International Public Health Commons^™

Maternal And Newborn Health Behaviors In Rural Uttar Pradesh: Findings From Learning Phase Baseline Survey 2013, M.E. Khan, Praween Kumar Agrawal, Avishek Hazra, Anvita Dixit, Isha Bhatnagar, Jaleel Ahmad, D.N. Ahmad

Reproductive Health

The Uttar Pradesh Community Mobilization Project (2011–16) aims to develop and scale up evidence-based interventions to improve reproductive, maternal, neonatal, and child health and nutrition health behaviors by an average of 10 percentage points among marginalized populations in Uttar Pradesh, India. The goal is to reduce neonatal mortality by improving maternal and child health behaviors through developing and scaling up a package of family health interventions and strengthening the management of Behavior Change Communication using self-help groups as the platform. The project is being carried out in two phases—a learning phase covering 10 blocks and a scale-up phase covering 100 …

Cultural Factors Associated With Utilization Of Antenatal Care Services In Rural India, Anjali Om

Undergraduate Research Posters

Despite vast economic growth in developing countries in the past few years, infant mortality continues to plague underdeveloped regions, particularly rural regions of India. Many of these deaths are caused by a lack of education and motivation in regard to utilization of antenatal and neonatal care services to prevent and treat consequences of unhygienic umbilical cord care.

For years, high incidences of neonatal tetanus have plagued rural areas of India as a result of cultural practices that encourage topical applications of cow dung to cut umbilical stumps either directly or by using ghee heated with cow dung to warm umbilical …

A Silent Killer Of India’S Women: Investigating The Barriers To Adequate Tuberculosis Treatment And Diagnosis For Women In Bhopal, Madhya Pradesh, Evonne Mcarthur

Independent Study Project (ISP) Collection

Nearly 20 years ago, the World Health Organization declared tuberculosis as a global public health emergency, yet today TB still remains a major global health challenge. It is estimated that during 2012 8.6 million were infected with TB and 1.3 million died from the disease (WHO, 2013). Globally, more than one third of the population is infected with TB and, after HIV/AIDS, TB is the greatest killer world-wide due to a single infectious agent. 95 percent of the global TB burden lies within low and middle-income countries and among the 22 countries determined to be high epidemiological burden countries, India …

Femininity, Dependency, And Patriarchy: The Marginalization Of Women With Japanese Encephalitis And Neurological Sequelae In The Northern Terai Region Of Uttar Pradesh, Katherine Ehrenreich

Independent Study Project (ISP) Collection

The present study seeks to determine how girls and women who have suffered from neurological sequelae after a Japanese encephalitis (JE) infection are marginalized in the Northern Terai region of Uttar Pradesh, India. Societal and familial values were studied in comparison to behaviors towards a neurologically disabled girl after a JE infection in order to determine how women infected with JE are excluded from cultural practices and norms. The 4 study was conducted in the Northern Terai region of Uttar Pradesh in the districts of Bahraich and Shrawasti under the guidance of DEHAT and Dr. Jitendra Chaturvedi. Semi-structured interviewing was …

Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru

Reproductive Health

This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …

Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai

Reproductive Health

The objectives of this Population Council study were twofold: first to collect information on prevailing practices of abortion and post‐abortion care in Pakistan and, second, to gauge changes in the magnitude and quality of abortion‐related complications and care during the last decade (since the 2002 national study of “Unwanted Pregnancy and Post‐abortion Complications in Pakistan”). The study found that the level of post‐abortion family planning (FP) counseling in both public and private health facilities offering PAC services was inadequate. There has been no improvement over the decade in the level of counseling reported, and, even more disappointingly, only half of …

Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew

Reproductive Health

No abstract provided.

Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on …

The Contracting World Of Girls At Puberty: Violence And Gender-Divergent Access To The Public Sphere Among Adolescents In South Africa, Kelly Hallman, Nora Kenworthy, Judith A. Diers, Nick Swan, Bashi Devnarain

Poverty, Gender, and Youth

This Population Council working paper describes a participatory mapping project undertaken with single-sex groups of grade 5 and grade 8–9 children in urban and rural KwaZulu-Natal, South Africa. At grade 5, female self-defined community areas were equal to or larger in size than those of males in both sites. However, wide gender divergence in access to the public sphere was found among grade 8–9 children. Although curtailed spatial access, especially in urban areas, is intended to protect post-pubescent girls, grade 8–9 girls reported most spaces in their small navigable areas unsafe. Reducing girls’ access to the public sphere does not …

Subjective Health Status And Health-Related Quality Of Life Among Women With Recurrent Vulvovaginal Candidosis (Rvvc) In Europe And The Usa, Samuel Aballéa, Florent Guelfucci, Julian Wagner, Amine Khemiri, Jean-Paul Dietz, Jack Sobel, Mondher Toumi

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.

Methods

A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing …

Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar

Reproductive Health

Maternal mortality in Ethiopia remains among the highest in the world. A UN Commission Report in 2012 identified 13 life-saving commodities—defined as medicines, medical devices, and health supplies—that effectively address avoidable causes of death during pregnancy and childbirth that, if more widely accessed and properly used, could significantly reduce preventable deaths among women. This assessment, conducted by the Population Council, evaluates the availability of these life-saving commodities that are essential for basic emergency obstetric and neonatal care, and safe and clean delivery services within primary health care in Ethiopia. The report concludes that Ethiopia’s pharmaceutical procurement and supply system is …

Day Of Dialogue: Mainstreaming Emergency Contraception In The National Family Welfare Program, Population Council

Reproductive Health

The Population Council, in collaboration with the Family Planning Association of India, hosted a Day of Dialogue which addressed issues related to access, availability and use of emergency contraception pills (ECP). Some of the key issues addressed in this consultation included: provider knowledge on mechanism of action and attitudes toward easy access to ECP and its link to premarital sex and promiscuity, repeated use of ECP, and lack of information about ECP among potential users. The Population Council shared key findings of a recent study on knowledge, attitudes, and opinions of gynecologists and pharmacists on ECP use. The one-day consultation …

Day Of Dialogue: Expanding Opportunities For Increased Access To Emergency Contraception (Ec) In Nigeria, Population Council

Reproductive Health

In order to create a supportive policy and service delivery environment for emergency contraception (EC) and improve uptake in Nigeria, the Population Council conducted a survey of service providers’ knowledge, attitudes, and practices regarding EC, supplemented by in-depth interviews with key opinion leaders regarding their perceptions. This study revealed gaps that have implications for policy and programming. In collaboration with the International Consortium for Emergency Contraception, the Population Council convened a “Day of Dialogue” on EC to discuss the key research findings and to recommend strategic considerations for repositioning EC within the country's family planning program. This report describes the …

Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab

Reproductive Health

These slides present results from a Population Council study conducted in Egypt aimed at identifying factors that prevent Egyptian couples from attainment of their reproductive goals using a rights-based, gender-sensitive analysis of family planning service demand and supply. The analysis focused on six aspects of clients’ rights: clinic/provider readiness, accessibility and affordability, privacy and confidentiality, choice and autonomy, informed decisionmaking, and the right to complain. The presentation concludes with recommendations for closing gaps that exist with regard to protection of clients’ rights to autonomy, choice, informed decisionmaking, privacy, and confidentiality.

Effectiveness Of A Comprehensive Sexual And Gender-Based Violence Prevention Project For In-School Girls In Swaziland, Swaziland Action Group Against Abuse (Swagaa)

Reproductive Health

Swaziland is one of the sub-Saharan African countries affected by sexual and gender-based violence (SGBV) and HIV and AIDS, with women facing greater risk compared to men. In response to increasing reports of violence against women and children in the country, the Swaziland Action Group Against Abuse launched a Girls’ Empowerment Clubs (GEC) program in primary and secondary schools in order prevent SGBV cases. Due to limitations of the program (such as being led by teachers and reliance on volunteers), an intervention study was carried out by the Population Council to test the effectiveness of an enhanced version, “GEC-Plus,” that …

Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew

Reproductive Health

This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …

Journee De Dialogue Sur La Contraception D'Urgence (Cu), Population Council, International Consortium For Emergency Contraception

Reproductive Health

Le Population Council en collaboration avec le Consortium International sur la Contraception d’Urgence, a organisé, une journée de dialogue sur la contraception d’urgence (CU) au Sénégal, en partenariat avec le Ministère de la Femme, de l’Enfant et de l’Entreprenariat Féminin; le Ministère de la Santé et de l’Action Sociale; et le Ministère de la Jeunesse, de l’Emploi et de la Promotion des Valeurs Civiques. L’objectif principal de la journée était de développer un plan d’actions pour la création d’un environnement politique et juridique plus favorable à l’offre de CU, et pour la vulgarisation de la CU auprès des communautés. Suite …

Mitigating The Consequences Of Sexual Violence In Zambia By Decentralizing Emergency Medical Responses To Police Victim Support Units: Report On The Feasibility Of Police Provision Of Post-Exposure Prophylaxis For Hiv (Pep) In Zambia, Mary Zama, Mardieh Dennis, Jessica Price, Stephanie M. Topp, Jonathan Kaunda Mwansa, Jill Keesbury

Reproductive Health

The Zambian Ministry of Home Affairs (housing the Zambia Police Service); the Ministry of Health, the Ministry of Community Development, Mother and Child Health; and the Population Council collaborated on operations research studies to increase provision of emergency medical care to survivors of sexual violence via the Zambia Police Services (ZP). Recognizing the need to strengthen linkages between the police and the health sector and following up on the lessons learned from earlier models of police delivery of emergency contraception, this feasibility study was designed to: determine if victim support unit (VSU) officers could be trained to safely and effectively …

Gender-Based Violence: A Qualitative Exploration Of Norms, Experiences And Positive Deviance, Shireen J. Jejeebhoy, K.G. Santhya, Shagun Sabarwal

Reproductive Health

This report presents the findings of formative research the Population Council conducted, with support from UK aid, in the district of Patna, India that aimed to better understand the context of violence—physical, emotional, and sexual—against women and girls, and notably, the prevailing norms about men’s entitlement and women’s acquiescence to violence. Findings suggest that violence against women and girls is widespread and widely justified, that women are perceived as having few options but to tolerate violence, and that the most common response to violence is silence. At the same time, many women and some positive deviant men recognize the injustice …

Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu

Reproductive Health

Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The specific objectives of the initiative were to: increase knowledge, awareness, and use of EC among Kenyan women; increase knowledge and awareness of EC among health providers; and strengthen EC provision in both the private and public sectors. This policy brief describes a toolkit designed for policymakers and service providers which draws on the achievements, lessons learned, and experiences from this project.

Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community

Reproductive Health

The East, Central and Southern Africa (ECSA) Health Community, which prioritizes gender-based violence and child sexual abuse as regional health concerns, partnered with the Population Council to convene a pre-conference Expert Committee meeting of the Research, Information and Advocacy Programme. The conference marked a major milestone in the ECSA Health Community’s commitment to promote and support region-wide sharing and utilization of health research and policy information among its member states. This report summarizes the deliberations of the two-day workshop and the recommendations for implementing an advocacy plan to address this important facet of the region’s development agenda.

Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes

Reproductive Health

Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …

Reviewing The Evidence And Identifying Gaps In Family Planning Research: The Unfinished Agenda To Meet Fp2020 Goals, Ian Askew, Martha Brady

Reproductive Health

The Population Council produced this paper to help guide discussions and considerations regarding the key evidence gaps and research investments needed to achieve the FP2020 goal and objectives. The paper focuses primarily on the social science, implementation, and operations research that will be needed to achieve the first three objectives. Research shows that through high-quality voluntary family planning (FP) programs, governments can reduce fertility and generate substantial improvements in health, wealth, human rights, and education. Family planning programs for the 21st century will require thoughtful design—engaging both public and private sectors—to meet the growing need for safe and effective FP …

Access To Emergency Contraception And Safe Abortion Services For Survivors Of Rape And Defilement In Sub-Saharan Africa: A Regional Overview, Jill Thompson, Chi-Chi Undie, Ian Askew

Reproductive Health

No abstract provided.

Adapting The Who Tool On Sexual And Reproductive Health And Human Rights: Experiences In Four Countries, Ian Askew, Kaila Clarke, Fauzia Akhter Huda, Joyce Mumah, Mary Philip Sebastian

Reproductive Health

No abstract provided.

Cost Estimation For Scale-Up Of Voucher Services In Kenya, Shubhra Kumar, Smita Sanghrajka, Benjamin Bellows

Reproductive Health

This document reports on the Government of Kenya’s Output-Based Aid (OBA) vouchers program—an affordable strategy to meet the international and national objectives for improved maternal and reproductive health. To help achieve the global Millennium Development Goals related to maternal and child health, the Kenyan government has launched several initiatives including this Vision 2030 flagship program which harmonizes global and national objectives by improving access and enhancing equity in health service delivery. The report finds that the three maternal health MDG indicators—maternal mortality rate, rate of institutional deliveries, and contraceptive prevalence—can all be improved substantially by scaling up the OBA program. …

Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

Un profil pays a été préparé pour le Sénégal pour compiler et synthétiser les informations disponibles sur la santé de la reproduction, en particulier les grossesses non désirées et par conséquent les besoins non satisfaits en matière de planification familiale. D’importants efforts ont été consentis par l’Etat sénégalais, mais de nombreux obstacles continuent de freiner les progrès réalisés. Un programme national plus cohérent et ciblé est donc nécessaire pour réduire ces obstacles. Dans le même temps, les acteurs non-gouvernementaux devraient poursuivre leurs efforts pour renforcer leur programmation pour produire des effets plus immédiats, tout en assurant une meilleure coordination entre …

Analyse Des Besoins Non Satisfaits Au Sénégal, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Cette étude vise à établir l’importance relative d’un manque d’accès et d’attitudes de résistance envers l’utilisation de la contraception dans les strates géographiques et de population du Sénégal. Elle est destinée à informer les décideurs politiques sur la priorité à accorder à la communication pour le changement de comportement ou pour l’amélioration de l’accès/de l’information, et également à aider lors de la conception d’interventions pour réduire les inquiétudes par rapport à la santé et la peur des effets secondaires, tels que la provision d’une gamme de méthodes plus élargie et le counseling amélioré. Plus de la moitié des femmes ayant …

International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with STEP UP and AFIDEP, held a seminar in Nanyuki, Kenya, in May 2013. The seminar brought together 44 scientists, policymakers, and program managers to present and discuss a range of issues relating to the definition, determinants, and consequences of unmet need for family planning and program interventions designed specifically to reduce unmet need in groups at high risk. Based on discussions and presentations, unmet need (and family planning in general) should be looked at both from a development perspective and from a service-delivery and health-sector perspective. Overall, the seminar papers, …

Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed

Reproductive Health

The Population Council Bangladesh, in collaboration with the Directorate General of Family Planning and Marie Stopes Bangladesh, with funding from the World Health Organization and the DFID-supported STEP UP project, conducted an 18-month operations research study from January 2012 to June 2013. This operations research tested the feasibility of introducing menstrual regulation with medication (MRM) in Bangladesh and assessed accessibility of the combination regimen of mifepristone and misoprostol in urban and rural health facilities. Based on this study’s results, the feasibility of introducing MRM services in Bangladesh is clear, and women receiving MRM were satisfied with their overall quality of …