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Population Council

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Quality of Care

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Full-Text Articles in Women's Health

Using Evidence To Improve Quality Of Pharmacy-Delivered Medical Abortion, Katharine Footman, Nancy Termini Lachance Jan 2018

Using Evidence To Improve Quality Of Pharmacy-Delivered Medical Abortion, Katharine Footman, Nancy Termini Lachance

Reproductive Health

The goal of family planning and reproductive health operations research is to generate evidence that helps policies and programs maximize access to and quality of services for women and their families. Yet the crucial step of ensuring the utilization of that evidence often receives inconsistent or inadequate attention. The goal of this case study is to document an activity of Marie Stopes International (MSI) in Kenya, part of the STEP UP research program consortium, which resulted in successful evidence utilization. STEP UP research on quality of care for medical abortion, particularly on pharmacy provision of medical abortion, has provided the …


Improving Family Planning Services In Public Health Facilities To Reach More Women, Caroline W. Kabiru, Jessica Brinton, Joyce Mumah, Carol Mukiira, Chimaraoke O. Izugbara Jan 2014

Improving Family Planning Services In Public Health Facilities To Reach More Women, Caroline W. Kabiru, Jessica Brinton, Joyce Mumah, Carol Mukiira, Chimaraoke O. Izugbara

Reproductive Health

Although Kenya has made significant progress in ensuring its citizens’ right to reproductive health, many Kenyans still lack access to or fail to use contraceptives, in part because of the lack of quality family planning (FP) services. Through the STEP UP research program, the African Population and Health Research Center developed a comprehensive country profile report that outlines the status, causes, and consequences of unintended pregnancy in Kenya. One of the most prominent findings was how important public health facilities are to reducing unmet need for FP. In order to solidify gains achieved and make further progress, concerted commitment from …


Reduce Contraception Discontinuation In Bangladesh By Improving Counseling On Side Effects, Fauzia Akhter Huda, Sabiha Chowdhuri Jan 2014

Reduce Contraception Discontinuation In Bangladesh By Improving Counseling On Side Effects, Fauzia Akhter Huda, Sabiha Chowdhuri

Reproductive Health

High rates of contraceptive discontinuation and method failure could cause Bangladesh to lose the progress made in increasing contraceptive use over the past 20 years. This policy brief concludes that if women are adequately counseled and supported to sustain their use of more effective contraceptive methods, they will need less medical attention, have fewer unintended pregnancies, and reduce the workload for medical clinics. Furthermore, if providers are adequately trained and supported in counseling and managing side effects and in helping women to switch methods when they do have a problem, the Family Planning Clinical Contraception Services Delivery Program would meet …


Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey Jan 2012

Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey

Reproductive Health

An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and …


Increasing Access To Family Planning And Reproductive Health Services Through Community Work: A Case Study Of A Dual Cadre Model In India, Jaleel Ahmad, Isha Bhatnagar, M.E. Khan Jan 2012

Increasing Access To Family Planning And Reproductive Health Services Through Community Work: A Case Study Of A Dual Cadre Model In India, Jaleel Ahmad, Isha Bhatnagar, M.E. Khan

Reproductive Health

Before the introduction of Accredited Social Health Activists (ASHAs) in India, mid-level auxiliary nurse midwives (ANMs) were responsible for community health education and services such as antenatal care, delivery, IUCD insertion, and sterilization referrals. The Population Council studied how community extension work and some primary care responsibilities have been shifted to ASHAs, who are tasked with identifying pregnant women; facilitating ANC check-ups; motivating women for institutional deliveries during ANC checkups; and organizing child immunization. Establishing dual worker cadres in India by shifting community extension tasks from ANMs to local ASHAs has been well conceived. Task shifting has allowed ANMs, as …


Increasing Access To Safe Abortion In Rural Maharashtra: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala Jan 2011

Increasing Access To Safe Abortion In Rural Maharashtra: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This assessment of a Comprehensive Abortion Care (CAC) model was conducted by the Population Council on behalf of the Consortium for Safe Abortions in India. The goal of the Consortium is to increase access to legal, safe, and comprehensive abortion services, including post-abortion family planning, in the public health system, and especially among the rural poor. This report describes the CAC model implemented in Aurangabad district, Maharashtra, and examines the extent to which the model improved (a) the availability and quality of abortion services in public sector facilities, and (b) women’s awareness and experiences with regard to abortion services. It …


Increasing Access To Safe Abortion In Rural Rajasthan: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala Jan 2011

Increasing Access To Safe Abortion In Rural Rajasthan: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This report describes an assessment by the Population Council of the Comprehensive Abortion Care (CAC) model implemented in Tonk district, Rajasthan. Findings highlight that at the time of the baseline survey, the availability of abortion services was limited; also evident was the poor quality of abortion-related care. Given this context, and given the short duration of implementation, the changes achieved by the intervention are promising. The district-level CAC model succeeded in strengthening facilities, training providers, and increasing women’s access to safe abortion services at the Primary Health Centre level. Community-level activities were less successful, attributable to a considerable extent to …


Innovative Financing Through Pay-For-Performance For Providers To Improve Quality Of Care In Bangladesh: Transforming Research Into Action, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena Jan 2011

Innovative Financing Through Pay-For-Performance For Providers To Improve Quality Of Care In Bangladesh: Transforming Research Into Action, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena

Reproductive Health

To improve access to and use of facility-based obstetric and newborn care, the Government of Bangladesh is implementing two innovative performance-based financing programs, namely demand-side financing (DSF) and pay-for-performance (P4P). With the purpose of identifying the lessons learned, limitations of the P4P and DSF models, and scopes for cross learning, a two-day workshop was organized in Dhaka. This workshop report, prepared by the Population Council, resulted in several recommendations to modify DSF and P4P schemes. In Bangladesh, the need for continuing performance-based financing programs to meet MDGs and other health indicators is beyond argument, but it is urgently required to …


Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef Jan 2010

Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef

Reproductive Health

The Population Council launched a pilot study to test two Pay-for-Performance (P4P) strategies to improve MNCH services in Bangladesh. This document presents guidelines for offering incentives to providers, distributing coupons, and forming P4P and/or Coupon Committees and Quality Assurance Groups. The guidelines were developed over the course of five policy-level and consensus-building workshops with national and local-level program managers and service providers, organized under the leadership of the DGHS, in consideration of the local context and sustainability in case of nationwide replication in the country. These guidelines will come into effect upon receiving approval from the DGHS, Ministry of Health …


Integration Of Services In Senegal, Population Council Jan 2010

Integration Of Services In Senegal, Population Council

Reproductive Health

With financial support from USAID and technical support from IntraHealth, The Population Council, Siggil Jigeen Network, and Helen Keller International, Senegal’s Ministry of Health and Prevention has built a package of integrated services called SMNI/PF/PALU. Integrating services allow women to access a wider range of information and care during the same visit and thus increases the utilization of services while also improving their quality and efficiency. Findings in this report indicate that integration of services is a central feature of SMNI/PF/PALU’s success. In conjunction with integrated service delivery models, program activities which strengthen systems and support efficient implementation of services …


Introduction Of Quality Of Care And A Gender Perspective In Reproductive Health Service Organizations In Latin America And The Caribbean, Patricia Riveros, Antonieta Martin, Ricardo Vernon Jan 2008

Introduction Of Quality Of Care And A Gender Perspective In Reproductive Health Service Organizations In Latin America And The Caribbean, Patricia Riveros, Antonieta Martin, Ricardo Vernon

Reproductive Health

In 2005 and with the technical assistance of the Frontiers in Reproductive Health (FRONTIERS) Program, the Integrated Health Coordination Program (PROCOSI), a Bolivian network of 33 nongovernmental organizations, designed and tested a set of four guidelines to help organizations deliver high-quality reproductive health services with a gender perspective. The guidelines were: 1) to present a strategy to certify organizations as “gender sensitive” healthcare providers; 2) to present the knowledge staff members should know to be certified; 3) to describe procedures to collect and analyze the data to evaluate implementation of the strategy; and 4) to describe how to assess strategy …


Taller Regional De Utilización De Resultados De Investigación Operativa Para Incrementar El Acceso, La Calidad E Integración De Los Servicios Anticonceptivos En América Latina Y El Caribe, M. Estela Rivero-Fuentes, Antonieta Martin Jan 2008

Taller Regional De Utilización De Resultados De Investigación Operativa Para Incrementar El Acceso, La Calidad E Integración De Los Servicios Anticonceptivos En América Latina Y El Caribe, M. Estela Rivero-Fuentes, Antonieta Martin

Reproductive Health

En octubre de 2007, el programa Fronteras de la Salud Reproductiva (FRONTERAS) realizó un taller regional de tres días en La Antigua, Guatemala, para difundir los resultados de sus proyectos de investigación operativa. Durante el taller, los participantes escucharon los avances en la metodología anticonceptiva y escucharon las estrategias efectivas que probó FRONTERAS para incrementar el acceso al DIU y la vasectomía; la integración de la planificación familiar con los servicios posparto, postaborto y PTMI. Los investigadores habloaron sobre los resultados de los estudios, los gerentes de los programas explicaron cómo se usaban los instrumentos y se habló de la …


Regional Workshop To Use The Findings From Operations Research To Increase The Access, Quality And Integration Of Contraceptive Services In Latin America And The Caribbean, M. Estela Rivero-Fuentes, Antonieta Martin Jan 2008

Regional Workshop To Use The Findings From Operations Research To Increase The Access, Quality And Integration Of Contraceptive Services In Latin America And The Caribbean, M. Estela Rivero-Fuentes, Antonieta Martin

Reproductive Health

In October 2007, the Frontiers in Reproductive Health (FRONTIERS) program held a three-day regional workshop in La Antigua, Guatemala, to disseminate results of its operations research projects. During the workshop, participants received contraceptive technology updates, and learned about effective strategies tested by FRONTIERS to increase access to the IUD and vasectomy; and about integration of family planning with postpartum, postabortion, and PMTCT. Researchers discussed study results, program managers explained how they were used, and practitioners talked about implementing the interventions—a combination of perspectives that successfully transmitted the message that the interventions were not difficult to apply, could have a great …


Development Of A Quality Assurance Procedure For Reproductive Health Services For District Public Health Systems: Implementation And Scale-Up In The State Of Gujarat, M.E. Khan, Anurag Mishra, Vivek Sharma, Leila Caleb-Varkey Jan 2008

Development Of A Quality Assurance Procedure For Reproductive Health Services For District Public Health Systems: Implementation And Scale-Up In The State Of Gujarat, M.E. Khan, Anurag Mishra, Vivek Sharma, Leila Caleb-Varkey

Reproductive Health

This project was carried out in India, in two districts each in Gujarat and Maharashtra states. It confirmed that quality assurance (QA) checklists and an implementation manual, developed by the USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council in collaboration with UNFPA/India, are useful and effective tools that the Ministry of Health and Social Welfare (MOHFW) can use to monitor the quality of services provided by health facilities. It also demonstrated that this QA mechanism can be easily institutionalized at the district level management. One key lesson has been the critical role that the commitment of state …


Avances En La Atención Postaborto En América Latina Y El Caribe: Investigando, Aplicando Y Expandiendo, Deborah L. Billings, Ricardo Vernon Jan 2007

Avances En La Atención Postaborto En América Latina Y El Caribe: Investigando, Aplicando Y Expandiendo, Deborah L. Billings, Ricardo Vernon

Reproductive Health

This work by the Population Council and Ipas documents the intellectual, financial, and managerial effort that many organizations and institutions in Latin America and the Caribbean have made to achieve the objective of improving the quality and effectiveness of postabortion care services. This volume is a contribution to the preparation of directors, owners, and service providers, and to the creation and implementation of policies and programs based on scientific evidence, which will benefit women and the services themselves. Its five sections include an overview; results from country studies, and information about providers and program components; clinical care with various technologies, …


Using Systematic Screening To Increase Integration Of Reproductive Health Services Delivery In Senegal, Diouratie Sanogo, Ricardo Vernon, James R. Foreit, Awa M. Coll-Seck, Colonel Adama Adoye, Laty G. Ndoye, Cheikh Bamba Diop, Balla Mbacke Mboup, Omar Sarr Jan 2005

Using Systematic Screening To Increase Integration Of Reproductive Health Services Delivery In Senegal, Diouratie Sanogo, Ricardo Vernon, James R. Foreit, Awa M. Coll-Seck, Colonel Adama Adoye, Laty G. Ndoye, Cheikh Bamba Diop, Balla Mbacke Mboup, Omar Sarr

Reproductive Health

This study tested the systematic screening technique to increase the integration of reproductive health services in Senegal. The study took place in four urban health posts in the city of Dakar and three rural health posts in the district of Kebemer. A before and after design tested the hypothesis that the use of the systematic screening tool would result in more services received per client visit. In Dakar, services per visit increased significantly by 20 percent, while in Kebemer, services per visit also increased significantly by 35 percent. The study also examined several techniques to improve provider compliance with the …


Nursing Staff Dynamics And Implications For Maternal Health Provision In Public Health Facilities In The Context Of Hiv/Aids, Loveday Penn-Kekana, Duane Blaauw, Khin San Tint, Desiree Monareng, Jane Chege Jan 2005

Nursing Staff Dynamics And Implications For Maternal Health Provision In Public Health Facilities In The Context Of Hiv/Aids, Loveday Penn-Kekana, Duane Blaauw, Khin San Tint, Desiree Monareng, Jane Chege

Reproductive Health

This study, carried out in Limpopo, KwaZulu-Natal, and Mpumalanga provinces in South Africa, aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. The study found that a high percentage of nursing staff working in public facilities were demotivated, burnt out, and were considering leaving the facility where they were working. A range of factors, both financial and nonfinancial, were associated with nurses considering going overseas: inadequate pay, poor promotion, feeling unsupported by management, and having bad relationships at work were all associated with lack of organizational commitment. As a result …


Feasibility Of Introducing A Comprehensive Package Of Antenatal Care Services In Rural Public Clinics In South Africa, Jane Chege, Ian Askew, Nzwakie Mosery, Mbali Ndube-Nxumalo, Busi Kunene, Mags Beksinska, Janet Dalton, Ester Snyman, Wilem Sturm, Preshny Moodley Jan 2005

Feasibility Of Introducing A Comprehensive Package Of Antenatal Care Services In Rural Public Clinics In South Africa, Jane Chege, Ian Askew, Nzwakie Mosery, Mbali Ndube-Nxumalo, Busi Kunene, Mags Beksinska, Janet Dalton, Ester Snyman, Wilem Sturm, Preshny Moodley

Reproductive Health

The Maternal, Child and Women’s Health Unit, in collaboration with the Population Council’s FRONTIERS in Reproductive Health (FRONTIERS) program, the Reproductive Health Research Unit of the University of Witwatersrand, and the Department of Medical Microbiology and Infectious Diseases of the Nelson Mandela School of Medicine, University of Natal, developed and then pilot-tested this revised model in KwaZulu-Natal, South Africa. The project’s objective was to develop and test an improved and integrated antenatal care program for public-sector clinics that would increase the range and quality of services received by pregnant women and improve their reproductive health behavior and status. Various problems, …


Encuestas De Voluntad De Pago Para Fijar Precios De Productos Y Servicios De Salud Reproductiva: Manual De Usuarios, Karen G. Fleischman Foreit, James R. Foreit Jan 2004

Encuestas De Voluntad De Pago Para Fijar Precios De Productos Y Servicios De Salud Reproductiva: Manual De Usuarios, Karen G. Fleischman Foreit, James R. Foreit

Reproductive Health

Social programs need to balance volume (coverage) and income (sustainability). The law of supply and demand states that we can not obtain coverage and support at the same time, because when prices rise, demand decreases. This manual presents willingness-to-pay (WTP) surveys that allow program managers to simulate changes in demand related to price, without actually changing prices. The Population Council with The Futures Group International developed these surveys that can be used for existing and new products and services, collect responses from clients with no formal education with sensitivity to their individual characteristics, and provide conservative estimates that accurately predict …


One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo Jan 2003

One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo

Reproductive Health

This report presents a one-year assessment of quality-of-care improvements in Peru, following provider training on the job aids–assisted Balanced Counseling Strategy. Results showed significant enhancement of quality of care, an increase in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) …


Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth Jan 2003

Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth

Reproductive Health

EngenderHealth, in collaboration with the Ministry of Health, conducted an operations research project to examine the feasibility of introducing an integrated three-element model of postabortion care (PAC) services in secondary- and primary-level sites in two predominantly rural regions in Senegal. The intervention provided health personnel with: 1) training to improve clinical competence, counseling, infection prevention, and general care; 2) technical assistance, materials, and support to aid in overcoming challenges; and 3) ongoing monitoring and supervision. The project findings attest to the benefits of expanding existing PAC programs in rural settings and suggest that the advantages of such an expansion outweigh …


Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya Jan 2002

Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya

Reproductive Health

The goal of this study was to determine the sustainability of the postabortion care (PAC) training and service delivery intervention introduced in the Hospital Nacional Daniel Alcides Carrión in Lima, Peru, and the extent to which the outcomes of the intervention have continued. The objectives of the study were to assess changes over time in the following outcomes: the use of manual vacuum aspiration for incomplete abortion, provision of family planning information to postabortion patients, acceptance of contraception by postabortion patients prior to discharge, provision of medical care information to patients, length of hospital stay, and resources used by the …


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

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

Reproductive Health

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


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

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

Reproductive Health

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


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

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

Reproductive Health

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