Open Access. Powered by Scholars. Published by Universities.®
Articles 91 - 117 of 117
Full-Text Articles in International Public Health
Making Pregnancy Safe For Women In Rajasthan: Targeting The Most Vulnerable, K.G. Santhya
Making Pregnancy Safe For Women In Rajasthan: Targeting The Most Vulnerable, K.G. Santhya
Poverty, Gender, and Youth
As recently as 2005–06, almost two out of three women in Rajasthan, India were married before age 18 years (of those aged 20–24). Moreover, half of currently married girls aged 15–19 years in the state had already begun childbearing. The dangers of childbearing among adolescent girls, whose bodies have not physically matured, are widely acknowledged, as are the links between poverty and unsafe pregnancy. Yet, less is known about whether morbidity and mortality experiences vary within the subgroup of adolescent girls, whether such experiences differ between adolescent and adult women of similar parity, and whether treatment-seeking behaviors and the delays …
Understanding Pregnancy-Related Morbidity And Mortality Among Young Women In Rajasthan, K.G. Santhya
Understanding Pregnancy-Related Morbidity And Mortality Among Young Women In Rajasthan, K.G. Santhya
Poverty, Gender, and Youth
Pregnancy and childbearing continue to occur in adolescence for considerable proportions of women in India. The dangers of childbearing for adolescent girls, whose bodies have not physically matured, are widely acknowledged. Yet, little is known about whether morbidity and mortality experiences vary within the subgroup of adolescent girls, whether such experiences differ between adolescent and adult women of similar parity, and whether treatment-seeking behaviors and the delays experienced in seeking treatment differ between adolescent and adult mothers. To begin to fill this gap, the Population Council undertook an exploratory study of the pregnancy-related morbidity and mortality experiences of women who …
Translating Medical Evidence Into Practice: Working With Communities And Providers To Promote Active Management Of The Third Stage Of Labour, B. Subha Sri
Reproductive Health
Although postpartum hemorrhage is a leading cause of death in India, and despite the fact that active management of the third stage of labor (AMTSL) has been established as a best practice, efforts to promote it have been limited. This paper documents the experiences of a project that aimed to enable the translation of available evidence regarding AMTSL into practice through two strategies, at community and provider levels respectively. Community-level activities included efforts to build awareness regarding safe delivery practices, sensitize individuals regarding the rights perspective and their entitlement to safe services, and facilitate the translation of this awareness into …
Empowering Communities To Make Pregnancy Safer: An Intervention In Rural Andhra Pradesh, Dipa Sinha
Empowering Communities To Make Pregnancy Safer: An Intervention In Rural Andhra Pradesh, Dipa Sinha
Reproductive Health
Recognizing that multiple factors are responsible for adverse pregnancy-related outcomes, a community-based intervention was implemented in Mominpet, in Andhra Pradesh, India in collaboration with the M.V. Foundation, a nongovernmental organization. The intervention focused on improving maternal health outcomes by raising awareness and building family and community support for pregnant women; involving pregnant women’s families, notably their husbands, in pregnancy-related care; and supporting pregnant women to access health services. This report describes the experience and outcomes of the intervention. In particular, it explores the extent to which the intervention was effective in increasing community support for safe motherhood on the one …
Obstetric Fistula: Can Community Midwives Make A Difference? Findings From Four Districts In Kenya, Charlotte E. Warren, Annie Mwangi
Obstetric Fistula: Can Community Midwives Make A Difference? Findings From Four Districts In Kenya, Charlotte E. Warren, Annie Mwangi
Reproductive Health
As part of the UNFPA Global Campaign to End Obstetric Fistula, the Population Council and UNFPA built on Kenya’s Community Midwifery Approach to develop a comprehensive community midwifery intervention strategy that aimed at increasing skilled attendants at birth and prevention of obstetric fistula. This report seeks to understand the experiences of women affected by fistula and whether community midwives can contribute to preventing obstetric fistula in rural settings in Kenya. The key recommendations emerging from this report are to: update health facility midwives in maternal and neonatal health (MNH) skills including prevention, treatment, and care of obstetric fistula; train more …
South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health
South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health
Reproductive Health
South Africa’s medical infrastructure is relatively well developed, but its maternal mortality rate remains high and numerous studies document poor maternal care. Shortages in nursing staff are a major factor in quality-of-care problems on maternity wards. A Population Council FRONTIERS study of antenatal care in rural clinics in Kwa-Zulu Natal showed that between one-third and one-half of providers interviewed had worked at their clinics for less than a year. In 2004, FRONTIERS followed up on the Kwa-Zulu Natal study to document factors affecting the tenure, motivations, and working conditions of maternal-health nursing staff in three South African provinces. The study …
Health Systems And Maternal Mortality, Neonatal Mortality And Child Health: Review Of Selected Service Delivery Models, Md. Noorunnabi Talukder, Ubaidur Rob
Health Systems And Maternal Mortality, Neonatal Mortality And Child Health: Review Of Selected Service Delivery Models, Md. Noorunnabi Talukder, Ubaidur Rob
Reproductive Health
Effective maternal and child health services at the community level in developing countries are rarely available. In many developing countries the health systems cannot provide quality maternal and child health care services due to lack of adequate human resources; shortages of equipment, drugs, and supplies; and absence of proper referral mechanisms. Strengthening health systems is central to improving maternal and child health. A variety of targeted interventions have been implemented in the health systems of developing countries. This study was conducted to identify the health service delivery models that have contributed to the reduction of maternal, infant, and child mortality …
Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen
Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen
Reproductive Health
The Safe Motherhood Applied Research and Training (SMART) project, an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan, was a three-year project (2003 to 2006) funded by the European Union. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas to accomplish its goals: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role …
Make Better Use Of Provider Time In Public Health Clinics, Barbara Janowitz
Make Better Use Of Provider Time In Public Health Clinics, Barbara Janowitz
Reproductive Health
Funding for reproductive health services is stagnant or declining globally, yet population projections, particularly in Africa, indicate that demand for services will increase in the near term. Between 2002 and 2025, for example, the population of women of childbearing age (15–49) is expected to increase by 2 percent annually in sub-Saharan Africa. With this growth will come increased demand for contraception, and other reproductive health services such as antenatal care, safe birthing services, and postpartum care for mothers and children. Concern about increasing demand for services has led program managers to examine the productivity and costs of existing programs. While …
Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller
Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller
Reproductive Health
Maternal mortality in Pakistan is believed to be quite high, at about 350–500 maternal deaths per 100,000 live births. Reducing maternal mortality is one of the major objectives of the Government of Pakistan. Interventions required to address maternal mortality include safe motherhood, which means a woman’s ability to have a safe and healthy pregnancy and delivery. The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal and neonatal mortality in a predominantly rural district of Pakistan. The vast majority of maternal deaths are attributed to delays in …
Correlates Of Inter-Birth Intervals: Implications Of Optimal Birth Spacing Strategies In Mozambique, Saumya Ramarao, John Townsend, Ian Askew
Correlates Of Inter-Birth Intervals: Implications Of Optimal Birth Spacing Strategies In Mozambique, Saumya Ramarao, John Townsend, Ian Askew
Reproductive Health
The Optimal Birth Spacing Initiative (OBSI) was created under the auspices of USAID to place optimal birth spacing on the global leadership priority agenda. As part of this initiative, Advance Africa documented a pilot intervention to introduce the new spacing message in Mozambique. The FRONTIERS program of the Population Council collaborated with Advance Africa providing technical input, and assistance in the conceptualization of intervention design and evaluation. This paper was written to inform Advance Africa’s efforts in Mozambique and includes a short review of correlates of birth intervals; a presentation of results from analysis of Mozambique-DHS 1997 data that identify …
Safe Motherhood Applied Research And Training (Smart) Report 3: Changes In Knowledge And Behavior Of Women And Families, Muhammad Shafique Arif, Peter C. Miller, Nayyer Munir, Irfan Masood
Safe Motherhood Applied Research And Training (Smart) Report 3: Changes In Knowledge And Behavior Of Women And Families, Muhammad Shafique Arif, Peter C. Miller, Nayyer Munir, Irfan Masood
Reproductive Health
The Safe Motherhood Applied Research and Training (SMART) project was conceived as an operations research project designed to test the effectiveness of two different strategies for improving maternal and neonatal health in Pakistan. To evaluate the results of this test, several types of evaluative research were conducted, including qualitative studies of various types, health systems assessments, evaluations of specific components, and household surveys. The household surveys are the subject of this report, which is Report 3 (Changes in knowledge and behavior of women and families) in a series of six. The surveys are two types: a large-scale, before-after household survey …
Safe Motherhood Applied Research And Training (Smart) Report 4: Knowledge And Behaviour Of Service Providers, Zakir Hussain Shah, Saima Pervaiz
Safe Motherhood Applied Research And Training (Smart) Report 4: Knowledge And Behaviour Of Service Providers, Zakir Hussain Shah, Saima Pervaiz
Reproductive Health
The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role in decision-making and seeking care for their families in matters relating to maternal and newborn …
Testing A Model For The Delivery Of Emergency Obstetric Care And Family Planning Services In The Bolivian Public Health System, Deborah L. Billings, Eliana Del Pozo, Hugo Arevalo
Testing A Model For The Delivery Of Emergency Obstetric Care And Family Planning Services In The Bolivian Public Health System, Deborah L. Billings, Eliana Del Pozo, Hugo Arevalo
Reproductive Health
Unsafe abortion is a serious public health problem in Bolivia, accounting for up to 25 percent of maternal mortality. Postabortion care (PAC) was recognized as a priority public health action in Bolivia in 1994 and the operations research project summarized in this report was undertaken at the request of the Ministry of Health to help guide the improvement of PAC services in the country’s revised health plan. Improvements were made in the following areas: informing women of their health status after the uterine evacuation procedure; elements of the procedure itself (instrument to be used, pain control, possible risks); and informing …
Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth
Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth
Reproductive Health
EngenderHealth, in collaboration with the Ministry of Health, conducted an operations research project to examine the feasibility of introducing an integrated three-element model of postabortion care (PAC) services in secondary- and primary-level sites in two predominantly rural regions in Senegal. The intervention provided health personnel with: 1) training to improve clinical competence, counseling, infection prevention, and general care; 2) technical assistance, materials, and support to aid in overcoming challenges; and 3) ongoing monitoring and supervision. The project findings attest to the benefits of expanding existing PAC programs in rural settings and suggest that the advantages of such an expansion outweigh …
Estimating Costs Of Post-Abortion Services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico, Population Council
Estimating Costs Of Post-Abortion Services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico, Population Council
Reproductive Health
Health care systems around the world are facing problems providing quality care with increasingly constrained resources. While modern practices and diagnostic tests have made pregnancy a much less risky event than in the past, not all pregnancies have a favorable outcome. Spontaneous abortion occurs in 15–45% of all known pregnancies, and studies show that 25% of all obstetric/gynecology hospital admissions are for incomplete abortion. Given the high level of resources devoted to treating this condition, it is imperative to develop cost-effective methodologies to provide quality care. Unsafe abortion performed by untrained and inexperienced providers is the fourth leading cause of …
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Reproductive Health
Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …
The Life Saver: The Mother Friendly Movement In Indonesia, Abdullah Cholil, Meiwita B. Iskandar, Rosalia Sciortino
The Life Saver: The Mother Friendly Movement In Indonesia, Abdullah Cholil, Meiwita B. Iskandar, Rosalia Sciortino
Reproductive Health
The focus of this book is the Mother Friendly Movement in Indonesia, a collective effort to reduce maternal mortality. The idea of documenting the Mother Friendly Movement or Gerekan Sayang Ibu (GSI) was originally suggested by Her Excellency Mien Sugandhi, the State Minister for the Role of Women, Republic of Indonesia, in the belief that the Indonesian experience in reducing maternal mortality would be relevant to other countries struggling with the same problem. The authors were entrusted with producing an illustrated monograph on the pilot projects implemented in eight districts from June to December 1997. Besides extensively monitoring these activities, …
The Impact Of Monetary Crisis And Natural Disasters On Women's Health And Nutrition, Meiwita B. Iskandar
The Impact Of Monetary Crisis And Natural Disasters On Women's Health And Nutrition, Meiwita B. Iskandar
Poverty, Gender, and Youth
This paper analyzes the short-term effects of the monetary crisis and natural disasters in Indonesia on women's health and nutritional status, and activities to monitor and address these problems. The monetary crisis which was announced in January 1998 hit the highest monthly inflation rate of 13 percent in February. Natural disasters that have plagued Indonesia since early 1997, including droughts and forest fires, have been projected to cause famines and an increased likelihood of infant and adult mortality. The economic crisis also directly impacts millions of workforce members threatened by the downsizing of thousands of businesses and factories, in the …
Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings
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 …
Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey
Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey
Reproductive Health
In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and …
Women's Perceptions Of Sexuality In Rural Giza, Hind Khattab
Women's Perceptions Of Sexuality In Rural Giza, Hind Khattab
Poverty, Gender, and Youth
This study on sexuality among women in rural Giza, Egypt, is part of a broader project on women's health and reproductive morbidity conducted by the Population Council’s Reproductive Health Working Group. Reproductive tract infections (RTIs) and other ailments associated with reproduction among women in the rural community surveyed suggest that a heavy burden of disease is being borne by women living in underprivileged areas in this region. This research on sexuality has been conducted within a conceptual framework that uses a socio-cultural approach to health and illness. The investigation is an assessment of women's perception of and knowledge about sexuality …
Unsafe Abortion In Kenya: Findings From Eight Studies, Khama Rogo, Ann Leonard
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 …
District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Gorakhpur, P.N. Kapoor, P.K. Chopra, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend
District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Gorakhpur, P.N. Kapoor, P.K. Chopra, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend
Reproductive Health
The state of Uttar Pradesh (UP) in India had a population of 139 million, as of the 1991 census. The socioeconomic profile is characterized by relatively low levels of per capita income and literacy. Further, assessment of the family planning program and the demographic status as measured by Couple Protection Rate (CPR) and Mortality/Fertility rates marks UP as one of the country’s more demographically disadvantaged states. UP has a relatively higher infant mortality rate, crude death rate, birth rate, and total fertility rate than the country as a whole, whereas CPR is much too low. The district of Gorakhpur falls …
Family Planning And Child Survival Programs As Assessed In 1991, John A. Ross, W. Parker Mauldin, Steven R. Green, E. Romana Cooke
Family Planning And Child Survival Programs As Assessed In 1991, John A. Ross, W. Parker Mauldin, Steven R. Green, E. Romana Cooke
Poverty, Gender, and Youth
This volume continues a tradition initiated at the Population Council nearly 25 years ago when the first edition of “Population and Family Planning Programs” was issued. That factbook began a series of 12 editions produced through 1993. The data in that series were consolidated and updated in another publication, and the present volume is now issued, based partly upon a 1989 questionnaire inquiry to over 100 developing countries. A range of maternal and child survival data were added to the family planning information. The relationships among fertility behavior, infant and child mortality, and maternal health are closely interwoven; moreover, many …
Maternal Risk, Beverly Winikoff
Maternal Risk, Beverly Winikoff
Reproductive Health
This presentation to the 1991 Berzelius Symposium, Stockholm, Sweden, explores the issue of maternal risk—the probability or chance of dying or being seriously injured in pregnancy—as it is used in maternal health care. This concept of risk has been a useful tool for research and medical and epidemiological education, but its use as a tool for service delivery design has been more problematic. In order to construct a risk system, one has to have reliable data on the relationships between individual characteristics and the outcome being studied—something that is difficult to develop with regard to maternal health. Furthermore the system …
Limitations Of Maternal Care To Improve Maternal Health, Beverly Winikoff
Limitations Of Maternal Care To Improve Maternal Health, Beverly Winikoff
Reproductive Health
In a presentation at the 1991 Berzelius Symposium in Sweden, a Population Council researcher described the limitations of healthcare systems, specifically during pregnancy, in terms of their effect on maternal health status. These limitations stem from an inability to improve health because of social conditions—poverty and illiteracy, overwork, inequality in sexual relationships—that cannot be solved by medical interventions. Maternal ill health originates before pregnancy and endures beyond it, whereas the window of contact with women during pregnancy is small. Nevertheless, recent evaluations suggest that the impact of prenatal care is in the caring process more than any specific aspect of …