International Public Health Commons^™

An Integrated Peer Outreach And Clinic-Based Intervention To Improve The Sexual Health Of Young Men Who Have Sex With Men In Myanmar: A Link Up Evaluation, Population Council

HIV and AIDS

This brief describes an evaluation that assessed the impact of a peer-driven intervention for young men who have sex with men (MSM) in Myanmar, designed to improve the sexual health and rights of this marginalized community. The intervention and evaluation activities were conducted as part of Link Up, a global consortium led by the International HIV/AIDS Alliance aimed at improving sexual and reproductive health and rights among young vulnerable communities in Africa and Asia. In collaboration with the Burnet Institute, the Population Council–led evaluation study sought to assess whether the Link Up intervention improved sexual and health-seeking behaviors, and whether …

Impact Of Peer Education And On-Site Clinical Services For Female Sex Workers In Bangladesh Brothels: A Link Up Evaluation Study, Population Council

HIV and AIDS

This brief describes an evaluation of a brothel-based HIV and sexual and reproductive health and rights (SRHR) intervention that combined peer outreach with the provision of on-site clinical services in several Bangladesh brothels. The aim of this evaluation was to assess whether peer educator one-on-one or group sessions and on-site satellite clinics improved SRHR knowledge and behaviors among women who sell sex in three Bangladesh brothels. The study was conducted by the Population Council as part of the Link Up project, a global consortium led by the International HIV/AIDS Alliance aimed at improving the SRHR of young people. The findings …

Reducing Provider-Held Stigma And Improving Young Client Satisfaction In Bangladesh: Findings From A Link Up Evaluation, Population Council

HIV and AIDS

To address HIV stigma in Bangladesh, a training program was designed and evaluated among service providers as part of Link Up, a global project led by the International HIV/AIDS Alliance designed to improve the sexual and reproductive health and rights (SRHR) of young people. These trainings aimed at sensitizing healthcare providers to the needs and rights of young people at high risk of stigmatization—such as sex workers, sexual minorities, or young people who engage in premarital sex. The Population Council collaborated with Marie Stopes International Bangladesh (MSIB) to evaluate whether stigma-reduction trainings improved provider attitudes toward these young marginalized populations, …

Sexual And Reproductive Health And Rights Needs Of Young Men Who Live In The Streets In Dhaka City: A Link Up Exploratory Study, Population Council

HIV and AIDS

Under the Link Up project—a global consortium led by the International HIV/AIDS Alliance and supported by the Dutch Ministry of Foreign Affairs—the Population Council conducted an exploratory study of the HIV and sexual and reproductive health and rights (SRHR) needs of young men who live in the streets of Dhaka City, Bangladesh. The study investigated their knowledge, behaviors, needs, and service utilization related to HIV and SRHR. The findings elucidate the substantial vulnerabilities and risks faced by young men who live in the streets of Dhaka City, most notably in terms of sexual risk and physical violence. Participants reported very …

Using Peers To Improve Sexual And Reproductive Health And Rights Of Young People Living With Hiv In Uganda: Findings From A Link Up Evaluation, Population Council

HIV and AIDS

Link Up, a global consortium led by the International HIV/AIDS Alliance, sought to meet the immediate HIV care needs and also the broader sexual and reproductive health and rights (SRHR) for Ugandan young people living with HIV (YPLHIV), by creating linkages between comprehensive community- and facility-based HIV and SRHR services. In addition, Link Up delivered health education, counseling, and peer support tailored to the needs of YPLHIV in order to educate and empower them to recognize their rights, and feel confident in seeking health services. This brief presents findings from the Population Council’s evaluation of Link Up activities among YPLHIV …

Building Evidence To Guide Prep Introduction For Adolescent Girls And Young Women, Nanlesta Pilgrim, Sanyukta Mathur, Ann Gottert, Naomi Rutenberg, Julie Pulerwitz

HIV and AIDS

This document was developed by the Population Council, with support from the Bill & Melinda Gates Foundation, to provide DREAMS country teams with practical guidance on building evidence to guide pre-exposure prophylaxis (PrEP) introduction for adolescent girls and young women (AGYW). The primary audiences for this document are health policymakers and program planners who will be making decisions about how PrEP is introduced and the researchers who will assess AGYW’s specific needs and experiences. Our aim is to complement emerging global guidance on PrEP and ongoing work regarding delivery platforms, marketing, and policy and regulatory frameworks for PrEP introduction more …

How To Reduce Hiv Risk Among Adolescent Girls And Young Women In Sub-Saharan Africa? Implementation Science Around The Dreams Initiative, Population Council

HIV and AIDS

The Population Council, with funding from the Bill & Melinda Gates Foundation and the US Agency for International Development through Project SOAR, is leading the implementation science portfolio of the timely and innovative DREAMS partnership in 10 sub-Saharan countries, producing evidence to strengthen DREAMS activities and other community-based programming. The Council’s research focuses on how best to reach the most vulnerable adolescent girls and young women (AGYW) and their male partners and engage them in activities and services, and how to roll out pre-exposure prophylaxis (PrEP) for HIV prevention among AGYW. By examining these critical HIV prevention issues, the Council’s …

Impact Of A Community-Based, Hiv Intervention On Antiretroviral Treatment Retention And Adherence In Tanzania, Project Soar

HIV and AIDS

Project SOAR is contributing to the evidence base on community-based care models by conducting implementation research in Tanzania, a country where 1.5 million people are in need of HIV care services, and where clients eligible for antiretroviral therapy (ART) often drop out or are lost to follow up. While the country has a cadre of community-based HIV service (CBHS) providers, they remain largely informal. Project SOAR and its partners are evaluating a coordinated, integrated model in which CBHS providers deliver an enhanced service package to HIV-positive clients. The evaluation will advance understanding of the value of CBHS providers in improving …

Project Soar's Voluntary Medical Male Circumcision Portfolio, Project Soar

HIV and AIDS

Project SOAR has developed an extensive voluntary medical male circumcision (VMMC) portfolio to support multiple countries with data to make informed policy and programmatic decisions about VMMC that address their specific needs and environments. A critical component of this portfolio is research utilization. At the country level, Project SOAR seeks to generate data to support planning, implementing, and monitoring VMMC programs and increase access to and use of this data through user-friendly interfaces and dissemination strategies. Simultaneously, SOAR aims to advance VMMC as a vital prevention strategy by filling important data gaps in the global discourse around VMMC. This brief …

Barriers To Fistula Repair In Nigeria: A Formative Study, Population Council

Reproductive Health

A formative research study was conducted in Nigeria to better understand the barriers and enabling factors for fistula repair care delivery and access. This brief presents results from a literature review conducted to identify and understand the delays in accessing and receiving treatment and corresponding barriers, to document interventions that help to overcome barriers, and to specify gaps in the literature that require further research. The report concludes that women’s concern over healing and reintegration reflects their expectation that the holistic approach of hospitals will bring them back to normal life incorporating physical, sexual, psychosocial, and economic rehabilitation. Awareness, financial, …

Strengthening Factory Health Systems Under Levi Strauss & Co.'S Worker Well-Being Initiative In Egypt, Population Council, The Evidence Project

Reproductive Health

The pilot intervention described in this brief took place at an apparel manufacturing company, Lotus, located in Port Said, Egypt as part of the Worker Well-being Initiative. Worker Well-being is an initiative of Levi Strauss & Co. and the Levi Strauss Foundation that seeks to move beyond a “do no harm” compliance model of labor rights in its global supply chain. The interventions in Egypt have contributed to the overall development of a health system–strengthening approach to private workplaces, which is a new concept for management. The work in Egypt contributed to a collaboration between the Evidence Project/RAISE Health and …

Does Shifting Gender Norms On The Community Level Lead To Increased Hiv Services Uptake?, Project Soar

HIV and AIDS

Project SOAR and partners are building on an ongoing National Institute of Mental Health–funded randomized controlled trial being conducted in South Africa—Community Mobilization for Treatment as Prevention. Specifically, the study aims to strengthen and expand the gender content of the intervention to engage both women and men in critically examining gender norms and power inequalities. This brief presents the particularly timely study that will address a key question in the field as to how gender norms may operate to affect HIV service utilization. Building the evidence base in this area is vital for improving care outcomes as well as creating …

Estimating The Costs Of Providing Voluntary Medical Male Circumcision In South Africa, Project Soar

HIV and AIDS

The South African government introduced voluntary medical male circumcision (VMMC) as an HIV-prevention intervention in 2010, based on the compelling evidence that VMMC reduces men’s risk of becoming HIV infected by approximately 60 percent. To inform strategic planning for continued scale-up of its VMMC program and better understand cost drivers and cost variances across provinces, the South African National Department of Health in 2014 requested estimates of the unit cost of VMMC and the level of current spending for VMMC demand creation. The results of this study provide a comprehensive analysis of the unit cost of providing VMMC in South …

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

Reproductive Health

This district profile of Multan is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of antenatal and delivery care services; use of family planning; 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/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 …

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

Reproductive Health

This district profile of Sukkur 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; 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 and a chart listing district-specific donors, projects, and implementing partners. The …

Analyzing Tuberculosis Diagnosis And Treatment In Kasungu, Malawi, Andrew Currier

Honors Theses

Despite Tuberculosis (TB) being a highly curable disease, it continues to result in over 5% of deaths in the Sub-Saharan African country of Malawi. Coupled with HIV, the disease remains one of the leading causes of death in Malawi. In the summer of 2015, I joined a research team from Partners in Hope to conduct a survey evaluating the health centers that provide TB care in the Kasungu region of Malawi. After visiting 23 health centers, the results of the 47-question survey were compiled and analyzed to provide information on the capabilities and practices at each health center. The results …

Sexual And Reproductive Health Knowledge, Attitudes, And Practices Among Early Adolescents And Young Adults In Uganda: Findings From A Link Up Exploratory Study, Population Council

HIV and AIDS

The Population Council collaborated with Makerere University’s Child Health and Development Centre to conduct a study of males and females ages 10–24 to help inform future programs and policies affecting these young people. This study was conducted as part of the Link Up project, a global consortium led by the International HIV/AIDS Alliance that aims to improve the sexual and reproductive health and rights (SRHR) of young vulnerable people. Results indicate that adolescents and young adults have broad gaps in their knowledge about HIV and SRHR; early adolescents fared significantly worse in these areas than their older counterparts, suggesting that …

Youth In Pakistan: Priorities, Realities And Policy Responses, Zeba Sathar, Iram Kamran, Maqsood Sadiq, Sabahat Hussain

Poverty, Gender, and Youth

Youth is a pivotal stage during which the right policies and interventions in the health, social, educational, and economic sectors can protect young people against risks, and turn the trajectories of their lives toward a safe and productive path of growth. This report explores some of the key issues facing youth in Pakistan, in the main spheres marking their transition to adult roles. It also presents the results of an age-based segmentation analysis capturing where youth in Pakistan stand in terms of school enrollment, work force participation, and marriage, with a view to identifying the broad developmental priorities for each …

The Africa Regional Sgbv Network Learning Brief Series: Learning Updates From Uganda (Brief #6), Population Council

Reproductive Health

Sexual and gender-based violence (SGBV) in humanitarian contexts is recognized by the UN Refugee Agency as a global concern and as a priority in its programming. Crisis-affected populations often face multiple forms of SGBV at multiple time periods (during conflict, during flight from conflict, and within post-conflict settings). The Africa Regional SGBV Network, set up in 2006, is addressing SGBV in humanitarian contexts in East and Southern Africa. This Learning Brief is one in a series of two that share critical findings on effective responses to the issue in Uganda. This brief notes that relatively higher screening, disclosure, referral, and …

The Africa Regional Sgbv Network Learning Brief Series: Learning Updates From Swaziland (Brief #3), Population Council

Reproductive Health

Nearly half of girls aged 13–24 in Swaziland suffer some form of sexual violence, according to the country’s 2007 Violence Against Children (VAC) survey. About 10 percent of girls reported experiencing sexual and gender-based violence (SGBV) in school in particular. The Swaziland Action Group Against Abuse (SWAGAA) is recognized as Swaziland’s leading SGBV prevention, response, and advocacy organization. This Learning Brief describes how SWAGAA is tackling SGBV in schools in three different ways: 1) helping girls take more control of their school experience through a new self-efficacy module in the Girls’ Empowerment Clubs; 2) encouraging girls, and giving them the …

Operationalizing National Protocol For Preventing And Managing Pe/E In Community Facilities In Bangladesh, Population Council

Reproductive Health

Considering the maternal deaths associated with pre-eclampsia and eclampsia (PE/E), the Bangladesh Ministry of Health and Family Welfare, with technical assistance from the Obstetrical and Gynecological Society of Bangladesh, developed a national protocol allowing community providers to provide a magnesium sulphate (MgSO4) loading dose. With the approval of the National Technical Committee of the Directorate General of Family Planning, this study operationalized and assessed the ability of community providers to detect and treat PE/E, and administer the loading dose of MgSO4 before referral to higher-level facilities. The study results presented in this brief indicate that with national protocol, training, and …

Formative Research On Factors Influencing Access To Fistula Care And Treatment In Uganda, Pooja Sripad, Charlotte E. Warren

Reproductive Health

This formative research builds upon the results of a systematic review by the Population Council for better understanding of the barriers and enabling factors for fistula repair care and access in Uganda. The study focuses on Fistula Care Plus project-supported treatment facilities where fistula camps are routinely held. Results reveal the nuances of women’s experiences, along with the additional perspectives of their spouses, family members, community stakeholders, and fistula camp care providers including nurses/counselors, surgeons, and facility and district managers. Barriers and enablers to fistula repair care are clustered around the following factors: psychosocial, cultural, social, financial, transportation, facility shortages, …

Adapting A Health Systems Strengthening Model To Improve Access To Health Services In A Factory: A Pilot Project In Haiti, Carolyn Rodehau, David Wofford, Suzanne Brockman

Reproductive Health

The pilot intervention described in this brief took place at an apparel manufacturing company, Caribbean Island Apparel SA, located in Port-au-Prince, Haiti. The project by the USAID-funded RAISE Health Initiative sought to demonstrate the value of a new management approach to workplace health services and practices in a garment factory. Specifically, the pilot looked at how the health systems strengthening model could be adapted to the private sector and could help build the factory’s capacity to manage the health staff and infirmary, institute clinical best practices, and expand the primary care roles for nurses, including providing family planning and reproductive …

Analyzing The Building Blocks Of Resilience: Findings From A Baseline Survey Of The Tuungane Population, Health, And Environment Project In Western Tanzania, Kristin Bietsch, Reshma Naik, Kristen P. Patterson, Cara Honzak, Mustafa Kudrati, Hellen Magige, Cheryl Margoluis, Laura Subramanian, Christopher Hale, Carolyn Lamere, Sebastiaan Hess, Craig Leisher

Reproductive Health

Although the value of population, health, environment (PHE) programs is appreciated by the development community and the conceptual linkages they incorporate are sound, little evidence exists to demonstrate their short- and long-term impacts—particularly the role that the family planning (FP) component of PHE projects plays in building resilience, improving livelihoods, and helping people adapt to climate change. To contribute to filling this gap, the Evidence Project collaborated with Tuungane, a PHE project jointly implemented by The Nature Conservancy and Pathfinder International, to conduct further analysis of their existing data and examine the evidence base around integrated PHE programming, FP, climate …

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

Reproductive Health

This district profile of Lahore is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of contraceptive use and unmet need; 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. …

Abriendo Oportunidades Para Alcanzar Mi Plan De Vida: Programa De 5 Meses—14 A 18 Años, Cecilia Garcés, Paola Broll

Poverty, Gender, and Youth

Esta es la guía curricular del programa Abriendo Oportunidades del Population Council de Guatemala. Este programa de cinco meses ayuda a las niñas a desarrollar pasos para lograr su plan de vida, en módulos sobre los temas siguientes: llevarse bien con otras mujeres; conocerse y valorarse a sí mismo; autoestima; derechos humanos; aprendiendo a ser mujer; la fertilidad y el embarazo; reconociendo el peligro; y la importancia del ahorro.

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This is the curriculum guide for the Abriendo Oportunidades program of the Population Council of Guatemala. This five-month program helps girls develop steps to achieve their life plan, in modules …

Adolescent Girls Empowerment Program (Agep): Mid-Term Findings—Brief, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a four-year effort to support more than 11,000 of the most vulnerable adolescent girls in Zambia. AGEP was led by the Population Council, in partnership with the Young Women’s Christian Association of Zambia, the National Savings and Credit Bank of Zambia, and the Government of Zambia. The program design was based on the asset-building framework which posits that if girls are able to build social, health, and economic assets in the short term, there will be longer-term dividends on health and education outcomes. This brief reports on midterm findings of the study which …

Adolescent Girls Empowerment Programme: Research And Evaluation Mid-Term Technical Report—Executive Summary, Karen Austrian, Paul C. Hewett, Erica Soler-Hampejsek, Fiammetta Bozzani, Jere R. Behrman, Jean Digitale

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Programme (AGEP) was an ambitious project directed toward changing girls’ lives in a significant and meaningful way across areas of education, sexual and reproductive health, marriage and fertility, and experience of violence. This Executive Summary of the project’s findings shows that, overall, the AGEP cohort data, and lessons they have generated from the AGEP are rich, nuanced, and important for informing the next generation of programs for adolescents in Zambia and elsewhere. Even though the study is still under way, and the full longer-term effects of AGEP remain to be seen, the information presented in this …

Adolescent Girls Empowerment Programme: Research And Evaluation Mid-Term Technical Report, Karen Austrian, Paul C. Hewett, Erica Soler-Hampejsek, Fiammetta Bozzani, Jere R. Behrman, Jean Digitale

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Programme (AGEP) was a social, health, and economic asset-building program targeting vulnerable adolescent girls aged 10–19. The Population Council, in partnership with the Young Women’s Christian Association of Zambia, successfully implemented the AGEP program from late 2013 to early 2016. The results presented in this midterm report have implications for recommendations on future programming for adolescent girls in Zambia and elsewhere and should be coupled with burgeoning evidence from AGEP and the literature to adapt programming for vulnerable adolescent girls in order to improve impact. While the underlying root causes of girls’ vulnerabilities are interrelated, it …

Adolescent Girls Initiative-Kenya: Qualitative Report, Eunice N. Muthengi, Karen Austrian, Amanda Landrian, Benta Abuya, Joyce Mumah, Caroline W. Kabiru

Poverty, Gender, and Youth

The Adolescent Girls Initiative-Kenya (AGI-K) is currently delivering multisectoral interventions, targeting violence prevention, education, health, and wealth creation, to adolescent girls aged 11–14 in two marginalized areas of Kenya. This report provides a brief overview of the research design and intervention components being delivered in AGI-K, and presents findings from the first round of qualitative data collection intended to highlight the strengths and weaknesses of the implementation processes thus far. The findings provide important information about the perceived effects of the program from a diverse set of respondents. Overall, beneficiaries, their parents/guardians, and other key stakeholders value the program and …