Women's Health Commons^™

Scaling Up Family Planning In Zambia—Part 2: The Cost Of Scaling Up Family Planning Services, David Collins, Colin Gilmartin

Reproductive Health

This costing study is Part 2 of a broader implementation research study designed to establish the feasibility of integrating successful interventions and lessons from the Scaling Up Family Planning (SUFP) project into Zambia’s health system at the conclusion of the project, and to contribute to the global learning on scaling up family planning services. The main contribution of the costing study was to examine the cost implications in determining the scope and pace of scale up. Challenges experienced during the project reportedly included lack of equipment and limited space in some facilities, government staff shortages, and irregular access to supplies …

Understanding Demand For Family Planning And Reproductive Health Services Through The Indian National Health Insurance Scheme In Uttar Pradesh, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

The Indian National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), was launched by the Ministry of Labour and Employment in 2008 to promote equitable access to health services through the private and public sectors. This scheme is intended to offer economically disadvantaged families living below the poverty line in urban and rural areas access to a pre-specified package of health services including: general surgery, general medical care, pediatric care, gynecological care, family planning (FP) and other reproductive health (RH) services, dental, ophthalmology, urology, neurosurgery, and oncology. Almost eight years into the program, this is an opportune time to examine …

Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

In 2008, the Government of India launched the National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in both urban and rural areas to access a range of private health services. The available evidence suggests several limitations and barriers that may affect the utilization of RSBY services and warrants a more in-depth examination of the contexts of family planning/reproductive health (FP/RH) services. The Population Council, under the Evidence project, conducted a study among the urban poor to: 1) determine RSBY awareness and barriers to enrollment; 2) identify barriers and facilitating factors to …

Delivering Contraceptive Vaginal Rings To Breastfeeding Women, Population Council

Reproductive Health

The Progesterone Vaginal Ring (PVR) is a user-controlled contraceptive that helps breastfeeding women safely and effectively space, delay, or limit their next pregnancy. The Population Council and partners developed the PVR to help address the unmet need for contraception among breastfeeding women. The ring provides a convenient option that adds choices for new mothers and promotes optimal infant nutrition and health. This two-page brief provides fast facts for advancing nutrition and infant health with the PVR.

Building A National Pro-Choice Alliance In Mexico: Evaluation Of The Alliance Media Campaign To Promote Access To Safe, Free, And Legal Abortion Services, Population Council

Reproductive Health

The Population Council and Alliance partners designed a legal abortion media campaign aimed at informing women in Mexico City of their legal right to a safe, free elective abortion during the first 12 weeks of pregnancy. The impetus for the campaign was the apparent lack of knowledge regarding the legality of abortion in Mexico City among low-income, marginalized women of reproductive age combined with the inadequate number of Mexico City Ministry of Health facilities equipped to provide services to women living in an expansive metropolitan area such as Mexico City. This brief presents results of an evaluation that show that …

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Understanding Married Women's Vulnerability To Hiv Infection In Egypt: An Exploratory Study, Doaa Oraby, Nahla G. Abdel-Tawab

Reproductive Health

This study examines the behavioral, sociocultural, economic, programmatic, and legal factors that aggravate Egyptian women’s vulnerabilities to HIV/AIDS. The study concludes that in low-prevalence settings like Egypt, targeted interventions are the most strategic and cost-effective: for example, HIV awareness-raising with a special focus on the preventive role of consistent, correct condom use, and creating a cadre of peers that could provide psychosocial support and HIV counseling to migrant workers. Furthermore, premarital and antenatal care programs should include HIV awareness-raising and provider-initiated counseling and testing after screening of women to identify those at risk for HIV infection. Concurrently, efforts should be …

El Rol De Los Servicios Sociales En El Acompañamiento De Mujeres Durante El Proceso De Interrupción Legal Del Embarazo En Un Hospital Público En La Provincia De Buenos Aires / The Role Of Social Services In The Accompaniment Of Women During The Process Of Legally Terminating A Pregnancy In A Public Hospital In The Province Of Buenos Aires, Judy Rivière

Independent Study Project (ISP) Collection

El acceso a la Interrupción Legal del Embarazo (ILE) sigue siendo limitado para muchas mujeres en Argentina. En la mayoría de los hospitales públicos, no se hace la ILE. Este tema es todavía muy polémico y tiene implicaciones diferentes, no solo en el nivel provincial, sino también en el nivel municipal. En las instituciones donde se hacen interrupciones del embarazo, los profesionales de la salud tienen mirada abierta que incluyen factores biopsicosociales. Por eso, las trabajadoras sociales, que miran la salud desde la perspectiva de determinantes sociales, tienen un rol importante en la facilitación del acceso a la ILE para …

Análisis De Las Políticas Públicas De Prevención Del Cáncer De Cuello Uterino Vinculadas Al Control Del Virus Del Papiloma Humano (Vph) En Argentina / An Analysis Of Argentina’S Public Health Prevention Strategies Of Cervical Cancer Related To The Control Of The Human Papiloma Virus (Hpv), Caroline Seman

Independent Study Project (ISP) Collection

El objetivo general de este estudio es analizar las políticas públicas de prevención del cáncer de cuello uterino (CCU) basadas en la incorporación de nuevas tecnologías como el test de VPH (Virus del Papiloma Humano) y la vacuna contra el VPH en Argentina. Los objetivos específicos son 1) describir la implementación del test de VPH y la campaña de vacunación obligatoria contra el VPH como estrategias de prevención primaria del CCU a nivel nacional: 2) identificar los factores que las facilitan y las obstaculizan. El CCU es el segundo cáncer más diagnosticado en las mujeres de Argentina. Desde el año …

Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353

UROP Posters

Despite efforts of Vision 2020 in India, the Andhra Pradesh Eye Disease Study (APEDS) extrapolated, in 2000, approximately 18.7 million blind people in India and also, projected an increase to 31.6 million blind people by 2020. Within the state Andhra Pradesh itself, preventable corneal blindness increased to 1.84% from 1.5% in the late 1980s.

Numerous public health studies have been conducted to outline factors that cause and preclude treatment of avoidable corneal blindness in the India. Conclusively, the escalation of corneal blindness can be largely attributed to personal, social, and economic barriers in utilizing available eye-care services. However, due to …

Creating A Community Of Practice To Prevent Suicide Through Multiple Channels: Describing The Theoretical Foundations And Structured Learning Of Pc Cares, Lisa Wexler, Diane Mceachern, Gloria Difulvio, Cristine Smith, Louis F. Graham, Kirk Dombrowski

Department of Sociology: Faculty Publications

It is critical to develop practical, effective, ecological, and decolonizing approaches to indigenous suicide prevention and health promotion for the North American communities. The youth suicide rates in predominantly indigenous small, rural, and remote Northern communities are unacceptably high. This health disparity, however, is fairly recent, occurring over the last 50 to 100 years as communities experienced forced social, economic, and political change and intergenerational trauma. These conditions increase suicide risk and can reduce people’s access to shared protective factors and processes. In this context, it is imperative that suicide prevention includes—at its heart— decolonization, while also utilizing the “best …

Evaluating The Impact Of Pharmacist Health Education On The Perceptions Of The Pharmacist’S Role Among Women Living In A Homeless Shelter, Laura V. Tsu, Kelsey Buckley, Sarah Nguyen, Jennifer Kohn

Pharmacy Faculty Articles and Research

Objectives: To determine the impact of pharmacist-provided educational seminars on the participant’s perception of the pharmacist’s role in providing women’s health education. Secondary objectives include the participant’s level of perceived benefit from the information provided during each presentation, as well as determining characteristics of participants who are interested in attending seminars.

Methods: This is a prospective study conducted within a homeless women’s shelter in Phoenix, Arizona. Pharmacists and pharmacy students provided 10 monthly educational seminars on topics related to women’s health. Participants completed a pre- and post-seminar survey regarding their perceptions of the presentations and pharmacists.

Results: …

Reproductive Rights In Latin America: A Case Study Of Guatemala And Nicaragua, Katherine W. Bogen

Scholarly Undergraduate Research Journal at Clark (SURJ)

A lack of access to contraceptives and legal abortion for women throughout the nations of Nicaragua and Guatemala creates critical health care problems. Moreover, rural and underprivileged women in Guatemala and Nicaragua are facing greater limitations to birth control access, demonstrating a classist aspect in the global struggle for female reproductive rights. Although some efforts have been made over the past half-century to initiate a dialogue on the failure of medical care in these nations to adequately address issues of maternal mortality and reproductive rights, the women's reproductive health movements of Nicaragua and Guatemala have struggled to reach an effective …

Goddesses Versus Gynecologists: An Analysis Of The History Of Women’S Healthcare, Marion A. Mckenzie

Student Publications

Starting from the downfall of Goddess cultures in Europe, women's health care has been negatively impacted for generations. The rise of the white, male Indo-European "dominator model" along with the witch craze, caused the end of widespread wise women traditions and pharmacopeia methods. After women's traditional voice was silenced, medical colleges were established to pronounce new, "professional" knowledge. Only those who attended these universities were allowed to legally practice medicine; however, during this time, medical research and treatments for women primarily included mutilation and painful, nonsensical regimens. The horrifying state of women's healthcare has since improved, but was originally a …

La Santé Maternelle À Antsiranana Selon La Médicine Occidentale Et La Médicine Traditionnelle : Une Étude Des Traitements Opposés Pour Les Femmes Enceintes, Lauren Nguyen

Independent Study Project (ISP) Collection

Dans un pays comme le Madagascar, où des coutumes traditionnelles et le lien avec les ancêtres demeurent une grande partie de la culture, l’introduction des aspects « occidentales » présente un peu du désaccord. Cela est vu avec l’introduction de la médecine « occidentale », et le choix que font des Malagasy pour leurs soins médicaux. Spécifiquement dans le secteur de la médecine, la tension entre des pratiques occidentales et des pratiques traditionnelles est significative.

La présence des guérisseurs traditionnels et de la médecine traditionnelle sur l’île existait bien avant l’introduction de la médecine occidentale. Bien que de plus en …

Abortion In Brazil - Todo Mundo Faz: An Analysis Of Social Movements And Social Support For The Liberalization Of Brazil’S Abortion Law In Salvador, Brazil, Maria Camila Caicedo

Independent Study Project (ISP) Collection

This study analyzed the current actions of feminist movements, black women’s movements, and other advocacy groups that have a stake in the current debate for the legalization of abortion in Brazil. The purpose of the study was to assess the current political avenues for approaching the legislative body available to marginalized groups who are disproportionately affected by the criminalization of abortion. It was built upon a comprehensive review of existing literature, which found very little information on the actions of feminist movements and black women’s movements in Northeast Brazil. The study was conducted over the course of four weeks in …

‘They Can’T Report Abuse, They Can’T Move Out. They Are At The Mercy Of These Men’: Exploring Connections Between Intimate Partner Violence, Gender And Hiv In South African Clinical Settings, Courtenay Sprague

Conflict Resolution, Human Security, and Global Governance Faculty Publication Series

This qualitative study captured South African female health provider perspectives of intimate partner violence in female patients, gender norms and consequences for patients’ health. Findings indicated female patients’ health behaviours were predicated on sociocultural norms of submission to men’s authority and economic dependence on their partners. Respondents described how men’s preferences and health decision-making in clinics affected their patients’ health. Adverse gender norms and gender inequalities affected women’s opportunities to be healthy, contributing to HIV risk and undermining effective HIV management in this context. Some providers, seeking to deliver a standard of quality healthcare to their female patients, demonstrated a …

Adolescent Girls, Human Rights And The Expanding Climate Emergency, Holly G. Atkinson, Judith Bruce

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing.¹ These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent. The authors urge key actors responding to both the threats and opportunities that climate change poses to understand adolescent girls as exceptionally at risk on the one hand, and as exceptionally resilient and …

Statement And Action Agenda From The Girls In Emergencies Collaborative, Omar Robles, Judith Bruce, Holly G. Atkinson, Dale Buscher, Karen Scriven, Kristin Kim Bart, Shelby French, Judithe Registre, Audrey Anderson

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing. These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent.

Ouch, That Hurts: Childbirth-Related Pain Management And The Inappropriate Replacement Of Traditional Obstetrical Knowledge In Kumaon, Uttarakhand, India, Sabrina Zionts

Independent Study Project (ISP) Collection

Throughout India, obstetrical knowledge and practice has been developed and passed down by generations of women. In many Indian societies, traditional birth attendants, or dais, remain the gatekeepers of childbirth-related knowledge. Yet with the push towards institutional delivery, traditional knowledge and practices are being increasingly replaced with modern and Western ones. While the trend of hospital deliveries has yielded positive health outcomes, its socio-cultural consequences remain unclear. Situated in Uttarakhand’s Kumaon Himalayas, this study employs a bio-social framework and begins to reveal these consequences. Using labor pain management as an entry point, this study argues that the push towards institutional …

Muslim Women And United States Healthcare: Challenges To Access And Navigation, Dayna M. Seeger

What All Americans Should Know About Women in the Muslim World

This paper offers an analysis of the interactions of Muslim women in the US healthcare system in order to unpack challenges and propose potential accommodations. Islam may inform values or considerations in the context of other cultural factors or present Muslim women with specific challenges in seeking healthcare based on Islamic teachings or social constructs. This paper examines these factors by elaborating on an overview of Muslim interpretations of healthcare using religious authorities, text from the Qur’an, and social norms. It then delves into challenges faced by Muslim women in the US healthcare system and the implications of those challenges …

Barriers To Prevention And Treatment Of Type 2 Diabetes Mellitus: A Qualitative Analysis Of Women In East Sikkim, India, Emily Applewhite

Independent Study Project (ISP) Collection

Diabetes Mellitus is a metabolic disorder that affects more people in India than anywhere else in the world (Ramachandran et. al., 2010). A recent national study concluded that Sikkim, a small northeastern state in the Himalayas, has the highest prevalence of Diabetes Mellitus compared to any other state in India. In order to determine why this is so, this study looks at the barriers women face when attempting to prevent and treat Type 2 Diabetes Mellitus (T2DM) in East Sikkim. Fieldwork for this study was facilitated by The Volunteer Health Association of Sikkim, and took place in Gangtok and a …

Effect Of Females In Leadership Roles On Menstrual Sanitation In Rural Jamkhed, India, Kirsten Hughes

Independent Study Project (ISP) Collection

Introduction: Menstruation is integral to puberty and maturation of adolescent girls. Education about menstruation and menstrual hygiene effects a woman’s physical and psychosocial health through the majority of her life.

Purpose: This study seeks to answer the following questions: Who is providing information to girls before or after their first menstruation? Is this information timely, appropriate and accurate? Is the information effective enough to see changes in menstrual practices through a family and community? In answering these questions, the study attempts to determine the pathways of communications regarding menstruation and menstrual health in the Jamkhed area of the Ahmednagar district …

Are There Gender Differences In Perceived Sexual Self-Efficacy Among African-American Adolescents?, Michelle L. Redmond, Rhonda K. Lewis

Journal of Health Disparities Research and Practice

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population.

Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs.

Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, …

Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. At a workshop held in Burundi, 3–5 June 2014, the Population Council, Alliance Burundaise contre le SIDA, and local partners in Burundi identified successful activities, highlighted important challenges and best practices, and found innovative ways to improve Link Up programming. This document contains a selection of the most …

Sexual And Reproductive Health Among Young Female Sex Workers In Bangladesh Brothels—Baseline Findings From Link Up, Population Council

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. Consortium members PIACT Bangladesh and Marie Stopes Bangladesh implemented a brothel-based program for female sex workers to address sexual and reproductive health and rights. Working in eight brothels in seven districts, trained female sex worker peer educators provided face-to-face education, including referrals to on-site and off-site health care …

Experiences With Pregnancy Among Female Sex Workers In Ethiopia: A Link Up Exploratory Study, Population Council, Miz-Hasab Research Center, Organization For Social Services For Aids

HIV and AIDS

In Ethiopia, it is illegal to operate a brothel or procure sex workers as a commercial activity, but the sale of sex by women is not prohibited by law. Research suggests that the number of Ethiopian female sex workers is growing, with younger women and girls increasingly entering the sex trade. Public health programs and policies typically have emphasized HIV prevention in this vulnerable population. A 2014 study of 3,882 Ethiopian female sex workers found that HIV prevalence in the 10 study sites ranged from 15–33 percent, compared to national prevalence of 1.9 percent among women. Furthermore, since most female …

Low Use And High Discontinuation Of Modern Contraceptives In Pakistan: Reasons And Policy Recommendations, Population Council

Reproductive Health

According to the latest Pakistan Demographic and Health Survey, 20 percent of married women of reproductive age have unmet need for contraception. Moreover, the country’s contraceptive prevalence rate (CPR), for modern and traditional methods combined, is only 35 percent—one of the lowest CPRs in the region. In addition to the problem of nonuse, the country is finding it difficult to keep current contraceptive users onboard: compared to other developing countries, Pakistan has the highest rate of discontinuation of contraceptive use. Thus, while there has been an overall increase in the use of contraceptives—modern and traditional—there is a large difference between …

The Effect Of Integrating Hiv Services On Quality Of Postnatal Care, Integra Initiative

Reproductive Health

Addressing the postnatal needs of new mothers is a neglected area of care throughout sub-Saharan Africa. Unintended pregnancies during the first 12 months following delivery, and vertical transmission of HIV during labor and delivery, are some of the challenges faced by women during the extended postpartum period. Many women want to delay or avoid another pregnancy, but are not using a modern contraceptive method. Few developing countries ensure that mothers and newborns are assessed early and monitored during the initial six-week period as recommended by WHO, which contributes to discontinuity of services received during pregnancy and delivery and limits linkages …

Reducing Maternal And Child Mortality In Punjab: 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 Punjab’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 45 percent of maternal deaths, 26 percent of infant deaths, and 76 percent of young child deaths. FP’s wider health …