Women's Health Commons^™

Availability, Use And Quality Of Care For Medical Abortion Services In Private Facilities In Kenya, Wilson Liambila, Francis Obare, Edward Ikiugu, Vitalis Akora, Jesse Njunguru, Michael Njuma, Kate Reiss, Harriet Birungi

Reproductive Health

The overall goal of this study was to generate evidence on the availability, use, and quality of care for medical abortion services in private facilities (pharmacies and clinics) in Kenya. With the passing of a new constitution in 2010, there was renewed interest in the right to health and the need to reduce the high levels of maternal morbidity and mortality arising from unsafe abortion in the country. In spite of recent developments, there is limited understanding of the extent to which the changes have influenced the provision of medical abortion information and services in the country, the acceptability of …

Understanding The Reproductive Health Needs Of Adolescents In Selected Slums In Ghana: A Public Health Assessment, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew

Reproductive Health

Over the past decade, adolescent sexual and reproductive health (ASRH) concerns have increasingly been on the development agenda of the government of Ghana. This concern has been driven by such factors as early age of sexual debut, early childbearing, and prevalence of HIV/AIDS among this subgroup of the population. The overall objective of the study was to generate evidence on the knowledge, perceptions, and practices regarding ASRH among slum communities in Ghana. The findings of the study indicate a need for intensifying efforts to inform and educate adolescents living in the slums about responsible and healthy attitudes toward sexuality, delaying …

Education Sector Response To Early And Unintended Pregnancy: A Review Of Country Experiences In Sub-Saharan Africa, Harriet Birungi, Chi-Chi Undie, Ian Mackenzie, Anne Katahoire, Francis Obare, Patricia Machawira

Reproductive Health

In Sub-Saharan Africa (SSA), early and unintended pregnancy leads to a colossal loss of educational opportunities for girls. Existing studies that show associations between early/unintended pregnancy and school dropout lead to critical questions about how the education sector is responding to the issue in SSA. Conducted from August 2014 to April 2015, this review was devoted to an examination of such responses across six countries: Botswana, Kenya, Malawi, Tanzania, Uganda, and Zambia. The review focused on several key issues, including: education-sector policies for pregnant students and adolescent mothers; integration of pregnancy prevention into sexuality education curricula; the school environment as …

Fertility Transitions In Kenya And Ghana: Trends, Determinants And Implications For Policy And Programs, Ian Askew, Baker Ndugga Maggwa, Francis Onyango

Reproductive Health

The literature on fertility transitions in the sub-Saharan Africa region suggests that an early transition was observed across nearly all age groups, socioeconomic groups, and countries. This workshop report analyzes fertility transitions in Ghana and Kenya which are influenced by a multiplicity of factors, with marked similarities and differences between each country. Paradoxically, these analyses and critiques of policy and programming experiences suggest that, if enabling women and couples to achieve their wanted fertility rates within a rights-based approach that reduces inequities as well as reducing TFR toward replacement level are the goals of a national family planning program, then …

Strengthening School Health Programming In Nairobi City County, Joyce Mumah

Reproductive Health

No abstract provided.

Fertility Transitions In Kenya And Ghana: Trends, Determinants And Implications For Policy And Programs, Ian Askew, Baker Ndugga Maggwa, Francis Onyango

Reproductive Health

No abstract provided.

How Does Quality Of Care Relate To A Rights-Based Approach To Family Planning Programs?, Jan Kumar

Reproductive Health

Quality of care has long been a pillar of health care in general and family planning programs in particular. However, the theme has been getting less attention in recent years and its meaning has gotten blurred, confusing the discourse and what it is donors and governments should invest in and monitor. This paper compares definitions of quality and contrasts them with the essentials of a rights-based approach. It aims to create common understanding of what these terms mean, where they overlap, and how they differ. In its conclusion, this paper argues in favor of adopting the broader construct of rights-based …

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 …

Srh And Hiv Service Integration And Stigma, Integra Initiative

Reproductive Health

Stigma is frequently faced by people living with HIV and those who they are associated with, and is frequently followed by discrimination. 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 School of Hygiene & Tropical Medicine and the Population Council. Issue 3 of the series explores the experience of stigma among clients living with HIV in a variety of settings, both service-based (when seeking family planning, antenatal, and postnatal care services) and facility-based …

Cost And Technical Efficiency Of Integrated Hiv And Srh Services In Kenya And Swaziland, Integra Initiative

Reproductive Health

Policymakers and researchers have long hypothesized the potential benefits of integrating HIV prevention, treatment, and care with sexual and reproductive health (SRH) services in settings with generalized HIV epidemics. In addition to improving health and social outcomes, integration of services holds the promise of increasing efficiency of service delivery and maximizing health care resources. Economic theory suggests several potential efficiency advantages at the service and programmatic levels. However, evidence on the unit cost and efficiency gains associated with integration remains scarce. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings …

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: Review Of Postpartum And Postnatal Care Programs In Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku

Reproductive Health

Postpartum family planning is a major component of postpartum care services. The Population Council is working to introduce an additional method of contraception in Nigeria—the Progesterone Contraceptive Vaginal Ring (PCVR). The PCVR is administered vaginally but acts systemically to inhibit ovulation. The PCVR contains natural progesterone and is meant for breastfeeding women to augment lactational amenorrhea. As the Council conducts a series of activities as a prelude to eventual introduction of the PCVR in sub-Saharan Africa, including Nigeria, the detailed evaluation of the postpartum program environment is very important. Understanding the prevailing postpartum and postnatal care landscapes will be crucial …

Delivering Contraceptive Vaginal Rings: Review Of Postpartum Service Packages In Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time, yet this is the most neglected period for the coverage and provision of quality care. The building blocks of the WHO health systems model were applied in describing the status and health system structures that support the provision of postpartum and postnatal care (PNC) services in Kenya. Many opportunities exist for facilitating the delivery of the Population Council’s Progesterone Contraceptive Vaginal Rings (PCVR) within PNC services in Kenya, such as integration with other primary health care …

Emerging Priorities In Reproductive, Maternal, And Newborn Health, Population Council

Reproductive Health

The Population Council’s Ending Eclampsia project 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. Ending Eclampsia is working in Nigeria and Bangladesh to assess the level of program activities, gaps, and challenges around prevention and treatment of PE/E and magnesium sulfate (MgSO4). The project will build upon this landscape analysis to expand services to detect and manage PE/E, develop and support implementation of strategic plans for replicating the intervention package, and increase global PE/E evidence shared through knowledge and learning platforms. …

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 Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council

Reproductive Health

Fear of disrespect and abuse along with misconceptions about procedures required to assist women during childbirth often negatively influence the decision to seek care at a health facility. Maternity Open Days provide an opportunity for pregnant women and their families to interact with health care providers and visit maternity units to demystify birthing practices and mitigate fears regarding childbirth in a facility. Such an approach brings together women, their families, and providers to enable pregnant women to understand what happens in a maternity unit. This brief is part of a Respectful Maternity Care Resource Package developed by the Kenya Heshima …

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 …

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 …

Summary Report Of The Measuring And Monitoring Quality Of Care Meeting, Population Council

Reproductive Health

At the request of the Packard Foundation, the Population Council organized a meeting at its office in Washington, DC, on December 16, 2014, to establish links with key stakeholders interested in quality of care, and to refocus attention on challenges in measuring and monitoring diverse dimensions of quality of care. Thirty experts from donor, service, and research organizations participated. This summary report, based on the deliberations at the meeting, is intended as a preamble to the formation of a community of practice for advancing quality of care agenda globally. The key message is that improved quality in service delivery is …

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 2: Rapport De Synthese, Fatou Mbow, Leslie Dubent, 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 …

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 …

Expanding Access To Rights-Based Family Planning: Activity Brief, The Evidence Project

Reproductive Health

The human rights dimensions of family planning programs have been recognized for nearly half a century and affirmed in numerous declarations, conventions, and treaties endorsed by governments and the international community. While discourse about respecting, protecting, and fulfilling these rights is growing, a gap persists between human rights rhetoric and integrating rights in family planning policy, programs, and practice. Governments and programs struggle with defining and operationalizing a rights-based approach to family planning. Overall, there is scant evidence on: how to implement rights-based family planning (RBFP) programming, how to measure rights-based programming and outcomes, and the effect on family planning/reproductive …

Reducing Maternal And Child Mortality In Sindh: 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 Population Council/Evidence Project policy brief explains why FP must be prioritized in Sindh, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. Evidence shows that FP is one of the most powerful tools at the government’s disposal for a rapid reduction in maternal, infant, and child mortality. FP’s wider health benefits include reduced anemia among women; lower …

Reducing Maternal And Child Mortality In Khyber Pakhtunkhwa: 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 Population Council/Evidence Project policy brief explains why family planning must be prioritized in Khyber Pakhtunkhwa, 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 37 percent of maternal deaths and 57 percent of infant deaths. FP’s wider health benefits include reduced …

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 …

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 …

Impact Of A Community-Based Perinatal And Newborn Preventive Care Package On Perinatal And Neonatal Mortality In A Remote Mountainous District In Northern Pakistan, Zahid Memon, Gul N Khan, Sajid Bashir Soofi, Imam Y Baig, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: There is limited evidence from community-based interventions to guide the development of effective maternal, perinatal and newborn care practices and services in developing countries. We evaluated the impact of a low-cost package of community-based interventions implemented through government sector lady health workers (LHWs) and community health workers (CHWs) of a NGO namely Aga Khan Health Services on perinatal and neonatal outcomes in a sub-population of the remote mountainous district of Gilgit, Northern Pakistan.
Methods: The package was evaluated using quasi experimental design included promotion of antenatal care, adequate nutrition, skilled delivery and healthy newborn care practices. Control areas …

Bridging Evidence, Policy, And Practice To Strengthen Health Systems For Improved Maternal And Newborn Health In Pakistan, Atsumi Hirose, Sarah Hall, Zahid Memon, Julia Hussein

Centre of Excellence in Women and Child Health

Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. …

Improving Birth Outcomes: Women’S Oral Health Project, Dilem Polat

Master's Projects and Capstones

Improving Birth Outcomes: Women’s Oral Health Project is a new project housed within the Child Health and Disability Prevention, CHDP Program. The main goal of the project is to improve the birth outcomes of high-risk pregnant women and their children, by educating participants within the Maternal Child and Adolescent Health Section at the San Francisco Department of Public Health. The educational component will focus on the importance of oral health and the impact of oral disease on perinatal health. Following the educational component, referrals for appropriate dentists will be provided for participants to they may begin improving their oral health. …