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Full-Text Articles in International Public Health
Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline
Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline
Poverty, Gender, and Youth
Theories of the fertility transition now routinely reserve a place for diffusion effects. Two fundamental behavioral mechanisms account for such effects: social learning and social influence. Social learning refers to the acquisition of information from others. The information might have to do with a new technology or with the health, social, and economic consequences of decisions. In the case of fertility, individuals might learn from others about the availability of a new contraceptive, or about health side effects of certain contraceptives, or about the apparent gains and losses from having fewer children and investing in their schooling. Social influence refers …
What Can Be Done To Foster Multisectoral Population Policies? Summary Report Of A Seminar, Population Council, Overseas Development Council
What Can Be Done To Foster Multisectoral Population Policies? Summary Report Of A Seminar, Population Council, Overseas Development Council
Poverty, Gender, and Youth
The 1994 International Conference on Population and Development in Cairo was a watershed moment in the definition of population policies. The meeting put an end to the unproductive debate on which is more instrumental in achieving voluntary fertility decline: providing family planning (FP) services or improving social and economic development. The answer was that both are essential. The Cairo meeting also defined the most desirable services and the kind of development that was most empowering, particularly with respect to achieving reproductive choice. Despite this strong dual message from Cairo, only the call for a move away from a narrow vision …
Continuing The Strengthening Of Situation Analysis Methodology: An Africa-Focused Approach, Robert A. Miller
Continuing The Strengthening Of Situation Analysis Methodology: An Africa-Focused Approach, Robert A. Miller
Reproductive Health
In 1995, the Population Council’s Africa OR/TA Project II proposed a three-year subproject to organize and strengthen the Situation Analysis methodology that had been developed by the first Africa OR/TA Project in 1989. This subproject proposed to concentrate on three areas of continuing importance in the African context: wider use of the established database to explore program issues in reproductive health (RH); synthesis of the knowledge that has been collected about African family planning (FP) programs into a monograph analyzing program issues, patterns of services, and their implications; and continued assistance in training and data processing on field studies. These …
The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark
The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark
Poverty, Gender, and Youth
In Kenya, adolescent girls fare poorly relative to boys in an educational system characterized by enormous growth, deteriorating quality, and rising costs. Girls are more likely than boys to drop out of school prematurely and are less likely to do well on the primary school leaving exams that come at the end of grade eight. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 36 primary schools in which those adolescents reside, this paper investigates the effect of school quality on the likelihood of dropping out from primary school in three districts of Kenya. In …
On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney
On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney
Poverty, Gender, and Youth
Demographers have known since the 1940s that standard measures of period fertility, such as the widely used total fertility rate, are distorted by changes in the timing of childbearing. Period fertility rates are depressed during years in which women delay childbearing and inflated in years when childbearing is accelerated. This problem is usually ignored because there has been no generally accepted method for solving it. This study proposes a method for removing the tempo distortions from the total fertility rate. The key assumption of the method is that period effects, rather than cohorts effects, are the primary force in fertility …
Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll
Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll
Poverty, Gender, and Youth
Five categories of possible government influence on a nation’s fertility are explored: (1) through publicly funded programs that explicitly seek to affect family-size outcomes (2) through the legal order and system of public administration (3) through measures that affect economic opportunity, social mobility, and gender relations; (4) through public-sector expenditures and transfer payments keyed to age or family status; and (5) through the state’s supplanting of local beliefs and traditions with the symbols of national identity and through the parallel expansion of cultural frames of reference. Aside from the first of these, intentions to influence fertility are either incidental or …
Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia
Poverty, Gender, and Youth
This is the first of several editions of Quality/Calidad/Qualité that describe methodologies designed to assist family planning program managers and staff to self-assess the quality of services they are providing. These tools give program sponsors an opportunity to identify shortfalls in their service environment and propose solutions. This issue focuses on AVSC International's COPE (client-oriented, provider-efficient) methodology, a self-assessment tool that has now been used in 35 countries around the world. The report examines the experience of the National Family Planning Association of Kenya, provides some lessons learned, and demonstrates that these self-assessment exercises are, in fact, resulting in system-wide …
Integrating Rti Service With Primary Health Care, Population Council
Integrating Rti Service With Primary Health Care, Population Council
Reproductive Health
The reproductive health (RH) movement worldwide has brought reproductive tract infections (RTIs) under sharp focus as an urgent health need of women. While RTIs are preventable or treatable, they are often the cause of infertility, ectopic pregnancy, cervical cancer, fetal loss, low birth-weight infants, infant blindness, and neonatal pneumonia. The adverse health effects of RTIs, particularly STIs, is much higher for women than men. Recent research has demonstrated that RTIs are closely linked to other areas of health care like family planning (FP), safe motherhood, child survival, and HIV prevention. Hence, each could significantly contribute to the reduction and control …
Clinic-Based Family Planning And Reproductive Health Services In Africa: Findings From Situation Analysis Studies, Kate Miller, Robert A. Miller, Ian Askew, Marjorie C. Horn, Lewis Ndhlovu
Clinic-Based Family Planning And Reproductive Health Services In Africa: Findings From Situation Analysis Studies, Kate Miller, Robert A. Miller, Ian Askew, Marjorie C. Horn, Lewis Ndhlovu
Reproductive Health
The United States Agency for International Development (USAID) supported publication of “Clinic-Based Family Planning and Reproductive Health Services in Africa: Findings from Situation Analysis Studies.” The book reflects USAID's commitment to improving quality of reproductive health (RH) care and expanding access for underserved groups. Nowhere are these efforts more important than in Africa, where use of family planning (FP) and other measures of RH status are lowest among the world’s regions. Providing high-quality health services that meet couples' reproductive needs is a socially just and humane goal in itself. Moreover, higher-quality services can be expected to result in better outcomes …
Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad
Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad
Reproductive Health
This paper offers a broad definition of quality of care and presents a comprehensive conceptual framework for the assessment of quality of reproductive health services and methodological approaches for its measurement. It presents three studies that were conducted between 1990 and 1991 by members of the regional Reproductive Health Working Group from Egypt, Jordan, and Tunisia. The studies provide examples of applications of the framework and its measurement using multiple data sources. Selected findings are presented to illustrate comparative results between countries. Based on the lessons learned from the studies, examples of reproductive health interventions that may improve the quality …
Advances And Challenges In Postabortion Care Operations Research: Summary Report Of A Global Meeting, Dale Huntington
Advances And Challenges In Postabortion Care Operations Research: Summary Report Of A Global Meeting, Dale Huntington
Reproductive Health
The Global Meeting on Postabortion Care: Advances and Challenges in Operations Research was held at the Population Council’s New York office on January 19–21, 1998, to review progress made by three regional operations research (OR) projects in improving delivery of postabortion care. The resources of the three OR contracts were pooled, and, in collaboration with Ipas and the Ebert Program, approximately 65 researchers, senior program managers, and government officials from Africa, Latin America, the Middle East, and Southeast Asia were convened. Three objectives guided the planning of the meeting: review progress in the development of OR methodologies pertaining to postabortion …
Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council
Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council
Reproductive Health
Much literature has been written about improving the quality of reproductive health (RH) care at service delivery points (SDPs) because women deserve quality services, and as a means of increasing use of family planning (FP) and other RH services. There are six fundamental dimensions of quality of care: choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to encourage continuity, and an appropriate constellation of services. Improving these elements is thought to increase client satisfaction, resulting in an increase in contraceptive use and eventually fertility decline. Existing research has not convincingly demonstrated this link between quality of …
Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller
Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller
Reproductive Health
The Planned Parenthood Association of Ghana (PPAG) is one of the most active nongovernmental organizations delivering reproductive health (RH) services in Ghana, focusing particularly on youth issues and services. USAID suggested to the Population Council’s Africa OR/TA Project II staff that PPAG might benefit from technical assistance. A large and well-funded IPPF program to promote sexual health among youth of the Volta Region offered a good opportunity to begin OR work. Earlier, the program was envisioned as a demonstration educational program of five years duration. Further discussions suggested that this program was unlikely to be duplicated anywhere, because of its …
Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob
Strengthening Rti/Std Services: Lessons Learned From A Pilot Project, Ismat Bhuiya, Ubaidur Rob
Reproductive Health
The national family planning and maternal child health (FP-MCH) program in Bangladesh has raised FP acceptance among couples of reproductive age significantly. A major challenge still facing the program, however, is strengthening its reproductive health (RH) component. The Population Council launched a pilot project to examine the feasibility of strengthening comprehensive reproductive tract infection (RTI) and sexually transmitted disease (STD) services at the Health and Family Welfare Center level. The project had three phases. First, a needs assessment was conducted. Then the components of the intervention were identified, designed, and implemented. And at the third phase, an evaluation was carried …
Strengthening The Utilization Of Family Planning Operations Research: Findings From Case Studies In Africa, Julie Solo, Annamaria Cerulli, Robert A. Miller, Ian Askew, Elizabeth Pearlman
Strengthening The Utilization Of Family Planning Operations Research: Findings From Case Studies In Africa, Julie Solo, Annamaria Cerulli, Robert A. Miller, Ian Askew, Elizabeth Pearlman
Reproductive Health
The goal of undertaking operations research (OR) on family planning (FP) and reproductive health (RH) services is to strengthen the ability of programs and policies to maximize access to and quality of these services. This report addresses the need for a greater understanding of how information from OR studies is utilized. The Africa OR/TA Project II undertook a study to assess the extent to which information from OR studies conducted under the Africa OR/TA Project I (1988–1993) was utilized. The study also examined the factors influencing how study results were utilized. Case studies of several OR projects were undertaken to …
Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab
Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab
Reproductive Health
As more work in the area of male involvement in reproductive health (RH) is expected in Egypt, it is important that researchers and donor agencies become aware of existing studies, topics covered, and main research findings so duplication can be avoided. It is also important that policymakers and program managers learn about the results of existing studies so they can use those results in designing more effective policies to increase male involvement in Egypt. To address this need, the Population Council’s ANE OR/TA Project organized a seminar on “Disseminating Results of Research on Male Involvement in Reproductive Health in Egypt” …
Analysis Of Price Change On The Perceptions And Use Of Dmpa Among Clients Using Reproductive Health Services In Uttar Pradesh, India, Leila Caleb-Varkey, John Townsend, Sneh Vishwanath, Sudha Tiwari
Analysis Of Price Change On The Perceptions And Use Of Dmpa Among Clients Using Reproductive Health Services In Uttar Pradesh, India, Leila Caleb-Varkey, John Townsend, Sneh Vishwanath, Sudha Tiwari
Reproductive Health
Depo-medroxy Progesterone Acetate (DMPA) is a progesterone-only injectable contraceptive that has been approved by the Government of India for provision in the commercial sector, where it is marketed under the brand name Depo-Provera. In 1996, it was available at rates between Rs. 140 to Rs. 180 per injection. At this price it is often beyond the reach of many women wanting a safe and effective contraceptive. In January 1996, DMPA was provided to women in three cities of Uttar Pradesh through Parivar Seva Sanstha’s (PSS) clinics at Rs. 150. In July 1996, as part of operations research (OR), the price …
Workshop On Youth Across Asia, John Townsend, Ann P. Mccauley, Kokila Agarwal
Workshop On Youth Across Asia, John Townsend, Ann P. Mccauley, Kokila Agarwal
Reproductive Health
The issues facing youth across Asia are as diverse as the cultures they represent. Issues involving schooling, employment, sexuality, and marriage take on increased significance for young people aged 10–24 in every country. Decisions made by youth and their families will dramatically affect their individual welfare. Few programs outside of public education systems exist at a sufficiently large scale to assist youth. Decisions to stay in school, opportunities to learn skills and manage resources, the exercise of sexual responsibility, and the process of family formation all impact both personal welfare and community development. Gender-equality issues compound many of the problems. …
Increasing Demand For Reproductive Health Services In A Peruvian Clinic, Federico R. Leon, Anibal Velasquez, Lissette Jimenez, Alicia Calderon
Increasing Demand For Reproductive Health Services In A Peruvian Clinic, Federico R. Leon, Anibal Velasquez, Lissette Jimenez, Alicia Calderon
Reproductive Health
Over the past few years, well-established family planning (FP) organizations in developing countries, such as INPPARES, the IPPF affiliate in Peru, have strived to implement the Cairo Agenda. In the process of including reproductive health (RH) in FP care, they have dedicated human resources and infrastructure to provide RH services seldom offered in the past. The problem these organizations now face is to increase use of the newly available RH care. Currently, clients seeking FP services may leave clinics unaware of the other RH care provided. At a time when international donors are phasing out financial assistance, the partially idle …
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health
Reproductive Health
The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga
Reproductive Health
Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …
Factors Affecting The Outputs And Costs Of Community-Based Distribution Of Family Planning Services In Tanzania, Jane Chege, Naomi Rutenberg, Barbara Janowitz, Andrew Thompson
Factors Affecting The Outputs And Costs Of Community-Based Distribution Of Family Planning Services In Tanzania, Jane Chege, Naomi Rutenberg, Barbara Janowitz, Andrew Thompson
Reproductive Health
This study assesses the cost-effectiveness of reimbursement schemes for community-based distribution (CBD) programs in Tanzania, and answers whether agents who receive monetary incentives perform better and are more cost-effective than those that receive nonmonetary incentives. Fieldwork was undertaken in April and May 1997, and data forming the basis of the analysis was collected from four CBD programs. These programs vary in their remuneration schemes and status of their CBD agents, size, and geographical coverage; the range of activities undertaken by the agents; and supervision and management structures. As noted in this report, CBD agents who receive monetary remuneration see more …
Youth Talk About Sexuality: A Participatory Assessment Of Adolescent Sexual And Reproductive Health In Lusaka, Zambia, Tamara Fetters, Evans Mupela, Naomi Rutenberg
Youth Talk About Sexuality: A Participatory Assessment Of Adolescent Sexual And Reproductive Health In Lusaka, Zambia, Tamara Fetters, Evans Mupela, Naomi Rutenberg
Reproductive Health
Thirty-six percent of Zambia’s 9 million inhabitants are between 10 and 19 years of age, and most adolescents are sexually active by their mid-teens. Pregnant teenagers have an elevated risk of maternal mortality and complications related to birth. In 1990, at Lusaka’s University Teaching Hospital, self-induced abortion accounted for up to 30 percent of maternal mortality, and one-quarter of these deaths occurred in women under 18 years. Sexually transmitted infections (STIs) are a major health problem for adolescents, yet only a small proportion protect themselves from pregnancy and STIs. There are many barriers to improving the situation, including opposition by …
Getting Men Involved In Family Planning: Experiences From An Innovative Program, Directorate Of Family Planning, National Institute Of Population Research And Training, Population Council
Getting Men Involved In Family Planning: Experiences From An Innovative Program, Directorate Of Family Planning, National Institute Of Population Research And Training, Population Council
Reproductive Health
This study was designed to determine the effect of interventions on accelerated proactive male involvement in family planning (FP) and factors influencing acceptance of male contraceptive methods. It was observed that a program can be successful if management cadres can be motivated and involved in the process. Other findings suggest the importance of education and communication materials, supply of information, orientation of fieldworkers, and mobilization of resources including hands-on refresher training. Misconceptions about male contraception (particularly vasectomy) are rampant in traditional Bangladeshi society, thus ideas should be positively expressed through visual aids. Among the various communications materials, at least one …
Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain
Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain
Reproductive Health
The project "Involving Private Medical Practitioners (PMPs) in Family Planning Services" is an innovative initiative to involve PMPs in protecting the reproductive health (RH) of couples, attract private investment in the family planning (FP) sector, and eventually reduce the increasing financial pressure on the government. The project was implemented in two phases. In phase I, qualified PMPs from urban areas were given training on FP. In phase II, nonqualified PMPs were given training on FP. PIACT Bangladesh, a local NGO, conducted two pilot projects to involve the PMPs in FP. The first one was to involve qualified PMPs in urban …
Family Planning Operations Research: A Book Of Readings, James R. Foreit, Tomas Frejka
Family Planning Operations Research: A Book Of Readings, James R. Foreit, Tomas Frejka
Reproductive Health
For as long as there have been family planning programs, there has been family planning research. At the theoretical level, researchers examine the effect of fertility on health and socioeconomic development and study the determinants of fertility for individuals and populations. At the policy level, studies explore the role of family planning programs in modifying fertility and health. The development of new contraceptives is accompanied by clinical and pre-introductory trials in program settings. Surveys measure changes in contraceptive use and fertility, and the results are used to make decisions affecting programs. Finally, programs themselves carry out operations research (OR) to …
Do Population Policies Matter? Fertility And Politics In Egypt, India, Kenya, And Mexico, Anrudh K. Jain
Do Population Policies Matter? Fertility And Politics In Egypt, India, Kenya, And Mexico, Anrudh K. Jain
Reproductive Health
How are effective population policies articulated and implemented? Have international agencies played a strong role in prompting developing-country governments to adopt and implement strong population policies? How has the international debate influenced deliberations on population issues in developing countries? The impetus for the four country studies presented in this book was provided by a desire to better understand some of these issues within specific contexts. Egypt, India, Kenya, and Mexico were selected because of their demographic weight, a long history of population policies and programs, and evidence of fertility decline. The four country studies examine the influence of many forces …
A Study Of Women's Preferences Regarding The Formulation Of Over-The-Counter Vaginal Spermicides, Christiana Coggins, Christopher J. Elias, Ronachai Atisook, Mary T. Bassett, Virginie Ettiegne-Traore, Peter D. Ghys, Laura Jenkins-Woelk, Earmporn Thongkrajai, Nancy L. Vandevanter
A Study Of Women's Preferences Regarding The Formulation Of Over-The-Counter Vaginal Spermicides, Christiana Coggins, Christopher J. Elias, Ronachai Atisook, Mary T. Bassett, Virginie Ettiegne-Traore, Peter D. Ghys, Laura Jenkins-Woelk, Earmporn Thongkrajai, Nancy L. Vandevanter
Reproductive Health
There is an urgent need for safe, effective, and acceptable vaginal barrier methods for the prevention of sexually transmitted diseases (STDs), including HIV, and a variety of existing spermicides have the potential to be used for both prevention of STDs and unwanted pregnancy. Unfortunately, very little is known about formulation preferences and the desirable characteristics of vaginal preparations among the diverse populations of women who would potentially use these products. In this study, we explored vaginal spermicidal preparations containing nonoxynol-9 and the characteristics that influence user preferences for three formulations, as well as the risk of vaginal and cervical irritation …
Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi
Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi
Reproductive Health
Family planning (FP) and maternal and child health (MCH) in Bangladesh have achieved commendable success in the recent past, mostly through a large-scale government service-delivery system supported by donors and nongovernmental organizations. Although encouraged by this success, there was concern about programmatic, financial, and social sustainability of the program, including quality of services. It is now believed that most of these concerns will be taken care of if effective community participation can be ensured. A pilot project was initiated in 1997 in Anowara, a low-FP-performing area in rural Chittagong, with assistance from the Population Council. The main objective of the …
Management Support For Postabortion Operations Research At The Egyptian Fertility Care Society, Population Council
Management Support For Postabortion Operations Research At The Egyptian Fertility Care Society, Population Council
Reproductive Health
The ANE OR/TA Project started its first five-year phase in 1991 addressing increased choice and accessibility of contraceptive use, promoting quality of family planning (FP) services in Asia and the Near East, and promoting the use of operations research (OR) to solve service-delivery problems. The first phase emphasized human resource development. During the years leading up to the 1994 International Conference on Population and Development, there was increased global attention to issues related to reproductive health (RH), and in particular the adverse health implications of harmful RH practices, including unsafe abortion. OR was being called upon to help implement this …