission. For effective prevention and management of RTIs, accurate information is necessary and should be widely available. In addition to a brief introduction to RTIs, this document contains 13 factsheets addressing medical and social issues on a variety of topics related to RTIs. The document, produced by the Population Council with support from the Ford Foundation, …

Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu

Reproductive Health

Quality of services is playing an increasingly important role in many family planning (FP) programs. In 1995, a national Situation Analysis Study of 254 health facilities was conducted in Kenya to assess the status and quality of FP services in the country. An in-depth survey of a subsample of 28 health facilities was conducted the following year. From these facilities, 1,834 women were interviewed about their experiences with services at facilities when they sought antenatal, child health, and FP services. The goal of the survey was to examine the links between quality of care in FP services and contraceptive behavior. …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah

Reproductive Health

This report aims to explain the discrepancies in crisis-related research results in Indonesia, and to recommend methodologies to enhance future crisis-related monitoring and surveillance. The discussion aims to identify where the discrepancies are in the readily available data, and how these discrepancies can be explained. The report does not attempt to clarify the impact that the economic crisis is having on the health status of women and children in Indonesia. Recommendations are made to deal with the following findings: Aggregation of data may hide important crisis impacts; attribution of identified changes to the economic crisis may be misleading; differences in …

Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon

Reproductive Health

The goal of this project was to inform physicians, pharmacists, and female factory workers about emergency contraception (EC) through mailings of booklets and posters. These materials were developed in a previous operations research project conducted by the Instituto Mexicano de Investigación de Familia y Población and supported by the Population Council INOPAL III project with funding from USAID. The study found that recipients generally liked the print materials and welcomed information about EC. Within three weeks of receiving the materials, many reported that they had taken immediate action to make EC available and/or to educate others about EC. This project …

Mexico: Protecting Informed Consent, Elsa Santos, Silvia Elena Llaguno, Ricardo Vernon

Reproductive Health

The objective of this three-month project in Mexico was to disseminate information among key audiences about: 1) the right of women to choose contraceptive methods in a free and informed manner; and 2) the laws and institutions available to help redress any violations of this right. Four publications on these topics, developed by a previous project funded by Population Council/INOPAL III, were reproduced and distributed to 2,750 people in the following target audiences: women of reproductive age; reproductive health service providers; national and state commissions of human rights, complaints offices in public hospitals, feminist and human rights organizations; and legal …

Peru: Providers' Compliance With Quality Of Care Norms, Federico R. Leon

Reproductive Health

Peru's Ministry of Health (MOH) introduced changes in its family planning service delivery strategy and set quality-of-care goals purported to ensure informed choice of methods and respect for the users’ reproductive intentions and rights. This study was designed to assess the extent to which providers comply with the guidelines in their daily routine. The study found that among the strongest elements of care are interpersonal relationships and free choice of methods. However, shortcomings were observed in screening for contraindications and information given to the client. The report includes a number of recommendations, including offering providers IEC materials, training, and supervision …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Youth Centres In Ghana: Assessment Of The Planned Parenthood Association Of Ghana Programme, Evam Kofi Glover, Annabel Erulkar, Joana Nerquaye-Tetteh

Reproductive Health

The sexual and reproductive health of adolescents has become a major public concern, particularly with the advent of HIV/AIDS. Many organizations have tried to find strategies to reach youth with reproductive health (RH) information and services through various service delivery models. One such model has been the multipurpose youth center approach. Multipurpose youth centers typically include recreational or vocational services as entry points for RH and family planning (FP) information and services. There is some evidence in a variety of African settings (notably Kenya and Zimbabwe) suggesting that these centers are underutilized and not cost-effective. As a result, the Planned …