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Family Planning

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Full-Text Articles in Maternal and Child Health

Understanding Unintended Pregnancy In Senegal: Country Profile Report, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff Jan 2014

Understanding Unintended Pregnancy In Senegal: Country Profile Report, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

As part of the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) research program, the Population Council has developed a Country Profile Report to understand unwanted pregnancies in Senegal. The Population Council conducted a literature review, analyzed available survey data, and conducted interviews to discuss some aspects in more detail with a number of key stakeholders. The Country Profile was discussed at a two-day workshop in Dakar bringing together key government actors at the central and regional levels, nongovernmental organizations, and civil society actors. The report is composed of six chapters, summarized in this evidence brief.


La Planification Familiale Postpartum Au Burkina Faso - Résumé En Français, Step Up Research Programme Consortium Jan 2014

La Planification Familiale Postpartum Au Burkina Faso - Résumé En Français, Step Up Research Programme Consortium

Reproductive Health

Ce résumé décrit une étude sur la planification familiale post-partum (PFPP) au Burkina Faso. L’étude avait pour but: de donner un aperçu de la disponibilité et la qualité des services prénatals, du post-partum, et de planification familiale au niveau des soins primaires, et d’évaluer la mesure dans laquelle ils fournissent des services efficaces de PFPP; d’évaluer l'accessibilité des services PFPP; d’explorer l’effet de facteurs sociaux, économiques, et culturels sur la demande et l'adoption de la PFPP; d’estimer l’impact, la pertinence, et la mise en œuvre de la politique nationale et des protocoles cliniques par rapport à la PFPP; et d’identifier …


International Seminar On Promoting Postpartum And Post-Abortion Family Planning: Challenges And Opportunities, Iussp Scientific Panel On Reproductive Health Jan 2014

International Seminar On Promoting Postpartum And Post-Abortion Family Planning: Challenges And Opportunities, Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with the Population Council, India, and the Department of Reproductive Health and Research, World Health Organization held a seminar on “Promoting postpartum and post-abortion family planning: Challenges and opportunities” in Cochin, India, November 2014. The seminar brought together 24 scientists, policymakers, and program managers to present and discuss a range of issues relating to postpartum and post-abortion family planning. This report summarizes the papers presented at the seminar which sought to answer several key questions pertaining to postpartum and post-abortion contraception. Several conclusions drawn from the evidence are presented and research …


Prevalence Of Unintended Pregnancy And Needs For Family Planning Among Married Adolescent Girls Living In Urban Slums Of Dhaka, Bangladesh, Fauzia Akhter Huda, Sabiha Chowdhuri, Bidhan Krishna Sarker, Noushin Islam, Anisuddin Ahmed Jan 2014

Prevalence Of Unintended Pregnancy And Needs For Family Planning Among Married Adolescent Girls Living In Urban Slums Of Dhaka, Bangladesh, Fauzia Akhter Huda, Sabiha Chowdhuri, Bidhan Krishna Sarker, Noushin Islam, Anisuddin Ahmed

Reproductive Health

This STEP UP research report examined the prevalence and basic underlying factors of unintended pregnancy among married adolescent girls in five urban slums in Dhaka, Bangladesh. The specific objectives of the study were to: 1) document the prevalence of unintended pregnancy among married adolescent girls aged 15–19 years living in urban slums of Dhaka; 2) identify the factors associated with or which contribute to unintended pregnancy among urban married adolescent girls; 3) estimate the proportion of married adolescent girls who have an unmet need for family planning (FP) services; and 4) explore the barriers to access and effective use of …


Unintended Pregnancy And Abortion In India: Country Profile Report, Mary Philip Sebastian, M.E. Khan, Daliya Sebastian Jan 2014

Unintended Pregnancy And Abortion In India: Country Profile Report, Mary Philip Sebastian, M.E. Khan, Daliya Sebastian

Reproductive Health

A review of literature and analysis of large surveys were carried out with funding from the STEP UP consortium led by Population Council to build a coherent body of robust research-based evidence on the situation in India in the context of unmet need for family planning (FP) and safe abortion services. The study found that there is insufficient training of different cadres of health staff in the public health system on abortion provision, post-abortion care, FP counseling of young couples, emergency contraception, and IUD insertion/removal. Despite service delivery guidelines in India expecting providers to provide FP counseling during antenatal visits, …


Second Consultation On Developing Standards For Identifying Evidence-Based Practices In Reproductive Health, Step Up Research Programme Consortium Jan 2014

Second Consultation On Developing Standards For Identifying Evidence-Based Practices In Reproductive Health, Step Up Research Programme Consortium

Reproductive Health

The STEP UP consortium and the High Impact Practices initiative, together with other partners, supported three consultation meetings to inform the use of appropriate standards of evidence for recommending best practices in reproductive health (RH). The second consultation, reported here, brought together researchers and funders to review the research designs and methodologies that can be used to generate evidence on the impact of FP/RH interventions and on their implementation; the mechanisms and structures through which such evidence is reviewed and translated into recommendations; and the implications for organizing and funding evidence generation to maximize its quality and utility. Drawing from …


Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew Jan 2014

Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew

Reproductive Health

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; …


Postpartum Family Planning In Burkina Faso, Marina Daniele Jan 2014

Postpartum Family Planning In Burkina Faso, Marina Daniele

Reproductive Health

This is a formative study aiming to identify the main barriers to the provision and uptake of quality postpartum family planning (PPFP) services at the supply, access, demand, and policy levels in Burkina Faso. This study reveals that there are substantial shortfalls in the availability of quality PPFP at all these levels. Most of the difficulties observed in the provision of PPFP services are due to the failure to translate largely sound policies and guidelines into practice. This study contributes to identifying priority areas and makes recommendations for improvement in order to respond to unmet need for family planning in …


Summarizing Bodies Of Evidence On The Implementation And Effectiveness Of Fp/Rh Interventions, Ian Askew Jan 2014

Summarizing Bodies Of Evidence On The Implementation And Effectiveness Of Fp/Rh Interventions, Ian Askew

Reproductive Health

No abstract provided.


Unintended Pregnancy By The Numbers: A Look At Kenya, Carol Mukiira, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara Jan 2014

Unintended Pregnancy By The Numbers: A Look At Kenya, Carol Mukiira, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara

Reproductive Health

This fact sheet summarizes data collated during the development of the STEP UP Country Profile Report on Unintended Pregnancies for Kenya, which presents a range of key evidence aimed at informing readers about the trends, magnitude, determinants, and consequences of unintended pregnancy in Kenya. The data shown in this fact sheet are drawn mainly from the 1993, 1998, 2003 and 2008/09 Kenya Demographic and Health Surveys (KDHS) as well as other secondary sources.


Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland Jan 2013

Insights Into Unmet Need In Kenya, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on …


The Unfinished Agenda To Meet Fp2020 Goals: 12 Actions To Fill Critical Evidence Gaps, Ian Askew, Martha Brady Jan 2013

The Unfinished Agenda To Meet Fp2020 Goals: 12 Actions To Fill Critical Evidence Gaps, Ian Askew, Martha Brady

Reproductive Health

More than 200 million women in the developing world who want to avoid pregnancy are not using a modern contraceptive method. The international community convened at the London Family Planning Summit in July 2012 and strengthened their resolve to address unmet need. National governments, civil society, and the private sector committed US$2.6 billion toward the goal of making contraceptive information, services, and supplies available to an additional 120 million women and girls by 2020. This book elaborates on one of two influential publications disseminated by the Population Council that assess the situation: Reviewing the Evidence and Identifying Gaps in Family …


Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar Jan 2013

Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar

Reproductive Health

Maternal mortality in Ethiopia remains among the highest in the world. A UN Commission Report in 2012 identified 13 life-saving commodities—defined as medicines, medical devices, and health supplies—that effectively address avoidable causes of death during pregnancy and childbirth that, if more widely accessed and properly used, could significantly reduce preventable deaths among women. This assessment, conducted by the Population Council, evaluates the availability of these life-saving commodities that are essential for basic emergency obstetric and neonatal care, and safe and clean delivery services within primary health care in Ethiopia. The report concludes that Ethiopia’s pharmaceutical procurement and supply system is …


Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes Jan 2013

Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes

Reproductive Health

Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …


Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff Jan 2013

Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

Un profil pays a été préparé pour le Sénégal pour compiler et synthétiser les informations disponibles sur la santé de la reproduction, en particulier les grossesses non désirées et par conséquent les besoins non satisfaits en matière de planification familiale. D’importants efforts ont été consentis par l’Etat sénégalais, mais de nombreux obstacles continuent de freiner les progrès réalisés. Un programme national plus cohérent et ciblé est donc nécessaire pour réduire ces obstacles. Dans le même temps, les acteurs non-gouvernementaux devraient poursuivre leurs efforts pour renforcer leur programmation pour produire des effets plus immédiats, tout en assurant une meilleure coordination entre …


Analyse Des Besoins Non Satisfaits Au Sénégal, Kazuyo Machiyama, John C. Cleland Jan 2013

Analyse Des Besoins Non Satisfaits Au Sénégal, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Cette étude vise à établir l’importance relative d’un manque d’accès et d’attitudes de résistance envers l’utilisation de la contraception dans les strates géographiques et de population du Sénégal. Elle est destinée à informer les décideurs politiques sur la priorité à accorder à la communication pour le changement de comportement ou pour l’amélioration de l’accès/de l’information, et également à aider lors de la conception d’interventions pour réduire les inquiétudes par rapport à la santé et la peur des effets secondaires, tels que la provision d’une gamme de méthodes plus élargie et le counseling amélioré. Plus de la moitié des femmes ayant …


International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health Jan 2013

International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with STEP UP and AFIDEP, held a seminar in Nanyuki, Kenya, in May 2013. The seminar brought together 44 scientists, policymakers, and program managers to present and discuss a range of issues relating to the definition, determinants, and consequences of unmet need for family planning and program interventions designed specifically to reduce unmet need in groups at high risk. Based on discussions and presentations, unmet need (and family planning in general) should be looked at both from a development perspective and from a service-delivery and health-sector perspective. Overall, the seminar papers, …


Understanding Unintended Pregnancy In Bangladesh: Country Profile Report, Fauzia Akhter Huda, Sabiha Chowdhuri, Yolande Robertson, Noushin Islam, Bidhan Krishna Sarker, Ashrafi Jahan Azmi, Laura Reichenbach Jan 2013

Understanding Unintended Pregnancy In Bangladesh: Country Profile Report, Fauzia Akhter Huda, Sabiha Chowdhuri, Yolande Robertson, Noushin Islam, Bidhan Krishna Sarker, Ashrafi Jahan Azmi, Laura Reichenbach

Reproductive Health

The objective of this report is to identify the determinants of unintended pregnancy and unmet need for family planning in Bangladesh and therefore provide a strong body of evidence that will contribute to issue identification, evidence generation, and communication for use of evidence in policy and programming. The evidence generated can be used to find ways to reduce the rate of unintended pregnancy and hence reduce the risk of abortion-related morbidity and mortality; ultimately this will aid Bangladeshi couples in reaching their fertility goals. Results demonstrate that Bangladesh has shown progress and promise in several areas of family planning and …


Insights Into Unmet Need In Ghana, Kazuyo Machiyama, John C. Cleland Jan 2013

Insights Into Unmet Need In Ghana, Kazuyo Machiyama, John C. Cleland

Reproductive Health

This study aims to establish the relative importance of lack of access and attitudinal resistance toward use of family planning for different population and geographical strata in Ghana. It is intended to inform policymakers on the priority that should be given to behavior change communication or improved access/information, and also helpful to interventions to reduce health concerns and fear of side effects, such as provision of broader method mix and better counseling. The most far reaching implication concerns the reproductive behavior of the best educated women and those living in the capital or surrounding areas. The results suggest an enduring …


Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland Jan 2013

Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Results presented in this STEP UP Research Report show that over half of women having unmet need for family planning in Senegal did not intend to use family planning in the future and this was consistent across all population strata. Reasons for non-use confirm the existence of widespread opposition to the use of modern contraception. Unfamiliarity and lack of information is likely to be a reason for such opposition; initial suspicion of contraception has also been documented. Thus a first policy priority, and one that is relatively easy to achieve, is to increase knowledge through the mass media and localized …


Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew Jan 2013

Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew

Reproductive Health

Prevention of unintended pregnancy is often considered the key outcome of reducing unmet need; it is the basic right of women and couples to become pregnant only when intended. This paper explores this relationship by reviewing the definition and measurement of unintended pregnancy, identifying key trends in its distribution within and between populations, and analyzing the relationship between unintended pregnancy, demand for family planning, and family planning program performance. The determinants and consequences of unintended pregnancy are reviewed to further understand the implications of using it as a policy and programming goal. The paper concludes by reviewing the broader policy …


Assessing Retention And Motivation Of Public Health-Care Providers (Particularly Female Providers) In Rural Pakistan, Ali M. Mir, Gul Rashida Shaikh, Saleem Shaikh, Neha Mankani, Anushe Hassan, Maqsood Sadiq Jan 2013

Assessing Retention And Motivation Of Public Health-Care Providers (Particularly Female Providers) In Rural Pakistan, Ali M. Mir, Gul Rashida Shaikh, Saleem Shaikh, Neha Mankani, Anushe Hassan, Maqsood Sadiq

Reproductive Health

The main objectives of this project in Pakistan were to explore the core issue of availability of health providers, especially female providers who are required for provision of maternal and neonatal healthcare, and to determine the range of factors that either constrain or motivate providers to serve in key positions in public facilities in rural areas. The study, conducted by the Population Council with funding from the Maternal and Newborn Health Programme ‐ Research and Advocacy Fund, identifies a number of problems faced by healthcare providers working in the public healthcare system in Pakistan and makes the following recommendations for …


The Antecedents, Process, And Consequences Of Female Sterilization For Low-Income Women In Mumbai, Marie A. Brault May 2012

The Antecedents, Process, And Consequences Of Female Sterilization For Low-Income Women In Mumbai, Marie A. Brault

Master's Theses

Surgical sterilization is the primary method of family planning among low-income women in India; the result of limited knowledge and poor access to family planning alternatives. To understand the dynamics of sterilization, 37 in-depth interviews were conducted with sterilized women from the study community, as well as key informant interviews with community men, providers and government officials. The results indicate that sterilization decisions are made after exceeding ideal family size, that the procedures for sterilization frequently do not follow official protocol, but that for the most part women are highly positive about being free of the risk of unwanted conception.


Expanding Access To Comprehensive Reproductive Health And Hiv Information And Services For Married Adolescent Girls In Nyanza Province, Chi-Chi Undie, Harriet Birungi, Francis Obare, Ben Ochieng, Wilson Liambila, Erick Oweya, Ian Askew, Rob Burnet, Bridget Deacon, Aisha Mohamed Jan 2012

Expanding Access To Comprehensive Reproductive Health And Hiv Information And Services For Married Adolescent Girls In Nyanza Province, Chi-Chi Undie, Harriet Birungi, Francis Obare, Ben Ochieng, Wilson Liambila, Erick Oweya, Ian Askew, Rob Burnet, Bridget Deacon, Aisha Mohamed

Reproductive Health

The objectives of this operations research study, conducted by the Population Council’s APHIA II Operations Research Project in Kenya, were to: 1) identify and design a set of interventions that promote the uptake of comprehensive reproductive health (RH)/family planning (FP) and HIV prevention services and information among married adolescent girls; and 2) expand access to comprehensive RH/FP and HIV prevention services and information among this population. The study demonstrated that the combined use of interactive media and community health worker visitation, health information provision, and referrals, is an effective means of reinforcing RH/FP and HIV messages, and of increasing access …


Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta Jan 2012

Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …


Executive Summary—Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta Jan 2012

Executive Summary—Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

This document contains the executive summary of “Family Planning Programs for the 21st Century: Rationale and Design.” The first half of the book makes the case for why increased funding and support for voluntary family planning programs are needed. The second half explains how reinvigorated voluntary family planning programs can be structured to operate more effectively. Family planning is one of the most successful development interventions of the past 50 years. It is unique in its range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …


Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs, Population Council Jan 2012

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs, Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …


Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs [Arabic], Population Council Jan 2012

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs [Arabic], Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …


Résumé Exécutif—Les Programmes De Planification Familiale Du Xxie Siècle: Fondement Et Conception, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta Jan 2012

Résumé Exécutif—Les Programmes De Planification Familiale Du Xxie Siècle: Fondement Et Conception, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Ce document contient le résumé exécutif de «Les programmes de planification familiale pour le XXIe siècle: Fondement et conception». La première moitié de l'ouvrage explique pourquoi un financement et un soutien accrus en faveur des programmes de planification familiale volontaire sont nécessaires. La seconde moitié explique comment les programmes renforcés de planification familiale volontaire peuvent être structurés de manière à fonctionner avec plus d’efficacité. La planification familiale est l'une des interventions les plus réussies de développement de ces 50 dernières années. Elle est unique en termes d’avantages potentiels, et englobe le développement économique, la santé maternelle et infantile, …


Increasing Access To Family Planning And Reproductive Health Services Through Community Work: A Case Study Of A Dual Cadre Model In India, Jaleel Ahmad, Isha Bhatnagar, M.E. Khan Jan 2012

Increasing Access To Family Planning And Reproductive Health Services Through Community Work: A Case Study Of A Dual Cadre Model In India, Jaleel Ahmad, Isha Bhatnagar, M.E. Khan

Reproductive Health

Before the introduction of Accredited Social Health Activists (ASHAs) in India, mid-level auxiliary nurse midwives (ANMs) were responsible for community health education and services such as antenatal care, delivery, IUCD insertion, and sterilization referrals. The Population Council studied how community extension work and some primary care responsibilities have been shifted to ASHAs, who are tasked with identifying pregnant women; facilitating ANC check-ups; motivating women for institutional deliveries during ANC checkups; and organizing child immunization. Establishing dual worker cadres in India by shifting community extension tasks from ANMs to local ASHAs has been well conceived. Task shifting has allowed ANMs, as …