Maternal and Child Health Commons^™

Improving Postpartum Care Among Low Parity Mothers In Palestine, Center For Development In Primary Health Care (Cdphc)

Reproductive Health

In an effort to improve the health status of Palestinian women and their children in the West Bank and Gaza, USAID, in collaboration with the Palestinian Ministry of Health and a number of NGOs, designed and funded a 28-month pilot activity, the Pilot Health Project (PHP), that was expected to have a positive impact on the health of women and children. This report describes the results of the intervention designed to measure the effectiveness of a second home visit on low-parity women in 1) improving their knowledge and practices regarding their own health as well as the health of their …

Policy And Program Implications Of The Matching Grants Program In The Philippines, Marilou Palabrica-Costello, Nimfa Ogena, Alejandro N. Herrin

Reproductive Health

In 1999, the Philippines Department of Health, with support from USAID and technical assistance from Management Sciences for Health (MSH), implemented the matching grants program (MGP) as a component of the local government performance program. The MGP aims to improve the capability of municipalities and component cities to expand service delivery, and to achieve significant increases in rates of fully immunized children, vitamin A supplementation, tetanus toxoid immunization for women, as well as in the use of family planning methods, especially modern methods. Upon the request of the USAID Mission, the Frontiers in Reproductive Health program worked closely with MSH …

Postabortion Family Planning Operations Research Study In Perm, Russia, Irina Savelieva, John M. Pile, Inna Sacci, Ratha Loganathan

Reproductive Health

EngenderHealth, the Population Council’s FRONTIERS program, and the Research Center of Obstetrics, Gynecology, and Perinatology of the Russian Academy of Medical Sciences, with support from the Perm Health Departments, undertook an operations research study to test models for increasing contraceptive use and reducing the repeat abortion rate among abortion clients in Perm, Russia. The study also assessed the direct and indirect costs of abortion and contraceptive use incurred by women in the year following their index abortion (the abortion which took place the day of entry into the study). The findings of the study were significant for the training interventions …

Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth

Reproductive Health

EngenderHealth, in collaboration with the Ministry of Health, conducted an operations research project to examine the feasibility of introducing an integrated three-element model of postabortion care (PAC) services in secondary- and primary-level sites in two predominantly rural regions in Senegal. The intervention provided health personnel with: 1) training to improve clinical competence, counseling, infection prevention, and general care; 2) technical assistance, materials, and support to aid in overcoming challenges; and 3) ongoing monitoring and supervision. The project findings attest to the benefits of expanding existing PAC programs in rural settings and suggest that the advantages of such an expansion outweigh …

Creation Of A Unified Management Information System For Three Ngos In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

The goal of the Pilot Health Project (PHP) has been to improve the health status of Palestinian women and children. To further this goal, the Health, Development, Information and Policy Institute (HDIP) was given the responsibility to develop a management information system (MIS) for the collection, storage, processing, and dissemination of information for PHP clinics. In cooperation with the Palestinian Ministry of Health (MOH) and various healthcare providers and MIS professionals, HDIP worked through a carefully organized and highly participatory process to design and develop the MIS for the PHP. This report reviews that process and presents the features of …

Assessment Of Pilot Health Project Outcome Indicators: West Bank/Gaza, Laila Nawar, Dale Huntington, Ibrahim Kharboush, Nancy Ali, Mahmoud Shaheen

Reproductive Health

The Pilot Health Project (PHP) was designed to address Palestinian women’s most pressing reproductive health needs. This report presents results from a single cross-sectional study that was conducted by the Health, Development, Information and Policy Institute (HDIP) between May and August 2000 in order to determine the baseline measures for the PHP’s key outcome indicators among healthcare providers and clients in the PHP clinics. Based on the findings reflected by the study, a number of recommendations were made that need to be followed up and implemented by the Improved Village and Community Health Services Project. These include the need for …

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

Reproductive Health

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

Renforcement Des Capacites Villageoises: Comment 23 Villages S'Initient Aux Droits Humains Et Abandonnent La Pratique De L'Excision Au Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

Replication Of The Tostan Programme In Burkina Faso: How 23 Villages Participated In A Human Rights-Based Education Programme And Abandoned The Practice Of Female Genital Cutting In Burkina Faso, Nafissatou J. Diop, Edmond Bagde, Djingri Ouoba, Molly Melching

Reproductive Health

This document is a summary of the process followed in implementing a community-based education program in Burkina Faso. The Population Council initiated a collaboration between two NGOs, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the program for improving women’s reproductive health and contributing to the end of female genital cutting (FGC). In Burkina Faso, the participants (men and women) held discussions to analyze the problems faced by their communities and to find appropriate solutions. Many positive changes occurred in the participating villages: the communities now promote reproductive health and human rights and work to improve public …

Institutional Support For A Program Of Activities Within The Pilot Health Project In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

This document contains reports on three activities undertaken by the Pilot Health Project (PHP) in order to upgrade antenatal and postpartum services for Palestinian women. Specifically, it includes results of a survey and a comprehensive assessment of the antenatal and postpartum care services, including family planning, that are currently provided at the project clinics. The findings show that the shortage of care provided to women during the perinatal period could be partially overcome by conducting home visits to provide information on many reproductive health issues, to help women and their families make decisions regarding their future fertility, and to provide …

An Analysis Of The Changing Forces Behind Health Insurance Coverage Of Homebirth, Christina Anne Gasbarro

Dissertations and Theses

The expansion of managed care, which is premised on containing costs while maintaining market share, represents a radical transformation of the U.S. health care system. A central question for medical sociologists is to determine how the changes brought by managed care influence health insurance and health care options. In evaluating the impacts of managed care, obstetrics is a particularly important site of study. Part of this agenda involves gathering baseline data on a specific transformation in obstetrics practice new to the managed care scene: the emergence of health insurance coverage for the option of home birth. The research project detailed …

Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité discusses the Manuela Ramos Movement and its efforts to improve women’s health and well-being through a range of empowerment strategies in rural Peru. A joint project with USAID, named Reprosalud, demonstrates how combining the resources of an international donor with local women’s organizations allows a more organic and multifaceted family planning program to develop. Such programs can produce impressive improvements on a number of indicators, including contraceptive use.

An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu

Reproductive Health

Within South Africa there is much interest in expanding youth center programs, particularly in the nongovernmental sector, in part because of recognition that the HIV/AIDS crisis is disproportionately affecting young South Africans. This study was designed to give implementing agencies and donors a broad view of how the youth centers function, who they reach, and the quality of information and services. The assessment underscored the importance of monitoring the performance of programs and understanding who is being reached with what interventions. Youth centers that focus on providing recreational facilities attract a large number of clients, often boys who are repeat …

An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku

Reproductive Health

Maendeleo Ya Wanawake (MYWO), with technical assistance from the Program for Appropriate Technology in Health (PATH), has been implementing an Alternative Rite of passage programme as part of its efforts to eradicate the practice of female genital mutilation (FGM) in five districts in Kenya. This study addressed the factors that influence some families and individuals to adopt the Alternative Rite while others, exposed to the same messages discouraging FGM, decide not to. It also evaluated the effect of the training component of the Alternative Rite on the girls who participated.

Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi

Reproductive Health

The Special Studies Program was implemented as part of the Pilot Health Project in the West Bank and Gaza to provide small grants to Palestinian researchers, research organizations, and advanced graduate students to conduct research that examines critical reproductive health topics related to maternal and child health care, including family planning. The research implemented under the Special Studies Program covered a range of topics including male involvement in reproductive health, clients' satisfaction with family planning programs, the relationship between early marriage and the delivery of premature infants, factors affecting compliance for iron supplementation, and diabetes mellitus during pregnancy. The research …

Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk

Reproductive Health

This paper is part of the Policy Series in Reproductive Health, which shares research undertaken by the Reproductive Health Working Group (RHWG). It describes the Reproductive Health Intervention Study, which designed and tested a model of essential reproductive health (RH) services. RHWG was established in 1988 as part of a special program on the health of women and children within the context of the family and community initiated by the Population Council’s Regional Office for the West Asia and North Africa region. The paper identifies a framework of basic service components that address RH and shows that their delivery is …

Risk Factors Associated With Infant Mortality Among Very Low Birthweight Infants Of Teenage Mothers In San Bernardino County, C. Letitia Henry

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Typically, infant mortality decreases as maternal age increases in teenagers. In contrast to these national data, San Bernardino County (SBC) experienced a different phenomenon in 1989-1994 among very low birthweight (VLBW) infants. The infant mortality rate (IMR) of VLBW infants born to mothers under 17 years old (283 per 1000 live births) was significantly lower than the IMR of VLBW infants born to mothers between the ages of 17-19 years old (430 per 1000 live births) (p = .02).

Purpose. The purpose of the study was to explain the discrepancy between IMRs of VLBW infants of younger teenage mothers …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …

Emergency Contraception In Zambia: Setting A New Agenda For Research And Action, Yusuf Ahmed, M. Ketata, John P. Skibiak

Reproductive Health

This report summarizes the activities and findings of the first phase of the operations research study, “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the study was designed to explore a broad range of issues relating to emergency contraception within a developing country context. With financial and technical support from the United States Agency for International Development, the World Health Organization, the Canadian Public Health Association, and the British Department for International Development (DFID), the study consists of an initial exploratory exercise and a subsequent research phase. The report is divided into …

La Familia En La Mira: Nuevas Perspectivas Sobre Madres, Padres E Hijos, Judith Bruce, Cynthia B. Lloyd, Ann Leonard, Patrice L. Engle, Niev Duffy

Poverty, Gender, and Youth

A pesar de la retórica de los últimos años que lamenta la pérdida de la "familia tradicional," las familias jamás se han podido encajonar en modelo único. "Familia" puede referirse a la gente que se ha vinculado entre sí por matrimonio o parentesco, o a los que pretenden descender de antecesores comunes. Las personas pueden formar y extender familias, ya sea mediante la adoptación o crianza de niños, o definiendo como familiares a gente no emparentada o mediante el establecimiento de sociedades consensuales. Las familias son tan adaptables como diversas, pues se reconfiguran a sí mismas en el transcurso de …

Covert Contraceptive Use: Prevalence, Motivations, And Consequences, Ann E. Biddlecom, Bolaji M. Fapohunda

Poverty, Gender, and Youth

This paper examines women’s covert use of contraceptives, that is, use without the knowledge of their husbands. Covert use may highlight conflict between husbands and wives about family planning, or it may reflect behaviors that spouses find difficult to discuss together. This study addresses three questions: 1) How is covert use measured in different settings? 2) How prevalent is it? and 3) What are the factors underlying covert use? We examine these questions by drawing on existing studies and detailed survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and a subsample of …

Introduction Des Soins Obstétricaux D'Urgence Et De La Planification Familiale Pour Les Patientes Présentant Des Complications Liées À Un Avortement Incomplet, Population Council, Jpiego

Reproductive Health

En 1997, le Centre de Formation et de Recherche en Santé de la Reproduction en partenariat avec la Clinique Gynécologique et Obstétricale du CHU Le Dantec ont entrepris une étude de faisabilité sur l’introduction des Soins Après Avortement dans trois structures sanitaires de référence de la région de Dakar. Cette expérience pilote a été appuyée par le Population Council dans le cadre du projet de Recherche Opérationnelle et d’Assistance Technique (RO/AT II) en Afrique et par JHPIEGO qui a appuyé le volet Formation/Prestations de service. Elle s’inscrit dans le cadre de la mise en œuvre des recommandations issues des conférences …

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior, Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago. METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey. RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …

Pregnancy Outcomes: A Study Testing A Model For Predicting Health Outcomes In Pregnancy, Tamera Ann Hart-Johnson

Dissertations and Theses

There is a persistent relationship between socioeconomic status and physical health outcomes found in the literature; however the variables mediating this relationship are many, and ways that they interact with each other are complex. The goal of understanding this relationship is to decrease the disparity in health by socioeconomic status.

This study tested a biopsychosocial model proposed by David Williams (1990) to explain the relationship between socioeconomic status and physical health outcomes. The model included the following latent factors: demographics, socioeconomic status, biomedical risk, medical care, psychosocial variables, and health outcomes. The model was tested through a secondary data analysis. …

An Assessment Of Community-Based Family Planning Programs In Kenya, Jane Chege, Ian Askew

Reproductive Health

Kenya has a long history of using community-based distribution (CBD) as an integral part of its family planning (FP) program. The purpose of this study was to assess the role of CBD programs in terms of providing information and services, to learn more about the determinants of program effectiveness, and to attempt to compare the programs’ cost-effectiveness. Fieldwork was undertaken in mid-1995 when data were collected from seven of the major CBD programs in Kenya. Four rural and three urban programs were included, as were programs that remunerated their agents and those that did not, and programs that had full-time …

Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Nakuru Municipal Council's Project On Strengthening Std/Aids Control, James Kariba Wabaru, Bedan Kiare Kariuki, Baker Ndugga Maggwa

Reproductive Health

Kenya’s Nakuru Municipal Council (NMC) operates five clinics located primarily in residential areas with high concentrations of people. The clinics provide basic antenatal, child welfare, STI, and other curative services, and family planning services are available at four of the clinics. One provincial referral hospital operated by the Ministry of Health also provides MCH-FP and HIV/STI services in a special STI treatment clinic. The seven public health facilities in Nakuru Municipality are participating in a collaborative project with the Department of Community Health at the University of Nairobi, the University of Manitoba in Canada, and the Nairobi Municipal City Council. …

Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend

Reproductive Health

Evidence from community studies indicates that significant proportions of Indian women (30 percent) may have reproductive tract infections (RTIs). Given that women are in general asymptomatic and that even symptomatic women may not seek care, the estimates are the minimum levels of prevalence. Most women do not seek treatment for RTIs for such reasons as lack of awareness, acceptance that RTIs are part of women's lives, and lack of treatment facilities. On the supply side, in the public sector the treatment for RTIs is limited with most services provided through STD clinics in urban areas. Seeking treatment at STD clinics …

Clinic-Based Investigation Of The Typology And Self-Reporting Of Fgm In Egypt, Population Council

Reproductive Health

This clinic-based study of female genital mutilation (FGM) was designed and carried out by the Egypt Fertility Care Society to gather detailed information on the types of FGM practiced in Egypt. The study involved interviews with clinic clients to elicit information about their experience and attitudes concerning FGM, and gynecological examinations by specially trained OB/GYN physicians. In all, 93% of the women in this study were found to have some type of FGM. The study's findings were incorporated in the final report of the 1995 Egyptian Demographic and Health Survey, with the aim of contributing to the scientific understanding of …

Gente Joven: Un Diálogo Sobre La Sexualidad Con Adolescentes Mexicanos, Magaly Marques, John M. Paxman, Judith Bruce

Poverty, Gender, and Youth

Este número de Quality/Calidad/Qualité relata la experiencia de Gente Joven, un programa de educacion sexual para adolescentes en Mexico. Gente Joven comenzó reconociendo una realidad: que los problemas relativos a la sexualidad no desaparecen por mucho que tratemos de negar su existencia. A través de los años los dirigentes de Gente Joven han aprendido, y siguen aprendiendo, muchas lecciones sobre como diseñar un programa eficaz para adolescentes. En estas páginas ellos comparten algunas de esas experiencias y el epilogo explora con mayor detalle un tema que Gente Joven ha identificado como su próximo gran desafío: una reconsideración del programa desde …