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Articles 1 - 30 of 117
Full-Text Articles in Women's Health
A Randomized Controlled Study Of The Effects Of Targeted Health Education On Uptake Of Contraceptives Among Women Of Reproductive Age In Nnewi City, South-East Nigeria, Yanmeer Tyotswam, Rosebella Iseme-Ondiek, Eliphas Makunyi
A Randomized Controlled Study Of The Effects Of Targeted Health Education On Uptake Of Contraceptives Among Women Of Reproductive Age In Nnewi City, South-East Nigeria, Yanmeer Tyotswam, Rosebella Iseme-Ondiek, Eliphas Makunyi
Population Health, East Africa
Objective: There is a need for contraception uptake among people to enable them to fulfil their right to determine the timing, number and spacing of their children. In regions with poor contraceptive prevalence rates, lack of effective education has been largely implicated, and Nigeria falls among such regions. Thus, the present study is designed to examine the impact of an educational intervention on uptake of contraceptives among women aged 18–49 years seeking care at the Nnamdi Azikiwe University Teaching Hospital Nnewi.
Methods: Being an interventional study to underscore the effect of targeted health education on uptake of contraceptives, …
Pattern And Determinants Of Contraceptive Use Among The Muslim Women In Wajir And Lamu Counties In Kenya: A Cross-Sectional Study., Batula Abdi, Jerry Okal, Gamal Serour, Vincent Were, Marleen Temmerman, Peter Gichangi
Pattern And Determinants Of Contraceptive Use Among The Muslim Women In Wajir And Lamu Counties In Kenya: A Cross-Sectional Study., Batula Abdi, Jerry Okal, Gamal Serour, Vincent Were, Marleen Temmerman, Peter Gichangi
Centre of Excellence in Women and Child Health
Background; Improving access to family planning (FP) is associated with positive health benefits that includes averting nearly a third of all maternal deaths and 10% of childhood deaths. Kenya has made great strides in improving access to family planning services. However, amid this considerable progress, regional variation has been noted which begs the need for a clearer understanding of the the patterns and determinants that drive these inconsistencies.
Methods; We conducted a cross-sectional study that involved 663 Muslim women of reproductive age (15–49 years) from Wajir and Lamu counties in Kenya between March and October 2018.The objective of this study …
Improving Acceptability, Use, And Continuation Of Iud In Bangladesh, Sharif M.I. Hossain, Abdullah Al Mahmud Shohag, Zakaria Hossain, Shongkour Roy, Ubaidur Rob
Improving Acceptability, Use, And Continuation Of Iud In Bangladesh, Sharif M.I. Hossain, Abdullah Al Mahmud Shohag, Zakaria Hossain, Shongkour Roy, Ubaidur Rob
Sexual and Reproductive Health, Rights, and Choices
Although the nonhormonal copper intra-uterine device (IUD) is the safest and cheapest long-acting contraceptive method, its use has been declining day-by-day in Bangladesh. Less than 1% of married women 15-49 years of age who currently use a contraceptive method use an IUD. Researchers conducted a quasi-experimental pre-post-test non-equivalent control group designed study to test a simple intervention intended to increase acceptance, use, and continuation of the IUD among married women of reproductive age (18 to 45 years) in Keraniganj, Savar, and Nawabganj Upazilas (sub-districts) in Bangladesh. The study was conducted in a real-life situation of Union Health and Family Welfare …
Sexual Education In Adolescence: Contraception Education For Adolescents Leads To Improved Sexual Practices, Marie Poellinger, Erica Jade Fong
Sexual Education In Adolescence: Contraception Education For Adolescents Leads To Improved Sexual Practices, Marie Poellinger, Erica Jade Fong
Nursing | Student Research Posters
Adolescents of low socioeconomic status from 13-18 years of age face many challenges when it comes to maintaining safe sexual health practices, leading to unwanted pregnancies and exposure to sexually transmitted diseases (STI’s). Challenges include:
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economic barriers → limited access to health care or lack of health insurance
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lack of proper sex education and therefore limited knowledge around contraceptive
Addressing these challenges is crucial for better sexual health outcomes. The nurse’s role is essential in providing education about contraceptive options, access to local resources, and guidance pertaining to safe sexual health practices (Dixon, 2014)
Empowering Choices: Patient Education For Contraceptive Confidence, Maria Anns Abraham
Empowering Choices: Patient Education For Contraceptive Confidence, Maria Anns Abraham
Nursing | Student Research Posters
The complexity of birth control options significantly impacts women's lives, with hormonal contraceptives being commonly used but often misunderstood. These contraceptives, which contain estrogen and progestin or progestin only, come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches, offering benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they can also lead to adverse effects including increased blood pressure, nausea, headaches, breakthrough bleeding, and heightened risk of blood clots, with research indicating a potential link between their use and a decline in mental health. Given the prevalence of depression, particularly in …
Ica Foundation Supports Lng Ius Access In Low- And Middle-Income Countries, Population Council
Ica Foundation Supports Lng Ius Access In Low- And Middle-Income Countries, Population Council
Research Utilization and Impact Briefs
The Population Council has developed and introduced several of the world’s most effective and popular contraceptive methods, including the levonorgestrel-releasing intrauterine system (LNG IUS). Through the International Contraceptive Access (ICA) Foundation, a public-private foundation based in Finland, the Council supports LNG IUS distribution to women in over 35 low- and middle-income countries (LMICs) in partnership with international and local organizations. Over 150,000 LNG IUS units have been delivered to date at no cost, laying the groundwork for method introduction in LMICs and further expanding access to safe, long-acting, reversible contraception.
Struggling With Long-Time Low Uptake Of Modern Contraceptives In Pakistan, Nasim Zahid Shah, Tazeen S. Ali, Imtiaz Jehan, Xaher Gul
Struggling With Long-Time Low Uptake Of Modern Contraceptives In Pakistan, Nasim Zahid Shah, Tazeen S. Ali, Imtiaz Jehan, Xaher Gul
Woman and Child Health
Background: Efforts to expand access to reproductive health care in Pakistan date as far back as the early 1950s. Despite such efforts, the fertility rate has declined at a slower pace compared to that in neighbouring countries.
Aims: To explore the underlying reasons and challenges for long-time low contraceptive use among female clients and key service providers of community-based family planning programmes in Pakistan.
Methods: A qualitative study was carried out with a total of 10 focus group discussions and 7 in-depth interviews with female clients and key service providers. The data were analysed using qualitative content analysis.
Results: The …
Utilization Of Family Planning Contraceptives Among Women Inthe Coastal Area Of South Buru District, Maluku, 2017, Christiana Rialine Titaley, Ninik Sallatalohy
Utilization Of Family Planning Contraceptives Among Women Inthe Coastal Area Of South Buru District, Maluku, 2017, Christiana Rialine Titaley, Ninik Sallatalohy
Kesmas
Maluku Province is one among provinces in Indonesia with a contraceptive prevalence rate (CPR) lower than the national average. This study aimed toexamine factors associated with the utilization of family planning contraceptives among women of reproductive age living in the coastal area of South BuruDistrict, Maluku, Indonesia. Data were derived from a household health survey conducted in five subdistricts in South Buru, e.g., Namrole, Leksula, Waesama,Kapala Madan and Ambalau Subdistricts on November 2017 by the Faculty of Medicine, Pattimura University in Ambon. Information on contraceptive usewere collected from 390 married women aged 20 - 49 years. Bivariate and multivariate logistic …
Contraceptive Use Following Unintended Pregnancy Among Ugandan Women Living With Hiv, Jana Jarolimova, Jerome Kabakyenga, Kara Bennett, Winnie R. Muyindike, Annet Kembabazi, Jeffrey N. Martin, Peter W. Hunt, Yap Boum, Jessica E. Haberer, David Bangsberg, Angela Kaida, Lynn T. Matthews
Contraceptive Use Following Unintended Pregnancy Among Ugandan Women Living With Hiv, Jana Jarolimova, Jerome Kabakyenga, Kara Bennett, Winnie R. Muyindike, Annet Kembabazi, Jeffrey N. Martin, Peter W. Hunt, Yap Boum, Jessica E. Haberer, David Bangsberg, Angela Kaida, Lynn T. Matthews
OHSU-PSU School of Public Health Faculty Publications and Presentations
Background: Preventing unintended pregnancy is critical for women living with HIV (WLWH) to safely achieve their reproductive goals. Family planning services should support WLWH at risk of repeat unintended pregnancies. We examined the relationship between unintended pregnancy and subsequent contraception use among WLWH in Uganda.
Study design: This was a retrospective analysis of data from a longitudinal cohort of individuals initiating antiretroviral therapy (ART), restricted to women with pregnancy (confirmed via urine β-hcg testing) between 2011–2013. The exposure of interest was intended vs unintended pregnancy, and the outcome was self-report of modern contraceptive use (hormonal methods, intrauterine device, sterilization, and/or …
Are Family Planning Vouchers Effective In Increasing Use, Improving Equity And Reaching The Underserved? An Evaluation Of A Voucher Program In Pakistan, Moazzam Ali, Syed Khurram Azmat, Hasan Bin Hamza, Md Mizanur Rahman, Waqas Hameed
Are Family Planning Vouchers Effective In Increasing Use, Improving Equity And Reaching The Underserved? An Evaluation Of A Voucher Program In Pakistan, Moazzam Ali, Syed Khurram Azmat, Hasan Bin Hamza, Md Mizanur Rahman, Waqas Hameed
Community Health Sciences
Background: Low modern contraceptive prevalence rate and high unmet need in Pakistan aggravates the vulnerabilities of unintended pregnancies and births contributing to maternal morbidity and mortality. This research aims to assess the effectiveness of a free, single-purpose voucher approach in increasing the uptake, use and better targeting of modern contraceptives among women from the lowest two wealth quintiles in rural and urban communities of Punjab province, Pakistan.
Methods: A quasi-interventional study with pre- and post-phases was implemented across an intervention (Chakwal) and a control district (Bhakkar) in Punjab province (August 2012-January 2015). To detect a 15% increase in modern contraceptive …
What Influences Family Planning In Rural Pakistan: Franchised Service Provider And Community Health Worker Perspective, Waqas Hameed, Junaid-Ur-Rehman Siddiqui, Muhammad Ishaque, Sharmeen Hussain, Xaher Gul, Hina Najmi, Shehla Noorani, Ghulam Mustafa, Asma Balal
What Influences Family Planning In Rural Pakistan: Franchised Service Provider And Community Health Worker Perspective, Waqas Hameed, Junaid-Ur-Rehman Siddiqui, Muhammad Ishaque, Sharmeen Hussain, Xaher Gul, Hina Najmi, Shehla Noorani, Ghulam Mustafa, Asma Balal
Community Health Sciences
Background: Pakistan has a low modern contraceptive prevalence rate, 26%, leading family planning (FP) programmes to explore partnerships with local private providers to improve access to quality FP services. This study aims to understand the socio-cultural and organizational factors that influence delivery of quality family planning services.
Methods: This qualitative study was conducted with private service providers and community health workers (CHW) in Marie Stopes Society's (MSS) social franchise network. A total of 31 providers and 28 CHWs from Sindh, Punjab, and Khyber Pakhtunkhwa provinces of Pakistan were purposively selected for in-depth interviews. The study used thematic content analysis to …
Dynamics Of Injectable Contraceptive Use In India, The Evidence Project
Dynamics Of Injectable Contraceptive Use In India, The Evidence Project
Reproductive Health
This brief describes a research study by the Population Council, with support from USAID/India, whose purpose is to provide evidence that can be used to strengthen the family planning program and meet the needs of reversible contraceptive users who want to prevent pregnancy in India. Understanding the experiences of the small but growing population of women choosing the injectable is important as the Government of India continues to roll out injectable contraceptive methods in the public sector. The report’s key recommendations include: disseminating messaging about potential side effects of the injectable, institutionalizing quality of care in pre-service trainings for all …
Dynamics Of Oral Contraceptive Pill Use In India, The Evidence Project
Dynamics Of Oral Contraceptive Pill Use In India, The Evidence Project
Reproductive Health
The purpose of this brief is to provide evidence that can be used to strengthen the family planning program in India, particularly for community-based and facility-based distribution of oral contraceptive pills (OCPs), use of which remains low despite their availability. Understanding women’s interactions with frontline health workers while obtaining the method and during follow-up counseling can help the Government of India improve its National Family Planning Program. Based on its findings, the report recommends that all providers, especially frontline health workers, receive training focusing on four domains of quality of care: 1) respectful care, 2) counseling to enable appropriate method …
The Need For Improved Information Exchange Between Family Planning Providers And Clients, Population Council
The Need For Improved Information Exchange Between Family Planning Providers And Clients, Population Council
Reproductive Health
The information exchanged during a contraceptive visit is important because providers need to understand clients’ reproductive intentions and clients need to receive adequate information about the method options and possible method-related side effects and problems. Little is known about how information exchange has changed over time and across countries, so FP2020 identified 17 core indicators to track progress made by FP programs, including the method information index (MII). The purpose of this study is to address the following issues: how the MII varies among countries, how it changes between two surveys in the same country, how it varies by type …
Ensuring Contraceptive Security Through Effective Supply Chains, Moazzam Ali
Ensuring Contraceptive Security Through Effective Supply Chains, Moazzam Ali
Reproductive Health
Establishing and maintaining well-functioning supply chains that meet the needs of public and private sectors, as well as health professionals at all levels in family planning programs, will play a critical role in reducing unmet need for modern contraception in low and middle income countries. This evidence brief identifies two evidence-based solutions to address the challenges faced by these countries: increasing the visibility of product flows and user demand, and leveraging the expertise of the private and public sector to ensure a total market approach to supply-chain management. Strengthening the capacity of public and private-sector family planning providers and managers …
What Do Users Really Want?, Saumya Ramarao, John Townsend, James Sailer
What Do Users Really Want?, Saumya Ramarao, John Townsend, James Sailer
Reproductive Health
No abstract provided.
Method-Specific Attributes That Influence Choice Of Future Contraception Among Married Women In Nairobi’S Informal Settlements, Joyce Mumah, John B. Casterline, Kazuyo Machiyama, Marylene Wamukoya, Caroline W. Kabiru, John C. Cleland
Method-Specific Attributes That Influence Choice Of Future Contraception Among Married Women In Nairobi’S Informal Settlements, Joyce Mumah, John B. Casterline, Kazuyo Machiyama, Marylene Wamukoya, Caroline W. Kabiru, John C. Cleland
Reproductive Health
No abstract provided.
Women's Perceptions And Experiences Of Family Planning By Contraceptive Methods In Kenya And Bangladesh: Preliminary Results, Kazuyo Machiyama, Joyce Mumah, Caroline W. Kabiru, George Odwe, Francis Obare, Fauzia Akhter Huda, John C. Cleland, John B. Casterline
Women's Perceptions And Experiences Of Family Planning By Contraceptive Methods In Kenya And Bangladesh: Preliminary Results, Kazuyo Machiyama, Joyce Mumah, Caroline W. Kabiru, George Odwe, Francis Obare, Fauzia Akhter Huda, John C. Cleland, John B. Casterline
Reproductive Health
No abstract provided.
Contribution Of Contraceptive Discontinuation To Unintended Births In 36 Developing Countries, Population Council
Contribution Of Contraceptive Discontinuation To Unintended Births In 36 Developing Countries, Population Council
Reproductive Health
High contraceptive discontinuation results in millions of women having an unmet need for contraception. This Population Council study using data from 36 Demographic and Health Surveys shows that contraceptive discontinuation also results in millions of unintended pregnancies and births. This brief recommends attention to issues related to quality of care, such as counseling, to ensure that each woman has the method she needs/wants and uses it correctly. This will help women avoid contraceptive discontinuation and associated unmet need and unintended fertility right from the beginning. As programs become more successful, quality of care will become key to expanding contraceptive use …
Uganda Retail Audit: Analysis And Report, The Evidence Project
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 …
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Kenya, Population Council
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Kenya, Population Council
Reproductive Health
This factsheet outlines the Delivering Contraceptive Vaginal Rings project, awarded by USAID to the Population Council in October 2013 to foster the introduction of two contraceptive methods. The objectives of this project are to: 1) improve availability and affordability of a three-month Progesterone Vaginal Ring for postpartum breastfeeding women, and 2) facilitate regulatory approval and introduction of a one-year contraceptive vaginal ring containing Nestorone® and ethinyl estradiol—a long-acting method for non-breastfeeding women that is in the late stages of development. The factsheet identifies milestones achieved and new opportunities in Kenya to implement activities in the year ahead.
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Nigeria, Population Council
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Nigeria, Population Council
Reproductive Health
This factsheet outlines the Delivering Contraceptive Vaginal Rings project, awarded by USAID to the Population Council in October 2013 to foster the introduction of two contraceptive methods. The objectives of this project are to: 1) improve availability and affordability of a three-month Progesterone Vaginal Ring for postpartum breastfeeding women, and 2) facilitate regulatory approval and introduction of a one-year contraceptive vaginal ring containing Nestorone® and ethinyl estradiol—a long-acting method for non-breastfeeding women that is in the late stages of development. The factsheet identifies milestones achieved and new opportunities in Nigeria to implement activities in the year ahead.
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Senegal, Population Council
Introducing Contraceptive Methods In Low-Resource Settings: New Opportunities In Senegal, Population Council
Reproductive Health
This factsheet outlines the Delivering Contraceptive Vaginal Rings project, awarded by USAID to the Population Council in October 2013 to foster the introduction of two contraceptive methods. The objectives of this project are to: 1) improve availability and affordability of a three-month Progesterone Vaginal Ring for postpartum breastfeeding women, and 2) facilitate regulatory approval and introduction of a one-year contraceptive vaginal ring containing Nestorone® and ethinyl estradiol—a long-acting method for non-breastfeeding women that is in the late stages of development. The factsheet identifies milestones achieved and new opportunities in Senegal to implement activities in the year ahead.
Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee
Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee
Reproductive Health
To support the Government of Zambia in addressing its reproductive health challenges and in meeting its goals for 2020, the United Kingdom Department for International Development funded a four-year effort to support public sector contraceptive expansion under the Scaling Up Family Planning (SUFP) Project, led by Abt Associates. Launched in 2012, and with a focus on hard-to-reach areas and youth and expanding access to long-acting reversible contraceptives, SUFP was a technical assistance program designed to strengthen the ability of the public sector to provide services to meet the country’s FP2020 goals. SUFP focused on capacity building, infrastructure strengthening, behavior change …
Scaling Up Family Planning In Zambia—Part 2: The Cost Of Scaling Up Family Planning Services, David Collins, Colin Gilmartin
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 …
Delivering Contraceptive Vaginal Rings To Breastfeeding Women, Population Council
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.
Family Planning Knowledge, Attitudes, And Practices Among Married Men And Women In Rural Areas Of Pakistan: Findings From A Qualitative Need Assessment Study, Ghulam Mustafa, Syed Khurram Azmat, Waqas Hameed, Safdar Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed, Erik Munroe
Family Planning Knowledge, Attitudes, And Practices Among Married Men And Women In Rural Areas Of Pakistan: Findings From A Qualitative Need Assessment Study, Ghulam Mustafa, Syed Khurram Azmat, Waqas Hameed, Safdar Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed, Erik Munroe
Community Health Sciences
This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning …
Women's Contraceptive Choices: A Look Into The Women Of Warren And Allen Counties, Kentucky, Mollie M. Berger
Women's Contraceptive Choices: A Look Into The Women Of Warren And Allen Counties, Kentucky, Mollie M. Berger
Mahurin Honors College Capstone Experience/Thesis Projects
According to the 2013 Census, 76.2 million US women of childbearing age (15 to 50). About half (51%) of the 6.6 million pregnancies in the United States each year (3.4 million) are unintended. Although there is an overwhelming need for contraceptives, not everyone has access. This study seeks to gain information on the motivation behind women’s contraceptive choices in Warren and Allen County, KY. A questionnaire was created and distributed to patients in the clinic waiting rooms of Barren River District Health Department and Allen County Health Department, and additional surveys were sent to Western Kentucky University students enrolled in …
Low Use And High Discontinuation Of Modern Contraceptives In Pakistan: Reasons And Policy Recommendations, Population Council
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 …
Delivering Contraceptive Vaginal Rings—Task Sharing In The Delivery Of Family Planning Programs: Experiences From Senegal, Babacar Mane, Nafissatou Diop, Saumya Ramarao
Delivering Contraceptive Vaginal Rings—Task Sharing In The Delivery Of Family Planning Programs: Experiences From Senegal, Babacar Mane, Nafissatou Diop, Saumya Ramarao
Reproductive Health
The Population Council is conducting activities to facilitate the introduction of vaginal rings in sub-Saharan Africa. This report notes that the first ring to be introduced will be the Council’s Progesterone Contraceptive Vaginal Ring (PCVR), which is relevant in contexts where women practice prolonged lactation. The PCVR will also address the high unmet need for family planning (FP), especially for postpartum women. The Council aims to expand the availability and affordability of vaginal rings in Kenya, Nigeria, and Senegal. One of the challenges is the lack of skilled providers. To design plans for involving mid- and lower-level health workers in …