Public Health Education and Promotion Commons^™

Comprehensive Responses To Gender-Based Violence In Low-Resource Settings: Lessons Learned From Implementation, Jill Keesbury, Ian Askew

Reproductive Health

The Population Council undertook a program of technical assistance and research to strengthen the evidence base on sexual and gender-based violence (SGBV) programming in sub-Saharan Africa. This project created an active network of implementers and researchers across sub-Saharan Africa, all of whom were charged with developing, implementing, and evaluating core elements of a comprehensive, multisectoral model for strengthening responses for survivors of SGBV, especially survivors of sexual violence. Based on the experiences of these partners, this document reviews the findings, lessons learned, and promising practices in the provision of comprehensive SGBV services in sub-Saharan Africa. The findings are intended to …

Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina

Reproductive Health

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the …

Training Service Providers Increases Tb Screening In Postnatal Care, Population Council

Reproductive Health

This document summarizes a Population Council operations research project undertaken in collaboration with the Kenya Ministry of Health to develop and pilot-test an intervention to improve TB screening, case detection, treatment, and care among postnatal clients. The intervention demonstrated that it is feasible to use postnatal care services as a platform to increase TB screening and case detection. Training providers, giving them job-aids, and strengthening client flow within the facility also improved the overall quality of care that the clients received. The actual number of cases of TB detected was extremely low, however; thus the report recommends that the Ministry …

Life-Skills Education Leads To Improved Effect On Adolescents' Sexual Behavior, Population Council

Reproductive Health

The Kenya Adolescent Reproductive Health Project (KARHP) was a three-pronged program implemented in schools, communities, and health facilities, to provide information and services to adolescents in order to improve their reproductive health outcomes. This operations research summary from the Population Council sought to discover whether the activities started under the project and desired reproductive health outcomes had been sustained in the 10-year period since inception, and to identify challenges experienced in sustaining the model. Although the survey suggests that the efforts to sustain KARHP/ASRH activities may be having desirable behavioral outcomes among adolescents, there is a need to strengthen these …

Training Institutions For Community Midwives In Pakistan: An Initial Assessment, Zakir Hussain Shah, Momina Salim, Mumraiz Khan

Reproductive Health

This study focuses on the training of community midwives (CMWs) in Pakistan, to specifically look at the institutions providing CMW training to see what resources (both physical and human resources) they had available and how these resources were being utilized. This study served as an early evaluation of the trainings and upgrades by the PAIMAN project, to assess how their interventions fared, and provides documentation for future decisions regarding the management, training, and practice of CMWs in Pakistan. As Pakistan transitions from a country with a high level of home births to a country where most births take place in …

Process Evaluation Of Community Mobilization Activities, Zakir Hussain Shah

Reproductive Health

This report presents the findings of a process evaluation by the Population Council of community mobilization (CM) activities implemented under the PAIMAN project in Pakistan. PAIMAN developed a comprehensive communication, advocacy, and mobilization (CAM) strategy to increase knowledge and awareness of harmful practices among women and their family and to improve their health-seeking behaviors. The CAM roadmap acknowledges the importance of engaging communities in order to achieve behavior change and links clients with providers and services. The main objective of this evaluation was to assess the process of CM implementation and to identify its gaps in order to develop corrective …

The Pregnancy Cycle Approach To Safe Motherhood, Saumya Ramarao, Sarah Raifman

Reproductive Health

The Population Council's Reproductive Health program partnered with the Maternal Health Task Force (MHTF), the Partnership for Maternal, Newborn and Child Health (PMNCH), and the PAC Consortium, to address the UN Millenium Development Goal of improving maternal health, and reducing child mortality. Specifically this brief examines the pregnancy cycle approach whereby women’s needs from facilitating a desired pregnancy to successful parturition are addressed in a range of settings—home, community and health facility. This brief covers the different stages including abortion and postabortion care, antenatal care, delivery, and postpartum and beyond.

The Role Of Traditional Leaders In Preventing And Addressing Sexual And Gender-Based Violence: Findings From Kwazulu-Natal, Northwest And Limpopo Provinces In South Africa, Mantshi Teffo-Menziwa, Saiqa Mullick, Prince Cedza Dlamini

Reproductive Health

The Population Council, in partnership with the Ubuntu Institute, embarked on a program to engage traditional Leaders in three South African provinces (North West, KwaZulu-Natal and Limpopo) to address sexual and gender-based violence (SGBV) in rural communities. The overarching goals of the program were to strengthen linkages between the Population Council and traditional communities, generate and share strategic information on SGBV, strengthen prevention and response to child sexual assault, engage new partners to address prevention of and access to SGBV services, and expand access to comprehensive post-rape services by working with traditional leadership structures. Some of the key findings reflect …

Introducing And Pilot-Testing The National Guidelines On Integrating The Management Of Stis/Rtis Into Reproductive Health Settings In Kenya, Wilson Liambila, Saiqa Mullick, Ian Askew, Nathalie Broutet, Bartilol Kigen, Cosmas Mutunga, Daniel Sande, Nimrod Garama, Benjamin Tsofa, Christine Awuor, Ibrahim Mohammed

Reproductive Health

This report evaluated a project in ten Kenyan health facilities. It examined the feasibility, acceptability and effect of introducing reproductive tract infection and sexually transmitted infection (RTI/STI) guidelines on the quality of care provided, and the incremental costs of integrating these services into existing reproductive health (RH) services; it also disseminated the results and lessons learnt within Kenya. Overall, the results showed that integration of activities to screen for and manage STIs/RTIs into RH services is feasible, acceptable to clients and providers, and effective in improving the range and quality of services offered to clients.

Emergency Contraception: Idea To Program, Saumya Ramarao, John Townsend, Sarah Raifman

Reproductive Health

This report summarizes the role of the Population Council in generating evidence, providing technical leadership, and demonstrating at scale that emergency contraception (EC) can be easily integrated into national family planning programs and other reproductive health services. Since the 1990s, the Population Council, along with other partners, has contributed to the changes seen in the provision and availability of EC, now available in over 140 countries around the world. While much progress has been made in the campaign for access to EC, the Council is committed to improving existing methods of service delivery and to leading advocacy efforts and research …

Future Demands For Services From Public Health Facilities In Uttar Pradesh, Population Council

Reproductive Health

A Population Council-led consortium in India conducted a study to assess (a) the expected workload of public health facilities, and (b) the extent to which the demand for contraception could be met by the existing health facilities in Uttar Pradesh, following the implementation of behavior change communication (BCC) activities. This policy brief recommends that BCC efforts create demand for services and address perceptions that it is “not necessary” to access health care services. BCC must play a greater role in motivating women to move to facilities not just for institutional delivery but for other services as well. BCC can also …

Increasing The Practice Of Thermal Care To Prevent Newborn Hypothermia: Implications For Behavior Change Communication In Rural Uttar Pradesh, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess current newborn bathing practices and the methods adopted to keep the baby warm immediately after birth; explore the beliefs that guide these customs and practices; identify the barriers and facilitating factors in adopting healthy newborn care practices, such as skin-to-skin contact (STSC); and identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of newborn care practices. Barriers included misconceptions about the consequences of bathing a newborn and a lack of awareness among mothers and health workers about STSC. Facilitating factors included contact …

Une Bonne Surveillance De La Grossesse Pour Préparer L'Accouchement, Population Council

Reproductive Health

This brief reports on a situation analysis conducted to provide basic information to help Senegal’s SMNI/PF/PALU program identify priority intervention areas or readjust the interventions originally proposed. More specifically, the analysis aimed to assist in the development of the integrated RH service package to be implemented at the service delivery points and to develop the training resources needed for capacity-building among providers and for the organization of services. The analysis recommends: dissemination of new procedures and protocols and orientation of providers, with a view to improving implementation; providing supervision and post-training follow-up of providers; and orienting providers to the systematic …

Community Mobilization For Postabortion Care In Kenya: Baseline Evaluation Report, Chi-Chi Undie, Saumya Ramarao

Reproductive Health

Maternal health complications, including those arising from unsafe abortion and miscarriage, are a leading cause of morbidity among women in Kenya. These realities necessitate interventions to prevent unintended or unwanted pregnancies and to ensure access to quality care for women with postabortion complications. In response to this need, the RESPOND Project designed an intervention package aimed at increasing awareness and use of postabortion care (PAC) services and improving family planning, reproductive health, and maternal health outcomes. As part of the intervention, RESPOND works with districts and communities to: strengthen service delivery points to provide PAC services; conduct community mobilization to …

Evaluation Of Hiv Counseling And Testing In Anc Settings And Adherence To Short Course Antiretroviral Prophylaxis For Pmtct In Francistown, Botswana, Carolyn Baek, Tracy Creek, Lee Ann Jones, Louis Apicella, Jennifer Redner, Naomi Rutenberg

HIV and AIDS

The vast majority of children infected with HIV are the result of mother-to-child transmission (MTCT) of the virus during pregnancy, labor, or breastfeeding. Botswana is one of the first countries in the developing world with a national prevention program (PMTCT) to reduce vertical transmission. The Horizons Program of the Population Council, in collaboration with the Centers for Disease Control and Prevention (CDC) and Premiere Personnel in Botswana, conducted an evaluation to describe the adherence of pregnant women to the current PMTCT regimen. The report recommends standardizing post-test counseling content through the use of job aids and adapting existing WHO materials, …

Being (Becoming Empowered In Nursing Growth): Training Guide For Nursing Students On Sexuality And Gender, Maryann Washington

Reproductive Health

This training guide was produced as part of a Health and Population Innovation Fellowship administered by the Population Council, India, and aims to help the faculty of nursing students to deliver comprehensive sexuality education effectively and efficiently, to help trainee nurses see the whole picture of sexuality in its matrix of safety, pleasure, reproduction, illness, and health. The package is called ‘BEING’ (acronym for Becoming Empowered in Nursing Growth) as it is assumed that, if delivered well, it could empower nurses’ growth to address these issues.

Exploring The Lives Of Youth In The Bpo Sector: Findings From A Study In Gurgaon, Monisha Vaid

Reproductive Health

This report seeks to fill gaps in information on the lives of unmarried youth in the business process outsourcing (BPO) sector in India. Specifically, it documents young people’s self-efficacy and their connections with their family and peers, as well as their sexual experiences and substance use practices. The findings presented in this report reiterate the fact that BPO employment not only provides young adults with a profitable and challenging work environment, but also has other positive outcomes: many young BPO employees associated their increased independence and self-efficacy to their employment in this sector, many reported close peer networks, and many …

Assessment Of Risk Factors For Hiv Infection Among Men Who Have Sex With Men In The Metropolitan Area Of Campinas City, Brazil, Using Respondent-Driven Sampling, Maeve De Mello, Adriana De Araujo Pinho, Magda Chinaglia, Waimar Tun, Aristides Barbosa Junior, Maria Cristina, F.J. Ilario, Paulo Reis, Regina C.S. Salles, Suzanne Westman, Juan Diaz

HIV and AIDS

The Population Council, in collaboration with the Brazil Ministry of Health, the Municipal Program of STD/AIDS of Campinas, and the US Centers for Disease Control and Prevention/Global AIDS Program/Brazil, conducted a study to characterize the sociodemographic, behavioral, and environmental factors associated with subgroups of MSM who are most at risk for HIV infection. This research is the first Brazilian study to provide population-based estimates for HIV, syphilis, and HIV-related risk behaviors using an innovative sampling technique to reach members of the target population. Our data suggest the importance for HIV prevention programs to address not only sexual risk reduction, but …

Is It Feasible To Integrate Alcohol-Related Risk Reduction Counseling Into Vct Services? Findings From Kenya, Caroline Mackenzie, Karusa Kiragu, George Odingo, Rukia Yassin, Peter Shikuku, Patrick Angala, Nduku Kilonzo, William Sinkele, Melania Akinyi

HIV and AIDS

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the …

Promoting Gender Equity As A Strategy To Reduce Hiv Risk And Gender-Based Violence Among Young Men In India, Ravi K. Verma, Julie Pulerwitz, Vaishali Sharma Mahendra, Sujata Khandekar, A.K. Singh, S.S. Das, Sunil Mehra, Anita Nura, Gary Barker

HIV and AIDS

The Horizons Program, CORO for Literacy, MAMTA, and Instituto Promundo developed, piloted, and scaled-up a behavior-change intervention in India to examine the effectiveness of interventions to improve young men’s attitudes toward gender roles and sexual relationships, and to reduce HIV risk behaviors and partner violence. The results of this study suggest that young men became less supportive of inequitable gender norms after participating in the interventions. Similarly, there were significant improvements among intervention participants in key outcome indicators, including condom use, partner communication, partner violence, and attitudes toward PLHIV. To maximize the chances of long-term sustainability of these positive changes, …

Catalyzing Personal And Social Change Around Gender, Sexuality, And Hiv: Impact Evaluation Of Puntos De Encuentro´S Communication Strategy In Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Propiciando Cambio Personal Y Social Alrededor Del Género, Sexualidad Y Vih: Evaluación De Impacto De La Estrategia De Comunicación De Puntos De Encuentro En Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Caring For Caregivers: An Hiv/Aids Workplace Intervention For Hospital Staff In Zambia—Evaluation Results, Karusa Kiragu, Mutinta Nyumbu, Thabale J. Ngulube, Panganani Njobvu, Chilufya Mwaba, Arthur Kalimbwe, Spike Bradford

HIV and AIDS

The Horizons Program collaborated on a Caring for Caregivers initiative in Zambia whose objective was to develop and test a risk-reduction workplace program for hospital staff. This was motivated by the recognition that hospital workers are often overlooked in HIV programming, and yet many are infected or affected by HIV. It was also motivated by the fact that hospital staff are heterogeneous, with both clinical and non-clinical staff having varying levels of understanding regarding HIV transmission. Caring for Caregivers was a peer education program targeted at hospital staff and implemented in two hospitals in Zambia, with a combined staff of …

Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan

HIV and AIDS

This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction …

Improving Hospital-Based Quality Of Care In Vietnam By Reducing Hiv-Related Stigma And Discrimination, Khuat Thi Hai Oanh, Kim Ashburn, Julie Pulerwitz, Jessica Ogden, Laura Nyblade

HIV and AIDS

To address HIV-related stigma and discrimination, and improve the quality of care in the healthcare setting in Vietnam, the Institute for Social and Development Studies, the International Center for Research on Women, and the Horizons Program conducted intervention research in four hospitals. The study team conceptualized two fundamental causes of HIV-related stigma: 1) fear of casual transmission; and 2) negative values/social judgments and associations between HIV and certain behaviors and groups, such as sex workers and injecting drug users. Both intervention strategies successfully reduced stigma and discrimination toward HIV-positive patients in these healthcare settings. The findings show that addressing stigma …

Assessment Of Risk Factors For Hiv Infection In Female Sex Workers And Men Who Have Sex With Men In Ciudad Del Este, Paraguay, Magda Chinaglia, Waimar Tun, Maeve Mello, Magdalena Insfran, Juan Diaz

HIV and AIDS

Research conducted by the Population Council/Brazil, supported by the USAID-funded Horizons Project, documents findings from a study in Paraguay among men who have sex with men and female sex workers to estimate HIV and syphilis prevalence; examine knowledge, attitudes, and risk behaviors related to HIV and STIs; and describe the contextual and behavioral factors influencing HIV and STI transmission. Findings provide guidance to the development of HIV and STI prevention and care interventions and further operations research to test strategies and interventions to reduce the spread of HIV and STIs in these groups.

School As A Workplace In Kenya: Evaluation Of The Teachers Matter Hiv/Aids Project, Karusa Kiragu, Caroline Mackenzie, Jennifer Weiss, Murungaru Kimani, Debbie Gachuhi

HIV and AIDS

The Horizons program of the Population Council embarked on an operations research initiative in Kenya to test the feasibility of implementing a teacher-centered workplace program based in schools. The study was conducted in partnership with the Ministry of Education, the Kenya Institute of Education, the Teachers Service Commission, and UNICEF. Called Teachers Matter, the project’s main audience was primary and secondary school teachers. The purpose of the research was to assess whether such a program would improve teachers’ HIV-related knowledge, attitudes, and behaviors; increase the proportion of teachers seeking voluntary testing and counseling; and enhance their ability to cope with …

Informed Consent In Hiv Prevention Trials: Highlights From An International Workshop, Population Council

HIV and AIDS

Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Consentement Éclairé Dans Les Essais De Prévention Du Vih: Points Saillants D'Un Atelier International, Population Council

HIV and AIDS

Résumé adapté du rapport de l'atelier co-organisé par le Population Council et Family Health International en mai 2005. Le résumé se concentre spécifiquement sur les outils et stratégies présentés lors de l'atelier qui sont utilisés dans les essais de prévention du VIH pour faciliter le consentement éclairé, expliquer concepts difficiles et évaluer la compréhension parmi les participants à l'essai. Des exemples illustratifs d'essais achevés et en cours sont mis en évidence. Ce résumé sera utile à un public de chercheurs locaux, d'avocats et de membres du personnel des essais cliniques.

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Brief adapted from the report of a workshop co-hosted …

Moving Forward: Tackling Stigma In A Tanzanian Community, Laura Nyblade, Kerry Macquarrie, Gideon Kwesigabo, Aparna Jain, Lusajo Kajula, Fausta Philip, William Henerico Tibesigwa, Jessie K. Mbwambo

HIV and AIDS

The International Center for Research on Women, the Muhimbili University College of the Health Sciences, the Population Council, and Family Health International conducted an evaluation of a community-based effort to reduce stigma surrounding HIV infections in a peri-urban community in Tanzania. Results presented a mixed, but hopeful, picture for a way forward in tackling stigma at the community level. Tackling stigma requires that the individuals tasked with doing this undergo personal change. Programs can start by focusing stigma-reduction efforts on a smaller, more manageable geographical area and adding specific anti-stigma components to their portfolio of activities. Engaging community opinion leaders …