Maternal and Child Health Commons^™

Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative

Reproductive Health

At the end of 2013, an estimated 35 million people were living with HIV, and sub-Saharan Africa was disproportionately affected. With major efforts directed at expanding access to life-saving antiretroviral therapy in sub-Saharan Africa, many people are living longer with HIV, leading productive and sexually active lives. Unintended pregnancies and the potential of vertical transmission are some of the challenges faced by women living with HIV. Understanding the fertility preferences and reproductive decisions of these women is vital for informing efforts to enable them to achieve these desires effectively and safely. The “Steps to Integration” series provides a guide on …

Delivering Contraceptive Vaginal Rings: Review Of Postpartum And Postnatal Care Programs In Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku

Reproductive Health

Postpartum family planning is a major component of postpartum care services. The Population Council is working to introduce an additional method of contraception in Nigeria—the Progesterone Contraceptive Vaginal Ring (PCVR). The PCVR is administered vaginally but acts systemically to inhibit ovulation. The PCVR contains natural progesterone and is meant for breastfeeding women to augment lactational amenorrhea. As the Council conducts a series of activities as a prelude to eventual introduction of the PCVR in sub-Saharan Africa, including Nigeria, the detailed evaluation of the postpartum program environment is very important. Understanding the prevailing postpartum and postnatal care landscapes will be crucial …

Delivering Contraceptive Vaginal Rings: Review Of Postpartum Service Packages In Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time, yet this is the most neglected period for the coverage and provision of quality care. The building blocks of the WHO health systems model were applied in describing the status and health system structures that support the provision of postpartum and postnatal care (PNC) services in Kenya. Many opportunities exist for facilitating the delivery of the Population Council’s Progesterone Contraceptive Vaginal Rings (PCVR) within PNC services in Kenya, such as integration with other primary health care …

Emerging Priorities In Reproductive, Maternal, And Newborn Health, Population Council

Reproductive Health

The Population Council’s Ending Eclampsia project seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. Ending Eclampsia is working in Nigeria and Bangladesh to assess the level of program activities, gaps, and challenges around prevention and treatment of PE/E and magnesium sulfate (MgSO4). The project will build upon this landscape analysis to expand services to detect and manage PE/E, develop and support implementation of strategic plans for replicating the intervention package, and increase global PE/E evidence shared through knowledge and learning platforms. …

Landscape Analysis Of Pre-Eclampsia/Eclampsia In Nigeria, Charlotte E. Warren, Salisu Mohammed Ishaku, Ayodeji Oginni, Gloria Adoyi, Karen Kirk, Amy Dempsey

Reproductive Health

The Population Council’s Ending Eclampsia project, with support from USAID, seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. The Council conducted a landscape analysis on PE/E in Nigeria in 2015. Its main objectives were to understand the level of programmatic and policy support for PE/E prevention and treatment; to analyze gaps in providers’ competence to prevent, detect, and manage PE/E; to determine capacity at primary health facilities to manage PE/E; to assess community awareness, beliefs, and experiences around PE/E; to understand …

Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council

Reproductive Health

Fear of disrespect and abuse along with misconceptions about procedures required to assist women during childbirth often negatively influence the decision to seek care at a health facility. Maternity Open Days provide an opportunity for pregnant women and their families to interact with health care providers and visit maternity units to demystify birthing practices and mitigate fears regarding childbirth in a facility. Such an approach brings together women, their families, and providers to enable pregnant women to understand what happens in a maternity unit. This brief is part of a Respectful Maternity Care Resource Package developed by the Kenya Heshima …

Promoting Respectful Maternity Care Resource Package—Alternative Dispute Resolution: Resolving Incidents Of Disrespect And Abuse, Population Council

Reproductive Health

Alternative Dispute Resolution (ADR) is a process whereby an independent and impartial third party facilitates negotiation between disputing parties, in this case to resolve incidents of disrespect and abuse (D&A) in a health care setting. In Kenya, ADR was originally used to settle land disputes and inheritance issues at the community level. The voluntary ADR mechanism brings the aggrieved parties together with an opportunity to solve problems in a locally acceptable way. ADR supports both providers’ and clients’ rights and obligations by ensuring each side is heard. This Respectful Maternity Care (RMC) resource provides guidance on the sequence of steps …

Promoting Respectful Maternity Care Resource Package—Debriefing Sessions: Caring For The Carers, Population Council

Reproductive Health

Caring for the Carers is an activity aimed at reducing work-related stress—a major driver of disrespect and abuse (D&A) during facility-based childbirth. Pregnancy, labor, and delivery are expected to be joyous moments for the mother, her family, and the service providers. However, this is not always the case due to maternal complications or even death. Maternity units often have high workloads. This, coupled with lack of professional support for staff and providers, and poor governance and leadership, may lead to work-related stress. These critical incidents can accumulate and contribute to staff stress and emotional exhaustion, which ultimately prevents provision of …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Facilitator’S Guide, Population Council

Reproductive Health

This training guide was produced by the Population Council as part of the Respectful Maternity Care (RMC) Resource Package developed by the Kenya Heshima Project. The Heshima Project, as part of the USAID Translating Research into Action (TRAction) project, was tasked with determining the manifestations, types, and prevalence of disrespect and abuse (D&A) in childbirth; identifying and exploring the potential drivers of D&A; and designing, implementing, monitoring, and evaluating the impact of interventions for reducing D&A including generating lessons for scale-up. The Resource Package is based on the most effective interventions, and provides practical, low-cost, and easily adaptable strategies for …

Summary Report Of The Measuring And Monitoring Quality Of Care Meeting, Population Council

Reproductive Health

At the request of the Packard Foundation, the Population Council organized a meeting at its office in Washington, DC, on December 16, 2014, to establish links with key stakeholders interested in quality of care, and to refocus attention on challenges in measuring and monitoring diverse dimensions of quality of care. Thirty experts from donor, service, and research organizations participated. This summary report, based on the deliberations at the meeting, is intended as a preamble to the formation of a community of practice for advancing quality of care agenda globally. The key message is that improved quality in service delivery is …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Partie 2: Rapport De Synthese, Fatou Mbow, Leslie Dubent, Nafissatou Diop, Fatou Ndiaye Turpin, Bocar Mamadou Daff, Babacar Mane

Reproductive Health

Le Plan d’Action National de Planification Familiale 2012–15 (PANPF 2012–15) du Sénégal est basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où le PANPF 2012–15 arrivait à terme, et qu’un nouveau plan était élaboré, le Population Council a mené une étude pour documenter la mise en œuvre et les réalisations de l’Approche 3D en relation avec le PANPF. Cette étude documente l’Approche 3D en relation avec le PANPF à travers une revue documentaire et une recherche qualitative. Elle décrit les leçons apprises de sa mise en œuvre et partage les bonnes pratiques que d’autres pays pourraient adopter, en particulier …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Partie 1: Revue Documentaire, Leslie Dubent, Fatou Mbow, Nafissatou Diop, Fatou Ndiaye Turpin, Bocar Mamadou Daff, Babacar Mane

Reproductive Health

Le Plan d’Action National de Planification Familiale 2012–15 (PANPF 2012–15) du Sénégal est basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où le PANPF 2012–15 arrivait à terme, et qu’un nouveau plan était élaboré, le Population Council a mené une étude pour documenter la mise en œuvre et les réalisations de l’Approche 3D en relation avec le PANPF. Cette étude documente l’Approche 3D en relation avec le PANPF à travers une revue documentaire et une recherche qualitative. Elle décrit les leçons apprises de sa mise en œuvre et partage les bonnes pratiques que d’autres pays pourraient adopter, en particulier …

Expanding Access To Rights-Based Family Planning: Activity Brief, The Evidence Project

Reproductive Health

The human rights dimensions of family planning programs have been recognized for nearly half a century and affirmed in numerous declarations, conventions, and treaties endorsed by governments and the international community. While discourse about respecting, protecting, and fulfilling these rights is growing, a gap persists between human rights rhetoric and integrating rights in family planning policy, programs, and practice. Governments and programs struggle with defining and operationalizing a rights-based approach to family planning. Overall, there is scant evidence on: how to implement rights-based family planning (RBFP) programming, how to measure rights-based programming and outcomes, and the effect on family planning/reproductive …

Reducing Maternal And Child Mortality In Sindh: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Sindh, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. Evidence shows that FP is one of the most powerful tools at the government’s disposal for a rapid reduction in maternal, infant, and child mortality. FP’s wider health benefits include reduced anemia among women; lower …

Reducing Maternal And Child Mortality In Khyber Pakhtunkhwa: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family Planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why family planning must be prioritized in Khyber Pakhtunkhwa, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 37 percent of maternal deaths and 57 percent of infant deaths. FP’s wider health benefits include reduced …

Reducing Maternal And Child Mortality In Balochistan: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This brief explains why FP must be prioritized in Balochistan, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 41 percent of maternal deaths, 35 percent of infant deaths, and 74 percent of young child deaths. FP’s wider health benefits include reduced …

Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council

Reproductive Health

Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.

---

This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …

Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi

Reproductive Health

In collaboration with the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Programme Consortium, the Population Council implemented a project to increase the demand for secondary school education in Homa Bay County, Kenya—an area characterized by high, unintended teenage pregnancy and female school drop-out rates. To foster awareness of the school re-entry policy, the Population Council collaborated with the Homa Bay County Department of Education (Ministry of Education) to convene a policy dialogue for all principals of public, day, girls-only, and co-educational secondary schools in the area. The policy dialogue helped to create visibility around the issue of …

Let’S Talk About Sex, And What Happens When We Don’T: How Limited Sex Education In Nepal’S Government Schools Affects Women In Arranged Marriages, Isabelle Stillman

Independent Study Project (ISP) Collection

In Nepal’s government secondary schools, the reproductive health curriculum is often covered in a single week, and many teachers neglect to administer the lessons thoroughly due to beliefs that sex is a private matter, inappropriate or unnecessary for students. The government curriculum not only lacks detail about reproduction and intercourse, but, in the information it does include, defines male and female puberty processes, reproductive systems, sexual health, roles in family planning, and intercourse in ways that further the gender inequality so deeprooted in Nepali culture. Following secondary school, many women in Nepal are married in arranged matches, to men they …

La Atención De Mujeres Con Complicaciones Post-Aborto En Un Hospital Público Del Partido De La Matanza: La Perspectiva De Los Profesionales De La Salud / The Perspective Of Health Professionals On The Quality Oftreatment For Women With Complications Post-Abortion Ina Public Hospital In La Matanza, Hannah Collins

Independent Study Project (ISP) Collection

Background: In Argentina, abortion is illegal under all circumstances except for when a woman has been raped, has a mental disability or her life is in danger. There are approximately 500,000 abortions practiced each year in Argentina, and the majority is performed in an unsafe manner, which can result in complications that require medical attention. In 2010, over 50,000 women were hospitalized because of complications post-abortion. These complications can include hemorrhages, infections, or other toxic illnesses. After the International Conference on Population and Development in 1994 they identified post-abortion care as a worldwide problem. Subsequently, Argentina created a guide for …

Sexual And Reproductive Health And Rights Of Aymara Women In The Intercultural Health System In Chile / Salud Y Derechos Sexuales Y Reproductivos De Las Mujeres Aymara En El Sistema De Salud Intercultural De Chile, Ariela Schnyer

Independent Study Project (ISP) Collection

This investigation seeks to understand how Aymara women navigate their sexual and reproductive health and rights (SRHR) in Chile’s intercultural health care model. Indigenous communities have their own practices that complicate the provision of sexual and reproductive health by requiring health care providers to be aware of two different worldviews and how they may conflict, as well as what is necessary to provide respectful care. However, an ethnically and culturally pertinent framework is vital to actually assuring successful SRHR provision, whose tenants include autonomous choice and care free of discrimination, coercion or violence. These interactions were investigated through semi-structured interviews …

Premature Births And Maternal Health: An Analysis Of Risk Factors That Affect The Rate Of Prematurity / Los Nacimientos Prematuros Y La Salud Materna: Un Análisis De Los Factores De Riesgo Que Afecta La Tasa De Prematuridad, Alexandria Mickler

Independent Study Project (ISP) Collection

Research Question: What are the major socio-demographic risk factors influencing the rate of preterm birth in Valparaiso, Chile? Objectives: The objective of this study is to identify risk factors that influence the rate of preterm birth in an urban population of women living in Valparaiso, Chile. This study aims to understand whether a relationship exists between socio-demographic characteristics, such as economic level, education, lifestyle, access to medical attention and resources and the risk of prematurity. The outcomes of this study seek to determine the major biological, cultural, and social relationships and identify at-risk social groups. Additionally, this study considers the …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara G.J. Leech, Elizabeth A. Adams, Marci Bounds Littlefield

Journal of Health Disparities Research and Practice

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serves as a …

“In Light Of Real Alternatives”: Negotiations Of Fertility And Motherhood In Morocco And Oman, Victoria E. Mohr

Student Publications

Many states in the Arab world have undertaken wide-ranging family planning polices in the last two decades in an effort to curb high fertility rates. Oman and Morocco are two such countries, and their policies have had significantly different results. Morocco experienced a swift drop in fertility rates, whereas Oman’s fertility has declined much more slowly over several decades. Many point to the more conservative religious and cultural context of Oman for their high fertility rates, however economics and the state of biomedical health care often present a more compelling argument for the distinct differences between Omani and Moroccan family …

Syrian Refugee Families’ Awareness Of The Health Risks Of Child Marriage And What Organizations Offer Or Plan In Order To Raise Awareness, Rachel Fowler

Independent Study Project (ISP) Collection

The hypothesis of the study assumes: If Syrian refugee families understood the health risks involved with child marriage and the severity of these risks, they would be less likely to choose to marry off their daughter under the age of 18. If these families had more health educational programs and had more access to these programs, these programs would influence their decision towards avoiding child marriage for their daughter(s).

According to UNICEF, one-third of registered marriages among Syrian refugees in Jordan between January and March 2014 involved girls under the age of 18. Child marriage puts girls at risk of …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara Leech, Elizabeth A. Adams, Marci Littlefield

Department of Public Health Scholarship and Creative Works

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serve as a …

Policy Impact Assessment: The “Reasonable Break Time” Provision Of The Patient Protection And Affordable Care Act, Merritt Juliano

21st Century Social Justice

Breastfeeding continues to be the most optimal source of nutrition for infants under 6 months of age, and has been associated with a wide variety of infant and maternal health benefits, including protection against certain illnesses and diseases. Most health organizations recommend exclusive breastfeeding for at least the first 6 months post-birth. Despite these recommendations, breastfeeding women, especially those in lower socioeconomic groups face many challenges in our society. Moreover, maternal employment stands as a significant barrier to successful breastfeeding durations. To counter these problems, Section 4207 of the Patient Protection and Affordable Care Act [ACA] was enacted to offer …

Implementing A Community-Based Intervention For African American Mothers And Daughters, Teri Aronowitz, Nandini Sengupta

Office of Community Partnerships Posters

Adolescents represent one of the fastest growing risk groups for HIV. Inner-city, minority youth are at highest risk because of concentration of HIV in inner-city areas, higher rates of STDs, and early sexual initiation. Mothers are the primary sex educator of daughters, and girls state their relationship with their mother was an important influence on their delaying sexual activity. With 70% of adolescent HIV seroconversions occurring among African American (AA) females, studies are urgently needed to enhance mother-daughter sexual communication. The purpose of this poster is to offer insights on the logistics of carrying out a manualized program.

Breakthrough Series Collaborative To Support Trauma-Informed Practice In Early Care & Education, Anne Douglass

Office of Community Partnerships Posters

This study investigated the use of a Breakthrough Series Collaborative (BSC) to promote the adoption of trauma-informed practices in urban early care & education (ECE) programs. Through this BSC, ECE programs implement new practices to promote safe, stable, and nurturing relationships and prevent trauma exposure; protect children exposed to trauma, help children heal, and support family protective factors that help children thrive.

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Africa's Youth: Insights From A Multi-Country Study, Babatunde A.O. Ahonsi, Nahla G. Abdel-Tawab, Scott Geibel, Sam Kalibala, Jerry Okal, Babacar Mane, Nathi Sohaba, Julialynne Walker, Eric P. Green

HIV and AIDS

This report contains information from a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and …