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Family Planning

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Full-Text Articles in Maternal and Child Health

Youth Talk About Sexuality: A Participatory Assessment Of Adolescent Sexual And Reproductive Health In Lusaka, Zambia, Tamara Fetters, Evans Mupela, Naomi Rutenberg Jan 1998

Youth Talk About Sexuality: A Participatory Assessment Of Adolescent Sexual And Reproductive Health In Lusaka, Zambia, Tamara Fetters, Evans Mupela, Naomi Rutenberg

Reproductive Health

Thirty-six percent of Zambia’s 9 million inhabitants are between 10 and 19 years of age, and most adolescents are sexually active by their mid-teens. Pregnant teenagers have an elevated risk of maternal mortality and complications related to birth. In 1990, at Lusaka’s University Teaching Hospital, self-induced abortion accounted for up to 30 percent of maternal mortality, and one-quarter of these deaths occurred in women under 18 years. Sexually transmitted infections (STIs) are a major health problem for adolescents, yet only a small proportion protect themselves from pregnancy and STIs. There are many barriers to improving the situation, including opposition by …


Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi Jan 1998

Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi

Reproductive Health

Family planning (FP) and maternal and child health (MCH) in Bangladesh have achieved commendable success in the recent past, mostly through a large-scale government service-delivery system supported by donors and nongovernmental organizations. Although encouraged by this success, there was concern about programmatic, financial, and social sustainability of the program, including quality of services. It is now believed that most of these concerns will be taken care of if effective community participation can be ensured. A pilot project was initiated in 1997 in Anowara, a low-FP-performing area in rural Chittagong, with assistance from the Population Council. The main objective of the …


Follow-Up Household Survey In Agra District, Jayanti Tuladhar, R.B. Gupta, V.S. Sridhar, Tilak Mukherjee Jan 1998

Follow-Up Household Survey In Agra District, Jayanti Tuladhar, R.B. Gupta, V.S. Sridhar, Tilak Mukherjee

Reproductive Health

This follow-up household survey in Agra District, India, was conducted with funding from USAID under the Population Council’s Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. The main objective of this study, as noted in this report, is to assess changes in the program indicators of family welfare activities, including some of the selected reproductive health indicators, from 1995 (before method-specific targets were withdrawn) and 1997 (30 months after targets were withdrawn). The study’s objectives are to detect changes in FP knowledge and use among currently married women in rural areas; detect changes in level of …


Follow-Up Household Survey In Sitapur District, Jayanti Tuladhar, R.B. Gupta, B.P. Thiagrajan, Tausif Alam Khan, Hemlata Sadhwani Jan 1998

Follow-Up Household Survey In Sitapur District, Jayanti Tuladhar, R.B. Gupta, B.P. Thiagrajan, Tausif Alam Khan, Hemlata Sadhwani

Reproductive Health

This follow-up household survey in Sitapur, India, was conducted with funding from USAID under the Population Council's Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project. The main objective of the study, as noted in this report, is to assess changes in the program indicators of family welfare activities, including some of the selected reproductive health indicators, from 1994–95 (before the method-specific targets were withdrawn) and 1997 (30 months after the targets were withdrawn). The study has the following immediate objectives: detect changes in family planning (FP) knowledge and use among currently married women in rural areas; …


Monitoring Of Macro-Level Family Planning Quality Of Care Indicators, Meiwita B. Iskandar Jan 1998

Monitoring Of Macro-Level Family Planning Quality Of Care Indicators, Meiwita B. Iskandar

Reproductive Health

The success of population development in Indonesia can be seen partly from success in reducing population growth. Population growth has declined from 2.32 percent (1971–80) to 1.98 percent (1980–90), and then to 1.66 percent (1990–95). The continued slowing of population growth is expected to bring expanded opportunities for economic development and improved quality of life. The success of family planning (FP) programs cannot be judged solely on reduction of population growth but should also be judged in terms of quality of care (QOC) and success in helping women achieve their reproductive goals. The Indonesian National Family Planning Coordinating Board (BKKBN) …


Technical Assistance To Enhance The Institutionalization Of Operations Research Within The Philippines Family Planning Program, Population Council Jan 1998

Technical Assistance To Enhance The Institutionalization Of Operations Research Within The Philippines Family Planning Program, Population Council

Reproductive Health

This technical assistance project supports the goal of the Asia Near East Operations Research and Technical Assistance (ANE OR/TA) project of helping strengthen family planning (FP)/reproductive health (RH) operations research (OR) capabilities in the Philippines. During the extension period of the ANE OR/TA project, four OR studies were implemented in the Philippines dealing with cross-cutting issues, including a study to assess the feasibility of integrating RTI management within FP/MCH programs; an intervention study dealing with improving quality of care via expanded FP counseling; an intervention to address high unmet need in Pangasinan Province; and an intervention study to increase male …


Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez Jan 1998

Male Involvement Through Reproductive Health Awareness In Bukidnon Province, The Philippines: An Intervention Study, Lita Palma-Sealza, Marilou P. Costello, Chona R. Echavez

Reproductive Health

Recent years have been characterized by an increasing consensus that, in order to support women's goals and aspirations, health programs directed to the improvement of women's and children's health must consider men's perspectives. Although family planning (FP) is often viewed as the woman's responsibility, men have an important role in decisions of whether FP will be practiced and which method will be used. Even though gender relations in the Philippines are often characterized as being relatively egalitarian, there are several reasons for believing that male involvement in FP is highly relevant for this country. Studies indicate that not only are …


Improving Quality Of Care In Fp/Rh Of Selected Communities Of Pangasinan Province: An Intervention Study, Zelda C. Zablan, Josefina V. Cabigon, Luzviminda Muego, Marilou P. Costello, Chona R. Echavez Jan 1998

Improving Quality Of Care In Fp/Rh Of Selected Communities Of Pangasinan Province: An Intervention Study, Zelda C. Zablan, Josefina V. Cabigon, Luzviminda Muego, Marilou P. Costello, Chona R. Echavez

Reproductive Health

This intervention study was designed to improve the quality of family planning (FP) services within the Integrated Family Planning and Maternal Health Program of the Pangasinan Population and Family Planning Program in the Philippines. It addresses high unmet need and studies the feasibility of enhancing quality of services by training service providers in fixed clinics and orienting outreach workers on the method of identifying women who have unmet need for FP. Four municipalities were chosen from the 47 municipalities comprising the province of Pangasinan and randomly assigned to experimental and control groups. Four indicators were used to match the chosen …


Dual Protection In An Integrated Community-Based Program: A Case Study Of Tanzania Family Health/Ministry Of Health Project In Mbeya, Grace Mbekem, Jane Chege Jan 1998

Dual Protection In An Integrated Community-Based Program: A Case Study Of Tanzania Family Health/Ministry Of Health Project In Mbeya, Grace Mbekem, Jane Chege

Reproductive Health

One of the most pressing challenges for health programs in most sub-Saharan African countries is effectively addressing the increasing prevalence of HIV/AIDS. Recent evidence suggests that controlling sexually transmitted diseases (STDs) through undertaking preventive measures, early diagnosis, and treatment significantly slows the spread of HIV/AIDS. In regard to STI/HIV, Maternal and Child Health (MCH) and Family Planning (FP) clients are described as “low risk” groups. However, in a number of sub-Saharan African countries, the reported levels of STDs are significantly high enough to justify use of limited resources to target this group for STD services. MCH/FP programs have begun to …


An Assessment Of Community-Based Family Planning Programs In Kenya, Jane Chege, Ian Askew Jan 1997

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 …


Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez Jan 1997

Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez

Reproductive Health

A Situation Analysis (SA) was conducted in seven local government health centers as part of a larger project studying the feasibility of integrating RTI services within the existing Family Planning/Reproductive Health Program of the Department of Health (DOH). The SA was part of a series of baseline activities conducted by the Family Planning Operations Research and Training Project as part of its study on Integrating RTI Management in Local Government Unit Health Centers. It was conducted by Population Council, Manila, for the DOH. Participating health centers were located in a large and highly urbanized community, a medium-sized city, and two …


Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew Jan 1997

Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew

Reproductive Health

Sub-Saharan Africa is confronting an HIV/AIDS epidemic and virtually all health programs in the region are seeking ways of preventing and reducing the spread of this virus. To compound the problem, the presence of certain sexually transmitted infections (STIs) is known to increase risk of the sexual transmission of HIV. The sub-Saharan region is believed to have some of the highest levels of STIs in the world, thus controlling STIs is not only an important reproductive health care strategy in itself but also a key strategy in reducing the spread of HIV. The strongest evidence to support this has come …


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 Jan 1997

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. …


Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Busoga Diocese Family Life Education Program, Uganda, Joy Mukaire, Florence Kalikwani, Baker Ndugga Maggwa Jan 1997

Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Busoga Diocese Family Life Education Program, Uganda, Joy Mukaire, Florence Kalikwani, Baker Ndugga Maggwa

Reproductive Health

The Family Life Education Project (FLEP) was started in 1986 by the Busoga Diocese of the Anglican Church of Uganda with assistance from Pathfinder International. The project provides integrated MCH, FP, STD, and HIV/AIDS services to more than 500,000 individuals through 48 clinics and 162 trained village health workers (VHWs). Each clinic serves an estimated 11,000 people living in a sub-Parish. Each sub-Parish has a health subcommittee selected by the community that is responsible for hiring clinic staff, identifying VHWs, and mobilizing resources for clinic staff salaries. Data suggest that the program is reaching a large number of clients through …


Dmpa Provision In Pss Clinics In Uttar Pradesh: Costs And Prices, Saumya Ramarao, John Townsend, Leila Caleb-Varkey, Sudha Tiwari, Sneh Vishwanath, Harbans Singh Jan 1997

Dmpa Provision In Pss Clinics In Uttar Pradesh: Costs And Prices, Saumya Ramarao, John Townsend, Leila Caleb-Varkey, Sudha Tiwari, Sneh Vishwanath, Harbans Singh

Reproductive Health

The injectable contraceptive DMPA was introduced in the private sector in India in 1993, contingent on completion of a post-marketing surveillance study of users. The commercial price of a dose of DMPA is about Rs. 150-180, exclusive of the fees of the medical provider. This price puts it beyond the reach of most Parivar Seva Sanstha (PSS) clients in need of safe and effective family planning (FP) services in Uttar Pradesh. Since April 1996, an experiment has been underway with three PSS clinics in Uttar Pradesh to study the effect of price on demand for DMPA. The study seeks to …


A Situation Analysis Of The Maternal And Child Health/Family Planning (Mch/Fp) Program In Botswana, Benjamin Baakile, Lucy Sejo Maribe, Baker Ndugga Maggwa, Robert A. Miller Jan 1996

A Situation Analysis Of The Maternal And Child Health/Family Planning (Mch/Fp) Program In Botswana, Benjamin Baakile, Lucy Sejo Maribe, Baker Ndugga Maggwa, Robert A. Miller

Reproductive Health

Botswana has a rapid annual population growth rate and a high total fertility rate. It also has one of the highest levels of contraceptive use in sub-Saharan Africa. Infant and under-5 mortality rates have fallen, yet maternal mortality remains high. The Government of Botswana has developed an extensive network of health care facilities that provide services through an integrated approach. Family planning (FP) services are available at all three levels of the MOH system (hospitals, clinics, health posts). Services for managing sexually transmitted diseases (STDS) have recently undergone a substantial change with the introduction of the Syndromic Approach to STD …


Community Participation In Health, Family Planning And Development Activities: A Review Of International Experiences, Abbas Bhuiya, Fatima Yasmin, Farida Begum, Ubaidur Rob Jan 1996

Community Participation In Health, Family Planning And Development Activities: A Review Of International Experiences, Abbas Bhuiya, Fatima Yasmin, Farida Begum, Ubaidur Rob

Reproductive Health

The family planning (FP)/maternal and child health (MCH) program in Bangladesh has achieved success in the recent past, mostly through a large-scale government service-delivery system with support and cooperation from donors and nongovernmental organizations. There is concern about the financial and social sustainability of the program. Other issues include achievement of replacement-level fertility within a stipulated period and improvement of MCH-FP service quality. It is widely believed that most of the concerns will be taken care of with effective community participation. Before activating community initiatives, it is worth carrying out action research. A literature review was completed from July to …


Quality Of Family Planning Programme In India: A Review Of Public And Private Sector, Dileep V. Mavalankar Jan 1996

Quality Of Family Planning Programme In India: A Review Of Public And Private Sector, Dileep V. Mavalankar

Reproductive Health

Increasing attention has been paid to quality of care (QOC) in family planning (FP) during the last few years, and there have been several initiatives to strengthen QOC in FP in the developing world. This paper reviews the quality of the FP program in India’s public and private sectors, and examines six elements: choice of methods, information given to clients, technical competence, interpersonal relations, continuity of care and follow-up, and appropriate constellation of services. Overall, the paper finds that not much attention has been paid to QOC and hence the level is quite low. Evidence and observations indicate that QOC …


Integration Of Sti And Hiv/Aids Services With Mch/Fp Services: A Case Study Of The Mkomani Clinic Society In Mombasa, Kenya, Amina Twahir, Baker Ndugga Maggwa, Ian Askew Jan 1996

Integration Of Sti And Hiv/Aids Services With Mch/Fp Services: A Case Study Of The Mkomani Clinic Society In Mombasa, Kenya, Amina Twahir, Baker Ndugga Maggwa, Ian Askew

Reproductive Health

Most national MCH-FP programs in sub-Saharan Africa are shifting their programmatic strategies toward a broader reproductive health service approach that includes integrating STI and HIV/AIDS services into existing MCH-FP programs. This is based on the belief that integration will lead to more cost-effective and better-quality service, and maximize use of existing resources. There is an assumption that the basic infrastructure for the MCH-FP programs can absorb the extra demands of the STI/HIV/AIDS services with minimal additional inputs and that staff providing MCH-FP services require only minimal training to be able to provide STI/HIV/AIDS services. There is a further assumption that …


Indonesia: Utilization Of Completed Operations Research Studies, Meiwita B. Iskandar, Subadra Indrawati Jan 1996

Indonesia: Utilization Of Completed Operations Research Studies, Meiwita B. Iskandar, Subadra Indrawati

Reproductive Health

In the past eight years, many operations research (OR) programs were implemented in Indonesia to increase the availability, accessibility, and acceptability of services desired by family planning (FP) users. OR has also been employed to improve quality and sustainability by studying the performance, efficiency, and effectiveness of services delivered by providers. Nonetheless, relatively little is known about the true effects of OR studies in identifying and solving program problems in order to support the planning and coordinating of a particular program. Measuring utilization of OR results is not simple. In 1989, USAID signed its last bilateral assistance agreement with the …


Lactational Amenhorrhoea Method For Birth Spacing In Uttar Pradesh, India: Supporting Technical Data, Leila Caleb-Varkey, John Townsend Jan 1996

Lactational Amenhorrhoea Method For Birth Spacing In Uttar Pradesh, India: Supporting Technical Data, Leila Caleb-Varkey, John Townsend

Reproductive Health

Following the International Population and Development Conference in Cairo, there has been widespread consensus in the international community that family planning (FP) programs must be people-centered and focus not just on contraception, but on the reproductive health (RH) of men and women throughout their lives. This policy brief reviews the research and policy implications of promoting the Lactational Amenorrhea Method (LAM) as a component of FP counseling in India. The Government of India and the Population Council are using a pregnancy-based approach in Uttar Pradesh to improve the delivery of FP services through the rural primary health care system. Introducing …


Population Policy In Bangladesh: A Review Of Ten Priority Areas, Barkat-E- Khuda, Abul Barkat, Javed Helali, Peter C. Miller, John G. Haaga Jan 1994

Population Policy In Bangladesh: A Review Of Ten Priority Areas, Barkat-E- Khuda, Abul Barkat, Javed Helali, Peter C. Miller, John G. Haaga

Poverty, Gender, and Youth

One of the most important factors contributing to the success of Bangladesh’s FP-MCH Program in recent years has been the strong support provided at the policy level by all the governments of Bangladesh since independence. This has given the government confidence and supported the development of a coherent set of policies at the implementation level. However, the success of policies at one stage in the development of a family planning (FP) program carries with it the need for changes in policy to support the program at the next stage. In Bangladesh, if the nation is to attain the demographic goals …


Factors That Contribute To The Varying Performance Of Bspos And Bhws In The Delivery Of Family Planning Services In Iloilo City, Fely David, Fely Chin Jan 1994

Factors That Contribute To The Varying Performance Of Bspos And Bhws In The Delivery Of Family Planning Services In Iloilo City, Fely David, Fely Chin

Reproductive Health

In 1992, the Population Council established the Family Planning Operations Research and Training (FPORT) Program in the Philippines. It brought together program managers and regional researchers to identify problem areas that might benefit from operations research. From Western Visayas (Region VI), the City Population Office (CPO) of Iloilo City in collaboration with the Social Science Research Institute of the Central Philippine University, identified a problem concerning the poor performance of volunteer family planning (FP) workers and undertook to study it. The study focused on the Barangay Service Point Officers (BSPOs) who assist in the delivery of FP services under the …


Employment-Based Family Planning Services, Placide Tapsoba, Ian Askew, J. Tunde Taylor Thomas, Sering Falu Njie, Momodou Jasseh Jan 1993

Employment-Based Family Planning Services, Placide Tapsoba, Ian Askew, J. Tunde Taylor Thomas, Sering Falu Njie, Momodou Jasseh

Reproductive Health

Although The Gambia Family Planning Association (GFPA) has always been interested in promoting contraceptive use in the Greater Banjul Area (GBA), insufficient funds and the need to prioritize program expansion in rural areas hindered this. The GFPA operates two clinics in GBA, open to few workers. The government has three Family Planning and Maternal and Child Health clinics in Banjul, also used by few workers. Factory managers, trade union leaders, and the GFPA believe that a well-organized family planning (FP) education and service delivery program could benefit employees and employers. This operations research study tested the feasibility of a work-based …


By And For Women: Involving Women In The Development Of Reproductive Health Care Materials, Valerie J. Hull, Barbara L. Ibrahim, Nadia Farah, Blanca Figueroa, Margaret Winn Jan 1992

By And For Women: Involving Women In The Development Of Reproductive Health Care Materials, Valerie J. Hull, Barbara L. Ibrahim, Nadia Farah, Blanca Figueroa, Margaret Winn

Poverty, Gender, and Youth

The studies in this issue of Quality/Calidad/Qualité describe three efforts to involve women in the development of reproductive health care materials in different settings in the developing world. In Cairo, a women's health collective produced a comprehensive reference book for women; in Peru, a woman's group, with the extensive involvement of their nonliterate audience, developed a series of illustrated teaching materials; and in the South Pacific, an all-woman production crew produced three motivation and teaching videos developed in response to the expressed needs of Pacific Island women. Despite contrasts in the characteristics of the intended audiences, the development process, and …


Por Y Para Mujeres: Motivando Su Participación En El Desarrollo De Materiales Para La Atención En Salud Reproductiva, Valerie J. Hull, Barbara L. Ibrahim, Nadia Farah, Blanca Figueroa, Margaret Winn Jan 1992

Por Y Para Mujeres: Motivando Su Participación En El Desarrollo De Materiales Para La Atención En Salud Reproductiva, Valerie J. Hull, Barbara L. Ibrahim, Nadia Farah, Blanca Figueroa, Margaret Winn

Poverty, Gender, and Youth

Los estudios en este número de Calidad/Quality/Qualité describen tres esfuerzos para involucrar a las mujeres en el desarrollo de materiales de atención de salud reproductiva en diferentes escenarios del mundo en desarrollo. En El Cairo, un colectivo de salud de mujeres elaboró un libro comprehensivo de consulta para mujeres; en Perú, un grupo de mujeres, con una gran participación de su audiencia analfabeta, desarrolló una serie de materiales ilustrados para la enseñanza; y en el Pacífico del Sur, un grupo de producción integrado por mujeres, produjó tres videos motivacionales y para la enseñanza, desarrollados como respuesta a las necesidades expresadas …


The Bangladesh Women's Health Coalition, Bonnie J. Kay, Adrienne Germain, Maggie Bangser Jan 1991

The Bangladesh Women's Health Coalition, Bonnie J. Kay, Adrienne Germain, Maggie Bangser

Poverty, Gender, and Youth

The Bangladesh Women's Health Coalition (BWHC) represents an important initiative in the movement toward more responsive modes of family planning delivery. In the context of a society where there are strict limits on the social role and physical mobility of most girls and women, BWHC has set itself the ambitious goal of enabling women—no matter what their income or education—to learn how to manage their own reproductive health and the health of their children in a way that enhances their sense of strength and competence. One of the real strengths of BWHC has been its willingness to learn from experience …