Open Access. Powered by Scholars. Published by Universities.®

International Public Health Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 91 - 120 of 181

Full-Text Articles in International Public Health

An Assessment Of Trends In The Use Of The Iud In Ghana, John Gyapong, Gifty Addico, Ivy Osei, Mercy Abbey, Dominic Atweam Kobinah, Henrietta Odoi-Agyarko, Gloria Quansah Asare, Harriet Birungi, Ian Askew Jan 2003

An Assessment Of Trends In The Use Of The Iud In Ghana, John Gyapong, Gifty Addico, Ivy Osei, Mercy Abbey, Dominic Atweam Kobinah, Henrietta Odoi-Agyarko, Gloria Quansah Asare, Harriet Birungi, Ian Askew

Reproductive Health

Use of the IUD in relation to other contraceptive methods is reported to have either stagnated or declined in a number of countries including Ghana. The overall aim of this study was to inform the Ghana Health Service, USAID, and other partners on future directions for contraceptive promotion and supply. The stagnating demand for the IUD as a family planning method can be attributed to several factors, including perceptions and rumors about the method. The study recommends: intensified marketing of the IUD through the Ghana Life Choices Program; IUD-focused training and creation of a critical mass of trained IUD providers; …


Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena Jan 2003

Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena

Reproductive Health

The purpose of this study was to identify the reasons for the low use of the IUD in Guatemala and to explore the reasons why other reversible methods are selected more frequently than IUDs. The study aimed to determine the availability and acceptability of IUDs as a contraceptive option within the Ministry of Health, the Guatemalan Social Security Institute, and APROFAM. Results indicated that service providers do not take into consideration women’s reproductive needs or intentions when they provide family planning counseling. There are several demand-side factors that affect the use of the IUD, including lack of knowledge about the …


One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo Jan 2003

One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo

Reproductive Health

This report presents a one-year assessment of quality-of-care improvements in Peru, following provider training on the job aids–assisted Balanced Counseling Strategy. Results showed significant enhancement of quality of care, an increase in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) …


Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health Jan 2003

Introducing Dmpa Injectable Contraceptives To Private Medical Practitioners In Urban Gujarat, Frontiers In Reproductive Health

Reproductive Health

Many public, NGO, and private-sector service-delivery systems are suitably matched to the requirements of providing injectable contraceptives in India, including the ability to ensure choice and service delivery quality. This operations research study was designed to demonstrate the feasibility of providing injectable contraceptives in private medical practices and to contribute to the body of scientific literature on the acceptability of this method in India. DKT India and EngenderHealth formed a partnership with the Population Council’s Frontiers in Reproductive Health program to conduct this study in Gujarat. The ability to generate recommendations is limited, however, by the special characteristics of the …


Strategic Assessment Of Reproductive Health In The Dominican Republic, Suellen Miller, Argelia Tejada, Patricio Murgueytio Jan 2002

Strategic Assessment Of Reproductive Health In The Dominican Republic, Suellen Miller, Argelia Tejada, Patricio Murgueytio

Reproductive Health

This report documents the findings of a strategic assessment of reproductive health in the Dominican Republic (DR), carried out by the Ministry of Health and Social Welfare (SESPAS) and the Dominican Social Security Institute with support from the Population Council’s Expanding Contraceptive Choice (ECC) program and its Latin American and Caribbean regional offices, and the United States Agency for International Development (USAID). The USAID/DR has been working closely with SESPAS to understand the major reproductive health problems in the DR. To better assist SESPAS and to plan the country’s Reproductive Health Strategy for 2002–2007, USAID asked the Population Council’s ECC …


Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health Jan 2002

Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health

Reproductive Health

In 1999, Frontiers in Reproductive Health collaborated on studies on the impact of interventions to improve quality of care in the Philippines and Senegal. The two interventions were part of a multicountry Population Council study (also undertaken in Pakistan and Zambia) to test whether improving quality affects women’s contraceptive continuation. The Philippines study focused on training in family planning (FP), supportive supervision, and refresher courses to improve client-provider interaction. The Senegal study compared the impact of improved quality of care at five newly established “reference centers” with five clinics that served as controls. Data were gathered through analyses of quality …


Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque Jan 2001

Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque

Poverty, Gender, and Youth

The principal aim of this study is to assess the strength in Pakistan of a set of hypothesized obstacles to practicing contraception. Our concern is those factors that prevent women from translating a desire to avoid becoming pregnant into contraceptive practice, a common predicament in Pakistan in recent decades. We analyze survey data collected in Punjab province in 1996 that contain unusually detailed measurement of various perceived costs of practicing contraception, as well as focused measurement of fertility motivation. The framework guiding the research specifies six major obstacles to contraceptive use: the strength of motivation to avoid pregnancy, awareness and …


Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett Jan 2001

Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett

Poverty, Gender, and Youth

There is accumulating evidence that social diffusion processes affect the pace of the adoption of modern contraception in societies undergoing fertility transition. In settings where mortality has declined and many other social and economic changes are underway, decisions about contraception are fraught with uncertainty and risk. In such circumstances, couples may rely on other persons for information and guidance. In this paper, we examine the influence of informal social networks on the contraceptive behavior of reproductive-age women, using longitudinal data collected in six communities in southern Ghana. Our results confirm the hypothesis that adoption of modern contraception is strongly affected …


Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health Jan 2001

Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health

Reproductive Health

To support the Government of Ghana’s plan to expand community-based distribution (CBD) programs, the Planned Parenthood Association of Ghana (PPAG) and the Population Council conducted a study in 1999 of the CBD programs of 13 nongovernmental agencies. The study also assessed in depth PPAG’s CBD program, which is the country’s largest and oldest. Data sources included interviews with 301 CBD agents, 27 supervisors, and 20 clinicians in rural and urban areas in 16 districts; observations of 51 PPAG agents interacting with 6 clients each; and 15 focus group discussions with community members, former CBD agents, and CBD clients. CBD programs …


Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health Jan 2001

Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

In 1999, the Honduran Ministry of Health (MOH) revised national guidelines on women’s health services delivery to allow nurse auxiliaries to insert IUDs, give DMPA injections, and take Pap smears. This policy change addresses low contraceptive use among rural women and reflects findings from a 1998 Population Council study that showed that nurse auxiliaries can safely and successfully provide these services. Under the previous guidelines, rural women had limited access to long-term family planning methods. In 2000, the Population Council and the MOH assessed the effectiveness and cost of using a simple leaflet, distributed by nurse auxiliaries, to market the …


Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health Jan 2001

Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

En 1999, la Secretaría de Salud de Honduras (SSH) modificó las Normas de Atención Integral a la Mujer a fin de autorizar a las auxiliares de enfermería a prestar los servicios de inserción de DIU, aplicación del inyectable DMPA y toma de Papanicolaou. Este cambio en las normas aborda el problema de la baja prevalencia en el uso de anticonceptivos en áreas rurales. El cambio también refleja los hallazgos de un estudio anterior, realizado por el Population Council, que mostró que las auxiliares de enfermería pueden proporcionar estos servicios de manera segura y con buena calidad. Anteriormente, las mujeres en …


An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed Jan 2001

An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed

Reproductive Health

The Egyptian Ministry of Health and Population and FRONTIERS discussed the need for investigating service delivery aspects of the Egyptian NORPLANT® program. This study emerged from those consultations. The study provides a comprehensive assessment of the program: how services are administered and used through the ongoing Introduction Program as it approaches five years of operation. The report lists major findings with program implications and offers recommendations regarding quality of care; tracking and locating NORPLANT® users; program sustainability; and information, education, and communication strategies.


Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar Jan 2001

Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar

Reproductive Health

The Honduran Ministry of Health (MOH) and the Population Council’s INOPAL III Project tested the acceptability of postpartum/postabortion contraception at the Escuela Hospital, the largest in the country. The project showed that more than 30 percent of the women seen for a delivery or a complication due to abortion, were interested in adopting a contraceptive method prior to discharge from the hospital. Given the success of the project, the MOH asked the Population Council’s FRONTIERS program for technical and financial support to extend those services to five additional hospitals in the country. Important improvements were found for the four indicators …


Burkina Faso: Mejorar La Atención Postaborto Beneficia A Pacientes Y Proveedores, Frontiers In Reproductive Health Jan 2000

Burkina Faso: Mejorar La Atención Postaborto Beneficia A Pacientes Y Proveedores, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


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 …


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 …


Egipto: Los Proveedores De Servicios De Planificación Deben Motivar A Sus Clientas A Hablar De Sus Problemas De Sexualidad, Frontiers In Reproductive Health Jan 2000

Egipto: Los Proveedores De Servicios De Planificación Deben Motivar A Sus Clientas A Hablar De Sus Problemas De Sexualidad, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


The Potential Role Of Contraception In Reducing Abortion, John Bongaarts, Charles F. Westoff Jan 2000

The Potential Role Of Contraception In Reducing Abortion, John Bongaarts, Charles F. Westoff

Poverty, Gender, and Youth

Since the 1960s the proportion of couples practicing contraception has risen rapidly, particularly in the developing world, and the mix of methods is now dominated by modern methods. Despite these trends, the incidence of unintended pregnancy remains high mainly because the number of children desired has declined. Worldwide there are almost as many unintended as intended pregnancies each year (not counting miscarriages, which are excluded in this analysis) and more than half of these unintended pregnancies end in abortion. This study examines the potential role of further increases in contraceptive prevalence and effectiveness in reducing abortion rates. The model used …


Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson Jan 2000

Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson

Poverty, Gender, and Youth

The main objectives of this study are to review existing methodologies for projecting future trends in contraception, evaluate the validity of the assumptions underlying these projections, propose methodological improvements, and assess the prospects for new methods of contraception in the coming decade. The prevalence of contraception in the developing world has increased dramatically over the past several decades from near zero to around 60 percent in 2000. Demand for contraception can be expected to continue to rise rapidly for the next few decades as population size continues to grow and fertility declines further to near the replacement level. As a …


Pérou: Les Gestionnaires Doivent Régulièrement Veiller Á La Qualité Des Soins, Frontiers In Reproductive Health Jan 2000

Pérou: Les Gestionnaires Doivent Régulièrement Veiller Á La Qualité Des Soins, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


Spatial Variation In Contraceptive Use In Bangladesh: Looking Beyond The Borders, Sajeda Amin, Alaka Malwade Basu, Rob Stephenson Jan 2000

Spatial Variation In Contraceptive Use In Bangladesh: Looking Beyond The Borders, Sajeda Amin, Alaka Malwade Basu, Rob Stephenson

Poverty, Gender, and Youth

This paper tries to promote a more complete understanding of social change by analyzing spatial patterns of contraceptive use in Bangladesh and the contiguous state of West Bengal in India. The paper takes it’s cue from earlier analysis which found strong evidence of higher contraceptive prevalence in districts of Bangladesh that border Bengali speaking districts on India, as well as from analysis of fertility decline in historical Europe where language played a critical role. Using multilevel analysis to control for variations in individual and household level correlates, mapping districts that deviate considerably from their regional averages, the analysis highlights an …


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 …


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 …


Senegal: Capacite A Más Proveedores En Atención Postaborto, Frontiers In Reproductive Health Jan 2000

Senegal: Capacite A Más Proveedores En Atención Postaborto, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


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 …


Perú: Los Administradores Deben Supervisar Rutinariamente La Calidad De La Atención, Frontiers In Reproductive Health Jan 2000

Perú: Los Administradores Deben Supervisar Rutinariamente La Calidad De La Atención, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


Egypte: Les Prestataires De Service De Planification Familiale Doivent Encourage Les Discussions Sur Les Problèmes Sexuels, Frontiers In Reproductive Health Jan 2000

Egypte: Les Prestataires De Service De Planification Familiale Doivent Encourage Les Discussions Sur Les Problèmes Sexuels, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


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 …


Pérou: Informer Les Clients Sur Le Mode D'Utilisation De Leur Méthode De Choix, Frontiers In Reproductive Health Jan 2000

Pérou: Informer Les Clients Sur Le Mode D'Utilisation De Leur Méthode De Choix, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu Jan 1999

Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu

Reproductive Health

Quality of services is playing an increasingly important role in many family planning (FP) programs. In 1995, a national Situation Analysis Study of 254 health facilities was conducted in Kenya to assess the status and quality of FP services in the country. An in-depth survey of a subsample of 28 health facilities was conducted the following year. From these facilities, 1,834 women were interviewed about their experiences with services at facilities when they sought antenatal, child health, and FP services. The goal of the survey was to examine the links between quality of care in FP services and contraceptive behavior. …