Maternal and Child Health Commons^™

Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef

Reproductive Health

The Population Council launched a pilot study to test two Pay-for-Performance (P4P) strategies to improve MNCH services in Bangladesh. This document presents guidelines for offering incentives to providers, distributing coupons, and forming P4P and/or Coupon Committees and Quality Assurance Groups. The guidelines were developed over the course of five policy-level and consensus-building workshops with national and local-level program managers and service providers, organized under the leadership of the DGHS, in consideration of the local context and sustainability in case of nationwide replication in the country. These guidelines will come into effect upon receiving approval from the DGHS, Ministry of Health …

Public Expenditure On Health Care In Orissa: Focus On Reproductive And Child Health Services, Sarit Kumar Rout

Reproductive Health

In view of the importance of public financing in influencing health outcomes and the paucity of studies that have explored patterns of resource allocation on reproductive and child health services, a study was undertaken in Orissa, India to examine the pattern of and trends in public expenditure on health care with a special focus on expenditure on reproductive and child health services. The study was part of the Population Council, India’s Health and Population Innovation Fellowship program. Findings indicate that major policy issues such as the transfer of power to panchayati raj institutions and those involving health administration and management, …

Increasing Appropriate Complementary Feeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to determine current complementary feeding practices among children aged 6–23 months; understand the facilitating factors and barriers in adopting appropriate complementary feeding practices; and identify programmatic and behavior change communication (BCC) initiatives that could promote the adoption of appropriate complementary feeding practices. The qualitative study shows that women and family members did not feed a measured quantity of food to their children. A lack of knowledge and lack of communication created barriers to initiating complementary feeding. The policy brief recognized education and antenatal care as facilitating factors and …

Increasing Early And Exclusive Breastfeeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to determine the current status of early and exclusive breastfeeding, understand the facilitating factors and barriers in adopting the desired breastfeeding practices, and identify programmatic and behavior change communication (BCC) initiatives to promote the practice. Findings indicate that efforts by Primary Health Centre staff to counsel and encourage women to breastfeed early could significantly increase adoption of this practice. The policy brief identifies barriers that reflect a lack of knowledge and misperceptions about breastfeeding, but finds that education, supportive family members, and knowledgeable health workers can facilitate breastfeeding. …

Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …

Integration Of Services In Senegal, Population Council

Reproductive Health

With financial support from USAID and technical support from IntraHealth, The Population Council, Siggil Jigeen Network, and Helen Keller International, Senegal’s Ministry of Health and Prevention has built a package of integrated services called SMNI/PF/PALU. Integrating services allow women to access a wider range of information and care during the same visit and thus increases the utilization of services while also improving their quality and efficiency. Findings in this report indicate that integration of services is a central feature of SMNI/PF/PALU’s success. In conjunction with integrated service delivery models, program activities which strengthen systems and support efficient implementation of services …

Une Stratégie Pour La Réduction De La Mortalité Maternelle Et Néonatale, Population Council

Reproductive Health

As part of the strategies to reduce maternal and neonatal mortality, the introduction of a minimum integrated package of maternal and newborn care including Active Management of the Third Stage of Labor (AMTSL) and Essential Newborn Care (ENC) are simple and inexpensive approaches in poor countries. This brief reports on a study conducted by the Senegal Ministry of Health and Prevention, with support from IntraHealth and the Population Council, whose objectives included: 1) evaluating the functional capacity of the targeted health structures to offer the AMTSL and ENC, 2) evaluating the knowledge and skills of the providers, and 3) identifying …

A Strategy For The Reduction Of Maternal And Neonatal Mortality, Population Council

Reproductive Health

As part of the strategies to reduce maternal and neonatal mortality, the introduction of a minimum integrated package of maternal and newborn care including Active Management of the Third Stage of Labor (AMTSL) and Essential Newborn Care (ENC) are simple and inexpensive approaches in poor countries. This brief reports on a study conducted by the Senegal Ministry of Health and Prevention, with support from IntraHealth and the Population Council, whose objectives included: 1) evaluating the functional capacity of the targeted health structures to offer the AMTSL and ENC, 2) evaluating the knowledge and skills of the providers, and 3) identifying …

Intégration Des Services Au Sénégal, Population Council

Reproductive Health

With financial support from USAID and technical support from IntraHealth, The Population Council, Siggil Jigeen Network, and Helen Keller International, Senegal’s Ministry of Health and Prevention has built a package of integrated services called SMNI/PF/PALU. Integrating services allow women to access a wider range of information and care during the same visit and thus increases the utilization of services while also improving their quality and efficiency. Findings in this report indicate that integration of services is a central feature of SMNI/PF/PALU’s success. In conjunction with integrated service delivery models, program activities which strengthen systems and support efficient implementation of services …

Proceedings And Presentations From The Free State Child Abuse Indaba, Population Council

Reproductive Health

The Free State Department of Health and its partners held a “first-of-its kind” Child Sexual Assault Indaba (conference) in South Africa to streamline relationships between services for effective prevention and management of child abuse. This report details the presentations delivered at the conference, which was a resounding success, with participation from a wide range of stakeholders. The recurring theme of all the presentations was the urgent need to unite and fight against child sexual assault. The most appropriate strategy was unanimous—information—and clarity in terms of the role of each stakeholder. The Free State Department of Health will coordinate the development …

Comprehensive Responses To Gender-Based Violence In Low-Resource Settings: Lessons Learned From Implementation, Jill Keesbury, Ian Askew

Reproductive Health

The Population Council undertook a program of technical assistance and research to strengthen the evidence base on sexual and gender-based violence (SGBV) programming in sub-Saharan Africa. This project created an active network of implementers and researchers across sub-Saharan Africa, all of whom were charged with developing, implementing, and evaluating core elements of a comprehensive, multisectoral model for strengthening responses for survivors of SGBV, especially survivors of sexual violence. Based on the experiences of these partners, this document reviews the findings, lessons learned, and promising practices in the provision of comprehensive SGBV services in sub-Saharan Africa. The findings are intended to …

Training Service Providers Increases Tb Screening In Postnatal Care, Population Council

Reproductive Health

This document summarizes a Population Council operations research project undertaken in collaboration with the Kenya Ministry of Health to develop and pilot-test an intervention to improve TB screening, case detection, treatment, and care among postnatal clients. The intervention demonstrated that it is feasible to use postnatal care services as a platform to increase TB screening and case detection. Training providers, giving them job-aids, and strengthening client flow within the facility also improved the overall quality of care that the clients received. The actual number of cases of TB detected was extremely low, however; thus the report recommends that the Ministry …

The Pregnancy Cycle Approach To Safe Motherhood, Saumya Ramarao, Sarah Raifman

Reproductive Health

The Population Council's Reproductive Health program partnered with the Maternal Health Task Force (MHTF), the Partnership for Maternal, Newborn and Child Health (PMNCH), and the PAC Consortium, to address the UN Millenium Development Goal of improving maternal health, and reducing child mortality. Specifically this brief examines the pregnancy cycle approach whereby women’s needs from facilitating a desired pregnancy to successful parturition are addressed in a range of settings—home, community and health facility. This brief covers the different stages including abortion and postabortion care, antenatal care, delivery, and postpartum and beyond.

Emergency Contraception: Idea To Program, Saumya Ramarao, John Townsend, Sarah Raifman

Reproductive Health

This report summarizes the role of the Population Council in generating evidence, providing technical leadership, and demonstrating at scale that emergency contraception (EC) can be easily integrated into national family planning programs and other reproductive health services. Since the 1990s, the Population Council, along with other partners, has contributed to the changes seen in the provision and availability of EC, now available in over 140 countries around the world. While much progress has been made in the campaign for access to EC, the Council is committed to improving existing methods of service delivery and to leading advocacy efforts and research …

Future Demands For Services From Public Health Facilities In Uttar Pradesh, Population Council

Reproductive Health

A Population Council-led consortium in India conducted a study to assess (a) the expected workload of public health facilities, and (b) the extent to which the demand for contraception could be met by the existing health facilities in Uttar Pradesh, following the implementation of behavior change communication (BCC) activities. This policy brief recommends that BCC efforts create demand for services and address perceptions that it is “not necessary” to access health care services. BCC must play a greater role in motivating women to move to facilities not just for institutional delivery but for other services as well. BCC can also …

Increasing The Practice Of Thermal Care To Prevent Newborn Hypothermia: Implications For Behavior Change Communication In Rural Uttar Pradesh, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess current newborn bathing practices and the methods adopted to keep the baby warm immediately after birth; explore the beliefs that guide these customs and practices; identify the barriers and facilitating factors in adopting healthy newborn care practices, such as skin-to-skin contact (STSC); and identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of newborn care practices. Barriers included misconceptions about the consequences of bathing a newborn and a lack of awareness among mothers and health workers about STSC. Facilitating factors included contact …

Une Bonne Surveillance De La Grossesse Pour Préparer L'Accouchement, Population Council

Reproductive Health

This brief reports on a situation analysis conducted to provide basic information to help Senegal’s SMNI/PF/PALU program identify priority intervention areas or readjust the interventions originally proposed. More specifically, the analysis aimed to assist in the development of the integrated RH service package to be implemented at the service delivery points and to develop the training resources needed for capacity-building among providers and for the organization of services. The analysis recommends: dissemination of new procedures and protocols and orientation of providers, with a view to improving implementation; providing supervision and post-training follow-up of providers; and orienting providers to the systematic …

Community Mobilization For Postabortion Care In Kenya: Baseline Evaluation Report, Chi-Chi Undie, Saumya Ramarao

Reproductive Health

Maternal health complications, including those arising from unsafe abortion and miscarriage, are a leading cause of morbidity among women in Kenya. These realities necessitate interventions to prevent unintended or unwanted pregnancies and to ensure access to quality care for women with postabortion complications. In response to this need, the RESPOND Project designed an intervention package aimed at increasing awareness and use of postabortion care (PAC) services and improving family planning, reproductive health, and maternal health outcomes. As part of the intervention, RESPOND works with districts and communities to: strengthen service delivery points to provide PAC services; conduct community mobilization to …

The Birds & The Bees Of The West Usambaras: Family Planning & Population Of Sagara & Kizanda Villages, Melissa Neville

Independent Study Project (ISP) Collection

My study in the West Usambaras took place November 2009. The main objectives of the study were to identify the principle family planning methods of women in Sagara and Kizanda villages, why those specific methods were used, and how they may be changing over time. The study also focused on the population growth and fertility rates of the two villages. I predicted that fertility rates were high and constant, and that most women would use traditional methods of birth control, with only a few choosing to use medication available at the local health clinic or dispensary. My predictions turned out …

Effect Of Oral Stimulation On Feeding Progression In Preterm Infants, Brenda Lessen

Scholarship

This is a poster presentation of original research conducted to assess the safety and efficacy of a newly developed prefeeding oral stimulation intervention (Beckman Oral Motor Intervention-Premature Infant) on feeding progression and length of stay on preterm infants younger than 30 weeks PMA.

Implications For Child Welfare Teaching And Human Services Personnel Perspectives Experiences Of Children With Special Needs, Sarah Huesmann

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

Revisiting The Regulation Debate: The Effect Of Food Marketing On Childhood Obesity, Nicole E. Hunter

The University of New Hampshire Law Review

[Excerpt] “Despite the widespread concern regarding childhood obesity, there is broad divergence of opinion regarding responsibility for the crisis. Whether the government, food industry, or parents are accountable has become the focus of much debate. Public health groups have attempted various strategies to confront childhood obesity, such as litigation, legislation, and government regulation. While many researchers and advocates agree that government should play an affirmative role with respect to childhood obesity, they are very much divided over what that role should be. For example, although none of these acts has become law, eighty-six bills have been proposed regarding obesity since …

2008 - 2009 Touro College Project Aspire Yearbook, Touro College Project Aspire

Yearbooks and Newsletters

With the support of Touro College's School of Health Sciences and the Touro University College of Osteopathic Medicine, Project Aspire is a program offered for pre-kindergarten through first grade students and their families at P.S. 197 in Harlem, New York. The program provides basic education on health and promotes healthy lifestyle choices including proper nutrition and exercise.

Evaluation Of Hiv Counseling And Testing In Anc Settings And Adherence To Short Course Antiretroviral Prophylaxis For Pmtct In Francistown, Botswana, Carolyn Baek, Tracy Creek, Lee Ann Jones, Louis Apicella, Jennifer Redner, Naomi Rutenberg

HIV and AIDS

The vast majority of children infected with HIV are the result of mother-to-child transmission (MTCT) of the virus during pregnancy, labor, or breastfeeding. Botswana is one of the first countries in the developing world with a national prevention program (PMTCT) to reduce vertical transmission. The Horizons Program of the Population Council, in collaboration with the Centers for Disease Control and Prevention (CDC) and Premiere Personnel in Botswana, conducted an evaluation to describe the adherence of pregnant women to the current PMTCT regimen. The report recommends standardizing post-test counseling content through the use of job aids and adapting existing WHO materials, …

Being (Becoming Empowered In Nursing Growth): Training Guide For Nursing Students On Sexuality And Gender, Maryann Washington

Reproductive Health

This training guide was produced as part of a Health and Population Innovation Fellowship administered by the Population Council, India, and aims to help the faculty of nursing students to deliver comprehensive sexuality education effectively and efficiently, to help trainee nurses see the whole picture of sexuality in its matrix of safety, pleasure, reproduction, illness, and health. The package is called ‘BEING’ (acronym for Becoming Empowered in Nursing Growth) as it is assumed that, if delivered well, it could empower nurses’ growth to address these issues.

Implications For Nursing Practice: Delivering The Folic Acid Message, Kimberly Townsend Little

UNLV Theses, Dissertations, Professional Papers, and Capstones

In 1995, North Carolina (NC) had one of the highest prevalence rates of neural tube defects (NTDs) in the United States. Since the NC Folic Acid Council began focusing their efforts on educating women of childbearing age regarding NTDs in 1994, the prevalence of NTDs has declined overall by 40%; however, NTD prevalence among Hispanics in NC continues to be double the rate of non-Hispanics. Research has found daily consumption of a multivitamin with folic acid significantly decreases NTDs. Healthy People 2010 include in their objectives the need to increase folic acid consumption in women and reduce the NTD rates. …

The Association Of Maternal Intention To Breastfeed, Early Skin-To-Skin Mother/Infant Contact, And Exclusive Breastfeeding During The Maternity Hospital Stay, Leslie Mary Bramson

Loma Linda University Electronic Theses, Dissertations & Projects

Breastfeeding is the optimal method to nourish and nurture an infant. Exclusive breastfeeding rates in the United States have reached the goal of Healthy People 2010 that 75% of mother's breastfeed in the immediate postpartum period. Yet, less than 35% of San Bernardino county mothers and 47.7% of Riverside county mothers are exclusively breastfeeding during their maternity hospital stays, with as many as 50% of the infants being weaned from the breast in the first 14 days of life.

This prospective study examined archived data collected by Perinatal Services Network (PSN) of Loma Linda University Medical Center/Children's Hospital for the …

Infant Feeding Decisions Among Pregnant Black Wic Participants And The Role Of Peer Support, Astrid D. Mickens

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal …

Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan

HIV and AIDS

This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction …

If You Build It, Will They Come? Kenya Healthy Start Pediatric Hiv Study: A Diagnostic Study Investigating Barriers To Hiv Treatment And Care Among Children, Karusa Kiragu, Katie D. Schenk, Julie Murugi, Avina Sarna

HIV and AIDS

In Kenya the proportion of eligible HIV-positive children receiving ART treatment is only 11 percent. This study explored and documented possible barriers in the community to accessing pediatric HIV testing and treatment, to guide the development of new interventions to encourage uptake. The study identified barriers such as cost, use of traditional healers, low knowledge of treatment options, attitudinal barriers, stigma, unique treatment issues, and dissatisfaction with available services. Additionally, healthcare workers missed opportunities to provide services and cited numerous service-side challenges. The study recommends prioritizing community awareness, mobile clinics, strengthening capacity of healthcare workers, supporting family-based HIV testing, and …