Women's Health Commons^™

Enquête Sur La Contraception D'Urgence (Cu) Au Niveau Des Pharmacies, Nafissatou J. Diop, Babacar Mane, Ousseynou Faye, Cheikh Ibrahima Niang, Thiaba Thiaw, Aissatou Sano Coly, Fatou Mbow, Youmane Niang Faye

Reproductive Health

No abstract provided.

Operational Research For The Introduction Of An Adolescent Health Package In The Context Of Cervical Cancer Prevention, Marieke G. Van Dijk, Katherine Wilson, Claudia Diaz, Sandra G. Garcia

Reproductive Health

This report provides findings from a WHO/PAHO/UNFPA meeting that took place in Mexico City in 2009. Participants discussed a proposed operational research study on adolescent health and cervical cancer prevention that would help support countries that have already made or will soon make a policy decision to introduce the HPV vaccine. Adolescents typically have little contact with health services, particularly for immunization programs. Since new HPV vaccines target adolescent girls, the introduction of HPV vaccines may provide an opportunity for adolescents to engage more with health services and this may create openings to offer packages of adolescent health services that …

Mainstreaming Ec In Africa: The Ec Facilitative Re-Granting Program—Final Narrative Report, Jill Keesbury, Wilson Liambila, Youmane Niang Faye, Victoria Rumbold

Reproductive Health

Since 2006, ECafrique has been working to build the capacity of African nongovernmental organizations to design, implement, and evaluate successful emergency contraception (EC) mainstreaming projects. Through a process of “facilitative regranting,” ECafrique annually awarded nine grants ranging from $25,000 to $30,000 to organizations from across Anglophone and Francophone Africa. The program’s objectives were to increase access to EC across Africa by supporting projects intended to introduce, scale up, or mainstream the method, and build the capacity of African NGOs to design, implement, and evaluate successful EC mainstreaming projects. Each grantee participated in an international proposal development workshop and received individualized …

Special Needs Of In-School Hiv Positive Young People In Uganda, Francis Obare, Harriet Birungi, Anne Katahoire, Hannington Nkayivu, Aggrey David Kibenge

Reproductive Health

Since 2006, the Population Council has pioneered operations research in collaboration with local partners in Uganda to promote the sexual and reproductive health and rights of young people aged 10–19 years infected with HIV. Key findings show that many young people perinatally infected with HIV want to be in school to avoid social isolation, and about 70 percent of them attend school. However, there has been limited understanding of how the education sector should support this vulnerable group of learners. The objective of this study was to explore the special needs of HIV-positive young people in primary and secondary schools …

Standards Required In Maintaining The Chain Of Evidence In The Context Of Post Rape Care Services: Findings Of A Study Conducted In Kenya, Carol Ajema, Emily Rogena, Hadley Muchela, Buluma Bwire, Nduku Kilonzo

Reproductive Health

Sexual violence (SV) is a serious societal problem that creates significant challenges to local communities in their attempt to create an overall plan for meeting the medical, emotional, physical safety, and legal needs of SV survivors. It is important to understand the existing links between the health sector and police as a basis for addressing the complexities surrounding SV. Appropriate management of SV survivors requires a standardized clinical evaluation, an effective interface with law enforcement for the handling of forensic evidence, and coordination of the continuum of care. From the public health perspective, the issues to be addressed revolve around …

Improving The Health Care Response To Gender-Based Violence: Phase Ii, Meiwita P. Budiharsana, Mai Quoc Tung

Reproductive Health

In 2009, the Population Council/Vietnam in collaboration with the Hanoi Health Service carried out an evaluation survey among Duc Giang Hospital staff to assess the extent to which awareness and perceptions of gender-based violence (GBV) had changed since the project commenced in 2005. The survey also assessed the extent to which the response of the hospital and Women’s Center for Counseling and Health had been strengthened, and made recommendations on changes to improve the situation. Overall, this project has been effective in raising awareness and willingness to integrate GBV screening into health services. The project conducted its training program at …

Manual For Designing Community Based Interventions For Preventing Postpartum Hemorrhage (Pph) Using Misoprostol: Standardized Pilot-Test Training Manual, Saumya Ramarao, Tekle-Ab Mekbib, Sarah Raifman

Reproductive Health

This manual is a comprehensive, standardized, step-by-step guide for Population Council staff to use when designing and implementing community-based pilot interventions for the prevention of postpartum hemorrhage using misoprostol. The introduction and background section provide basic information about maternal mortality, normal and abnormal pregnancy, and postpartum hemorrhage. This section also describes prevailing methods of prevention and treatment for postpartum hemorrhage, active management of the third stage of labor, and use of misoprostol for the prevention and control of postpartum hemorrhage. The second half of the manual focuses on how to develop a protocol for an intervention study on misoprostol. It …

Sexual Violence: Setting The Research Agenda For Kenya, Catherine Maternowska, Jill Keesbury, Nduku Kilonzo

Reproductive Health

This research agenda is the result of a stakeholders’ meeting held in Nairobi on June 11–12, 2008, that identified, developed, and prioritized areas for research on sexual violence in Kenya. The meeting was convened by the Population Council, Liverpool VCT, Care & Treatment, and the International Centre of Reproductive Health, Kenya. Kenya’s research agenda is premised on the need to generate the evidence required to impact policy formulation and services strengthening. Knowledge gaps that form the basis of key research areas identified include the need to: 1) Understand the nature, contexts, and prevalence of sexual violence; 2) Document and evaluate …

Multi-Sectoral Approaches To Preventing Sexual Assault And Domestic Violence: A Collective Force To Stop The Violence, Population Council

Reproductive Health

The Multi-Sectoral Approaches to Preventing Sexual Assault and Domestic Violence Symposium took place May 6–7, 2009, in Gauteng, South Africa. The symposium aimed to: increase awareness of sexual assault and domestic violence and its relationship to HIV and AIDS among decision-makers; promote evidence-based programming for practitioners; advocate for increased preventative measures and service delivery around sexual and gender-based violence (SGBV) in the public and private sectors; facilitate networking, strengthen and develop partnerships, and create opportunities for ongoing collaboration between key stakeholders; and inspire a coordinated plan of action for prevention that supports the government’s 365-day plan. South Africa has some …

Ecp Handbook: Introducing And Mainstreaming The Provision Of Emergency Contraceptive Pills In Developing Countries, Sharif M.I. Hossain, M.E. Khan, Ricardo Vernon, Jill Keesbury, Ian Askew, John Townsend, Victoria Rumbold

Reproductive Health

For many women, emergency contraceptive pills (ECPs) offer an opportunity to prevent unintended pregnancy following contraceptive method failure, rape, or unprotected sex. Access to this safe, effective option remains an essential element of women’s quality reproductive health care. However, ECPs remain inaccessible across much of the world, particularly in developing countries where limited commodity supplies, provider competency, public awareness, and misinformation routinely coalesce to restrict availability. While ECPs have been introduced on a pilot basis in many countries, their effective integration into both the public and private sectors has lagged. Successful interventions are guided by the principle that provision of …

An Assessment Of Sexual And Gender Based Violence In Wajir District, North Eastern Kenya, Gladys K. Mwangi, Guyo W. Jaldesa

Reproductive Health

A 2006 baseline survey conducted by CARE Kenya indicated that sexual and gender-based violence (SGBV) is widespread throughout Kenya’s North Eastern Province. Other findings revealed that high levels of stigma and gender imbalances are associated with sexual violence and female genital mutilation (FGM) and that a coordinated approach to responding to the service needs of survivors is missing. As noted in this report, there is limited awareness of the legal mechanisms available to survivors. The Population Council’s study in Wajir District ascertained the need for and possible components of an integrated and comprehensive services model that could meet the needs …

Crude Birth Rates Among New York City’S Racial/Ethnic Groups And Latino Nationalities In 2002, Victoria Stone

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report analyzes crude birth rates among women in the three primary racial/ethnic groups, White, Black, and Latina, and further examines birth rates by age-specific groups in the five boroughs of New York City in 2002. In addition, this report presents the crude birth rates for six Latino nationalities: Mexican, Ecuadorian, Dominican, Colombian, Puerto Rican and Cuban.

Methods: The data examined here was derived from the NYC Vital Statistics 2002 Report and the Census 2000 SF4 table on Sex by Age by race and Latino nationality. The birth rates were calculated by dividing live birth numbers (Vital Statistics report) …

Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon

Reproductive Health

The first days, weeks, and months after a delivery represent a period of substantial information and service needs for both mother and child, including treatment of hemorrhage and infections, breastfeeding information and support, nutritional complements and micronutrients, immunizations for children and mothers, counseling for managing intimate partner violence and depression, and, most importantly, contraception. In areas of high HIV prevalence, contraceptives and antiretroviral therapy are especially critical elements of postpartum care. Yet despite its strategic importance, few organizations have made it a priority to address women's reproductive health and fertility needs during the year following delivery. The situation is compounded …

Manual For Building Capacity Of Trainers And Program Managers In Emergency Contraception, Sharif M.I. Hossain, M.E. Khan, Mary Philip Sebastian, Sohini Roychowdhury

Reproductive Health

This manual equips trainers with appropriate knowledge on emergency contraceptive pills (ECPs). Emergency contraception (EC) refers to any method of contraception that can be used by a woman to prevent an unwanted pregnancy within three days of unprotected intercourse or a contraceptive accident such as condom leakage. This manual discusses ECPs and the provision of related services. After a day’s training, trainers have the knowledge and skills necessary to train service providers and workers on ECPs. The manual is divided into four sessions. The first provides an overview of the demographic and reproductive health (RH) situation in South and South …

Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council

Reproductive Health

The World Health Organization recommends that women receive information on family planning (FP) during antenatal care (ANC), immediately after birth, and during postpartum and well-baby care. However, few studies have assessed the effect of information during each of these stages on women’s use of contraceptive methods. Data collected by FRONTIERS in the Dominican Republic, Haiti, and Nicaragua have been analyzed to answer this question. Use of maternal care services, exposure to FP information, and use of postpartum contraception varies among countries. All women interviewed in the Dominican Republic attended ANC services and delivered in a facility; ANC use and institutional …

Romance And Sex Before Marriage Among Young Women And Men In Maharashtra, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

Premarital partnerships among youth are widely discouraged in India. Indeed, there is a widespread perception that youth do not find opportunities to mix and form romantic relationships, and that premarital sex is negligible. These kinds of perceptions are often cited to argue against the provision of sexuality or family life education and sexual and reproductive health services to unmarried young people. While several small studies have noted that sizable proportions of young people, particularly young men, are sexually active before marriage, the lack of rigorous evidence on the levels and patterns of intimate partnerships among youth continues to hamper the …

Sexuality Education For Youth In Maharashtra: Yes Or No?, International Institute For Population Sciences (Iips)

Poverty, Gender, and Youth

Serious reservations have been expressed in Maharashtra about the sexuality component of programs intended to build awareness of safe and healthy behaviors for school-going youth. This policy brief answers: Is there a need for sexuality education in school and out-of-school in Maharashtra? Are the concerns expressed supported by evidence? Evidence was obtained from the Youth in India: Situation and Needs study conducted in Maharashtra, which explored young people’s awareness of sexual and reproductive matters, sexual experiences of youth, parent–child communication on sexual and reproductive matters, and experience and acceptability of sexuality education programs. Parents were asked whether they had discussed …

Female-Initiated Prevention Methods (Fipm) In Kenya: Focus On The Female Condom, Martha Brady

Poverty, Gender, and Youth

As noted in this brief, the female condom (FC) is the only female-initiated prevention product that provides simultaneous protection against pregnancy and sexually transmitted infections, including HIV. Although available for more than a decade, the FC remains limited in supply, not readily available, and underutilized. Obstacles to widespread availability and use are often generalized (e.g., high costs, resistance of partners, or unavailability). With the upcoming second generation of FCs—and ultimately microbicides—being added to female-initiated prevention methods, the need to overcome these impediments with concrete solutions is critical. Government and donor commitment to long-term, sustained supply and program support is essential. …

The Female Condom In Ghana: Exploring The Current State Of Affairs And Gauging Potential For Enhanced Promotion, Reshma Naik, Martha Brady

Poverty, Gender, and Youth

The female condom (FC) is the only safe and effective female-initiated method that provides simultaneous protection against unintended pregnancy as well as sexually transmitted infections, including HIV. An exploratory exercise was conducted by the Population Council to gain an understanding of the current and historical landscape of FC procurement, distribution, and programming in Ghana and to explore the viability of enhancing national FC promotion. The exercise revealed that a large-scale launch of the FC occurred in Ghana in 2000 and was largely successful in raising product awareness; however, uptake remained low. Momentum has waned since the initial launch and financial …

Evaluation Of The Long-Term Impact Of The Tostan Programme On The Abandonment Of Fgm/C And Early Marriage: Results From A Qualitative Study In Senegal, Nafissatou J. Diop, Amadou Moreau, Helene Benga

Reproductive Health

In 1998–99, a village empowerment program was implemented in the Thiès/Fatick and Kolda regions of Senegal by the nongovernmental organization Tostan, to mobilize communities to hold public declarations in support of abandoning harmful traditional practices, including female genital mutilation/cutting (FGM/C) and child marriage. The information presented in this report indicates that many did end the practices following a public declaration, however, the lack of follow-up in the field and the absence of support mechanisms pose a large obstacle. Nevertheless, the program achieved significant results: knowledge of life skills resulting in positive changes and a shift in the perception of FGM/C …

Analysis Of The Evolution Of The Practice Of Female Genital Mutilation/Cutting In Burkina Faso, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini

Reproductive Health

This study was undertaken as a collaboration between the Population Council’s Frontiers in Reproductive Health program and the Comité National de Lutte contre la Pratique de l’Excision (CNLPE) within the Ministry of Social Action and National Solidarity in Burkina Faso. The creation of a favorable environment for the campaign against excision in Burkina Faso has facilitated various anti-cutting activities over the past two decades and enabled the achievement of gains, both in terms of awareness and behavior change. However some of the strategies need further readjustment: among the reasons why excision still continues in Burkina Faso is a certain view …

South Africa: Integrated Approach Improves Quality Of Post-Rape Care, Population Council

Reproductive Health

In South Africa, an integrated model for post-rape care by nurses in a rural district hospital, which included a designated room for medical management and guidelines for providing reproductive health and HIV services, improved the quality of care provided. However, nurses remained reluctant to collect forensic evidence that could be used for prosecuting perpetrators. South Africa has developed a strong policy framework outlining medical management of rape survivors, which includes provision of HIV testing and post-exposure prophylaxis and emergency contraception, ideally within 72 hours. However, implementation has been hampered by numerous obstacles, both in health care infrastructure and policy, and …

Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council

Reproductive Health

A program to operationalize and institutionalize a gender perspective in reproductive health services in Bolivia resulted in a significant reduc­tion in unmet need for contraception, increased client satisfaction, and improved communication between partners. Bolivia’s Integral Health Coordination Program (PROCOSI) encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their RH programs. In 2005, FRONTIERS collaborated with PRO­COSI to test the feasibility and costs of a sys­tem for certifying that its member organizations provided gender-sensitive RH services. The two-year project followed a 2000 intervention to incorporate gender perspectives in PROCOSI clinics that led …

Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council

Reproductive Health

In 2006, FRONTIERS collaborated with the National Committee Against the Practice of FGM/C on an analysis of recent trends in female genital mutilation/circumcision (FGM/C) in rural and urban Burkina Faso. The study, conducted to help develop policies and programs for FGM/C abandonment in Burkina Faso and more widely in Africa, had three components: a description of the institutional, political, and programmatic environ­ment in Burkina; a secondary analysis of data from existing studies; and an assessment of the community’s perceptions and behavior regarding FGM/C, as well as the factors that contribute to abandonment or continuation of the practice. For the policy …

Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council

Reproductive Health

In 2004, FRONTIERS collaborated with UNICEF on a study of female genital mutilation/cutting (FGM/C) in Kenya’s Somali community and on ways of managing maternal care for cut women. The study showed that the health-care system in North Eastern Province, where many Somalis live, is ill prepared to deal with women who have been cut, particularly infibulated women who are pregnant or delivering. The study recommended improving providers’ ability to counsel and treat pregnant cut women as part of an overall improvement of maternal care, and strengthening providers’ role as behavior change agents within communities. In 2005, FRONTIERS launched an intervention …

Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council

Reproductive Health

Kenya and Malawi have developed national policies to prevent malaria in pregnancy. Measures to prevent malaria among antenatal clients were shown to be sustainable several years after pilot interventions ended. In Malawi, the approach has been expanded nationwide. In most malaria-endemic areas of Africa, women in their first and second pregnancies have the highest risk of acquiring malaria and, consequently, of malaria-associated anemia and low birth-weight. Two USAID-funded interventions aimed at strengthening the prevention and management of malaria in pregnancy were pilot-tested at the district level in Kenya (1998–2002) and Malawi (1998–2004). As noted in this brief, the goal was …

Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council

Reproductive Health

In 1998, the nongovernmental organization Tostan implemented a village empowerment program in southern and western Senegal to help communities, especially women, improve living and health conditions in their villages, and to mobilize villages to hold public declarations supporting abandonment of harmful practices, particularly female genital mutilation/cutting (FGM/C) and child marriage. The program included modules on hygiene, literacy and numeracy, human rights, and children’s and women’s health. The Tostan approach has since been implemented more broadly in Senegal and in Burkina Faso, Guinea, and Sudan. In 2005–06, FRONTIERS evaluated the long-term impact of the program, focusing on the abandonment of FGM/C …

Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi

Reproductive Health

In 2001, the World Health Organization issued guidance on a new model of antenatal care (ANC) called goal-oriented or focused antenatal care (FANC), for implementation in developing countries. The new model reduces the number of required antenatal visits to four, and provides focused services shown to improve maternal outcomes. FANC emphasizes helping women maintain normal pregnancies by identifying existing health conditions, detecting emerging complications, promoting health, preparing for a healthy birth, and educating clients on postpartum care including nutrition, breastfeeding, and family planning. Trials conducted in Argentina, Cuba, Saudi Arabia, and Thailand proved that FANC was safe and was a …

Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia

Reproductive Health

As in many developing countries, young people in Kenya and Senegal (aged 10–20) account for about 25 percent of the population. To ensure their future contribution to their countries, it is of vital strategic importance to safeguard their welfare. Rapid social change in both countries exposes youth to sexual and reproductive health (RH) risks, including unintended pregnancy, sexually transmitted infections including HIV, and sexual violence. Beginning in 1999, the Population Council’s FRONTIERS program conducted operations research studies that tested the feasibility, acceptability, and cost of a public-sector, multisectoral intervention to enhance young people’s RH knowledge and behavior. Study findings showed …

South Africa: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council

Reproductive Health

The South African government wishes to expand availability and use of counseling and testing (C&T) for HIV. One option is to integrate C&T into well-attended services, such as family planning (FP). In 2004, the Population Council began a three-year study with the Department of Health in North West Province. The study tested the feasibility, acceptability, and cost of two models for integrating HIV prevention services within established FP programs, and evaluated their quality against standard practice. In the testing-model clinics, providers provided C&T services at the same consultation; in the referral-model clinics, providers offered HIV counseling and referred clients to …