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Articles 2671 - 2700 of 3148
Full-Text Articles in Maternal and Child Health
Transition To Marriage And Parenthood Among Youth In India, International Institute For Population Sciences (Iips), Population Council
Transition To Marriage And Parenthood Among Youth In India, International Institute For Population Sciences (Iips), Population Council
Poverty, Gender, and Youth
This Population Council policy brief documents the magnitude of early marriage and early childbearing in India and sheds light on young people’s marriage-related planning and preparedness for married life, and the nature of married life. While child marriage is particularly evident among young women, it is notable that significant proportions of young men too have married below the legal minimum age at marriage for males. Findings call for multi-pronged efforts to eliminate the practice of early marriage among young men and women, and to support newlywed young women. Ensuring that these programs reach young people and the influential adults in …
Building Programs To Address Child Marriage: The Berhane Hewan Experience In Ethiopia, Eunice N. Muthengi, Annabel Erulkar
Building Programs To Address Child Marriage: The Berhane Hewan Experience In Ethiopia, Eunice N. Muthengi, Annabel Erulkar
Poverty, Gender, and Youth
The development of a context-appropriate program to delay marriage in rural Ethiopia took place over many years and in stages. The program that ultimately became known as “Berhane Hewan” was developed by building an evidence base of understanding on the populations being served and developing partnerships between the Population Council and like-minded agencies with complementary expertise. The Berhane Hewan pilot demonstrated that significant impacts can be made on the social, educational, and health status of adolescent girls in a short period of time, through well designed and implemented support programs. However, high levels of exposure to all project components, make …
Kishor-Kishorider Jonno Ortho Sikkha [Financial Education For Adolescents], Sigma Ainul, Marzina Khatun, Najneen Mahbooba
Kishor-Kishorider Jonno Ortho Sikkha [Financial Education For Adolescents], Sigma Ainul, Marzina Khatun, Najneen Mahbooba
Poverty, Gender, and Youth
No abstract provided.
Youth In India: Situation And Needs 2006-2007—Executive Summary, Andhra Pradesh, International Institute For Population Sciences (Iips), Population Council
Youth In India: Situation And Needs 2006-2007—Executive Summary, Andhra Pradesh, International Institute For Population Sciences (Iips), Population Council
Poverty, Gender, and Youth
This study, implemented by the International Institute for Population Sciences, Mumbai and the Population Council, New Delhi is the first-ever subnationally representative study conducted to identify key transitions experienced by married and unmarried youth in India. In recognition of the importance of investing in young people, several national policies and programs formulated since 2000 have underscored a commitment to addressing the multiple needs of this group in India. Effective implementation of policies and programs, however, has been handicapped by lack of evidence on young people’s situation and needs. This study focused on married and unmarried young women and unmarried young …
Youth In India: Situation And Needs 2006–2007, International Institute For Population Sciences (Iips), Population Council
Youth In India: Situation And Needs 2006–2007, International Institute For Population Sciences (Iips), Population Council
Poverty, Gender, and Youth
This report is the result of a subnational study undertaken by the International Institute for Population Sciences, Mumbai and the Population Council, New Delhi as part of a project to collect information on key transitions experienced by youth in India. The project was implemented in six states of India, namely, Andhra Pradesh, Bihar, Jharkhand, Maharashtra, Rajasthan, and Tamil Nadu. The report offers a roadmap for programs and priorities that aim to address young people’s needs. More than 50,000 young people were interviewed in the study, providing a robust picture of youth in India and a wealth of evidence on almost …
Maternal Employment And Childhood Obesity Among Immigrant Families, Qi Zhang
Maternal Employment And Childhood Obesity Among Immigrant Families, Qi Zhang
Community & Environmental Health Faculty Publications
There are continued interests to examine the relationship between maternal employment and childhood obesity. However, little research has been focused on childhood obesity among immigrant families with working mothers. This study used the Panel Survey of Income Dynamics (PSID) and Child Development Supplement (CDS) in 2002 and compared the impact of maternal employment on childhood obesity between immigrant families and US-born families. The positive effect of maternal employment on children’s body weight status was much stronger in immigrant families than in US-born families. The full-time employment status of mothers had strong and significant effect on immigrant children’s BMI (beta = …
Summary Of Findings Health Status Of Children Entering Kindergarten: Results Of The 2009-2010 (Year Two) Nevada Kindergarten Health Survey, Nevada Institute For Children's Research And Policy Reports
Summary Of Findings Health Status Of Children Entering Kindergarten: Results Of The 2009-2010 (Year Two) Nevada Kindergarten Health Survey, Nevada Institute For Children's Research And Policy Reports
Nevada Institute for Children's Research and Policy Reports
Academic achievement for children is vital to their success in life. Those that do well in school have greater opportunities for post-secondary education, and later have better prospects for employment. One of the major factors that can affect a child’s academic achievement is his or her health status. Academic outcomes and health conditions are consistently linked in the literature (Taras & Potts-Datema, 2005). Children with poor health status, and especially those with common chronic health conditions, have increased numbers of school absences and more academic deficiencies (Taras & Potts-Datema, 2005). In a study concerning excused versus unexcused absences, children with …
Acceptance, Communication Mode And Use Of Audio Computer- Assisted Self Interview Using Touchscreen To Identify Risk Factors Among Pregnant Minority Women, Jutta S. Thornberry, Kennan B. Murray, M. Nabil El-Khorazaty, Michele Kiely
Acceptance, Communication Mode And Use Of Audio Computer- Assisted Self Interview Using Touchscreen To Identify Risk Factors Among Pregnant Minority Women, Jutta S. Thornberry, Kennan B. Murray, M. Nabil El-Khorazaty, Michele Kiely
Publications and Research
This paper evaluates the acceptability, communication mode and use of audio computer-assisted self-interview (A-CASI) among minority pregnant women receiving prenatal care in six Washington, DC sites. A total of 2,913 women were screened for demographic eligibility (18+ years old,gestation, Black/African-American or Hispanic) and risk (smoking, environmental tobacco smoke exposure, depression, intimate partner violence). Questions were displayed on touch screen laptop monitors and heard through earphones. The mean length of time to complete the screener was almost 6 minutes.
A-CASI experience, which included difficulty in using the computer, acceptability (enjoyment), and preferred communication mode, was compared across sites, the eligibility and …
Kishor-Kishorider Jonno Ortho Sikkha: Shikkhok Shahayika [Financial Education For Adolescents: Teacher's Manual], Sigma Ainul, Marzina Khatun, Najneen Mahbooba
Kishor-Kishorider Jonno Ortho Sikkha: Shikkhok Shahayika [Financial Education For Adolescents: Teacher's Manual], Sigma Ainul, Marzina Khatun, Najneen Mahbooba
Poverty, Gender, and Youth
No abstract provided.
L'Adolescence Des Filles Au Burkina Faso: Une Clé De Voûte Pour Le Changement Social, Martha Brady, Lydia Saloucou, Erica Chong
L'Adolescence Des Filles Au Burkina Faso: Une Clé De Voûte Pour Le Changement Social, Martha Brady, Lydia Saloucou, Erica Chong
Poverty, Gender, and Youth
Although a number of innovative programs have been created to meet their needs, Burkinabé adolescent girls continue to face many threats to their well-being. They still need considerable support and opportunities to improve their social and economic status and health status. This report, using a number of data sources, including Population Council studies and programs, and the Demographic and Health Survey of Burkina Faso, aims to provide a general overview of these young girls’ adolescence—the realities of life and the policy and program initiatives designed for them. The Population Council hopes that this report will make a significant contribution to …
Poverty, Marriage Timing, And Transitions To Adulthood In Nepal: A Longitudinal Analysis Using The Nepal Living Standards Survey, Ashish Bajracharya, Sajeda Amin
Poverty, Marriage Timing, And Transitions To Adulthood In Nepal: A Longitudinal Analysis Using The Nepal Living Standards Survey, Ashish Bajracharya, Sajeda Amin
Poverty, Gender, and Youth
This working paper examines the influence of household poverty experienced during early childhood on early marriage and outcomes in schooling and workforce participation during adolescence for girls in Nepal. Much of the evidence concerning these relationships is drawn from cross-sectional data that cannot be used, and has not been able, to address causality. This Population Council study uses longitudinal data from the Nepal Living Standards Survey (NLSS), a two-wave panel in which the waves were conducted eight years apart to address these questions. Analyzing the data by household-wealth quintiles reveals surprisingly nonlinear results indicating that these associations are largest for …
Life Skills: Psychosocial And Interpersonal Skills For Adolescent Girls In Urban Ghana—Mentor's Guide, Population Council
Life Skills: Psychosocial And Interpersonal Skills For Adolescent Girls In Urban Ghana—Mentor's Guide, Population Council
Poverty, Gender, and Youth
School dropout is common among urban adolescent girls in Ghana, leading to increased social isolation and high rates of teenage pregnancy. The curriculum described in this mentor’s guide is one component of the Population Council’s “Safe Spaces” asset-building program for vulnerable adolescent girls in urban Ghana. The curriculum consists of 20 Life Skills sessions, which each take 90 minutes to complete. The program approach used is based on giving girls a safe, girls-only space where they can meet friends and learn about important topics under the guidance of a female mentor. The number of sessions completed per week or per …
Youth In India: Situation And Needs 2006-2007—Executive Summary, International Institute For Population Sciences (Iips), Population Council
Youth In India: Situation And Needs 2006-2007—Executive Summary, International Institute For Population Sciences (Iips), Population Council
Poverty, Gender, and Youth
This executive summary presents, in brief, findings from the Youth in India: Situation and Needs study, a subnational study undertaken by the International Institute for Population Sciences, Mumbai and the Population Council, New Delhi to collect information on key transitions experienced by youth in India, including those related to education, workforce participation, sexual activity, marriage, health, and civic participation. The magnitude and patterns of young people’s sexual and reproductive practices before, within, and outside of marriage, as well as related knowledge, decisionmaking, and attitudes, is also assessed. The project was implemented in six states of India, namely, Andhra Pradesh, Bihar, …
Kishor-Kishorider Jonno Ortho Sikkha: Dishari Shohayika [Financial Education For Adolescents: Mentor's Manual], Sigma Ainul, Marzina Khatun, Najneen Mahbooba
Kishor-Kishorider Jonno Ortho Sikkha: Dishari Shohayika [Financial Education For Adolescents: Mentor's Manual], Sigma Ainul, Marzina Khatun, Najneen Mahbooba
Poverty, Gender, and Youth
No abstract provided.
The Nature Of Mothers' Work And Children's Schooling In Nepal: The Influence Of Income And Time Effects, Ashish Bajracharya
The Nature Of Mothers' Work And Children's Schooling In Nepal: The Influence Of Income And Time Effects, Ashish Bajracharya
Poverty, Gender, and Youth
Using nationally representative cross-sectional data from the Nepal Living Standards Survey, this Population Council working paper examines the influence of the nature of mothers’ work on Nepali children’s schooling outcomes. It analyses whether the engagement of mothers (and fathers) in nonagricultural work has significant consequences for their children’s school attendance and grade attainment, compared with these consequences when parents’ work is in traditional subsistence agriculture. Results indicate that children of parents who both work in the nonagriculture sector are significantly more likely to have attended or currently be attending school and have higher grade attainment, compared with children whose parents …
Planning And Implementing An Essential Package Of Sexual And Reproductive Health Services: Guidance For Integrating Family Planning And Sti/Rti With Other Reproductive Health And Primary Health Services, Katherine Williams, Charlotte E. Warren, Ian Askew
Planning And Implementing An Essential Package Of Sexual And Reproductive Health Services: Guidance For Integrating Family Planning And Sti/Rti With Other Reproductive Health And Primary Health Services, Katherine Williams, Charlotte E. Warren, Ian Askew
Reproductive Health
The second goal of the United Nations Population Fund’s (UNFPA’s) 2008–11 Strategic Plan is “Universal access to reproductive health by 2015 and universal access to comprehensive HIV prevention by 2010 for improved quality of life.” UNFPA identified a number of outcomes that will contribute to achieving this goal. Through an extensive search of the published literature and collation of unpublished literature on programmatic experiences with developing and implementing integrated packages of SRH services, the Population Council gathered a body of evidence from which this guidance for UNFPA staff and national counterparts has been developed. UNFPA identified two priority areas: integrating …
Manual On Financial Mechanism For The Health Facilities: Introducing Pay-For-Performance Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Laila Rahman, Dipak Kumar Shil, Md. Mamun-Or Rashid, Ismat Ara Hena, Md. Noorunnabi Talukder, Farhana Akter, Anup Kumar Dey, Ripa Ali, Joynal Abedin, Mursheda Rahman, Md. Ataur Rahman, Md. Julkarnayeen, Arifur Rahman, Md. Abdur Rab Sardar
Manual On Financial Mechanism For The Health Facilities: Introducing Pay-For-Performance Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Laila Rahman, Dipak Kumar Shil, Md. Mamun-Or Rashid, Ismat Ara Hena, Md. Noorunnabi Talukder, Farhana Akter, Anup Kumar Dey, Ripa Ali, Joynal Abedin, Mursheda Rahman, Md. Ataur Rahman, Md. Julkarnayeen, Arifur Rahman, Md. Abdur Rab Sardar
Reproductive Health
The Population Council initiated an operations research study to test two Pay-for-Performance (P4P) strategies to improve maternal, newborn, and child health (MNCH) services in Bangladesh in 2010. The P4P study is being implemented as part of the two ongoing MNCH and maternal and newborn health (MNH) projects of the United Nations Children’s Fund (UNICEF) implemented by the Directorate General of Health Services, Government of Bangladesh. The study has been testing two strategies. The first introduces incentives tied with performance for motivating service providers to improve the quantity as well as quality of services, and enable poor pregnant women, and mothers …
Facility Assessment Report: Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena, Farhana Akter, Mohammad Ataur Rahman, Md. Julkarnayeen, Md. Akteruzzaman, Md. Sohel Rana, Ripa Ali
Facility Assessment Report: Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena, Farhana Akter, Mohammad Ataur Rahman, Md. Julkarnayeen, Md. Akteruzzaman, Md. Sohel Rana, Ripa Ali
Reproductive Health
Under the leadership of the Directorate General of Health Services, the Population Council in collaboration with James P. Grant School of Public Health, BRAC University and with support from UNICEF is testing an innovative service delivery model to provide financial incentives to institutions to enhance their performance on maternal, newborn, and child health (MNCH) services in three districts of Bangladesh as part of GOB-UNICEF’s ongoing MNCH/MNH projects. A comparative analysis on the availability and condition of physical and human assets across 16 health facilities will inform what is needed in a facility in terms of inputs and processes. This report …
Future Of Family Planning Program In Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan
Future Of Family Planning Program In Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan
Reproductive Health
Bangladesh experienced large population growth in the past, but due to a successful family planning program, the total fertility rate (TFR) declined rapidly until the mid-nineties. Over the last decade, the country experienced a slow pace in fertility decline with a small increase in the contraceptive prevalence rate (CPR). This slow pace in fertility decline is causing serious concern for reaching replacement level fertility by 2015. CPR increased seven-fold from 1975 to 2000, but there was no significant increase from 2000-09, demonstrating the weakness of present program efforts. This raises concern among researchers, policymakers, and program managers about the prospect …
Urban Family Planning Program Of Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan
Urban Family Planning Program Of Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan
Reproductive Health
Extremely inadequate government primary health care (PHC) structure exists in cities in Bangladesh. Nongovernmental organizations (NGOs) play an important role in providing basic health and family planning services to a limited proportion of the urban population. However, NGO programs are time-bound and subject to the availability of development assistance. Bangladesh has one of the highest rates of growth of urban populations among developing countries. For this teeming urban population, there is no structured family planning service. To ensure continuous family planning services in urban areas it is critical to develop a sustainable primary health care structure with the thrust on …
Workshop Report: Introducing Pay-For-Performance (P4p) Approach And Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Ismat Ara Hena, Farhana Akter, Mohammad Ataur Rahman, Md. Julkarnayeen
Workshop Report: Introducing Pay-For-Performance (P4p) Approach And Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Ismat Ara Hena, Farhana Akter, Mohammad Ataur Rahman, Md. Julkarnayeen
Reproductive Health
In Bangladesh, improving skilled birth attendance at delivery and access to facility-based obstetric and newborn care are vital to improving maternal and neonatal health. The health system in Bangladesh faces a critical challenge on the supply side: unavailability of quality services at public health facilities, due to inadequately motivated providers, vacant positions, and provider absenteeism. As well, salaries of public-sector providers do not depend on quality of work or quantity of services provided. Paying an incentive to facilities based on a performance benchmark has the potential of increasing the quantity and quality of maternal, neonatal, and child health (MNCH) care. …
Brief Report: Activities And Achievements Of The P4p Project—Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Population Council
Reproductive Health
A pilot study was initiated in Bangladesh for testing Pay-for-Performance for providers and clients in improving maternal, newborn, and child health (MNCH) services by addressing supply and demand-side barriers. With funding from UNICEF, the Population Council provided technical assistance for the operations research study implemented by the Directorate General of Health Services, Ministry of Health and Family Welfare of the Government of Bangladesh. Necessary and key human resource placement and training on integrated management of childhood illness, emergency operations centers, newborn care, infection prevention, and waste management are important for better performance in all facilities. In spite of existing barriers, …
Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef
Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef
Reproductive Health
The Population Council launched a pilot study to test two Pay-for-Performance (P4P) strategies to improve MNCH services in Bangladesh. This document presents guidelines for offering incentives to providers, distributing coupons, and forming P4P and/or Coupon Committees and Quality Assurance Groups. The guidelines were developed over the course of five policy-level and consensus-building workshops with national and local-level program managers and service providers, organized under the leadership of the DGHS, in consideration of the local context and sustainability in case of nationwide replication in the country. These guidelines will come into effect upon receiving approval from the DGHS, Ministry of Health …
Public Expenditure On Health Care In Orissa: Focus On Reproductive And Child Health Services, Sarit Kumar Rout
Public Expenditure On Health Care In Orissa: Focus On Reproductive And Child Health Services, Sarit Kumar Rout
Reproductive Health
In view of the importance of public financing in influencing health outcomes and the paucity of studies that have explored patterns of resource allocation on reproductive and child health services, a study was undertaken in Orissa, India to examine the pattern of and trends in public expenditure on health care with a special focus on expenditure on reproductive and child health services. The study was part of the Population Council, India’s Health and Population Innovation Fellowship program. Findings indicate that major policy issues such as the transfer of power to panchayati raj institutions and those involving health administration and management, …
Increasing Appropriate Complementary Feeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council
Increasing Appropriate Complementary Feeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council
Reproductive Health
The Population Council conducted a formative study in rural Uttar Pradesh, India to determine current complementary feeding practices among children aged 6–23 months; understand the facilitating factors and barriers in adopting appropriate complementary feeding practices; and identify programmatic and behavior change communication (BCC) initiatives that could promote the adoption of appropriate complementary feeding practices. The qualitative study shows that women and family members did not feed a measured quantity of food to their children. A lack of knowledge and lack of communication created barriers to initiating complementary feeding. The policy brief recognized education and antenatal care as facilitating factors and …
Increasing Early And Exclusive Breastfeeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council
Increasing Early And Exclusive Breastfeeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council
Reproductive Health
The Population Council conducted a formative study in rural Uttar Pradesh, India to determine the current status of early and exclusive breastfeeding, understand the facilitating factors and barriers in adopting the desired breastfeeding practices, and identify programmatic and behavior change communication (BCC) initiatives to promote the practice. Findings indicate that efforts by Primary Health Centre staff to counsel and encourage women to breastfeed early could significantly increase adoption of this practice. The policy brief identifies barriers that reflect a lack of knowledge and misperceptions about breastfeeding, but finds that education, supportive family members, and knowledgeable health workers can facilitate breastfeeding. …
Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council
Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council
Reproductive Health
The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …
Improving The Health Care Response To Gender-Based Violence: Project Evaluation Report, Meiwita P. Budiharsana, Mai Quoc Tung
Improving The Health Care Response To Gender-Based Violence: Project Evaluation Report, Meiwita P. Budiharsana, Mai Quoc Tung
Reproductive Health
Consistent with previous studies, this study provides evidence that gender-based violence (GBV) remains a problem in Viet Nam with indications that it may be on the increase. In 2009 the Population Council Viet Nam in collaboration with the Hanoi Health Department, carried out an evaluation among the staff of Duc Giang Hospital to assess the extent to which awareness and perceptions of GBV had changed since a pilot intervention project commenced in 2005. Overall the project has been very effective in raising awareness and willingness to integrate GBV screening in the health services. This report documents the results and lists …
Integration Of Services In Senegal, Population Council
Integration Of Services In Senegal, Population Council
Reproductive Health
With financial support from USAID and technical support from IntraHealth, The Population Council, Siggil Jigeen Network, and Helen Keller International, Senegal’s Ministry of Health and Prevention has built a package of integrated services called SMNI/PF/PALU. Integrating services allow women to access a wider range of information and care during the same visit and thus increases the utilization of services while also improving their quality and efficiency. Findings in this report indicate that integration of services is a central feature of SMNI/PF/PALU’s success. In conjunction with integrated service delivery models, program activities which strengthen systems and support efficient implementation of services …
Une Stratégie Pour La Réduction De La Mortalité Maternelle Et Néonatale, Population Council
Une Stratégie Pour La Réduction De La Mortalité Maternelle Et Néonatale, Population Council
Reproductive Health
As part of the strategies to reduce maternal and neonatal mortality, the introduction of a minimum integrated package of maternal and newborn care including Active Management of the Third Stage of Labor (AMTSL) and Essential Newborn Care (ENC) are simple and inexpensive approaches in poor countries. This brief reports on a study conducted by the Senegal Ministry of Health and Prevention, with support from IntraHealth and the Population Council, whose objectives included: 1) evaluating the functional capacity of the targeted health structures to offer the AMTSL and ENC, 2) evaluating the knowledge and skills of the providers, and 3) identifying …