International Public Health Commons^™

The Private Sector As A Provider Of Family Planning Services In Egypt: Challenges And Opportunities [Arabic], Nahla G. Abdel-Tawab, Doaa Oraby, Benjamin Bellows

Reproductive Health

[In Arabic] The recent increase in Egypt’s fertility rate, following decades of progress in lowering fertility levels, highlights the need for renewed attention to the country’s family planning program. The Ministry of Health is currently the largest provider of family planning in Egypt, serving a diverse population of women, many of whom may not need the free public service. Expanding the role of the private sector in the provision of family planning services and supplies holds great potential to more effectively meet the current and future family planning needs of millions of Egyptian women. This brief examines the role of …

Understanding Demand For Family Planning And Reproductive Health Services Through The Indian National Health Insurance Scheme In Uttar Pradesh, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

The Indian National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), was launched by the Ministry of Labour and Employment in 2008 to promote equitable access to health services through the private and public sectors. This scheme is intended to offer economically disadvantaged families living below the poverty line in urban and rural areas access to a pre-specified package of health services including: general surgery, general medical care, pediatric care, gynecological care, family planning (FP) and other reproductive health (RH) services, dental, ophthalmology, urology, neurosurgery, and oncology. Almost eight years into the program, this is an opportune time to examine …

Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

In 2008, the Government of India launched the National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in both urban and rural areas to access a range of private health services. The available evidence suggests several limitations and barriers that may affect the utilization of RSBY services and warrants a more in-depth examination of the contexts of family planning/reproductive health (FP/RH) services. The Population Council, under the Evidence project, conducted a study among the urban poor to: 1) determine RSBY awareness and barriers to enrollment; 2) identify barriers and facilitating factors to …

Delivering Contraceptive Vaginal Rings To Breastfeeding Women, Population Council

Reproductive Health

The Progesterone Vaginal Ring (PVR) is a user-controlled contraceptive that helps breastfeeding women safely and effectively space, delay, or limit their next pregnancy. The Population Council and partners developed the PVR to help address the unmet need for contraception among breastfeeding women. The ring provides a convenient option that adds choices for new mothers and promotes optimal infant nutrition and health. This two-page brief provides fast facts for advancing nutrition and infant health with the PVR.

Building A National Pro-Choice Alliance In Mexico: Evaluation Of The Alliance Media Campaign To Promote Access To Safe, Free, And Legal Abortion Services, Population Council

Reproductive Health

The Population Council and Alliance partners designed a legal abortion media campaign aimed at informing women in Mexico City of their legal right to a safe, free elective abortion during the first 12 weeks of pregnancy. The impetus for the campaign was the apparent lack of knowledge regarding the legality of abortion in Mexico City among low-income, marginalized women of reproductive age combined with the inadequate number of Mexico City Ministry of Health facilities equipped to provide services to women living in an expansive metropolitan area such as Mexico City. This brief presents results of an evaluation that show that …

Evaluating The Impact Of Integrated Microfinance And Reproductive (Mf/Rh) Services On Household Wellbeing And Reproductive Health Behaviors Of Women In Nigeria, Population Council

Reproductive Health

A growing body of studies attempts to show that microfinance institutions are capable of contributing to improvements in women’s reproductive health (RH) status by integrating information that leads to behavioral change. In Nigeria, there is little evidence documenting the impact and health outcomes among beneficiaries of integrated microfinance and reproductive health (MF/RH) service. The integrated MF/RH program, funded by The David & Lucile Packard Foundation and implemented by Partners for Development, provided an opportunity to test the impact of integrating RH messaging and support for service provision into a microcredit scheme. The objective of this integrated approach was to improve …

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Evaluation Of The Impact Of Strengthening Union Health And Family Welfare Centers For Providing 24/7 Normal Delivery Services In Bangladesh, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan, Mohammed Sharif, Forhana Rahman Noor, Surojit Kundu, Shongkour Roy, Afsana Fatema Noor, Ubaidur Rob

Reproductive Health

In Bangladesh, the majority of the infant deliveries in rural areas take place at homes where there is a higher risk of morbidity and mortality. Most Union Health and Family Welfare Centers (UHFWCs) are unable to provide 24-hour normal delivery services in close proximity to most rural women. With this point of view, the Population Council has provided technical assistance to the Directorate General of Family Planning to implement an operations research (OR) study in 24 UHFWCs to test the effectiveness of a model to strengthen UHFWCs so that they can provide such services. This report presents the findings of, …

Landscape Analysis Of The Family Planning Situation In Pakistan: Brief Summary Of Findings, Population Council

Reproductive Health

This brief provides a summary of the Landscape Analysis of the Family Planning Situation in Pakistan carried out by the Population Council with the support of the Bill & Melinda Gates Foundation in 2015–16. The analysis provides a comprehensive assessment of consumer demand, contraceptive service provision, and contraceptive supply, and the provincial policy environment based on primary data collection in eight districts in Punjab, Sindh, and Khyber Pakhtunkhwa. Its aim is to identify investment opportunities to catalyze an escalation in contraceptive prevalence, enabling Pakistan to meet its FP2020 goals.

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Faisalabad, Population Council

Reproductive Health

This district profile of Faisalabad is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities, pharmacies, and lady health workers; distribution of public static and private facilities by cadre;, provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning. The analysis, conducted by the Population Council, was supported by …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Hyderabad, Population Council

Reproductive Health

This district profile of Hyderabad is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of family planning, including other socioeconomic indicators, and consumers’ perspectives on barriers to use of family planning. While it notes the lack of information among men; it also finds limited access to public health facilities compounded by poverty—a hurdle for the urban poor. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Landscape Analysis Of The Family Planning Situation In Pakistan, Population Council

Reproductive Health

Pakistan faces a number of challenges to increasing modern contraceptive use. Although there are encouraging signs, such as improved male participation, the addition of about four million current FP users, from 2007 to 2013, and a responsive policy environment with demonstrated political and financial commitment to meeting the country’s FP2020 goals, the task that lies ahead is still huge. This report presents the findings of a landscape analysis of family planning (FP) in Pakistan by the Population Council in 2015 and 2016, with support from the Bill & Melinda Gates Foundation. This landscape analysis assesses both demand and supply side …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Karachi, Population Council

Reproductive Health

This district profile of Karachi is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of family planning; use of antenatal and delivery care services; other socioeconomic indicators; availability of health facilities and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning. The analysis, conducted by the Population Council, was supported by the …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Peshawar, Population Council

Reproductive Health

This district profile of Peshawar is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of antenatal and delivery care services; other socioeconomic indicators; availability of health facilities, pharmacies, and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Rawalpindi, Population Council

Reproductive Health

This district profile of Rawalpindi is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of family planning and other socioeconomic indicators. It covers consumers’ perspectives on barriers to use of family planning noting the lack of information among men and women, especially migrants; problems of access among poor rural women; and difficulty in affording services, among poor couples. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Understanding Married Women's Vulnerability To Hiv Infection In Egypt: An Exploratory Study, Doaa Oraby, Nahla G. Abdel-Tawab

Reproductive Health

This study examines the behavioral, sociocultural, economic, programmatic, and legal factors that aggravate Egyptian women’s vulnerabilities to HIV/AIDS. The study concludes that in low-prevalence settings like Egypt, targeted interventions are the most strategic and cost-effective: for example, HIV awareness-raising with a special focus on the preventive role of consistent, correct condom use, and creating a cadre of peers that could provide psychosocial support and HIV counseling to migrant workers. Furthermore, premarital and antenatal care programs should include HIV awareness-raising and provider-initiated counseling and testing after screening of women to identify those at risk for HIV infection. Concurrently, efforts should be …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Districts Haripur And Nowshera, Khyber Pakhtunkhwa, Population Council

Reproductive Health

Through its Reproductive Maternal and Neonatal Child Health project, GIZ Pakistan is assisting the Government of Pakistan in strengthening its health system’s capacities for ensuring effective, efficient, client-oriented, and affordable reproductive, maternal, newborn, and adolescent health care. GIZ engaged with senior national and provincial government officials who indicated their interest in applying the innovative Made-In/Made-For (Maternal Death, from Informants/Maternal Death, Follow On Review) methodology, a cost-effective alternative for generating reliable estimates of maternal mortality through community-based informant networks. This Population Council study in two pilot districts identified specific areas that need strong policy and programmatic interventions to improve maternal health …

Using The Community Informant-Based (Made-In And Made-For) Methodology To Estimate The Neonatal Mortality Rate (Nmr) In Nowshera, Khyber Pakhtunkhwa: A Feasibility Study, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, Rehan M. Niazi

Reproductive Health

Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

The International Right To Health: What Does It Mean In Legal Practice And How Can It Affect Priority Setting For Universal Health Coverage?, Rebecca Dittrich, Leonardo Cubillos, Lawrence O. Gostin, Ryan Li, Kalipso Chalkidou

Georgetown Law Faculty Publications and Other Works

The international right to health is enshrined in national and international law. In a growing number of cases, individuals denied access to high-cost medicines and technologies under universal coverage systems have turned to the courts to challenge the denial of access as against their right to health. In some instances, patients seek access to medicines, services, or technologies that they would have access to under universal coverage if not for government, health system, or service delivery shortfalls. In others, patients seek access to medicines, services, or technologies that have not been included or that have been explicitly denied for coverage …

Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353

Undergraduate Research Posters

Despite efforts of Vision 2020 in India, the Andhra Pradesh Eye Disease Study (APEDS) extrapolated, in 2000, approximately 18.7 million blind people in India and also, projected an increase to 31.6 million blind people by 2020. Within the state Andhra Pradesh itself, preventable corneal blindness increased to 1.84% from 1.5% in the late 1980s.

Numerous public health studies have been conducted to outline factors that cause and preclude treatment of avoidable corneal blindness in the India. Conclusively, the escalation of corneal blindness can be largely attributed to personal, social, and economic barriers in utilizing available eye-care services. However, due to …

Documento Faz Diferença, Carlos Eduardo Siqueira, Gabriella Barretosoares, Pedro L Araújo Neto, Maria N Tracy

Gastón Institute Publications

Brazilian immigrants in the United States experience various social, labor, and health challenges. This study aimed to analyze the profile of female Brazilian domestic workers in Massachusetts, USA, through a description of their working conditions and sel-frated health. This was a cross-sectional study of 198 domestic workers in Massachusetts, recruited with “snowball” sampling. The instrument addressed participants’ demographic characteristics, work conditions, and self-rated health. Data were analyzed with SPSS 21.0. Among the interviewees, 95.5% were women, 62.1% were 30 to 49 years of age, and 55.6% were undocumented. Documented and undocumented participants showed statistically significant differences in demographics, work conditions, …

A Cross-Sectional Study On Patients' Access To Healthcare In A Developing Nation, Pawan Bhandari

All Graduate Theses, Dissertations, and Other Capstone Projects

The objective of this research study was to gauge the current status of patients' access to health care services in a developing nation or least-developed country (as defined by the World Bank and United Nations), Nepal. Many patients are not privileged to have a hospital at a close proximity in Nepal. They are also forced to travel and wait for long hours due to their inability to pay for services offered by private healthcare institutions. A survey questionnaire was developed to get a snapshot of how long patients travel to get to a public hospital for an outpatient service. The …