Women's Health Commons^™

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Ebonyi, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Nigeria’s Ebonyi State found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Ebonyi. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Katsina, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Nigeria’s Katsina State found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Katsina. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Uganda, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Uganda found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Uganda. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and counseling, but …

Results From Systematic Literature Review On Pe/E In Bangladesh, Karen Kirk, Amy Dempsey

Reproductive Health

By 2015, at the conclusion of the Millennium Development Goals, Bangladesh had achieved a reduction in maternal death from 550 per 100,000 live births in 1990, to 170 maternal deaths per 100,000 live births in 2015. Despite this progress, there are still between 5,000 and 6,000 maternal deaths every year in Bangladesh, where 20 percent are the result of pre-eclampsia and eclampsia (PE/E). This systematic review of peer-reviewed literature published between January 2000 and July 2016 identified interventions adopted to manage PE/E throughout Bangladesh. Specifically, it looked at issues around quality of care, gaps in the evidence, and barriers to …

Results From Systematic Literature Review On Pe/E In Nigeria, Amy Dempsey, Karen Kirk

Reproductive Health

Pre-eclampsia and eclampsia (PE/E), hypertensive disorders of pregnancy, are consistently cited as a leading cause of maternal and newborn morbidity and mortality in Nigeria. A recent, nationwide cross-sectional survey found that PE/E contributes to 28.2 percent of national maternal deaths. The other main contributors to maternal mortality are hemorrhage and pregnancy-related infection or sepsis. To fully understand the key challenges, gaps, and interventions related to the prevention and treatment of PE/E, the Ending Eclampsia project conducted a systematic review of papers on PE/E in Nigeria published between 2000–15. The methods, results, and recommendations are discussed in this brief.

Workplace Health And The Garment Sector In Cambodia, Bunmey Yat, Carolyn Rodehau, David Wofford, Ashish Bajracharya

Reproductive Health

In Cambodia, there has been considerable investment in improving the well-being of factory workers. Understanding the key stakeholders and their roles in improving worker health is essential for policy change and ensuring that interventions achieve sustainable, long-term impact in and around the workplace. This policy brief presents selected findings from a stakeholder and situational analysis undertaken by the Cambodia Worker Health Coalition (WorkerHealth) to understand the stakeholder landscape and policy environment for women’s health in the garment industry in Cambodia, with the objective of identifying leading stakeholders and their relationships, as well as strategies and opportunities for collaboration. Collaboration and …

Uganda Retail Audit: Analysis And Report, The Evidence Project

Reproductive Health

This brief presents results of a retail audit, carried out in January 2016, that was commissioned as part of PATH’s work under the USAID-funded Evidence Project to conduct a landscape assessment of the feasibility of a Total Market Approach (TMA) in Uganda. This project also involved key informant interviews with stakeholders on their attitudes toward TMA principles and the collection of a Uganda Market Research Summary of existing family planning knowledge. The approach is based on an understanding that equitably meeting the diverse needs of different population segments requires increased coordination across sectors, including the public, private for-profit, and not-for-profit …

Cervical Cancer Infrastructure, Knowledge And Attitudes In Kabale, Uganda, Nicole Robertson

Posters-at-the-Capitol

Cervical Cancer Infrastructure, Knowledge and Attitudes in Kabale, Uganda

Nicole Robertson¹, ShaCoria Winston², Kara Miller³, Julia Hanebrink⁴

¹University of Louisville ²Washington University in St. Louis ³University of California Riverside ⁴Christian Brothers University, Department of Anthropology

Cervical cancer has increasing prevalence in southwestern Uganda and is the most common cancer among women in sub-Saharan Africa. Despite this increased prevalence, the biomedical infrastructure in Uganda lacks support for cervical cancer screening and treatment. At the same time, cervical cancer carries a stigma as an incurable sexually transmitted disease similar to the …

Breast Is Best: Determinants Of Breastfeeding In Bali, Leah Hardenbergh

Independent Study Project (ISP) Collection

Breastfeeding greatly benefits the health of newborns, providing them with needed antibodies and protection from numerous diseases, including some of the leading causes of infant mortality. This paper explores breastfeeding practices in Bali, and the wide array of factors that have led to these practices. After discussing how breastfeeding fits into the larger context of maternal and newborn health, I explain factors in Bali that affect a woman’s decision to breastfeed and experience while breastfeeding. Determinants include those related to health, financial position, and social status. I explore the history of formula companies and formula as an alternative to breastmilk, …

The Road Into The Future Of Health Care: The Importance Of Addressing Access To Health Facilities In Transportation Infrastructure Investment Decisions, Nicola (Nikki) Van Den Heever

Independent Study Project (ISP) Collection

Background: One school of thought argues that transportation infrastructure is not an ultimate end goal of development and therefore shouldn’t be addressed within development funding decisions while the other argues that transportation infrastructure is the crucial foundation from which all development efforts are based and therefore needs to be addressed within development funding decisions. Within this framework, there is a lack of academic and other research addressing how physical access to health care for pregnant women can better be addressed when making decisions regarding funding of transportation infrastructure projects.

Purpose: To demonstrate the importance of considering access to health care …

Predictors Of Infant Age At Enrollment In Early Infant Diagnosis Services In Kenya., Kathy Goggin, Catherine Wexler, Niaman Nazir, Vincent S. Staggs, Brad Gautney, Vincent Okoth, Samoel A Khamadi, Andrea Ruff, Michael Sweat, An-Lin Cheng, Sarah Finocchario-Kessler

Manuscripts, Articles, Book Chapters and Other Papers

Despite the importance of early detection to signal lifesaving treatment initiation for HIV+ infants, early infant diagnosis (EID) services have received considerably less attention than other aspects of prevention of mother to child transmission care. This study draws on baseline data from an on-going cluster randomized study of an intervention to improve EID services at six government hospitals across Kenya. Two logistic regressions examined potential predictors of "on time" (infant ≤6 weeks of age) vs. "late" (≥7 weeks) and "on time" versus "very late" (≥12 weeks) EID engagement among 756 mother-infant pairs. A quarter of the infants failed to get …

Sociodemographic And Geospatial Correlates Of Stillbirths And Neonatal Mortality In Indonesia (1993–2007), Alka Dev

Dissertations, Theses, and Capstone Projects

Little research has focused on the determinants of stillbirth and neonatal mortality in Indonesia despite the fact that the country has one of the highest rates of stillbirths in the world and one of the highest rates of neonatal mortality in Asia. Several areas have not been explored due to data limitations, such as shared risk factors and measurement challenges, which can inform health policy and interventions and guide future research. This dissertation addresses this gap by comparing measurement challenges for stillbirth and neonatal mortality and identifying risk factors for both using Indonesian reproductive health survey data. Differences in estimates …

Hiv Risk And Psychological Distress Among Female Entertainment Workers In Cambodia: A Cross-Sectional Study, Carinne M. Brody, Pheak Chhoun, Sovannary Tuot, Khuondyla Pal, Siyan Yi

Background: In Cambodia, there has been an increase in entertainment work as a result of the breakdown of the traditional brothel-based sex industry, presenting new challenges to addressing the health issues and needs of people working in the entertainment industry. This study aims to identify factors associated with psychological distress among female entertainment workers (FEWs) in Cambodia.

Methods: A two-stage cluster sampling method was used to randomly select 657 FEWs from entertainment establishments in Phnom Penh and Siem Reap in April and May 2014 for interviews using a structured questionnaire. Psychological distress was measured using the General Health …

Are Text Messages A Feasible And Acceptable Way To Reach Female Entertainment Workers In Cambodia With Health Messages? A Cross-Sectional Phone Survey, Carinne M. Brody, Sukhmani Dhaliwal, Sovannary Tuot, Michael Johnson, Khuondyla Pal, Siyan Yi

Background: Despite great achievements in reducing the prevalence of HIV, eliminating new HIV infections remains a challenge in Cambodia. Entertainment venues such as restaurants, karaoke bars, beer gardens, cafes, pubs, and massage parlors are now considered important venues for HIV prevention efforts and other health outreach interventions.

Objective: The purpose of this study was to explore phone use and texting practices of female entertainment workers (FEWs) in order to determine if text messaging is a feasible and acceptable way to link FEWs to health services.

Methods: This cross-sectional phone survey was conducted in May 2015 with 97 …

Addressing Intimate Partner Violence And Power In Relationships In Hiv Testing Services: Results Of An Intervention Piloted In Nairobi, Kenya, Nicole Haberland, Charity Ndwiga, Katharine Mccarthy, Margaret Makanyengo, Rose Kosgei, Cecilia Choi, Julie Pulerwitz, Sam Kalibala

HIV and AIDS

The overarching goal of this study was to pilot an approach to HIV testing services (HTS) that addresses intimate partner violence (IPV) and sexual relationship power (SRP) inequalities, and explores the intervention’s potential for improving uptake and retention of antiretroviral therapy and prevention of mother-to-child transmission services. The project was implemented in Kenyatta National Hospital’s (KNH) antenatal care (ANC) clinic, and examined intermediate indicators of effect, as well as operational issues around incorporating attention to IPV in hospital procedures, especially in high-volume, high-need settings like KNH’s. The findings from this study suggest that providing some minimal IPV/SRP counseling to all …

Barriers To Fistula Repair In Nigeria: A Formative Study, Population Council

Reproductive Health

A formative research study was conducted in Nigeria to better understand the barriers and enabling factors for fistula repair care delivery and access. This brief presents results from a literature review conducted to identify and understand the delays in accessing and receiving treatment and corresponding barriers, to document interventions that help to overcome barriers, and to specify gaps in the literature that require further research. The report concludes that women’s concern over healing and reintegration reflects their expectation that the holistic approach of hospitals will bring them back to normal life incorporating physical, sexual, psychosocial, and economic rehabilitation. Awareness, financial, …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Sukkur, Population Council

Reproductive Health

This district profile of Sukkur is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities, pharmacies, and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The …

Formative Research On Factors Influencing Access To Fistula Care And Treatment In Uganda, Pooja Sripad, Charlotte E. Warren

Reproductive Health

This formative research builds upon the results of a systematic review by the Population Council for better understanding of the barriers and enabling factors for fistula repair care and access in Uganda. The study focuses on Fistula Care Plus project-supported treatment facilities where fistula camps are routinely held. Results reveal the nuances of women’s experiences, along with the additional perspectives of their spouses, family members, community stakeholders, and fistula camp care providers including nurses/counselors, surgeons, and facility and district managers. Barriers and enablers to fistula repair care are clustered around the following factors: psychosocial, cultural, social, financial, transportation, facility shortages, …

Abriendo Oportunidades Para Alcanzar Mi Plan De Vida: Programa De 5 Meses—14 A 18 Años, Cecilia Garcés, Paola Broll

Poverty, Gender, and Youth

Esta es la guía curricular del programa Abriendo Oportunidades del Population Council de Guatemala. Este programa de cinco meses ayuda a las niñas a desarrollar pasos para lograr su plan de vida, en módulos sobre los temas siguientes: llevarse bien con otras mujeres; conocerse y valorarse a sí mismo; autoestima; derechos humanos; aprendiendo a ser mujer; la fertilidad y el embarazo; reconociendo el peligro; y la importancia del ahorro.

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This is the curriculum guide for the Abriendo Oportunidades program of the Population Council of Guatemala. This five-month program helps girls develop steps to achieve their life plan, in modules …

Adolescent Girls Empowerment Programme: Research And Evaluation Mid-Term Technical Report—Executive Summary, Karen Austrian, Paul C. Hewett, Erica Soler-Hampejsek, Fiammetta Bozzani, Jere R. Behrman, Jean Digitale

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Programme (AGEP) was an ambitious project directed toward changing girls’ lives in a significant and meaningful way across areas of education, sexual and reproductive health, marriage and fertility, and experience of violence. This Executive Summary of the project’s findings shows that, overall, the AGEP cohort data, and lessons they have generated from the AGEP are rich, nuanced, and important for informing the next generation of programs for adolescents in Zambia and elsewhere. Even though the study is still under way, and the full longer-term effects of AGEP remain to be seen, the information presented in this …

Adolescent Girls Empowerment Programme: Research And Evaluation Mid-Term Technical Report, Karen Austrian, Paul C. Hewett, Erica Soler-Hampejsek, Fiammetta Bozzani, Jere R. Behrman, Jean Digitale

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Programme (AGEP) was a social, health, and economic asset-building program targeting vulnerable adolescent girls aged 10–19. The Population Council, in partnership with the Young Women’s Christian Association of Zambia, successfully implemented the AGEP program from late 2013 to early 2016. The results presented in this midterm report have implications for recommendations on future programming for adolescent girls in Zambia and elsewhere and should be coupled with burgeoning evidence from AGEP and the literature to adapt programming for vulnerable adolescent girls in order to improve impact. While the underlying root causes of girls’ vulnerabilities are interrelated, it …

Adolescent Girls Initiative-Kenya: Qualitative Report, Eunice N. Muthengi, Karen Austrian, Amanda Landrian, Benta Abuya, Joyce Mumah, Caroline W. Kabiru

Poverty, Gender, and Youth

The Adolescent Girls Initiative-Kenya (AGI-K) is currently delivering multisectoral interventions, targeting violence prevention, education, health, and wealth creation, to adolescent girls aged 11–14 in two marginalized areas of Kenya. This report provides a brief overview of the research design and intervention components being delivered in AGI-K, and presents findings from the first round of qualitative data collection intended to highlight the strengths and weaknesses of the implementation processes thus far. The findings provide important information about the perceived effects of the program from a diverse set of respondents. Overall, beneficiaries, their parents/guardians, and other key stakeholders value the program and …

Adolescent Sexual And Reproductive Health Situation: Insights From The 2014 Kenya Demographic And Health Survey, Francis Obare, George Odwe, Harriet Birungi

Reproductive Health

The 2015 Kenya National Adolescent Sexual and Reproductive Health Policy recognized the importance of addressing adolescent sexual and reproductive health (SRH) needs for achieving the country’s development goals. Although estimates from the 2014 Kenya Demographic and Health Survey (DHS) show the country registered improvements in key reproductive, maternal, and child health outcomes, adolescent outcomes likely remain poor given the challenges associated with adequately addressing their sexual and reproductive health needs. This report presents findings of further analysis of the 2014 Kenya DHS on key SRH outcomes among adolescent girls and boys 15 to 19 years old in Kenya. Understanding the …

Développer Les Compétences De Protection Des Filles: Ensemble D’Outils Pour La Conception D’Un Programme, Population Council

Poverty, Gender, and Youth

Les adolescentes sont devenues une population cible clé pour les initiatives d'autonomisation, de santé et de développement dans les pays en développement. Cette collection d’outils est destinée aux organisations qui se sont engagées à étendre leurs programmes pour atteindre les sous-catégories de filles et jeunes femmes exclues: les filles les plus pauvres dans les communautés les plus pauvres; les filles âgées de 10 à 14 ans non scolarisées et n’habitant pas avec leur père ou leur mère; ou d’autres sous-catégories de jeunes filles qui sont tout simplement susceptibles d’être laissées pour compte. Cet ensemble contient des outils et des exercices …

Boîte À Outils: Renforcement Des Compétences, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

Grâce à un processus appelé «conception intentionnelle», les outils d’apprentissage du Population Council aident à centraliser les besoins des filles. Ces outils s'appuient sur des preuves de la nécessité de maintenir les filles en bonne santé, de les intégrer socialement et de les préparer économiquement. La boîte à outils Renforcement des Compétences du Population Council aide les praticiens, les décideurs et les défenseurs à élaborer un contenu adapté, significatif et positif pour aider des sous-populations spécifiques de filles. La boîte à outils guide les praticiens à travers une série d'étapes qui doivent être suivies pour définir des cibles de bon …

Abriendo Oportunidades Para Alcanzar Mi Plan De Vida: Programa De 5 Meses—8 A 13 Años, Cecilia Garcés

Poverty, Gender, and Youth

Esta es la guía curricular del programa Abriendo Oportunidades del Population Council de Guatemala. Esta guía es para niñas de 8 a 13 años. Este programa de cinco meses ayuda a las niñas a desarrollar pasos para lograr su plan de vida, en módulos sobre los temas siguientes: llevarse bien con otras niñas; conocerse y valorarse a sí mismo; autoestima; derechos humanos; aprendiendo a ser mujer; la fertilidad y el embarazo; reconociendo el peligro; y la importancia del ahorro.

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This is the curriculum guide for the Abriendo Oportunidades program of the Population Council of Guatemala. This guide is for …

Adolescent Girls Empowerment Program (Agep): Savings Account, Population Council

Poverty, Gender, and Youth

Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners implemented a social, health, and economic asset-building program for over 10,000 vulnerable adolescent girls aged 10–19 years in Zambia. The AGEP intervention was comprised of three major components: 1) safe spaces groups in which girls met once a week over the course of two years for training on sexual and reproductive health, life skills, and financial education; 2) a health voucher that girls could use at contracted private and public facilities for a package of general wellness and sexual and reproductive health services; and 3) a savings account …

Adolescent Girls Empowerment Programme In Zambia: Qualitative Evaluation Report, Zoe Duby, Chipo Natasha Zulu, Karen Austrian

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) reaches over 10,000 vulnerable girls 10–19 years old in five urban and five rural sites spread across four provinces in Zambia. The program works to build adolescent girls’ social, health, and economic assets, providing them with key skills and opportunities to help them transition from adolescence to adulthood in a healthy way. This report presents these valuable insight into the views and experiences of girls who were involved in the AGEP program, as well as the perceptions of program mentors, the girls’ parents, and community leaders. In addition, these findings highlight the areas in …

Addressing Adolescent Girls' Vulnerability To Hiv/Aids: Lessons From The Meri Life Meri Choice Project, Sunil Mehra, Rajesh R. Singh, Vandana Nair, K.G. Santhya, A.J. Francis Zavier

Poverty, Gender, and Youth

This report details findings from an assessment of the Meri Life Meri Choice (MLMC) project in India, implemented by MAMTA—Health Institute for Mother and Child, with the support of the Elton John AIDS Foundation. The MLMC project sought to reduce the vulnerability of rural adolescent girls to HIV by enhancing their knowledge about sexual and reproductive matters and equipping them with skills that enable them to address vulnerability to HIV; increasing their utilization of sexual and reproductive health services from the public sector; and developing a supportive environment that enables adolescent girls to adopt protective actions to reduce vulnerability to …

Building Girls' Protective Assets: A Collection Of Tools For Program Design, Population Council

Poverty, Gender, and Youth

Adolescent girls have become a key target population for empowerment, health, and development initiatives in low- and middle-income countries. This collection of tools is intended for organizations that are committed to extending their programs to reach excluded subpopulations of girls and young women—whether they are the poorest girls in the poorest communities, the 10–14-year-old girls who are out of school and not living with either parent, or another subpopulation of young girls who are likely to miss out. The collection contains tools and exercises to help programmers translate evidence on “what works” into girl-centered programming. The resources in this collection …