International Public Health Commons^™

Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. The PVR was first registered in Chile and Peru in 1998 for use by postpartum women and has since been expanded to other Latin American countries. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Nigeria as part of a larger project that was also conducted in Kenya …

Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Kenya as part of a larger project that was also conducted in Nigeria and Senegal. The specific objectives of the study were to assess the factors influencing the acceptability of the method among clients, their spouses, providers, community members, …

Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council

Reproductive Health

Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.

---

This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …

Gender Considerations Along The Hiv Treatment Cascade: An Evidence Review With Priority Actions, Melanie Croce-Galis, Jill Gay, Karen Hardee, What Works Association, Population Council

Reproductive Health

This treatment brief provides policymakers and program implementers with evidence about the impact of gender dynamics on treatment access and adherence and the gender-related gaps in treatment research and programming. It also includes priority actions that can be taken to better address gender within treatment programming and raises questions for implementation science in order to achieve the global 90-90-90 goal. This brief draws from What Works for Women and Girls: Evidence for HIV Interventions and uses the WHO treatment cascade framework to identify and analyze major gender considerations in providing antiretroviral therapy to those living with HIV in low- and …

Proposed Indicators To Measure Adherence To And Effects Of Rights-Based Family Planning: Resource Guide, Kelsey Wright, Karen Hardee

Reproductive Health

At the London Summit on Family Planning in 2012, the goal of expanding access to FP programs by 120 million additional women and girls by 2020 was established. This goal calls attention to the need for FP information and services to be delivered in ways that are voluntary and respect human rights. While human rights have been codified and affirmed in declarations, conventions, and treaties, operationalizing rights in FP programs is still in an early stage of development. With the recent emergence of global numeric benchmarks for FP programs, there is the risk that the focus will move away from …

Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi

Reproductive Health

In collaboration with the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Programme Consortium, the Population Council implemented a project to increase the demand for secondary school education in Homa Bay County, Kenya—an area characterized by high, unintended teenage pregnancy and female school drop-out rates. To foster awareness of the school re-entry policy, the Population Council collaborated with the Homa Bay County Department of Education (Ministry of Education) to convene a policy dialogue for all principals of public, day, girls-only, and co-educational secondary schools in the area. The policy dialogue helped to create visibility around the issue of …

Creating Conditions For Scale Up: Technical Assistance As An Implementation Research Uptake Strategy, Ian Askew

Reproductive Health

No abstract provided.

The Influence Of Participating In An International Clinical Experience During Baccalaureate Nursing Education On Interprofessional Collaboration And Teamwork For New Registered Nurses, Sherylyn Watson

Nursing Faculty Publications

An increased focus on interprofessional collaboration and teamwork in the healthcare professions had placed demands on nursing education to identify evidence based instructional strategies that bolster the interprofessional competency in prelicensure nursing education. One approach in addressing the call was to explore current educational opportunities for their effectiveness in developing interprofessional collaboration and teamwork. The popular trend in nursing education was to offer international clinical experiences that provide nursing care to impoverished people of developing countries. The current literature on these experiences had primarily focused on short-term outcomes that demonstrate personal growth of the individual, exposing opportunity for research concentrating …

An O'Neill Institute Briefing Paper: Ebola, The World Health Organization, And Beyond: Toward A Framework For Global Health Security, Lawrence O. Gostin, Eric A. Friedman, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic has demonstrated that the world remains ill-prepared to respond to infectious disease outbreaks. A host of institutions are now reviewing what went wrong, and new institutions are being considered, including an African Centers for Disease Control and Prevention and World Bank-initiated Pandemic Emergency Facility. The World Health Organization itself failed in one of its core functions by allowing a preventable infectious disease to spiral out of control in the world’s poorest region. The 68th World Health Assembly (WHA), held in May 2015, provided an opportunity for the Organization to reflect on what went wrong and …

Agency Of The South Sudanese: Compensating For Health Care In Mungula Refugee Settlement, Lauren Schmidt

Independent Study Project (ISP) Collection

In reaction to the endemic violence, which has forced many South Sudanese to flee their homes and seek refuge within Uganda’s borders, the researcher spent the practicum interning with the Uganda Red Cross Society (URCS) in Mungula refugee settlement, under academic advisor Steven Mawa. As the organization is the leading health provider in the settlement, the researcher gained insight into the provision of social services to the population, which allowed an extensive study on the ability of the South Sudanese to compensate for shortages in care and various complications associated with doing so.

The researcher sought to entertain these inquiries …

Baseline Survey Of Nigerian Media Coverage Of Youth Sexual And Reproductive Health And Hiv And Aids Related Issues, January 1st–December 31st, 2012, Population Council

HIV and AIDS

To promote more informed public dialogue on youth vulnerabilities, responses to HIV/AIDS, and positive changes in relevant policies and programs via learning and advocacy interventions at the state and national levels in Nigeria, the Population Council commissioned a study of the print and electronic media’s coverage of HIV/AIDS and sexual and reproductive health–related issues among youth aged 15–24 years in Nigeria for the period January 1 to December 31, 2012. The study entailed a content analysis of four national and two regional newspapers, and an online forum that is one of the most frequently visited social media sites in Nigeria. …

Documentation Of Hiv Prevention Research And Programmatic Learnings From India—Selected Peer-Reviewed Journal Articles And Key Highlights: 2013-2014 (Volume 2), Population Council

HIV and AIDS

Over the past decade (2001–11), there has been a steady decline in adult HIV prevalence in India as a result of evidence-based, intensive, and scaled HIV-prevention programs. Findings from the implementation of programs have been widely documented and have been published both as reports and peer-reviewed journal articles. In “Documentation of HIV Prevention Research and Programmatic Learnings from India,” Volume 2, we bring together recent articles published in peer-reviewed journals on the lessons learned from the HIV-prevention program in India. The document is divided into four thematic sections, and research highlights are presented at the start of each section. This …

Balika Fact Sheet: Highlight On Livelihoods, Population Council

Poverty, Gender, and Youth

There are few income-earning opportunities for adolescent girls in the Bangladeshi Association for Life Skills, Income, and Knowledge for Adolescents (BALIKA) study area, and livelihoods opportunities vary considerably by economic status and education. The ability to acquire livelihood-relevant skills, networks, and work experience during adolescence can be an important predictor of productive capacity later in life. However, across the study districts, the proportion of adolescent girls who are working is low. Most girls work as tutors or are engaged in the agricultural and poultry sector. Better-educated girls are more likely to be engaged in paid work. This BALIKA “Highlight on …

Adolescents In Rajasthan 2012: Changing Situation And Needs, Shireen J. Jejeebhoy, Rajib Acharya

Poverty, Gender, and Youth

Several national policies and programs formulated since 2000 have underscored India’s commitment to addressing the multiple needs of youth. The Rashtriya Kishor Swasthya Karyakram (RKSK) program launched in 2014 helped provide the framework for services for young people’s health in general, and their sexual and reproductive health, mental health, and prevention and care of noncommunicable diseases, in particular. The earlier Youth in India: Situation and Needs 2006–2007 study was the first-ever subnationally representative study conducted to identify key transitions experienced by married and unmarried youth in India. Data have now become available from a repeated survey conducted in 2012 in …

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Africa's Youth: Insights From A Multi-Country Study, Babatunde A.O. Ahonsi, Nahla G. Abdel-Tawab, Scott Geibel, Sam Kalibala, Jerry Okal, Babacar Mane, Nathi Sohaba, Julialynne Walker, Eric P. Green

HIV and AIDS

This report contains information from a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and …

Formative Research To Develop An Intervention For Addressing Mental Health/Psychosocial Issues And Hiv Vulnerability Of Marginalized Adolescents In Addis Ababa, Ethiopia, Nrupa Jani, Katie D. Schenk

HIV and AIDS

Children and adolescents who migrate from rural regions to Addis Ababa, Ethiopia often flee their households to escape from abusive families, forced marriages, poverty, lack of economic opportunity and education, and other social problems. They are often met with equally harsh, if not worse, challenges when they arrive in Addis Ababa, including treacherous living situations, abusive working conditions with meager compensation, limited opportunities for education and socialization, and absence of family support. This study conducted a qualitative needs assessment to determine type and extent of mental health and psychological needs among adolescent migrants living in Addis Ababa in order to …

Pmtct Cascade Analysis In Côte D'Ivoire: Results From A National Representative Sample, Stephen S. Gloyd, Julia Robinson, Serge A. Dali, S. Adam Granato, Rebecca Bartlein, Seydou Kouyate, David Aka, Doroux A. Billy, Irma Ahoba, Ahoua Kone

HIV and AIDS

Without treatment, an HIV-positive pregnant woman has a 30–35 percent chance of transmitting the infection to her child. Early detection and appropriate treatment during pregnancy, childbirth, and breastfeeding can reduce those odds to less than 5 percent. Consequently, WHO and countries around the world have instituted prevention of mother-to-child transmission of HIV (PMTCT) programs, consisting of the “PMTCT cascade”: testing for HIV at the first antenatal visit; CD4 test of HIV-positive patients; antiretroviral (ARV) prophylaxis to mother throughout pregnancy and breastfeeding; ARV prophylaxis to child at delivery and throughout breastfeeding; HIV testing of child and initiation of antiretroviral therapy (ART) …

Provider Alerts And Reminders To Improve Tuberculosis Care Among People Living With Hiv In Kenya: Tb Tech Formative Report, Caricia Catalani, Eric P. Green, Lameck Diero, Jane Carter, Martin Were, Dennis Israelski, Adrian Gardner, Charity Ndwiga, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) have a 20-fold higher risk of dying from tuberculosis (TB) than the general population. Reducing TB morbidity and mortality among PLHIV requires identifying those with active TB and treating them, as well as preventing new TB infections among those not infected. WHO recommends screening all HIV-infected patients for symptoms of active TB infection, testing those who show symptoms, treating those with positive TB tests, and providing isoniazid preventive therapy (IPT) for those who are either asymptomatic or whose TB test results are negative. WHO classifies Kenya among the “high burden” countries for TB and notes …

Retention Of Adolescents Living With Hiv In Care, Treatment, And Support Programs In Uganda, Livingstone Ssali, Sam Kalibala, Josephine Birungi, Aggrey Egessa, Jonathan Wangisi, Joanne Lyavala Okullu, Celestin Bakanda, Stephen Okoboi, Francis Obare

HIV and AIDS

Understanding the extent to which adolescents aged 10–19 years who are living with HIV are retained in HIV care, treatment, and support is important for informing the design of effective services for this population to better meet their needs across three main areas of HIV and AIDS programming: treatment; care and support; and prevention. Retention in HIV programs is, in turn, important for positive clinical outcomes including viral suppression and survival. In 2013–2014, The AIDS Support Organization and the Population Council undertook a study to generate evidence on factors associated with retention of adolescents in HIV and AIDS programs in …

An Overview Of The Hiv Prevention Landscape In Zimbabwe: Implications For Tenofovir Gel, Population Council

HIV and AIDS

Zimbabwe has seen a tremendous shift in the HIV landscape in the last decade, particularly regarding prevalence. Yet many people, especially women, are still at high risk and efforts to identify and implement additional HIV-prevention options remain critical. Topical microbicides are a promising new technology that women can control or initiate, with a number of products tested in clinical trials over the past two decades. As research moves forward, decision-makers and other stakeholders need key background information to inform strategic decision-making regarding introduction of tenofovir gel and other new HIV-prevention products. The Population Council has designed a toolkit to assist …

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Nigeria's Youth, Population Council

HIV and AIDS

This report documents the findings of a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing Nigerian youth and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the national response to HIV. Researchers conducted an analytical review of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in Nigeria. In addition, qualitative and quantitative analyses enabled an evaluation of the factors associated with young people’s sexual …

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Of Nigeria's Youth: Summary Of Study Findings, Population Council

HIV and AIDS

Nigerian youth, especially females, are disproportionately affected by HIV yet remain a neglected subpopulation in the response to HIV. Current HIV-prevention interventions are often not youth-friendly in design and implementation. Youth, therefore, fail to access these services which further worsens their vulnerability to HIV/AIDS. This study, implemented between August 2011 and July 2012, sought to provide a comprehensive evidence-based picture of the HIV-related issues facing Nigerian youth and the prevailing legal, policy, and programmatic responses. Researchers conducted an analytical review of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in Nigeria. …

Policy And Programme Considerations For Arv-Based Prevention For Women: Insights From Key Opinion Leaders In Zimbabwe About Tenofovir Gel, Samukeliso Dube, Barbara Friedland, Saiqa Mullick, Martha Brady, C. Elizabeth Mcgrory

HIV and AIDS

Zimbabwe has seen a tremendous shift in the HIV landscape in the last decade, particularly regarding prevalence. Yet many people, especially women, are still at high risk and efforts to identify and implement additional HIV-prevention options remain critical. After nearly 20 years of microbicides research, 1 percent tenofovir gel is the first vaginal microbicide to show promise. Since 2011, Zimbabwe has been scaling up use of tenofovir-based regimens as first-line therapy for adults infected with HIV. A randomized, placebo-controlled, double-blind trial demonstrated that women assigned to use 1 percent tenofovir gel had a 39 percent lower risk of HIV infection …

Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council

HIV and AIDS

The 2011 National Sentinel Surveillance estimated that 1.9 million people in India aged 15 and older were living with HIV. An estimated 39 percent are women. Given the urgent need for HIV-prevention options for women, a number of efforts are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a guide to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The guide includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. The …

Reduce Contraception Discontinuation In Bangladesh By Improving Counseling On Side Effects, Fauzia Akhter Huda, Sabiha Chowdhuri

Reproductive Health

High rates of contraceptive discontinuation and method failure could cause Bangladesh to lose the progress made in increasing contraceptive use over the past 20 years. This policy brief concludes that if women are adequately counseled and supported to sustain their use of more effective contraceptive methods, they will need less medical attention, have fewer unintended pregnancies, and reduce the workload for medical clinics. Furthermore, if providers are adequately trained and supported in counseling and managing side effects and in helping women to switch methods when they do have a problem, the Family Planning Clinical Contraception Services Delivery Program would meet …

Confronting Disrespect And Abuse During Childbirth In Kenya: The Heshima Project, Population Council

Reproductive Health

No woman should be hit, yelled at, or abused in any way during childbirth. However, laboring women in Kenya and elsewhere may experience inhumane treatment in hospitals and clinics. This abuse is a key yet overlooked reason why only four in ten pregnant women in Kenya deliver at health facilities. To increase the number of women delivering in health facilities and thereby reduce maternal deaths, governments, health systems, and practitioners need sound evidence documenting the disrespect and abuse that women experience. Through the Heshima Project, the Population Council is changing how health systems and women think about quality maternity care …

Assessment Of Sex Selection In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Forhana Rahman Noor

Reproductive Health

According to UN estimates, the sex ratio at birth (SRB) has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. Generally, the SRB becomes skewed in a setting where fertility is declining or low and where son preference exists. Strong son preference compounded by the availability of measures to implement such preference can lead to increased SRB. For example, the increasing availability of prenatal diagnostic technologies, together with declining fertility desires and persistent son preference, has contributed to increased gender-biased sex selection in several Asian countries, including China and India. …

Setting The Stage For Arv-Based Prevention For Women: A Snapshot Of The Zimbabwean Context, Population Council

HIV and AIDS

Zimbabwe, with an estimated population of 12.7 million people, is among the countries in sub-Saharan Africa most affected by the HIV epidemic. Given the urgent need for HIV-prevention options for women, a number of projects are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a toolkit developed by the Population Council to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The toolkit includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. …

Validating Indicators Of The Quality Of Maternal Health Care: Final Report, Kenya, Charlotte E. Warren, James Kelly Kimani, Jackline Kivunaga, Brian Mdawida, Charity Ndwiga, Katharine Mccarthy, Ann K. Blanc

Reproductive Health

Despite widespread use, the majority of indicators proposed as measures of the quality of maternal health services have not been sufficiently validated. To accurately track progress toward national and global maternal health goals, the present study sought to validate and identify a set of maternal health indicators that can be practically applied in facility and population-based surveys. To evaluate indicators, the study employed a facility-based design. The study was conducted in public/government hospital facilities in Kenya and Mexico. Participants included women aged 15–49 who underwent labor and delivery at participating study facilities and the providers who attended them. Women’s self-report …

Achieving Mdgs 4 And 5 In Punjab: The Role Of Family Planning, Population Council

Reproductive Health

This brief focuses on the policy options available to the Punjab government to affect the province’s population growth by 2050 and its potential to achieve MDGs 4 and 5. Maternal mortality is a leading cause of death among women of reproductive age in Punjab—about 16 percent of the deaths in this age group are pregnancy-related. Approximately 6,000 women die each year in Punjab due to pregnancy-related factors. Pregnancies that occur too early, too late, or too frequently increase the risk of maternal death. Lowering fertility rates by increasing the use of family planning can help reduce pregnancy-related deaths. The good …