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Full-Text Articles in International Public Health

Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi Jan 2000

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

Reproductive Health

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


Intra-Household Decision-Making On Health And Resource Allocation In Borgou, Bénin, Pierre Ngom, Salome Wawire, Timothee Gandaho, Pierre Klissou, Toussaint Adjimon, Mbaye Seye, Emile Akouanou, Laurie Winter Jan 2000

Intra-Household Decision-Making On Health And Resource Allocation In Borgou, Bénin, Pierre Ngom, Salome Wawire, Timothee Gandaho, Pierre Klissou, Toussaint Adjimon, Mbaye Seye, Emile Akouanou, Laurie Winter

Reproductive Health

The African Population and Health Research Centre carried out this study, with support from FRONTIERS and USAID, in order to inform Benin’s Projet Intégré en Santé Familiale (Integrated Project on Family Health—PROSAF) about socio-cultural factors in Borgou that can impede health improvements. More specifically, the study aimed to identify key players in household decisionmaking processes, map out patterns of health-seeking behavior, elucidate how such patterns are associated with prevailing health services utilization, assess community valuation of existing health services and products, and recommend to PROSAF approaches to identified target groups for their intervention. The findings indicate that for all the …


Increasing The Coverage Of Reproductive Health Issues In The Egyptian Press, Sahar Hegazi, Mona Khalifa Jan 2000

Increasing The Coverage Of Reproductive Health Issues In The Egyptian Press, Sahar Hegazi, Mona Khalifa

Reproductive Health

This project, based on previous experiments of the FRONTIERS and POLICY projects, aimed to widen media coverage in Egypt of critical reproductive health issues and to communicate related research findings in a more systematic manner. Increasing coverage in the Egyptian press first required an assessment of the current coverage. Second, a network was formed of about 20 journalists from newspapers and magazines of different publishing houses, followed by four roundtable discussions on critical reproductive health issues. The results of evaluation sheets from the roundtable discussions showed a general increase in the journalists’ knowledge about reproductive health issues, especially for important …


Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health Jan 2000

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

Reproductive Health

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


Peru: Tell Clients How To Use Their Chosen Method, Frontiers In Reproductive Health Jan 2000

Peru: Tell Clients How To Use Their Chosen Method, Frontiers In Reproductive Health

Reproductive Health

In 1998, the Peruvian Ministry of Health (MOH) issued quality of care norms to ensure that family planning providers respond to clients’ reproductive health care needs and goals. In mid-1999, the Population Council collaborated with the MOH on a study to determine whether length of counseling sessions affects amount of information provided. The study focused on 19 health centers in 10 urban areas. Six simulated clients (women posing as clients) made a total of 114 visits to the health centers during June–July 1999. Each client was trained to say that she wanted to switch from the rhythm method to a …


Report On The International Symposium On Quality Of Care In China, Population Council Jan 2000

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

Reproductive Health

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


Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk Jan 2000

Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk

Reproductive Health

This paper is part of the Policy Series in Reproductive Health, which shares research undertaken by the Reproductive Health Working Group (RHWG). It describes the Reproductive Health Intervention Study, which designed and tested a model of essential reproductive health (RH) services. RHWG was established in 1988 as part of a special program on the health of women and children within the context of the family and community initiated by the Population Council’s Regional Office for the West Asia and North Africa region. The paper identifies a framework of basic service components that address RH and shows that their delivery is …


An Assessment Of The Community Based Distribution Programs In Ghana, Jane Chege, Diouratie Sanogo, Ian Askew, Angela Bannerman, Steve Grey, Evam Kofi Glover, Francis Yankey, Joana Nerquaye-Tetteh Jan 2000

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

Reproductive Health

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


Kenya: Offer Family Planning On Hospital Wards, Frontiers In Reproductive Health Jan 2000

Kenya: Offer Family Planning On Hospital Wards, Frontiers In Reproductive Health

Reproductive Health

In Kenya, more than one in three women hospitalized for gynecological problems has complications from miscarriage or unsafe abortion. These women generally receive no information or services for family planning (FP) or other reproductive health needs. During 1996–97, the Kenya Ministry of Health, the Population Council, and Ipas tested three models for providing postabortion care (PAC) and FP information and services in two areas of the hospital. Researchers compared model effectiveness by using surveys before and after the intervention. As concluded in this brief, the most effective way to ensure that women being treated for incomplete abortion obtain FP is …


Egypt: Family Planning Providers Should Encourage Clients To Discuss Sexual Problems, Frontiers In Reproductive Health Jan 2000

Egypt: Family Planning Providers Should Encourage Clients To Discuss Sexual Problems, Frontiers In Reproductive Health

Reproductive Health

This 1999 study examined the feasibility and impact of introducing the discussion of sexuality during family planning (FP) consultations. Conducted by the Population Council in collaboration with the Egyptian Ministry of Health and Population (MOHP), the study took place in four MOHP clinics and two affiliated private clinics. Nurses and physicians at all six clinics attended a two-day training session on contraceptives with an emphasis on barrier methods. Providers in the three clinics that had been randomly chosen as intervention sites also received three days of training on sexuality, gender, and counseling skills. To assess the acceptability of sexuality counseling …


Burkina Faso And Mali: Female Genital Cutting Harms Women's Health, Frontiers In Reproductive Health Jan 2000

Burkina Faso And Mali: Female Genital Cutting Harms Women's Health, Frontiers In Reproductive Health

Reproductive Health

In collaboration with the Ministries of Health (MOH) of Burkina Faso and Mali, the Population Council conducted two studies in 1998 to describe the occurrence and severity of health problems related to female genital cutting (FGC). Study participants were consenting women who received a pelvic exam during prenatal, family planning (FP), obstetric, or gynecological consultations at MOH clinics. Providers were trained to observe the types and complications of FGC. To assess their potential role as change agents, providers in Mali also received training on the health effects of FGC and client counseling. In Burkina Faso, health providers recorded information on …


Peru: Managers Must Monitor Quality Of Care Regularly, Frontiers In Reproductive Health Jan 2000

Peru: Managers Must Monitor Quality Of Care Regularly, Frontiers In Reproductive Health

Reproductive Health

In the late 1980s, Peru’s National Family Planning Program within the Ministry of Health (MOH) assigned method-specific targets to clusters of health facilities. In 1998, the MOH changed its policies to ensure that services responded to individual reproductive health needs and wishes. It eliminated method quotas, ended voluntary surgical contraception campaigns, and issued norms to ensure quality of care and informed choice. In 1999, the Population Council collaborated with the MOH to determine whether providers were complying with the new guidelines and, secondarily, to develop a monitoring system to assess compliance over time. As concluded in this brief, family planning …


Adolescents And Reproductive Health In Pakistan: A Literature Review, Ayesha Khan Jan 2000

Adolescents And Reproductive Health In Pakistan: A Literature Review, Ayesha Khan

Reproductive Health

This report reviews research and findings on adolescents and reproductive health in Pakistan. The material is drawn from a range of national surveys and medical research, as well as information gathered by nongovernmental organizations. Although adolescents make up a quarter of the population of Pakistan, they are still a new subject for research. The characterization of adolescents for this review is individuals ages 10–19, whether or not they are married, sexually active, or parents. The discussion of the research material is based on the assumption that adolescence is a developmental phase, a transition from childhood to adulthood. Basic data on …


The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council Jan 2000

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

Reproductive Health

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


Integrating Issues Of Sexuality Into Egyptian Family Planning Counseling, Nahla G. Abdel-Tawab, Laila Nawar, Hala Youssef, Dale Huntington Jan 2000

Integrating Issues Of Sexuality Into Egyptian Family Planning Counseling, Nahla G. Abdel-Tawab, Laila Nawar, Hala Youssef, Dale Huntington

Reproductive Health

The Population Council studied the acceptability of including sexuality issues in family planning (FP) in Egypt, a conservative society with social restrictions around discussions of sex. The study results showed that sexuality counseling is acceptable to family planning clients in Egypt; in fact, sexuality-related problems and concerns were found to be very common in the study group. Similarly, training family planning service providers on issues of sexuality is both feasible and acceptable to providers. The report offers recommendations for refining existing FP training programs and services including: integrating issues of sexuality into FP counseling, training FP service providers on the …


Enhancing The Use Of Emergency Contraception In A Refugee Setting: Findings From A Baseline Survey In Kakuma Refugee Camps, Kenya, Esther G. Muia, Joyce Olenja Jan 2000

Enhancing The Use Of Emergency Contraception In A Refugee Setting: Findings From A Baseline Survey In Kakuma Refugee Camps, Kenya, Esther G. Muia, Joyce Olenja

Reproductive Health

In August 1992, the International Rescue Committee (IRC) at the request of the United Nations, the United Nations High Commission for Refugees, and the Kenyan Government, initiated a primary health care program in the Kakuma Refugee Camp. Since then, the population of the camp has continued to grow, and activities have moved from a crisis to a maintenance phase. In January 1997, IRC assumed the additional responsibility of the camp hospital, bringing the entire health sector under their management. IRC's programs focus on maintaining and improving public health and promoting self-reliance, particularly of the most vulnerable communities. This project focuses …


Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health Jan 2000

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

Reproductive Health

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


Sexual And Reproductive Health And Health Sector Reform In Latin America And The Caribbean: Challenges And Opportunities, Ana Langer, Gustavo Nigenda, Sandra G. Garcia, Rosario Valdez, Emanuel Orozco, Jennifer Catino Jan 2000

Sexual And Reproductive Health And Health Sector Reform In Latin America And The Caribbean: Challenges And Opportunities, Ana Langer, Gustavo Nigenda, Sandra G. Garcia, Rosario Valdez, Emanuel Orozco, Jennifer Catino

Reproductive Health

Most countries in Latin America and the Caribbean (LAC) are at varying stages of a reform process to improve the response capacity of health systems by upgrading the effectiveness and sustainability of programs and services. Changes promoted by the reform focus on priority health needs and underprivileged society groups. Some problems, such as sexual and reproductive health (SRH), can be tackled with cost-effective technologies. Reform projects offer a unique opportunity to reconsider policies, programs, and services aimed at facing the issues encompassed in the term SRH. Nonetheless, the formulation of a strategy and the identification of concrete measures represent a …


Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health Jan 2000

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

Reproductive Health

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


Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health Jan 2000

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

Reproductive Health

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


Mali: Fgc Excisors Persist Despite Entreaties, Frontiers In Reproductive Health Jan 2000

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

Reproductive Health

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


Indonesia: Coordinated Studies Are Needed To Access Trends, Frontiers In Reproductive Health Jan 2000

Indonesia: Coordinated Studies Are Needed To Access Trends, Frontiers In Reproductive Health

Reproductive Health

In 1999, the Population Council/Indonesia conducted a critical review of 11 Indonesian surveys and studies that measured various indicators of maternal and child health (MCH) between 1996 and 1999. Many of these studies tried to link these indicators with the nation’s economic crisis that began in July 1997, however attributing changes in MCH indicators to the economic crisis may be misleading. Population Council staff sought to explain how these studies came up with divergent findings. As noted in this brief, longitudinal studies with consistent indicators and representative study populations are needed to identify changes in MCH indicators.


Meet Women's Health Needs With Postabortion Care, Frontiers In Reproductive Health Jan 2000

Meet Women's Health Needs With Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

Worldwide, one in eight pregnancy-related deaths result from complications of unsafe abortion such as bleeding, infection, or internal injuries. Many of these deaths could be prevented if women had the means to avoid unplanned pregnancy. At the 1994 United Nations International Conference on Population and Development, 180 governments identified postabortion care (PAC) as a high-priority public health issue. As part of the resulting global PAC initiative, the Population Council and other international organizations collaborated with governments and nongovernmental organizations in a worldwide program of operations research on interventions to improve postabortion care. This brief highlights the major findings of this …


Meeting Women's Health Care Needs After Abortion, Dale Huntington Jan 2000

Meeting Women's Health Care Needs After Abortion, Dale Huntington

Reproductive Health

Women who seek emergency treatment for abortion complications—bleeding, infection, and injuries to the reproductive tract system—should be a priority group for reproductive health care programs. These women often receive poor-quality services that do not address their multiple health needs. They may be discharged without counseling on postoperative recuperation, family planning (FP), or other reproductive health (RH) issues. Women who have had an induced abortion due to an unwanted pregnancy are likely to have a repeat abortion unless they receive appropriate FP counseling and services. Preventing repeat unsafe abortions is important for RH programs because it saves women's lives, protects women’s …


Men As Supportive Partners In Reproductive Health: Moving From Rhetoric To Reality, Saraswati Raju, Ann Leonard Jan 2000

Men As Supportive Partners In Reproductive Health: Moving From Rhetoric To Reality, Saraswati Raju, Ann Leonard

Reproductive Health

This book builds on presentations of the Workshop on Men as Supportive Partners in Reproductive and Sexual Health held in Kathmandu, Nepal, in 1998. By analyzing the experiences of nongovernmental organizations across India, this publication reviews important concerns that should inform the discourse on male partnership. The previous views of reaching men as contraceptive users and removing them as impediments to women’s efforts to control fertility are too limited. The argument is not whether men and women should use family planning, but rather the extent to which men can become supportive of women’s reproductive and sexual rights and actively take …


From The Home To The Clinic: The Next Chapter In Bangladesh's Family Planning Success Story Rural Sites, Linda Bates, Md. Khairul Islam, Sidney Ruth Schuler, Md. Alauddinn Jan 2000

From The Home To The Clinic: The Next Chapter In Bangladesh's Family Planning Success Story Rural Sites, Linda Bates, Md. Khairul Islam, Sidney Ruth Schuler, Md. Alauddinn

Reproductive Health

This study reports on Bangladesh’s new program model for reproductive health service delivery and people's reactions to it. NGOs in Bangladesh have discontinued door-to-door contraceptive distribution in response to the government’s integrated, clinic-focused approach. The findings from this study strongly support these policy changes: clients and communities are responding favorably to many aspects of the new model, and there do not seem to be intractable social barriers to service utilization. As the NGOs and the Bangladesh government proceed with implementation of the integrated, essential health services model, additional strategies will be needed to erode the paternalistic service delivery culture that …


Integrating Men Into The Reproductive Health Equation: Acceptability And Feasibility In Kenya, Esther G. Muia, Violet Kimani, Ann Leonard Jan 2000

Integrating Men Into The Reproductive Health Equation: Acceptability And Feasibility In Kenya, Esther G. Muia, Violet Kimani, Ann Leonard

Reproductive Health

This study’s objective was to improve understanding of Kenyan men’s actual and potential roles as supportive partners in various phases of reproductive health (RH), to help in the design of strategies to encourage men’s greater participation in a variety of RH initiatives in Kenya. The results of the study clearly show that, to a larger extent than anticipated, men in Kenya already participate in women-centered RH services. Overall the institutional barriers seemed to be more overwhelming than the cultural barriers, given that one of the reasons frequently given for nonparticipation was fear of non-acceptance by the health providers. Based on …


Rights, Technology, And Services In Reproductive Health: A Report From A Meeting, Marion Carter, C. Elizabeth Mcgrory Jan 2000

Rights, Technology, And Services In Reproductive Health: A Report From A Meeting, Marion Carter, C. Elizabeth Mcgrory

Reproductive Health

The Population Council’s Robert H. Ebert Program on Critical Issues in Reproductive Health convened a two-day meeting to explore some of the compelling issues at the intersection of technology, services, and rights. Nearly 70 professionals from the research, policy, service delivery, human rights, and advocacy fields came together to grapple with some of the political aspects of reproductive technologies. Participants also discussed how these technologies can facilitate or constrain rights, depending on the interests involved and the particular social, political, and economic contexts in which they are used. This report on the meeting concludes that in order for program managers …