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Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols Jan 2002

Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols

Reproductive Health

In Indonesia, paternalistic models of health care, social distance between clients and service providers, and cultural norms discourage family planning clients from playing an active role in consultations. This report discusses the interventions needed to encourage clients to communicate more openly and more vigorously with providers. The study confirmed that educational interventions directed to family planning clients can help them become effective partners in their own care, assuming they meet with receptive providers. Communication interventions like Smart Patient complement and reinforce provider interpersonal communication and counseling training by giving clients the confidence and the skills to take advantage of increased …


Hiv Voluntary Counseling And Testing Among Youth Ages 14 To 21: Results From An Exploratory Study In Nairobi, Kenya, And Kampala And Masaka, Uganda, Horizons Program, Kenya Project Partners, Uganda Project Partners Jan 2001

Hiv Voluntary Counseling And Testing Among Youth Ages 14 To 21: Results From An Exploratory Study In Nairobi, Kenya, And Kampala And Masaka, Uganda, Horizons Program, Kenya Project Partners, Uganda Project Partners

HIV and AIDS

HIV voluntary counseling and testing (VCT) programs increase safe sexual behavior and use of care and support services among adults. By helping clients learn their HIV serostatus and creating a personalized HIV risk-reduction plan, VCT can provide the information and support necessary to change risky behaviors that could lead to HIV infection or transmission. Counseling and a risk-reduction plan are the key features distinguishing VCT from other HIV testing services. VCT has become a widely advocated HIV/AIDS prevention strategy among adults. Sixty percent of all new HIV infections in sub-Saharan Africa, however, occur among young people ages 10–24. Because few …


Transitions To Adulthood In The Context Of Aids In South Africa: Report Of Wave I, Naomi Rutenberg, Cathrien Kehus-Alons, Lisanne Brown, Kate Macintyre, Anthea Dallimore, Carol E. Kaufman Jan 2001

Transitions To Adulthood In The Context Of Aids In South Africa: Report Of Wave I, Naomi Rutenberg, Cathrien Kehus-Alons, Lisanne Brown, Kate Macintyre, Anthea Dallimore, Carol E. Kaufman

HIV and AIDS

This is a prospective study of reproductive behavior and sexual health of adolescents in South Africa as well as their education and employment experiences, family and environmental conditions, and other factors in their lives that may influence their sexual behavior and choices. This report is designed to inform educators, policymakers, and the public in South Africa and beyond of the initial findings of the study, with the ultimate goal of helping to design and refine policies and programs that will improve opportunities and capacities of adolescents and may contribute to changing behaviors and choices. The report focuses on describing the …


Prevention Of Trafficking And The Care And Support Of Trafficked Persons In The Context Of An Emerging Hiv/Aids Epidemic In Nepal, Celine Daly Jan 2001

Prevention Of Trafficking And The Care And Support Of Trafficked Persons In The Context Of An Emerging Hiv/Aids Epidemic In Nepal, Celine Daly

HIV and AIDS

This study is a collaborative effort between the Asia Foundation (Kathmandu) and the Horizons project of the Population Council (New Delhi) to document the current intervention models and community-based study of human trafficking in the context of an emerging HIV/AIDS epidemic in Nepal. To address the human rights component of trafficking, the three components of this study focus on the rights and needs of trafficked persons as well as those who are vulnerable to trafficking. An analysis and assessment of the effectiveness of laws, policies, and interventions in the apprehension, prosecution, and conviction of alleged traffickers is not included in …


Acceptability Of The Female Condom After A Social Marketing Campaign In Campinas, Brazil, Horizons Program Jan 2001

Acceptability Of The Female Condom After A Social Marketing Campaign In Campinas, Brazil, Horizons Program

HIV and AIDS

The female condom is a relatively new product that is intended to serve the dual role of protecting against unwanted pregnancy and sexually transmitted infections (STIs). Recent research has found moderate to high levels of initial trial and acceptance of the female condom among women. However, information is lacking about its continued use, particularly among women at high risk of HIV and other STIs. The female condom was registered in Brazil in January 1997 and since then has been available commercially through DKT, a social marketing organization. In addition to socially marketed female condoms, the Brazilian Ministry of Health has …


Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing Programs In Dar Es Salaam, Tanzania, Suzanne Maman, Jessie K. Mbwambo, Margaret Hogan, Gad P. Kilonzo, Michael D. Sweat, Ellen Weiss Jan 2001

Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing Programs In Dar Es Salaam, Tanzania, Suzanne Maman, Jessie K. Mbwambo, Margaret Hogan, Gad P. Kilonzo, Michael D. Sweat, Ellen Weiss

HIV and AIDS

This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Men and women both perceive HIV testing as a way to plan for the future but are motivated to undergo testing by a number of different individual, relationship, and environmental factors. The women in our study described more barriers to HIV testing than did men, and women who have communicated with their partners about VCT before seeking services are significantly more likely to share their HIV test results than those who have not talked with their …


Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah Jan 2001

Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah

Reproductive Health

With the reform movement in Indonesia, the FRONTIERS project recognized the new opportunities for influencing public debate and informing public opinion on reproductive health issues and undertook a project for disseminating the results of contemporary research on reproductive health. The project had three main objectives: 1) to increase print media coverage of critical reproductive health issues by enhancing journalists’ role as responsible communication agents; 2) to contribute to public debate on emerging reproductive health issues in order to influence policy development and guide program management; and 3) to increase public awareness of key health issues, with a particular focus on …


From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan Jan 2001

From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan

Poverty, Gender, and Youth

With access to safe, legal abortion under severe constraint or debate in many parts of the world, less attention has been paid to the issue of quality of abortion care. This issue of Quality/Calidad/Qualité explores two programs that operate in very different settings but with a shared commitment to providing high-quality abortion care in a context of broader reproductive health services: the Clinique d’Orthogénie of Broussais Hospital in France and Parivar Seva Sanstha in India. In both programs, each woman or girl who arrives for abortion receives crucial basic care, including: appropriate medical treatment to ensure complete abortion and safe …


Influencing Reproductive Health Policy And Programs In The Philippines: Implementing An Advocacy Model For Utilization Of Operations Research, Saniata Masulit, Marilou P. Costello, Sahar Hegazi Jan 2001

Influencing Reproductive Health Policy And Programs In The Philippines: Implementing An Advocacy Model For Utilization Of Operations Research, Saniata Masulit, Marilou P. Costello, Sahar Hegazi

Reproductive Health

This project tested a model of operations research (OR) dissemination and utilization targeting program managers in Mindanao, the second largest island of the Philippines. The model combines capacity-building with the use of innovative advocacy approaches to disseminate OR results, by creating a network of policy champions who will advocate the use of OR findings through a variety of strategies after they have been provided with information on the advocacy issue and their presentation skills enhanced. The project demonstrated that this type of network could lead to significant program changes, but also revealed that there is no single strategy or approach …


Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health Jan 2001

Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

In 1999, the Honduran Ministry of Health (MOH) revised national guidelines on women’s health services delivery to allow nurse auxiliaries to insert IUDs, give DMPA injections, and take Pap smears. This policy change addresses low contraceptive use among rural women and reflects findings from a 1998 Population Council study that showed that nurse auxiliaries can safely and successfully provide these services. Under the previous guidelines, rural women had limited access to long-term family planning methods. In 2000, the Population Council and the MOH assessed the effectiveness and cost of using a simple leaflet, distributed by nurse auxiliaries, to market the …


Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health Jan 2001

Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health

Reproductive Health

Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …


South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health Jan 2001

South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health

Reproductive Health

To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, …


Zambia: Peer Educators Can Promote Safer Sex Behaviors, Frontiers In Reproductive Health Jan 2001

Zambia: Peer Educators Can Promote Safer Sex Behaviors, Frontiers In Reproductive Health

Reproductive Health

Zambian adolescents are at high risk of unwanted pregnancy, sexually transmitted infections (STIs), and HIV infection due to early sexual initiation, low use of contraceptives and condoms, and other high-risk sexual behaviors. During 1996–1998, CARE Zambia and the Population Council conducted a study to test community-based approaches to improve adolescent sexual and reproductive health. CARE Zambia talked to adolescents in four communities outside Lusaka. Using participatory learning and action techniques, researchers identified factors leading to high-risk sexual behaviors, including lack of economic, recreational, and educational opportunities for youth. This information helped to design the study. Two interventions—condom distribution by peer …


Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa Jan 2001

Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa

Reproductive Health

The Hospital Roosevelt is Guatemala’s largest hospital, and serves as a referral and training facility for the entire country. Within the Hospital Roosevelt, the Department of Obstetrics and Gynecology established a Reproductive Health Unit (RHU) to offer family planning information and services to obstetrics inpatients and OB/GYN outpatient clients, and to serve as a training site for medical residents completing their OB/GYN rotations. Hospital administrators requested assistance from the Frontiers in Reproductive Health (FRONTIERS) program to help establish a fee schedule for the RHU, with the goal of paying its own personnel costs after one year of operation. The FRONTIERS …


Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar Jan 2001

Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar

Reproductive Health

The Honduran Ministry of Health (MOH) and the Population Council’s INOPAL III Project tested the acceptability of postpartum/postabortion contraception at the Escuela Hospital, the largest in the country. The project showed that more than 30 percent of the women seen for a delivery or a complication due to abortion, were interested in adopting a contraceptive method prior to discharge from the hospital. Given the success of the project, the MOH asked the Population Council’s FRONTIERS program for technical and financial support to extend those services to five additional hospitals in the country. Important improvements were found for the four indicators …


Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon Jan 2001

Promoting Reproductive Health Services In Rural Communities In Honduras, Irma Mendoza, Ricardo Vernon

Reproductive Health

Using the results of a previous operations research study, the Ministry of Health of Honduras recently changed the National Women’s Health Service Delivery Guidelines to explicitly authorize nurse auxiliaries to insert IUDs, deliver Depo-Provera, and take Pap smears. These services are new to the rural communities served by rural health centers (RHCs). The objective of this project was to test whether the demand for these newly introduced services would increase if a promotional brochure was distributed in the surrounding communities by the RHC’s clients among potentially interested friends in these communities. The study found that the intervention that was tested …


An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz Jan 2001

An Assessment Of The Zimbabwe National Family Planning Council's Community Based Distribution Programme, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Ronika Nyakauru, Barbara Janowitz

Reproductive Health

Since its inception, the Zimbabwe National Family Planning Council’s (ZNFPC) community-based distribution (CBD) program has made significant and well-documented contributions to the demand for and use of family planning in Zimbabwe. Data from several studies have shown, however, a steady decline in this contribution and that the CBD agents spend more time resupplying existing clients than recruiting new acceptors. Moreover, the CBD program urgently needs to be able to address the AIDS crisis in the country. ZNFPC has undertaken this review to guide it in making appropriate decisions about the future direction of the program, allowing CBDs to have a …


Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi Jan 2000

Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi

HIV and AIDS

A growing body of scientific publications suggests that male circumcision is associated with reduced risk of HIV infection in sub-Saharan Africa. Thus, male circumcision is being considered as a potential intervention in the prevention of sexually transmitted HIV infection, even though this procedure has profound cultural implications and carries the risk of complications, and its benefits are realized only many years later. This report presents the findings of a meeting of international researchers, organized by the Horizons Project to explore the programmatic and research implications of the association between male circumcision and HIV prevention. Most studies on male circumcision and …


Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi Jan 2000

Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi

Reproductive Health

Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also …


Women Street Vendors: The Road To Recognition, Monique Cohen Jan 2000

Women Street Vendors: The Road To Recognition, Monique Cohen

Poverty, Gender, and Youth

This issue of SEEDS explores the experience of women working and organizing as urban street vendors at a time when both the volume of demand and the number of vendors are expected to grow. As municipalities seek to change laws that affect how street vendors ply their trade, it is clear that vendors must have a seat at the table. Local-level organizational efforts need to be consolidated at the national level to cement vendors’ hard-earned gains as rights in national laws and policy. A 1995 meeting in Bellagio conceived an international alliance of street vendors—StreetNet—which aims to promote the exchange …


Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health Jan 2000

Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health

Reproductive Health

At the request of the Family Health Directorate of the Ministry of Health in Burkina Faso, the Reproductive Health Research Network (CRESAR) conducted a study during 1996–98 to introduce emergency care for women with complications from miscarriage or unsafe abortion. With technical assistance from the Population Council and JHPIEGO, CRESAR trained staff at two large hospitals in Ouagadougou and Bobo-Dioulasso to provide postabortion care (PAC). Training for physicians, nurses, and midwives covered manual vacuum aspiration, family planning methods, infection prevention, and communication with patients. Staff also participated in the development of policies and standards for PAC services. To measure changes …


Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health Jan 2000

Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, and …


Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health Jan 2000

Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health

Reproductive Health

Since 1990, the Nakuru Municipal Council (Kenya) has implemented a multifaceted program to reduce the incidence of reproductive tract infections (RTIs), especially those that are sexually transmitted, including HIV/AIDS. Staff in the Council’s five health clinics use syndromic management guidelines, based on clients’ reported symptoms and clinical signs, to identify clients with RTIs. In 1998, the Population Council conducted a study to assess the accuracy of syndromic management and determine the best ways to integrate RTI management into existing antenatal (ANC) and family planning (FP) services. After an assessment of existing RTI services, 18 nurses from the five municipal clinics …


Mali: Empower Health Workers To Advocate Against Female Genital Cutting, Frontiers In Reproductive Health Jan 2000

Mali: Empower Health Workers To Advocate Against Female Genital Cutting, Frontiers In Reproductive Health

Reproductive Health

The various initiatives to eradicate FGC in Mali over the past two decades have had little impact on this traditional practice. This study assessed the use of health personnel to combat FGC, as recommended by the World Health Organization. Conducted in 1998 by the Association de Soutien au Developpement des Activites de Population, a nongovernmental organization, and the Ministry of Health, the study covered 14 urban and rural health centers in Bamako and Segou. In the eight health centers that served as experimental sites, 59 health providers, including physicians, midwives, nurses, and aides, attended a three-day training course on identifying …


Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health Jan 2000

Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

The Population Council has supported a series of studies to improve the quality of postabortion care (PAC) in Egypt. A 1994 pilot study in two Egyptian hospitals showed that upgrading PAC and training physicians in manual vacuum aspiration (MVA), infection control, and counseling led to significant improvements in the care of postabortion patients. The 1997 study, conducted by the Egyptian Fertility Care Society with support from the Population Council, sought to institutionalize improved postabortion medical care and counseling procedures in ten hospitals. Five senior physicians from each hospital attended a five-day training course in MVA, infection control, and family planning …


Egypt: Ngos Need To Join Forces To End Fgc, Frontiers In Reproductive Health Jan 2000

Egypt: Ngos Need To Join Forces To End Fgc, Frontiers In Reproductive Health

Reproductive Health

Until recently, the practice of female genital cutting (FGC) has been nearly universal in Egypt. However, a 1998 national survey found the first signs of a decline in the practice among adolescents since 1994. Nongovernmental organizations (NGOs) working in community development, health, and women’s rights have played a leading role in advocating eradication of FGC in Egypt. To document and assess the impact of anti-FGC programs, the Population Council conducted an assessment from August 1999 to February 2000. Researchers telephoned numerous Egyptian NGOs to identify those most actively involved in anti-FGC programs. Then they conducted in-depth interviews with officials of …


Egypt: Encourage Journalists To Cover Reproductive Health, Frontiers In Reproductive Health Jan 2000

Egypt: Encourage Journalists To Cover Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

To raise public awareness of reproductive health (RH) issues, the Population Council’s Frontiers project and the Futures Group’s Policy project jointly organized four press briefings and provided background materials to key journalists from Arabic newspapers and magazines. From May 1999 to June 2000, project staff worked closely with 20 Egyptian journalists, including editors of women’s pages and senior editors. The press briefings covered youth, marriage patterns, contraceptive technology, and menopause. The press kit prepared for each briefing contained fact sheets, reference materials, a contact list of key experts, and an evaluation sheet. To assess RH reporting and track coverage resulting …


Mali: Fgc Excisors Persist Despite Entreaties, Frontiers In Reproductive Health Jan 2000

Mali: Fgc Excisors Persist Despite Entreaties, Frontiers In Reproductive Health

Reproductive Health

About 94 percent of Malian women aged 15–49 have experienced female genital cutting (FGC). In Mali, FGC is associated with serious gynecological and obstetric complications. In 1998, the National Center of Scientific and Technological Research of the Mali Ministry of Secondary and Higher Education and Scientific Research conducted an evaluation of programs to eradicate FGC. The study assessed the work of three national nongovernmental organizations working in Bamako and five regions of Mali. These NGOs had attempted to persuade traditional practitioners of FGC (“excisors”) to abandon the practice. All three NGOs employed outreach workers to educate excisors and community members …


Report On The International Symposium On Quality Of Care In China, Population Council Jan 2000

Report On The International Symposium On Quality Of Care In China, Population Council

Reproductive Health

In 1995, China’s State Family Planning Commission (SFPC), the governmental agency charged with developing and implementing China’s population policy, issued an official call for the reorientation of the family planning program from a focus on demographic targets to meeting clients’ needs. In support of this reorientation effort, the SFPC selected six rural counties and five urban districts with comparatively good socioeconomic conditions as pilot sites for a quality-of-care experiment. This report provides a summary of an international symposium on quality of care held in Beijing from November 17–19, 1999. The symposium was sponsored by SFPC with the support of the …


An Assessment Of The Community Based Distribution Programs In Ghana, Jane Chege, Diouratie Sanogo, Ian Askew, Angela Bannerman, Steve Grey, Evam Kofi Glover, Francis Yankey, Joana Nerquaye-Tetteh Jan 2000

An Assessment Of The Community Based Distribution Programs In Ghana, Jane Chege, Diouratie Sanogo, Ian Askew, Angela Bannerman, Steve Grey, Evam Kofi Glover, Francis Yankey, Joana Nerquaye-Tetteh

Reproductive Health

This study was carried out to describe the major NGO community-based distribution (CBD) programs in Ghana, and to assess in some detail the functioning, quality of care, and performance of the Planned Parenthood Association of Ghana (PPAG) program. The study showed that national coverage by the NGO programs is extensive—virtually all the 110 districts in the 10 regions have at least one program. However, coverage within districts is sparse, as each program covers only a few communities. The results have been communicated to the NGOs whose programs were included in the study and PPAG has already identified a number of …