Women's Health Commons^™

Distribution D'Anneaux Vaginaux Contraceptifs, Population Council

Reproductive Health

Dans le cadre de son projet “Distribution d’anneaux vaginaux contraceptifs”, le Population Council a conclu un accord de coopération avec l’USAID pour introduire deux nouvelles méthodes contraceptives modernes sur les marchés en développement: l’anneau vaginal contraceptif à progestérone, un anneau contraceptif d’une durée d’action de trois mois spécifiquement conçu pour espacer les grossesses durant l’allaitement; et un anneau vaginal contraceptif expérimental d’une durée d’utilisation d’un an—l’anneau vaginal contraceptif Nestorone®/ethinyl estradiol—qui peut être utilisé par les femmes sexuellement actives en âge de reproduction (15 à 49 ans) pour retarder ou espacer les grossesses. Le Population Council vise à élargir le choix …

Proposed Indicators To Measure Adherence To And Effects Of Rights-Based Family Planning: Resource Guide, Kelsey Wright, Karen Hardee

Reproductive Health

At the London Summit on Family Planning in 2012, the goal of expanding access to FP programs by 120 million additional women and girls by 2020 was established. This goal calls attention to the need for FP information and services to be delivered in ways that are voluntary and respect human rights. While human rights have been codified and affirmed in declarations, conventions, and treaties, operationalizing rights in FP programs is still in an early stage of development. With the recent emergence of global numeric benchmarks for FP programs, there is the risk that the focus will move away from …

Willingness To Pay For Contraceptive Vaginal Rings In Senegal, Babacar Mane, Fatou Mbow, Deepa Rajamani, Nafissatou Diop, Saumya Ramarao

Reproductive Health

Contraceptive vaginal rings are an innovative category of products that have not been introduced into any sub-Saharan African country. As a result, there is little experience to guide the introductory pricing for the PVR and the one-year NES/EE CVR when it becomes available. The evidence generated by this consumer willingness to pay, and provider/procurer study has shed light on critical aspects of PVR introduction in Senegal. In general, the results generated here complement and reinforce findings from an acceptability study of the PVR and stakeholder discussions that have been occurring over the past three years. Results confirm that contraceptive vaginal …

Are Parents Talking To Adolescents About Sexuality? Evidence From Four Slums In Ghana, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew

Reproductive Health

This evidence brief summarizes the essential information from a part of a larger study that assessed the sexual and reproductive health (SRH) needs of adolescents in four slums in two regions of Ghana. The objective of this brief is to provide evidence to support and facilitate the improvement of parent–adolescent communication on sexuality. This study echoes several other studies by providing evidence that a majority of parents are not opposed to in-school sex education for their children and welcome the idea of empowering themselves (parents) to have productive discussions with their children. Nevertheless, there is a mismatch between the proportion …

Comprendre Les Grossesses Non Désirées Au Sénégal : Rapport Du Profil Pays [Compte Rendu De L’Atelier De Dissémination Des Résultats Auprès Des Parlementaires], Babacar Mane, Bocar Mamadou Daff, Marie-Jesus Buabey, Abdelylah Lakssir

Reproductive Health

En partenariat avec le Ministère de la Santé et de l'Action Sociale et l’initiative Partners in Population and Development, le bureau du Population Council—Sénégal a organisé une rencontre avec des membres de l’Assemblée Nationale et d’autres acteurs locaux clés pour diffuser les résultats du rapport de l’étude sur le profil pays menée dans le cadre du projet de recherche "Strengthening Evidence for Programming on Unintended Pregnancy” plus connu sous l’acronyme “STEP UP.” A l’issue de la réunion, les recommandations ont été formulées concernant la législation, le renforcement des capacités et la prise en charge des problèmes de santé de la …

Conceptualizing And Measuring Unintended Pregnancy And Birth: Moving The Field Forward, Population Council

Reproductive Health

Given the complexity of conceptualizing and measuring unintended pregnancy, STEP UP convened an expert group meeting in Accra, Ghana with the objectives of contributing to a clearer understanding and agreed-upon definition of unintended pregnancy; reviewing existing approaches to the conceptualization and measurement of unintended pregnancy; drawing from existing approaches to propose and draft indicators, metrics, data collection instruments, and analysis strategies for measuring and tracking unintended pregnancy through multiple data collection procedures; and identifying challenges and opportunities for communicating evidence on unintended pregnancy and informing policy, planning, and investment decisions. Following presentations and discussions on these issues, participants reviewed the …

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …

Promoting Respectful Maternity Care Resource Package—Implementing Respectful Maternity Care In Kenya, Population Council

Reproductive Health

The Respectful Maternity Care (RMC) Resource Package was developed by the Heshima project as part of the USAID Translating Research into Action (TRAction) project. The resource package is designed to be used by program managers, supervisors, trainers, technical advisors, and others who organize or facilitate RMC training workshops on sexual and reproductive health as well as skills training in emergency obstetric and newborn care. The resource package provides experienced facilitators with background information, materials, instructions, and tips for promoting respectful care in reproductive, maternal, and newborn health services in both facilities and communities. The resource package also includes tools for …

Strengthening The Role Of Patent Medicine Vendors In The Provision Of Injectable Contraception In Nigeria, Population Council, The Evidence Project

Reproductive Health

The majority of contraceptive services in Nigeria are offered in private settings, including Patent Medicine (PM) shops. PM shops are informal businesses owned by Patent Medicine Vendors (PMVs) licensed to sell patent or proprietary drugs. Injectable contraception is the most popular modern contraceptive method in Nigeria. However PMVs are not regulated to sell or administer injectable contraceptives because the businesses do not receive formal training. Despite this, some PMVs are selling and administering injectable methods in response to high demand. The Evidence Project, in collaboration with the Federal Ministry of Health, conducted implementation research to: demonstrate the feasibility of PMVs …

Peer Mentoring: An Effective Strategy For Integrating Hiv And Srh Services, Integra Initiative

Reproductive Health

Mentoring is an innovative approach to improving provider skills without compromising service delivery by harnessing the potential of existing providers. In Kenya, a peer-mentorship approach was designed and tested to improve service providers’ skills, knowledge, and capacity to provide high-quality integrated HIV and SRH services. A central component was to understand providers’ opinions on mentoring, so as to build a practical and sustainable mentorship model. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London …

Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative

Reproductive Health

At the end of 2013, an estimated 35 million people were living with HIV, and sub-Saharan Africa was disproportionately affected. With major efforts directed at expanding access to life-saving antiretroviral therapy in sub-Saharan Africa, many people are living longer with HIV, leading productive and sexually active lives. Unintended pregnancies and the potential of vertical transmission are some of the challenges faced by women living with HIV. Understanding the fertility preferences and reproductive decisions of these women is vital for informing efforts to enable them to achieve these desires effectively and safely. The “Steps to Integration” series provides a guide on …

Delivering Contraceptive Vaginal Rings—Task Sharing In The Delivery Of Family Planning Programs: Experiences From Senegal, Babacar Mane, Nafissatou Diop, Saumya Ramarao

Reproductive Health

The Population Council is conducting activities to facilitate the introduction of vaginal rings in sub-Saharan Africa. This report notes that the first ring to be introduced will be the Council’s Progesterone Contraceptive Vaginal Ring (PCVR), which is relevant in contexts where women practice prolonged lactation. The PCVR will also address the high unmet need for family planning (FP), especially for postpartum women. The Council aims to expand the availability and affordability of vaginal rings in Kenya, Nigeria, and Senegal. One of the challenges is the lack of skilled providers. To design plans for involving mid- and lower-level health workers in …

An Innovative Financing Model For The Progesterone Contraceptive Vaginal Ring Through Voucher Programs, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

This technical report introduces the theoretical framework for the demand generation and supply chain mechanisms for an effective reproductive health voucher system. The key roles and functions of an effective voucher system are described. A methodology for implementation of a voucher system for the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR), also referred to as the PCVR Voucher Based Care (VBC) program, has been designed to introduce the PCVR in the context of choice, equity in price, and range of outlets, ensuring quality of care and consistent availability of services. The model provides a framework and guidelines on how the …

Promoting Respectful Maternity Care Resource Package—Alternative Dispute Resolution: Resolving Incidents Of Disrespect And Abuse, Population Council

Reproductive Health

Alternative Dispute Resolution (ADR) is a process whereby an independent and impartial third party facilitates negotiation between disputing parties, in this case to resolve incidents of disrespect and abuse (D&A) in a health care setting. In Kenya, ADR was originally used to settle land disputes and inheritance issues at the community level. The voluntary ADR mechanism brings the aggrieved parties together with an opportunity to solve problems in a locally acceptable way. ADR supports both providers’ and clients’ rights and obligations by ensuring each side is heard. This Respectful Maternity Care (RMC) resource provides guidance on the sequence of steps …

Promoting Respectful Maternity Care Resource Package—Debriefing Sessions: Caring For The Carers, Population Council

Reproductive Health

Caring for the Carers is an activity aimed at reducing work-related stress—a major driver of disrespect and abuse (D&A) during facility-based childbirth. Pregnancy, labor, and delivery are expected to be joyous moments for the mother, her family, and the service providers. However, this is not always the case due to maternal complications or even death. Maternity units often have high workloads. This, coupled with lack of professional support for staff and providers, and poor governance and leadership, may lead to work-related stress. These critical incidents can accumulate and contribute to staff stress and emotional exhaustion, which ultimately prevents provision of …

Landscape Analysis Of Pre-Eclampsia/Eclampsia In Nigeria, Charlotte E. Warren, Salisu Mohammed Ishaku, Ayodeji Oginni, Gloria Adoyi, Karen Kirk, Amy Dempsey

Reproductive Health

The Population Council’s Ending Eclampsia project, with support from USAID, seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. The Council conducted a landscape analysis on PE/E in Nigeria in 2015. Its main objectives were to understand the level of programmatic and policy support for PE/E prevention and treatment; to analyze gaps in providers’ competence to prevent, detect, and manage PE/E; to determine capacity at primary health facilities to manage PE/E; to assess community awareness, beliefs, and experiences around PE/E; to understand …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Facilitator’S Guide, Population Council

Reproductive Health

This training guide was produced by the Population Council as part of the Respectful Maternity Care (RMC) Resource Package developed by the Kenya Heshima Project. The Heshima Project, as part of the USAID Translating Research into Action (TRAction) project, was tasked with determining the manifestations, types, and prevalence of disrespect and abuse (D&A) in childbirth; identifying and exploring the potential drivers of D&A; and designing, implementing, monitoring, and evaluating the impact of interventions for reducing D&A including generating lessons for scale-up. The Resource Package is based on the most effective interventions, and provides practical, low-cost, and easily adaptable strategies for …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Partie 1: Revue Documentaire, Leslie Dubent, Fatou Mbow, Nafissatou Diop, Fatou Ndiaye Turpin, Bocar Mamadou Daff, Babacar Mane

Reproductive Health

Le Plan d’Action National de Planification Familiale 2012–15 (PANPF 2012–15) du Sénégal est basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où le PANPF 2012–15 arrivait à terme, et qu’un nouveau plan était élaboré, le Population Council a mené une étude pour documenter la mise en œuvre et les réalisations de l’Approche 3D en relation avec le PANPF. Cette étude documente l’Approche 3D en relation avec le PANPF à travers une revue documentaire et une recherche qualitative. Elle décrit les leçons apprises de sa mise en œuvre et partage les bonnes pratiques que d’autres pays pourraient adopter, en particulier …

Reducing Maternal And Child Mortality In Balochistan: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This brief explains why FP must be prioritized in Balochistan, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 41 percent of maternal deaths, 35 percent of infant deaths, and 74 percent of young child deaths. FP’s wider health benefits include reduced …

Family Planning Vouchers To Improve Delivery And Uptake Of Contraception In Low And Middle Income Countries: A Systematic Review, Benjamin Bellows, Ashish Bajracharya, Carol Bulaya, Sophie Inambwae

Reproductive Health

Family planning vouchers have provided accessible and quality reproductive health services to the poor and have been critical to countries in making progress in achieving Millennium Development Goal 5. Increased utilization of contraception allows for birth spacing, decreases unintended pregnancy, and results in healthier mothers and families. Strategies to improve utilization through targeted subsidies in low- and middle income countries (LMICs) have not been fully documented in a systematic review of the literature. This study report summarizes the effect of voucher systems for contraceptive services on socioeconomic and demographic indicators in LMICs. A systematic review of unpublished reports and published …

Gender Considerations Along The Hiv Treatment Cascade: An Evidence Review With Priority Actions, Melanie Croce-Galis, Jill Gay, Karen Hardee, What Works Association, Population Council

Reproductive Health

This treatment brief provides policymakers and program implementers with evidence about the impact of gender dynamics on treatment access and adherence and the gender-related gaps in treatment research and programming. It also includes priority actions that can be taken to better address gender within treatment programming and raises questions for implementation science in order to achieve the global 90-90-90 goal. This brief draws from What Works for Women and Girls: Evidence for HIV Interventions and uses the WHO treatment cascade framework to identify and analyze major gender considerations in providing antiretroviral therapy to those living with HIV in low- and …

Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, The Evidence Project

Reproductive Health

In 2008, the Government of India launched the National Health Insurance program, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in urban and rural areas to access a range of private health services. Enrolled families can access packages of services from RSBY-participating private hospitals, including family planning (FP) and other reproductive health (RH) services. Despite the availability of insurance coverage, poor families’ utilization of RSBY for FP/RH services is believed to be negligible. The Evidence Project is conducting a study in three cities in Uttar Pradesh to better understand the factors affecting utilization of RSBY …

Rights-Based Family Planning: 10 Resources To Guide Programming, Jan Kumar, Karen Hardee

Reproductive Health

The FP2020 goal of providing FP services to 120 million more women and girls that emerged from the 2012 London Summit on Family Planning refocused attention on the need to ensure that FP programs respect, protect, and fulfill human rights. The current challenge is how to operationalize human rights in existing FP programs and new projects. This resource guide reviews ten key resources available to guide programming—FP2020: Rights and Empowerment Principles for Family Planning; Ensuring Human Rights in the Provision of Contraceptive Information and Services, Ensuring Human Rights Within Contraceptive Service Delivery: Implementation Guide; Voluntary Family Planning Programs that Respect, …

Progesterone Vaginal Ring: A Call-To-Action To Fill Critical Gaps In Post-Partum Family Planning, Population Council

Reproductive Health

The progesterone vaginal ring (PVR) is a safe and effective method of contraception for lactating women. It is a priority medicine on the WHO’s Essential Medicines List and is included in the Medical Eligibility Criteria for family planning providers. Developed by the Population Council, the PVR is an intravaginal ring that provides women who breastfeed at least four times a day with a contraceptive option as early as four weeks after giving birth. The PVR provides a new option to reduce unmet need among new mothers, allow women to safely space their pregnancies, and improve the health of women and …

Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend

Reproductive Health

Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …

Anneau Vaginal À Progestérone: Évite Les Grossesses, Population Council

Reproductive Health

Cette fiche de renseignements fournit des informations sur l’utilisation de l’anneau contraceptif vaginal à la progestérone pour prévenir la grossesse. L'anneau vaginal à progestérone (AVP) offre une nouvelle manière de fournir un moyen de contraception. Il a été prouvé qu'il s'agit d'une méthode contraceptive sûre et efficace pour les femmes qui allaitent. Utilisé par ces femmes, l'AVP évite les grossesses en inhibant la croissance folliculaire et, par conséquent, empêchant l'ovulation; renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation; étendant l'aménorrhée post-partum; et épaississant la glaire cervicale, et donc en empêchant les spermatozoïdes d'atteindre l'ovule. L'AVP donc étend la gamme …

Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. The PVR was first registered in Chile and Peru in 1998 for use by postpartum women and has since been expanded to other Latin American countries. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Nigeria as part of a larger project that was also conducted in Kenya …

Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council

Reproductive Health

Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.

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This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …

Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Kenya as part of a larger project that was also conducted in Nigeria and Senegal. The specific objectives of the study were to assess the factors influencing the acceptability of the method among clients, their spouses, providers, community members, …

Progesterone Vaginal Ring: Prevents Pregnancy, Population Council

Reproductive Health

This fact sheet provides information about how the progesterone vaginal contraceptive ring works to prevent pregnancy. The progesterone vaginal ring (PVR) offers a novel way of delivering safe and effective contraceptives for lactating women. When used by such women it prevents pregnancy by inhibiting follicular growth, hence preventing ovulation; reinforcing the inhibitory effect of breastfeeding on ovulation; extending postpartum amenorrhea; and thickening the cervical mucus, thus inhibiting sperm from meeting the egg. The PVR expands the range of contraceptives available to lactating women and has the potential to contribute to improving maternal and infant health.