Maternal and Child Health Commons^™

Executive Summary: Understanding The Lives Of Adolescents And Young Adults (Udaya) In Uttar Pradesh, India (2015–16), K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Ashish Kumar Gupta, Shilpi Rampal, Santosh Kumar Singh, A.J. Francis Zavier

Poverty, Gender, and Youth

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have …

Married Adolescent Girls In Rural Assiut And Souhag: Limited Choices And Unfulfilled Reproductive Health Needs, Nahla G. Abdel-Tawab, Doaa Oraby, Omaima El-Gibaly, Manal Darwish, Mirette Aziz, Amira Elgazzar, Heba Mahmoud

Poverty, Gender, and Youth

According to the Survey of Young People in Egypt 2014, a significant proportion of young women residing in rural Upper Egypt were reported to be married before 18. Early marriage deprives a girl of education and employment opportunities and places her at risk of early and repeat pregnancy, gender-based violence, and sexually transmitted infections. The present study examines the sexual and reproductive health needs of married adolescent girls (MAGs) in rural Upper Egypt and identifies key contextual and cognitive factors that could mitigate or exacerbate the effects of early marriage on their sexual and reproductive health. The report finds that …

More Than Brides Alliance: Baseline Report, India, Sharmistha Basu, Rajib Acharya, Andrea J. Melnikas, Sajeda Amin

Poverty, Gender, and Youth

The More Than Brides Alliance seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted surveys of adolescent girls and young women aged 12–19 in nine districts in four states in India to examine girls’ experiences, including education, marriage and relationships, literacy and numeracy, livelihoods, and gender-equitable attitudes. The study found that few girls were currently involved in any programs, despite demonstrated vulnerabilities (e.g., more than half of the sample was currently out of school) suggesting that there is a clear …

Project Brief: Understanding The Lives Of Adolescents And Young Adults (Udaya), Population Council

Poverty, Gender, and Youth

The program “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” is designed to establish the levels, patterns and trends in the situation of younger (10–14) and older (15–19) adolescents in India. UDAYA is funded by the Bill and Melinda Gates Foundation and the David and Lucile Packard Foundation, and the study is conducted by the Population Council, New Delhi. This project brief outlines the UDAYA project, which will explore the extent to which younger and older adolescents have acquired a set of assets that can help them make a healthy, safe, and successful transition …

The Impact And Cost Of Child Marriage Prevention In Three African Settings—Brief, Population Council

Poverty, Gender, and Youth

Child marriage affects a significant number of girls in developing countries. The negative consequences of the practice are numerous and powerful, spanning health, welfare, development, and demographic domains. Yet there is limited evidence on what works to delay child marriage in different cultural contexts and even less information on programmatic cost. This brief reports on a study that aims to identify the most effective and minimum basic package approaches to delay marriage among adolescent girls in different African settings. The study was undertaken in rural areas of Burkina Faso, Ethiopia, and Tanzania. The study also measures the cost of implementing …

The Journey Of Out-Of-School Girls In Ethiopia: Examining Migration, Livelihoods, And Hiv, Annabel Erulkar, Girmay Medhin, Lemi Negeri

Poverty, Gender, and Youth

Rates of urbanization in Ethiopia are increasing, and based on available data, HIV prevalence among urban girls who are in-migrants is significantly higher than among girls who are native to the area. Likewise, a significant number of out-of-school girls who migrate end up in low-status, exploitative, or risky professions, such as domestic work and sex work. This study of out-of-school girls in six regions of Ethiopia aimed to explore patterns of migration, transitions into different work roles, and situations that may put out-of-school migrant girls at increased risk of HIV infection or be protective and beneficial. Based on the study’s …

More Than Brides Alliance: Baseline Report, Malawi, Christine A. Kelly, Andrea J. Melnikas, Sajeda Amin, James Mkandawire, Hamza Daud

Poverty, Gender, and Youth

The More Than Brides Alliance seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted baseline surveys of adolescents in select areas of two districts in Malawi as part of an evaluation of interventions to delay marriage. The goals of the baseline were to: 1) provide information about the current situation and context for adolescent girls in select areas in Malawi in order to inform the intervention; 2) provide a benchmark against which changes resulting from the intervention may be measured …

More Than Brides Alliance: Baseline Report, Mali, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Mouhamadou Gueye

Poverty, Gender, and Youth

The More Than Brides Alliance seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted baseline surveys of adolescents in select areas of two regions in Mali (Sikasso and Segou) as part of an evaluation of interventions to delay marriage. Findings suggest that girls in these communities have a demonstrated need for interventions to address their vulnerabilities. Additional data collection will help explore some of these topics in greater depth and provide a more nuanced understanding of the situation of adolescent …

Measuring Disrespect And Abuse To Promote Respectful Maternity Care, Population Council

Reproductive Health

The Heshima project developed several study instruments to measure disrespect and abuse throughout the study’s formative, baseline, and endline stages. The quasi-experimental implementation research design applied a mixed methods approach to understanding the meaning and factors that drive disrespect and abuse in maternity settings in Kenya. These tools allowed the project to measure the prevalence of disrespect and abuse in this setting, as well as the changes affected by the project.

The Heshima project involved a complex set of multi-level interventions that sought to curb disrespectful and abusive practices during childbirth and promote dignified and respectful maternity care. The evidence …

Risk Factors For Pre-Eclampsia And Eclampsia In Belize, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Belize.

Risk Factors For Pre-Eclampsia And Eclampsia In Cambodia, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Cambodia.

Risk Factors For Pre-Eclampsia And Eclampsia In Guatemala, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Guatemala.

Risk Factors For Pre-Eclampsia And Eclampsia In Nepal, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Nepal.

Understanding Adolescent And Youth Sexual And Reproductive Health-Seeking Behaviors In Ethiopia: Implications For Youth Friendly Service Programming, Aparna Jain, Hussein Ismail, Elizabeth Tobey, Annabel Erulkar

Reproductive Health

To meet the unique sexual and reproductive health needs of its large adolescent and youth population, Ethiopia’s government has expanded and institutionalized youth-friendly services (YFS) at all levels of the health system. To help inform and improve these efforts, the Evidence Project, in collaboration with USAID/Ethiopia and the Ethiopian Federal Ministry of Health, conducted a study on adolescents’ and young people’s use of and opinions on YFS. Results showed that young people were satisfied overall with the health services they received, regardless of whether it was basic health services or YFS. Awareness and use of YFS was low, but many …

Using Data To Target And Scale-Up Girls' Support Programs And Child Marriage Prevention, The Evidence Project

Reproductive Health

Though child marriage is declining globally, it is estimated that over 100 million girls under age 18 will be married in the next decade. A 2012 review of child marriage interventions in developing countries found that the most effective approaches in delaying child marriage were those that offered incentives, such as conditional cash transfers or provision of school materials, and those that empower girls directly through interventions such as girls’ groups and training. The Berhane Hewan program in Ethiopia (meaning ‘Light for Eve’ in Amharic) was one of the earliest to test child marriage prevention interventions in sub-Saharan Africa. The …

Strengthening School-Based Sexual And Reproductive Health Education And Services In Accra, Ghana, Nancy Termini Lachance, Terence Adda-Balinia

Reproductive Health

This evidence brief presents results of a study aimed to assess the acceptability and feasibility of two proposed solutions for strengthening the content and delivery of in-school sexual and reproductive health (SRH) programs in Ghana. The study was conducted in Nima, a suburb of Accra, where stakeholders agreed there was a need for enhanced SRH services in school. The study explored providing comprehensive in-school SRH education to adolescents using trained psychologists and health workers to deliver and explain comprehensive sexuality education to adolescents and link them as needed to outside services. There was unanimous agreement that adolescent SRH needs are …

Bangladesh: Using Strong Evidence And Strategic Collaboration To Increase Access To Menstrual Regulation With Medication, Nancy Termini Lachance, Sharif M.I. Hossain

Reproductive Health

Through close cooperation with the Ministry of Health and Family Welfare of Bangladesh, and other partners, STEP UP generated strong evidence and cultivated ongoing collaboration that contributed to policy changes and program expansions to increase access to menstrual regulation with medication (MRM). Study results demonstrate that MRM is acceptable and effective in Bangladesh, and has thus been legalized and folded into the national FP program and scaled up nationwide. However, ongoing observation and studies are still needed to understand whether the efficacy and acceptability of MRM remains the case when services are delivered at scale on a national level. Furthermore, …

Harmonizing National Abortion And Pregnancy Prevention Laws And Policies For Sexual Violence Survivors With The Maputo Protocol, Jill Thompson, Chi-Chi Undie, Avni Amin, Ronald Johnson, Rajat Khosla, Ian Askew, Leopold Ouedraogo, Triphonie Nkurunziza, Sarah Rich, Elizabeth Westley, Melissa Garcia

Reproductive Health

In April 2016, the Population Council, the World Health Organization (WHO), and the International Consortium for Emergency Contraception (ICEC) convened a three-day regional technical meeting aimed at helping participating countries meet their obligations under the Maputo Protocol to protect and promote the reproductive health rights of women and girls, with a special emphasis on survivors of sexual and intimate partner violence. Participants included representatives from six countries in sub-Saharan Africa—Botswana, Ethiopia, Kenya, Malawi, Rwanda, and Zambia—as well as international and regional experts on reproductive health, law, and human rights. Presentations and discussions focused primarily on the prevention and management of …

What Do Users Really Want?, Saumya Ramarao, John Townsend, James Sailer

Reproductive Health

No abstract provided.

Addressing Pregnancy Prevention Needs Of Adolescents In East And Southern Africa Through Education And Health Sector Partnerships, Harriet Birungi, Chi-Chi Undie, Esther Lwanga Walgwe, Francis Obare, Caroline W. Kabiru, Joyce Mumah

Reproductive Health

No abstract provided.

Women's Perceptions And Experiences Of Family Planning By Contraceptive Methods In Kenya And Bangladesh: Preliminary Results, Kazuyo Machiyama, Joyce Mumah, Caroline W. Kabiru, George Odwe, Francis Obare, Fauzia Akhter Huda, John C. Cleland, John B. Casterline

Reproductive Health

No abstract provided.

A Systematic Review Of The Treatment And Management Of Pre-Eclampsia And Eclampsia In Bangladesh, Karen Kirk, Amy Dempsey

Reproductive Health

By 2015, at the conclusion of the Millennium Development Goals, Bangladesh had achieved a reduction in maternal deaths, however, despite the progress, there are still between 5,000 and 6,000 maternal deaths every year, with 20 percent the result of pre-eclampsia and eclampsia (PE/E). To fully understand the key challenges, gaps, and interventions related to the prevention and treatment of PE/E at the national level, Ending Eclampsia conducted a systematic review of papers in Bangladesh published between 2000 and 2015 specifically looking at issues around the quality of care, gaps in the evidence, and barriers to accessing PE/E services. The main …

Access To Reproductive Health And Hiv Services Among Young Mothers In Tanzania, Francis Obare, Annette Almeida, George Odwe, Jamilla Mwanga, Chi-Chi Undie, Maurice Hiza, Feddy Mwanga

Reproductive Health

This report presents findings from a Population Council study that examined the experiences of young mothers in Tanzania with accessing reproductive health and HIV services during pregnancy, delivery/pregnancy termination, and the postpartum period. The overall objective of the study was to generate evidence on access to reproductive health and HIV services among young mothers aged 12–19 years in Tanzania in order to inform programming and actions to better meet their needs. It specifically examined their experiences with accessing reproductive health (safe motherhood and contraception) and HIV (testing and counseling, PMTCT, antiretroviral therapy, and early infant diagnosis) services as well as …

Adolescent Friendly Health Corners (Afhcs) In Selected Government Health Facilities In Bangladesh: An Early Qualitative Assessment, Sigma Ainul, Iqbal Ehsan, Tasmiah Tanjeen, Laura Reichenbach

Reproductive Health

With high rates of early marriage, especially among girls, a significant proportion of adolescents in Bangladesh need sexual and reproductive health services (SRH), including contraceptive information. To address this gap and ensure that adolescents throughout the country, including unmarried adolescents, have access to SRH services through public health facilities, the Maternal and Child Health Services Unit of the Directorate General of Family Planning, with financial and technical assistance from development partners, has begun establishing Adolescent Friendly Health Corners (AFHCs) at selected government facilities at district and union levels. The Evidence Project/Population Council was asked to assess the implementation of the …

Charity: A Health Volunteer Success Story, Amy Dempsey

Reproductive Health

Results from Ending Eclampsia’s landscape analysis of seven states in Nigeria served as the catalyst for a training with Community Health Extension Workers (CHEWs) in Nigeria. Researchers conducted observations of client–provider interactions during antenatal care (ANC) visits and assessed healthcare providers’ knowledge of proven risk factors for pre-eclampsia, including chronic hypertension, previous history of PE/E, obesity, pre-existing diabetes or diabetes in pregnancy, advanced maternal age, sickle cell diseases, and connective tissue diseases. The training’s objective was to teach CHEWs how ANC providers can prevent pregnancy-related complications like pre-eclampsia and eclampsia (PE/E). Following the training the CHEWs felt that they can …

Contribution Of Contraceptive Discontinuation To Unintended Births In 36 Developing Countries, Population Council

Reproductive Health

High contraceptive discontinuation results in millions of women having an unmet need for contraception. This Population Council study using data from 36 Demographic and Health Surveys shows that contraceptive discontinuation also results in millions of unintended pregnancies and births. This brief recommends attention to issues related to quality of care, such as counseling, to ensure that each woman has the method she needs/wants and uses it correctly. This will help women avoid contraceptive discontinuation and associated unmet need and unintended fertility right from the beginning. As programs become more successful, quality of care will become key to expanding contraceptive use …

Enhancing Access To Post-Rape Care For Child Survivors In The Context Of Police And Health Services In Zambia: A Feasibility Assessment Of A Police Response Model, Nachela Chelwa, Kshipra Hemal, George Msipu Phiri, Michael Mbizvo, Chi-Chi Undie

Reproductive Health

This study builds on previous interventions by the Population Council and the Zambia Police Service to mitigate unintended pregnancy and HIV among survivors of sexual violence by involving trained police in task-sharing interventions. These previous efforts have involved police providing emergency contraceptive pills and HIV post-exposure prophylaxis to survivors reporting to police stations, in addition to referrals to health facilities. The objective of the current study was to assess the feasibility of implementing a transportation intervention within police stations, coupled with training and sensitization for police officers to perform their government-mandated roles in post-rape care. This intervention was developed as …

Enhancing Frontline Health Workers' Abilities To Improve Mnch Services In Bauchi State Through Task Shifting/Sharing, Sylvia Adebajo, Ekechi Okereke, Friday Joseph

Reproductive Health

Frontline health workers (FLHWs), including nurses, midwives, community health extension workers, and community health officers, are healthcare providers with the greatest access to clients and patients, and provide initial care to persons in need of health services. In 2014, Nigeria’s 57th National Council on Health approved a task-shifting and sharing (TSS) policy for essential healthcare services as a promising strategy for improving access and efficiency in Nigeria’s health system. Subsequently, FLHWs in Nigeria have been trained for new roles and functions traditionally reserved for mid- or high-level cadres, to optimize available providers and their capacities. This brief reviews the strategy …

Enhancing Frontline Health Workers' Abilities To Improve Mnch Services In Cross River State Through Task Shifting/Sharing, Sylvia Adebajo, Ekechi Okereke, Friday Joseph

Reproductive Health

There is a shortage of qualified and skilled health professionals providing cost-effective maternal, newborn, and child health (MNCH) services in Cross River State, Nigeria. Frontline health workers (FLHWs) have the potential to learn new skills as part of a task-shifting and sharing (TSS) policy. This brief highlights the results of the TSS policy in Cross River state: village health workers identify and refer pregnant women in their communities to antenatal clinics and provide oral medications; community health workers perform initial case management and ensure quick referrals to secondary facilities for specialized care; nurses and midwives deliver MNCH interventions that are …

Exploring The Association Between Fgm/C And Early/Child Marriage: A Review Of The Evidence, Jamlick Karumbi, David Gathara, Jacinta Muteshi-Strachan

Reproductive Health

Female genital mutilation/cutting (FGM/C) has been frequently linked to marriageability and thought to be associated with child marriage, yet there is remarkably little rigorous research to clarify the relationship between these two practices to inform discussions and responses. Furthermore, trends are also shifting in the timing of FGM/C from adolescence to early childhood, and the implications this might have on the links between early/child marriage and FGM/C are not well understood. This review of current available evidence aims to assess the association between FGM/C and early/child marriage in contexts where both practices are carried out. The social and cultural norms …