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Full-Text Articles in International Public Health

Developing And Testing Strategies For Increasing Awareness Of The Iud As A Contraceptive Option, Ricardo Vernon, M.E. Khan, Harriet Birungi, Ian Askew, William Stones Jan 2007

Developing And Testing Strategies For Increasing Awareness Of The Iud As A Contraceptive Option, Ricardo Vernon, M.E. Khan, Harriet Birungi, Ian Askew, William Stones

Reproductive Health

A workshop was held in England in 2004 to identify the most promising interventions for increasing access to the IUD and to generate protocols for small-scale operations research projects to be undertaken in selected countries. Participants were academics, policymakers, program staff, and service providers from Bangladesh, Ghana, Guatemala, Honduras, India, Kenya, and Nepal. The workshop objectives were to review international experiences with approaches to increase access to and use of the IUD; identify factors explaining the decline in IUD use in many countries; identify factors favoring client demand for IUD; review barriers to effective IUD service delivery; identify issues of …


Technical Assistance To The Institute Of Reproductive Health, Georgetown University In Researching Introduction Strategies For The Standard Days Contraceptive Method (Sdm), Saumya Ramarao, James R. Foreit Jan 2007

Technical Assistance To The Institute Of Reproductive Health, Georgetown University In Researching Introduction Strategies For The Standard Days Contraceptive Method (Sdm), Saumya Ramarao, James R. Foreit

Reproductive Health

The Institute of Reproductive Health (IRH), Georgetown University tested the impact of introducing the standard days contraceptive method (SDM) with the technical assistance (TA) of Population Council staff. FRONTIERS technical assistance had the immediate effect of allowing IRH to carry out evaluations of the SDM in Asia and Latin America. The IRH studies also produced important lessons learned on strategies for the introduction of natural methods. IRH staff responsible for the India and Ecuador projects learned specific skills in cost-analysis and research instrument design.


Effect Of Introducing An 'Afternoon Pay Clinic' On Service Utilization And Cost Recovery (Nepal), Mahendra Pd. Shrestha, Rajesh Swar, Pradeep Panda, M.E. Khan, Rick Homan Jan 2007

Effect Of Introducing An 'Afternoon Pay Clinic' On Service Utilization And Cost Recovery (Nepal), Mahendra Pd. Shrestha, Rajesh Swar, Pradeep Panda, M.E. Khan, Rick Homan

Reproductive Health

An operations research study was initiated with financial and technical assistance from the FRONTIERS program to examine whether introducing an afternoon clinic at the Chhetrapati Family Welfare Center (CFWC) in Nepal with a substantially higher registration fee could improve cost recovery by adding more to program revenues than to program costs. The study showed, however, that premium pricing of afternoon services generated very little additional demand for services. Even with a premium price, the afternoon clinic could reach its cost recovery goal only if the volume of afternoon clients were to increase significantly. However, client perceptions about the ability of …


Assessing The Feasibility, Acceptability And Cost Of Introducing Postabortion Care In Health Centres And Dispensaries In Rural Tanzania, Monica Wanjiru, Ian Askew, Nzoya Munguti, Saumya Ramarao, Rick Homan, Reheme Kahando, John M. Pile Jan 2007

Assessing The Feasibility, Acceptability And Cost Of Introducing Postabortion Care In Health Centres And Dispensaries In Rural Tanzania, Monica Wanjiru, Ian Askew, Nzoya Munguti, Saumya Ramarao, Rick Homan, Reheme Kahando, John M. Pile

Reproductive Health

The EngenderHealth ACQUIRE Project has been supporting the Tanzanian Ministry of Health (MOH) since early 2005 to decentralize the management of postabortion care (PAC) services to primary healthcare facilities (health centers and dispensaries), with the intention of bringing services closer to women who are unable to access them at district hospitals. Findings from this study were provided to the MOH and ACQUIRE to address issues arising from introduction of the intervention; and in September 2006, to assess the feasibility, cost, and effectiveness of the intervention. Findings show that the intervention appears to have broadened service providers’ range of clinical skills …


Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi Jan 2007

Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi

Reproductive Health

The objective of this paper is to explore the experiences of women undergoing a particular form of fertility regulation, namely sterilization or tubal ligation, in a variety of facilities in Chennai, India. The paper examines specifically the nature of information provided to clients, the consent-taking process, the nature of its documentation, and the extent to which clients made an informed choice. The findings underscore that although all the women respondents did wish to practice a method of contraception, and did want to adopt sterilization, several limitations were noted in the process of providing informed consent: inadequate information was provided to …


Health Systems And Maternal Mortality, Neonatal Mortality And Child Health: Review Of Selected Service Delivery Models, Md. Noorunnabi Talukder, Ubaidur Rob Jan 2007

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 …


Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health Jan 2007

Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health

Reproductive Health

Female genital cutting is strongly supported among the Somali ethnic community in Kenya, and the severest form (infibulation) is primarily practiced. This type of cut is associated with increased incidence and seriousness of obstetric and gynecological problems relative to uncut women and those with less severe forms of FGM/C. As stated in this brief, efforts to encourage abandonment should begin with community discussion about the socio-cultural reasons for cutting. Simultaneously, health-care providers need training in how to manage complications of FGM/C. In 2004, FRONTIERS collaborated with UNICEF on a four-month diagnostic study on FGM/C practices among the Somali community in …


The Impact Of Immunization On The Association Between Poverty And Child Survival: Evidence From Kassena-Nankana District Of Northern Ghana, Ayaga A. Bawah, James F. Phillips, Martin Adjuik, Maya Vaughan-Smith, Bruce Macleod, Fred N. Binka Jan 2006

The Impact Of Immunization On The Association Between Poverty And Child Survival: Evidence From Kassena-Nankana District Of Northern Ghana, Ayaga A. Bawah, James F. Phillips, Martin Adjuik, Maya Vaughan-Smith, Bruce Macleod, Fred N. Binka

Poverty, Gender, and Youth

Research conducted in Africa has demonstrated consistently that parental poverty and low educational attainment adversely affect child survival. Relative poverty has a pronounced effect on the survival of children, even in a setting where nearly all families are poor. Results from the research presented in the working paper lend strong support to the United Nations’ goal of reducing excess childhood mortality among the poor by directing a particular focus on immunization. Findings in this working paper show that the adverse effects of poverty disappear and that the effects of educational attainment are reduced in survival models that control for immunization …


Providing New Opportunities To Adolescent Girls In Socially Conservative Settings: The Ishraq Program In Rural Upper Egypt, Martha Brady, Ragui Assaad, Barbara L. Ibrahim, Abeer Salem, Rania Salem, Nadia Zibani Jan 2006

Providing New Opportunities To Adolescent Girls In Socially Conservative Settings: The Ishraq Program In Rural Upper Egypt, Martha Brady, Ragui Assaad, Barbara L. Ibrahim, Abeer Salem, Rania Salem, Nadia Zibani

Poverty, Gender, and Youth

Out-of-school girls are among the most disadvantaged adolescents in rural Upper Egypt. Compared with girls attending school, they are more likely to be engaged in poorly paid farm work, more likely to be married early, and at greater risk for early childbearing and poor pregnancy outcomes. To respond to their situation, through the partnership of Caritas, the Center for Development and Population Activities, the Population Council, and Save the Children, the Ishraq program was designed: a holistic intervention to address the unmet needs of out-of-school adolescent girls. The pilot phase of Ishraq was launched in four rural villages of one …


In Our Own Hands: Swaa-Ghana Champions The Female Condom, Kathleen Cravero, Michelle Skaer, Victoria Ebin, Martha Brady Jan 2006

In Our Own Hands: Swaa-Ghana Champions The Female Condom, Kathleen Cravero, Michelle Skaer, Victoria Ebin, Martha Brady

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité describes the vital role played by the Ghana branch of the Society for Women and AIDS in Africa (SWAA) in introducing the female condom, the only female-controlled method for protection from HIV. By addressing issues of gender inequity and communication within relationships, SWAA used the female condom to empower women to regain control of their bodies. Also in this issue are profiles of three other approaches to programming for the female condom from Brazil, South Africa, and Zimbabwe.


Multiple Disadvantages Of Mayan Females: The Effects Of Gender, Ethnicity, Poverty, And Residence On Education In Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz Jan 2006

Multiple Disadvantages Of Mayan Females: The Effects Of Gender, Ethnicity, Poverty, And Residence On Education In Guatemala, Kelly Hallman, Sara Peracca, Jennifer Catino, Marta Julia Ruiz

Poverty, Gender, and Youth

Although access to primary education in Guatemala has increased in recent years, particularly in rural areas, levels of educational attainment and literacy remain among the lowest in Latin America. Inequalities in school access and grade attainment linked to ethnicity, gender, poverty, and residence remain. Age trends show that Mayan females are the least likely to ever enroll, and, if they do enroll, start school the latest and drop out earliest. Innovative programs for girls that combine instruction with social interaction in safe local community spaces may increase their educational attainment and their social networks and means of social support. In …


Living Up To Their Name: Profamilia Takes On Gender-Based Violence, Claudia Garcia-Moreno, Rachel E. Goldberg Jan 2006

Living Up To Their Name: Profamilia Takes On Gender-Based Violence, Claudia Garcia-Moreno, Rachel E. Goldberg

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité describes the evolution of Profamilia through its work on gender-based violence in the Domincan Republic.Their project was conceived along two simultaneous paths: providing support services directly to women and girls who had experienced violence and initiating advocacy in the wider policy arena. Profamilia joined the commission that ultimately designed and promoted a law to increase protection against violence, especially domestic violence against women and children. Although the clinics now run a dynamic service program, the agency has also sustained its advocacy activities. Most of Profamilia’s advocacy work is undertaken in partnership with other NGOs or with …


Reproductive Health Update Trainings For Health Workers In North Eastern Province, Garissa, Kenya Ministry Of Health, Population Council Jan 2006

Reproductive Health Update Trainings For Health Workers In North Eastern Province, Garissa, Kenya Ministry Of Health, Population Council

Reproductive Health

The Somali community living in Kenya has practiced the severest form of female genital mutilation/cutting (FGM/C), infibulation, for centuries. To understand the context within which the practice takes place, and how its complications are managed, FRONTIERS undertook a diagnostic study in North Eastern Province and in the Eastleigh area of Nairobi. The study found that the health system is ill equipped to serve women who have been cut, and particularly infibulated women who are pregnant and delivering, stemming from an overall weakness in the availability and quality of maternal and neonatal heath services. Specific recommendations could strengthen these services so …


Strategies For Encouraging The Abandonment Of Female Genital Cutting In West Africa: Experiences From Senegal, Burkina Faso, And Mali, Nafissatou J. Diop, Ian Askew Jan 2006

Strategies For Encouraging The Abandonment Of Female Genital Cutting In West Africa: Experiences From Senegal, Burkina Faso, And Mali, Nafissatou J. Diop, Ian Askew

Reproductive Health

This article explores efforts to encourage abandonment of female genital cutting (FGC) in Senegal, Burkina Faso, and Mali. The strategy of encouraging traditional practitioners to stop performing FGC is not effective as community-level support for the practice remains high. Training health staff significantly improved healthcare providers' levels of knowledge about FGC and its complications. Consequently, it was recommended that such training be incorporated into preservice medical training. The use of community-based strategies like the Village Education Program (VEP) showed the most promise, as their multifaceted approach addresses knowledge, attitudes, actions, and communal support in an integrated manner. The way forward …


Technical Assistance To Organizations In Guinea Seeking To Reduce Female Genital Cutting, Nafissatou J. Diop Jan 2006

Technical Assistance To Organizations In Guinea Seeking To Reduce Female Genital Cutting, Nafissatou J. Diop

Reproductive Health

This reports details the technical assistance the Population Council’s FRONTIERS program provided to WHO’s Africa Bureau to implement a project addressing medicalization of female genital cutting (FGC), and to support Tostan in replicating its program in Guinea. Technical assistance had several aims: to improve the effectiveness of strategies to abandon FGC in Guinea, to assist WHO in developing and implementing a project to reduce FGC medicalization by health providers, to build the capacity of Guinean organizations to appropriately monitor and evaluate their FGC-related activities, and to enable the Comité de Lutte contre les Pratiques Traditionnelles portant Atteinte aux Femmes (CPTAFE) …


Costs Of Reproductive Health Services Provided By Four Christian Health Association Of Ghana (Chag) Hospitals, James Boateng, Henry Surnye, Alex Mensah, Bismark Boateng, Philomena Nyarko, Nzoya Munguti, John H. Bratt Jan 2006

Costs Of Reproductive Health Services Provided By Four Christian Health Association Of Ghana (Chag) Hospitals, James Boateng, Henry Surnye, Alex Mensah, Bismark Boateng, Philomena Nyarko, Nzoya Munguti, John H. Bratt

Reproductive Health

The Christian Health Association of Ghana (CHAG) is a large faith-based NGO which currently serves an estimated 35 percent of the Ghanaian population, mainly in remote rural areas. This study built capacity within the CHAG secretariat to calculate the economic cost and cost recovery levels of selected reproductive health services in four CHAG-affiliated hospitals. Techniques learned in the study are applicable to most costing problems, not just to reproductive health. Information obtained in the study forms the basis for negotiating reimbursement under the Ghana National Health Insurance Scheme, and for setting cost recovery and containment policies. CHAG senior managers plan …


Priority Setting For Reproductive Health At The District Level In The Context Of Health Sector Reforms In Ghana, Harriet Birungi, Philomena Nyarko, Ian Askew, Ayorinde Ajayi, Gifty Addico, Edward Addai, Caroline Jehu-Appiah Jan 2006

Priority Setting For Reproductive Health At The District Level In The Context Of Health Sector Reforms In Ghana, Harriet Birungi, Philomena Nyarko, Ian Askew, Ayorinde Ajayi, Gifty Addico, Edward Addai, Caroline Jehu-Appiah

Reproductive Health

This report outlines results of an in-depth assessment carried out in Ghana in order to provide a better understanding of key factors affecting reproductive health (RH) prioritization at the district level; and to make recommendations for policy dialogue, advocacy, resource allocation, and RH program implementation. In particular, the study examined whether or not districts are connecting to the central process of priority setting and reasons for not doing so. The report includes recommendations for bridging the policy implementation gap, including: ensuring that RH advocates participate in national policy dialogue; investing in systems development for procurement and delivery of drugs and …


Acceptability And Feasibility Of Introducing The Who Focused Antenatal Care Package In Ghana, Harriet Birungi, Philomena Nyarko, Margaret Armar-Klemesu, Daniel Arhinful, Sylvia Deganus, Henrietta Odoi-Agyarko, Gladys Brew Jan 2006

Acceptability And Feasibility Of Introducing The Who Focused Antenatal Care Package In Ghana, Harriet Birungi, Philomena Nyarko, Margaret Armar-Klemesu, Daniel Arhinful, Sylvia Deganus, Henrietta Odoi-Agyarko, Gladys Brew

Reproductive Health

The main objective of this study, undertaken by Noguchi Memorial Institute for Medical Research in collaboration with the Ghana Health Service and FRONTIERS, with USAID funding, was to examine the extent to which adaptation of the WHO focused antenatal care (ANC) package influenced quality of care received by pregnant women and its acceptability to both providers and clients. The results indicate that national-level support for focused ANC is high. The package appears to have been well accepted by both clients and providers because of its comprehensiveness and the individualized care. The process of stimulating changes in focused ANC service delivery …


Acceptability And Sustainability Of The Who Focused Antenatal Care Package In Kenya, Harriet Birungi, Washington Onyango-Ouma Jan 2006

Acceptability And Sustainability Of The Who Focused Antenatal Care Package In Kenya, Harriet Birungi, Washington Onyango-Ouma

Reproductive Health

The objectives of this study were to assess the Kenyan Ministry of Health’s capacity to adapt focused antenatal care (ANC) at the service delivery level so that it can be sustained, and to examine the extent to which adaptation of the package has increased coverage and quality of key ANC services and the overall quality of care received by pregnant women. The study showed that focused ANC is acceptable to both clients and providers and the approach has also received tremendous support from both the government and health development partners. However, the sustainability of the focused ANC package is contingent …


Cost Analysis Of Reproductive Health Services In Pcea Chogoria Hospital, Kenya, Nzoya Munguti, Moses Mokua, Rick Homan, Harriet Birungi Jan 2006

Cost Analysis Of Reproductive Health Services In Pcea Chogoria Hospital, Kenya, Nzoya Munguti, Moses Mokua, Rick Homan, Harriet Birungi

Reproductive Health

Presbyterian Church of East Africa Chogoria Hospital is a faith-based nongovernmental organization providing a wide range of healthcare services. The organization faces a number of challenges related to sustainability: declining donor support (especially for reproductive health services), low cost recovery levels, and increasing poverty levels among its clientele. In response to these concerns, a team from Chogoria Hospital attended a one-week workshop on financial sustainability held in Ghana and developed a small-scale operations research project to determine the cost of providing a selected number of reproductive health (RH) services and to evaluate their cost recovery levels. The study found that …


Correlates Of Inter-Birth Intervals: Implications Of Optimal Birth Spacing Strategies In Mozambique, Saumya Ramarao, John Townsend, Ian Askew Jan 2006

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 …


Sexual Harassment In The Workplace: Experiences Of Women In The Health Sector, Paramita Chaudhuri Jan 2006

Sexual Harassment In The Workplace: Experiences Of Women In The Health Sector, Paramita Chaudhuri

Reproductive Health

The objective of this report is to explore sexual harassment of women in the health sector in Kolkata, West Bengal, India. Specifically, it explores women’s perceptions of the occurrence of sexual harassment in hospital settings, and probes women’s own experiences of sexual harassment and incidents of sexual harassment in the hospital environment about which women are aware. The study also investigates the nature of action taken to seek redress, and the extent to which working women are aware of the complaint mechanism outlined by the Supreme Court. Findings confirm the persistence of sexual harassment in the workplace, the reluctance of …


Analyse De L'Evolution De La Pratique De L'Excision Au Burkina Faso: L'Environment Institutionel, Politique Et Programmatique De La Lutte Contre La Pratique De L'Excision, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini Jan 2006

Analyse De L'Evolution De La Pratique De L'Excision Au Burkina Faso: L'Environment Institutionel, Politique Et Programmatique De La Lutte Contre La Pratique De L'Excision, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini

Reproductive Health

La présente analyse du projet Frontiers du Population Council fait un tour historique des événements majeurs de la lutte contre la pratique de l’excision au Burkina Faso avant d’aborder les conventions internationales auxquelles le pays a adhéré ainsi que les textes nationaux adoptés en ce qui concerne les droits de l’homme, spécifiquement le droit des femmes et des enfants. Elle analyse également l’application de la loi à travers l’évolution des cas de condamnation depuis l’adoption de la loi. Enfin, elle s’intéressera à quelques programmes d’intervention mis en place en identifiant les acquis et les limites. Ce travail fait partie d’une …


Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru Jan 2005

Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru

Reproductive Health

The Somali community living in Kenya (and in their native Somalia) has practiced the severest form of female genital cutting (FGC)—infibulation—for centuries. To understand the context within which the practice takes place, and how its complications are managed, the Population Council’s Frontiers in Reproductive Health Program undertook a diagnostic study that confirmed that FGC is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice: religious obligation, family honor, and virginity as a prerequisite for marriage; an aesthetic preference for infibulated genitalia was also mentioned. The study also found that the health …


Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong Jan 2005

Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.


Willingness-To-Pay For Services Provided By The Clinical Services Improvement Project (Csi) In Egypt, John H. Bratt, Nahla G. Abdel-Tawab, Magdi A. Ibrahim, Mohammed Edress Jan 2005

Willingness-To-Pay For Services Provided By The Clinical Services Improvement Project (Csi) In Egypt, John H. Bratt, Nahla G. Abdel-Tawab, Magdi A. Ibrahim, Mohammed Edress

Reproductive Health

Willingness-to-pay (WTP) surveys are increasingly used in reproductive health programs to predict the impact of price changes on revenues, utilization, and client profile. The FRONTIERS program worked with the Clinical Services Improvement (CSI) project and the Cairo Demographic Center to carry out a WTP survey in six CSI clinics in Egypt. The survey found that most clients would be willing to pay higher prices for CSI services, and WTP did not vary much by client economic status. However, predictive validity was low when all reasons for client discontinuation were included. WTP surveys have the potential to be useful tools for …


An Assessment Of Trends In The Use Of The Iud In Ghana: National Results Dissemination And Utilization, Ivy Osei, John Gyapong, Monica Wanjiru, Ian Askew Jan 2005

An Assessment Of Trends In The Use Of The Iud In Ghana: National Results Dissemination And Utilization, Ivy Osei, John Gyapong, Monica Wanjiru, Ian Askew

Reproductive Health

The overall aim of this study was to inform the Ghana Health Service, USAID, and other partners involved in providing family planning services in Ghana about future directions that could be taken to reinvigorate the IUD within the context of a family planning service based on the principles of free and informed choice. The Health Research Unit conducted the study, with technical assistance from FRONTIERS and funding from USAID. The findings showed that the declining interest in and use of the IUD as a family planning method could be attributed to several factors, including negative perceptions and false beliefs about …


Improving The Ghanaian Safe Motherhood Programme, Ivy Osei, Bertha Garshong, Gertrude Banahene, John Gyapong, Placide Tapsoba, Ian Askew, Clement Ahiadeke, Richard Killian, Edward Bonku, Perle Combary, William Sampson Jan 2005

Improving The Ghanaian Safe Motherhood Programme, Ivy Osei, Bertha Garshong, Gertrude Banahene, John Gyapong, Placide Tapsoba, Ian Askew, Clement Ahiadeke, Richard Killian, Edward Bonku, Perle Combary, William Sampson

Reproductive Health

Prior to the Ghana Ministry of Health scaling up the country’s Safe Motherhood program, they requested support from the Population Council’s USAID-funded Frontiers in Reproductive Health program to undertake an operations research study to evaluate and compare the cost-effectiveness of two training approaches and other performance improvement interventions. The study measured and compared changes in provider knowledge and skills and the costs of implementing a three-week residential vs. self-paced learning (SPL) approach. The SPL approach costs more per trainer than the traditional residential approach, both in financial costs alone and when opportunity costs are added, however, a cost-effectiveness analysis showed …


Systematic Screening To Integrate Reproductive Health Services In India, N.P. Das, Urvi Shah, Varsha Chitania, Pratibha Patel, M.E. Khan, Anurag Mishra, James R. Foreit Jan 2005

Systematic Screening To Integrate Reproductive Health Services In India, N.P. Das, Urvi Shah, Varsha Chitania, Pratibha Patel, M.E. Khan, Anurag Mishra, James R. Foreit

Reproductive Health

This study, conducted in large public clinics and small health posts in the city of Vadodara, India, tested the effectiveness of a systematic screening technique in integrating reproductive health services at the provider level. The objective was to determine if women screened during clinic visits received more services, appointments, and referrals per visit than women who were not screened. Results show that in experimental group clinics the number of services per visit increased while control clinics experienced a slight decrease; the effect of systematic screening was smaller in health posts than in clinics. In experimental posts, services per visit increased …


Nursing Staff Dynamics And Implications For Maternal Health Provision In Public Health Facilities In The Context Of Hiv/Aids, Loveday Penn-Kekana, Duane Blaauw, Khin San Tint, Desiree Monareng, Jane Chege Jan 2005

Nursing Staff Dynamics And Implications For Maternal Health Provision In Public Health Facilities In The Context Of Hiv/Aids, Loveday Penn-Kekana, Duane Blaauw, Khin San Tint, Desiree Monareng, Jane Chege

Reproductive Health

This study, carried out in Limpopo, KwaZulu-Natal, and Mpumalanga provinces in South Africa, aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. The study found that a high percentage of nursing staff working in public facilities were demotivated, burnt out, and were considering leaving the facility where they were working. A range of factors, both financial and nonfinancial, were associated with nurses considering going overseas: inadequate pay, poor promotion, feeling unsupported by management, and having bad relationships at work were all associated with lack of organizational commitment. As a result …