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Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health Jan 2002

Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health

Reproductive Health

In September 1999, the Zimbabwe National Family Planning Council (ZNFPC) and the Population Council initiated a one-year study to assess the performance of ZNFPC’s community-based distribution (CBD) program. A continual decline in the program’s productivity, combined with the expanding HIV/AIDS epidemic, indicated a need to reconsider ZNFPC’s objectives and revise the roles and responsibilities of its full-time, salaried CBD agents. The study examined the productivity, costs, and potential sustainability of the CBD program. Researchers gathered information by reviewing program documents through 1999. They also interviewed program managers, district and community nurses, and community leaders and CBD agents from eight regions. …


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 …


Institutional Support For A Program Of Activities Within The Pilot Health Project In The West Bank And Gaza, Health, Development, Information And Policy Institute Jan 2002

Institutional Support For A Program Of Activities Within The Pilot Health Project In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

This document contains reports on three activities undertaken by the Pilot Health Project (PHP) in order to upgrade antenatal and postpartum services for Palestinian women. Specifically, it includes results of a survey and a comprehensive assessment of the antenatal and postpartum care services, including family planning, that are currently provided at the project clinics. The findings show that the shortage of care provided to women during the perinatal period could be partially overcome by conducting home visits to provide information on many reproductive health issues, to help women and their families make decisions regarding their future fertility, and to provide …


Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health Jan 2002

Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health

Reproductive Health

The Population Council’s Frontiers in Reproductive Health program, with funding from USAID, organized a consultative meeting on the practice of female genital cutting (FGC) in Nairobi, Kenya in April 2002. The meeting brought together a small group of researchers and program managers who are actively undertaking operations research and systematic program evaluations to review the state of the art concerning intervention research design and measurement issues. The deliberations at this workshop should stimulate interest both in undertaking operations research more routinely when programming anti-FGC activities and in furthering the development and application of research methods appropriate for this subject. Several …


Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing Programs In Dar Es Salaam, Tanzania, Suzanne Maman, Jessie K. Mbwambo, Margaret Hogan, Gad P. Kilonzo, Michael D. Sweat, Ellen Weiss Jan 2001

Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing Programs In Dar Es Salaam, Tanzania, Suzanne Maman, Jessie K. Mbwambo, Margaret Hogan, Gad P. Kilonzo, Michael D. Sweat, Ellen Weiss

HIV and AIDS

This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Men and women both perceive HIV testing as a way to plan for the future but are motivated to undergo testing by a number of different individual, relationship, and environmental factors. The women in our study described more barriers to HIV testing than did men, and women who have communicated with their partners about VCT before seeking services are significantly more likely to share their HIV test results than those who have not talked with their …


Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah Jan 2001

Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah

Reproductive Health

With the reform movement in Indonesia, the FRONTIERS project recognized the new opportunities for influencing public debate and informing public opinion on reproductive health issues and undertook a project for disseminating the results of contemporary research on reproductive health. The project had three main objectives: 1) to increase print media coverage of critical reproductive health issues by enhancing journalists’ role as responsible communication agents; 2) to contribute to public debate on emerging reproductive health issues in order to influence policy development and guide program management; and 3) to increase public awareness of key health issues, with a particular focus on …


From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan Jan 2001

From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan

Poverty, Gender, and Youth

With access to safe, legal abortion under severe constraint or debate in many parts of the world, less attention has been paid to the issue of quality of abortion care. This issue of Quality/Calidad/Qualité explores two programs that operate in very different settings but with a shared commitment to providing high-quality abortion care in a context of broader reproductive health services: the Clinique d’Orthogénie of Broussais Hospital in France and Parivar Seva Sanstha in India. In both programs, each woman or girl who arrives for abortion receives crucial basic care, including: appropriate medical treatment to ensure complete abortion and safe …


The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar Jan 2001

The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar

Poverty, Gender, and Youth

This paper assesses whether audio computer-assisted self-interviewing (audio-CASI), a technique designed in the United States to collect data on sensitive behaviors, is a feasible method of survey data collection in a developing-country setting and whether it produces more valid reporting of sexual activity and related behaviors than traditional survey methods. The analysis is based on interviews with nearly 4,400 unmarried adolescents aged 15-21 in Nyeri, a rural district of Kenya that was selected because previous research had indicated a wide discrepancy in the reporting of premarital sexual behavior between boys and girls. The study was based on a quasi-experimental design …


Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed Jan 2001

Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed

Reproductive Health

In September 1997, the Population Council and Lusaka’s University Teaching Hospital (UTH) launched a 15-month study to identify and explore the range of issues relating to the introduction of emergency contraception (EC) within a developing country context. The study allowed clinic-based family planning providers to accumulate enough first-hand experience to be able to identify strategies for overcoming difficulties associated with the introduction or delivery of EC services. One issue on most participants’ minds was the need to expand the delivery of EC services toward young women, especially out-of-school women, who are harder to reach. Participants recommended that future research activities …


An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu Jan 2001

An Assessment Of Youth Centres In South Africa, Annabel Erulkar, Mags Beksinska, Queen Cebekhulu

Reproductive Health

Within South Africa there is much interest in expanding youth center programs, particularly in the nongovernmental sector, in part because of recognition that the HIV/AIDS crisis is disproportionately affecting young South Africans. This study was designed to give implementing agencies and donors a broad view of how the youth centers function, who they reach, and the quality of information and services. The assessment underscored the importance of monitoring the performance of programs and understanding who is being reached with what interventions. Youth centers that focus on providing recreational facilities attract a large number of clients, often boys who are repeat …


An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku Jan 2001

An Assessment Of The Alternative Rites Approach For Encouraging Abandonment Of Female Genital Mutilation In Kenya, Jane Chege, Ian Askew, Jennifer Liku

Reproductive Health

Maendeleo Ya Wanawake (MYWO), with technical assistance from the Program for Appropriate Technology in Health (PATH), has been implementing an Alternative Rite of passage programme as part of its efforts to eradicate the practice of female genital mutilation (FGM) in five districts in Kenya. This study addressed the factors that influence some families and individuals to adopt the Alternative Rite while others, exposed to the same messages discouraging FGM, decide not to. It also evaluated the effect of the training component of the Alternative Rite on the girls who participated.


Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend Jan 2001

Strengthening Social Science Research On Women's Health: Lessons Learned From A Capacity Building Programme, M.E. Khan, Bella C. Patel, John Townsend

Reproductive Health

The International Conference on Population and Development in 1994 led to an upsurge in interest in implementing reproductive health (RH) programs worldwide. The urgency to act has led to the development of disparate activities in several developing countries including India. While programs have been growing in numbers, their quality is in question. A fundamental problem has been lack of capacity at all levels of the health service system to respond to the paradigm shift articulated by the advocates of the reproductive health and rights agenda. To redesign programs, considerable research must be undertaken to understand the health needs and sociocultural …


Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi Jan 2001

Special Studies Program Of The Pilot Health Project: West Bank And Gaza, Mahmoud Shaheen, Laila Nawar, Dale Huntington, Sahar Hegazi

Reproductive Health

The Special Studies Program was implemented as part of the Pilot Health Project in the West Bank and Gaza to provide small grants to Palestinian researchers, research organizations, and advanced graduate students to conduct research that examines critical reproductive health topics related to maternal and child health care, including family planning. The research implemented under the Special Studies Program covered a range of topics including male involvement in reproductive health, clients' satisfaction with family planning programs, the relationship between early marriage and the delivery of premature infants, factors affecting compliance for iron supplementation, and diabetes mellitus during pregnancy. The research …


Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya Jan 2001

Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya

Reproductive Health

Sexually transmitted infections (STIs), including HIV, currently have high salience on the health care agendas of many countries, including India. Strategies for their control are ideally based on a number of well-recognised principles. These include: assessments of the burden of disease; the availability of interventions at policy and programme levels, to influence behaviour change and technical ‘solutions’; and the calculated cost-effectiveness of these interventions. In the case of India, data to inform these principles are often lacking in the case of STI control. In this paper we have reviewed the evidence base for STI control in the Indian context. The …


Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi Jan 2000

Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi

Reproductive Health

Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also …


A Participatory Evaluation Of The Life-Skills Training Programme In Myanmar, Unicef, Population Council Jan 2000

A Participatory Evaluation Of The Life-Skills Training Programme In Myanmar, Unicef, Population Council

Poverty, Gender, and Youth

In 1993 UNICEF/Myanmar launched an innovative project aimed at preventing the further spread of HIV/AIDS through the promotion of reproductive health. One of the activities undertaken was life-skills training for women and youth, conducted in collaboration with the Myanmar Red Cross Society (MRCS) and the Myanmar Maternal and Child Welfare Association (MMCWA). The objective of the training activities was to encourage and promote informed decision-making and care-seeking behavior among youth and women. The training aims to provide detailed and accurate information concerning sexuality, birth spacing, sexually transmitted diseases, and HIV/AIDS, and to provide skills for youth and women to enable …


Adolescent Girls' Livelihoods. Essential Questions, Essential Tools: A Report On A Workshop, Carey Meyers Jan 2000

Adolescent Girls' Livelihoods. Essential Questions, Essential Tools: A Report On A Workshop, Carey Meyers

Poverty, Gender, and Youth

This report, co-published by the Population Council and the International Center for Research on Women, describes a workshop convened in Cairo in 1999 to learn more about the nature of both younger and older adolescents' work experience, differentiate the particular needs and potentials of adolescent girls, and identify programs and policies that might have promise for supporting them.


Alone You Are Nobody, Together We Float: The Manuela Ramos Movement, Judith Bruce, Debbie Rogow Jan 2000

Alone You Are Nobody, Together We Float: The Manuela Ramos Movement, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

Quality/Calidad/Qualité, a publication of the Population Council, highlights examples of clinical and educational programs which bring a strong commitment, as well as innovative and thoughtful approaches, to the issue of quality care in sexual and reproductive health. The series is based on the philosophy that women and their partners have a fundamental right to respectful treatment, information, choice, and follow-up from reproductive health care providers. This issue discusses improving women’s health and well being through a range of empowerment strategies in rural Peru.


Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health Jan 2000

Burkina Faso: Upgrading Postabortion Care Benefits Patients And Providers, Frontiers In Reproductive Health

Reproductive Health

At the request of the Family Health Directorate of the Ministry of Health in Burkina Faso, the Reproductive Health Research Network (CRESAR) conducted a study during 1996–98 to introduce emergency care for women with complications from miscarriage or unsafe abortion. With technical assistance from the Population Council and JHPIEGO, CRESAR trained staff at two large hospitals in Ouagadougou and Bobo-Dioulasso to provide postabortion care (PAC). Training for physicians, nurses, and midwives covered manual vacuum aspiration, family planning methods, infection prevention, and communication with patients. Staff also participated in the development of policies and standards for PAC services. To measure changes …


Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health Jan 2000

Senegal: Train More Providers In Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, and …


Kenya: Offer Family Planning On Hospital Wards, Frontiers In Reproductive Health Jan 2000

Kenya: Offer Family Planning On Hospital Wards, Frontiers In Reproductive Health

Reproductive Health

In Kenya, more than one in three women hospitalized for gynecological problems has complications from miscarriage or unsafe abortion. These women generally receive no information or services for family planning (FP) or other reproductive health needs. During 1996–97, the Kenya Ministry of Health, the Population Council, and Ipas tested three models for providing postabortion care (PAC) and FP information and services in two areas of the hospital. Researchers compared model effectiveness by using surveys before and after the intervention. As concluded in this brief, the most effective way to ensure that women being treated for incomplete abortion obtain FP is …


Peru: Managers Must Monitor Quality Of Care Regularly, Frontiers In Reproductive Health Jan 2000

Peru: Managers Must Monitor Quality Of Care Regularly, Frontiers In Reproductive Health

Reproductive Health

In the late 1980s, Peru’s National Family Planning Program within the Ministry of Health (MOH) assigned method-specific targets to clusters of health facilities. In 1998, the MOH changed its policies to ensure that services responded to individual reproductive health needs and wishes. It eliminated method quotas, ended voluntary surgical contraception campaigns, and issued norms to ensure quality of care and informed choice. In 1999, the Population Council collaborated with the MOH to determine whether providers were complying with the new guidelines and, secondarily, to develop a monitoring system to assess compliance over time. As concluded in this brief, family planning …


Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health Jan 2000

Kenya: Identifying Rtis Remain Problematic: Prevention Is Essential, Frontiers In Reproductive Health

Reproductive Health

Since 1990, the Nakuru Municipal Council (Kenya) has implemented a multifaceted program to reduce the incidence of reproductive tract infections (RTIs), especially those that are sexually transmitted, including HIV/AIDS. Staff in the Council’s five health clinics use syndromic management guidelines, based on clients’ reported symptoms and clinical signs, to identify clients with RTIs. In 1998, the Population Council conducted a study to assess the accuracy of syndromic management and determine the best ways to integrate RTI management into existing antenatal (ANC) and family planning (FP) services. After an assessment of existing RTI services, 18 nurses from the five municipal clinics …


Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health Jan 2000

Egypt: Expand Access To Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

The Population Council has supported a series of studies to improve the quality of postabortion care (PAC) in Egypt. A 1994 pilot study in two Egyptian hospitals showed that upgrading PAC and training physicians in manual vacuum aspiration (MVA), infection control, and counseling led to significant improvements in the care of postabortion patients. The 1997 study, conducted by the Egyptian Fertility Care Society with support from the Population Council, sought to institutionalize improved postabortion medical care and counseling procedures in ten hospitals. Five senior physicians from each hospital attended a five-day training course in MVA, infection control, and family planning …


Peru: Tell Clients How To Use Their Chosen Method, Frontiers In Reproductive Health Jan 2000

Peru: Tell Clients How To Use Their Chosen Method, Frontiers In Reproductive Health

Reproductive Health

In 1998, the Peruvian Ministry of Health (MOH) issued quality of care norms to ensure that family planning providers respond to clients’ reproductive health care needs and goals. In mid-1999, the Population Council collaborated with the MOH on a study to determine whether length of counseling sessions affects amount of information provided. The study focused on 19 health centers in 10 urban areas. Six simulated clients (women posing as clients) made a total of 114 visits to the health centers during June–July 1999. Each client was trained to say that she wanted to switch from the rhythm method to a …


Egypt: Ngos Need To Join Forces To End Fgc, Frontiers In Reproductive Health Jan 2000

Egypt: Ngos Need To Join Forces To End Fgc, Frontiers In Reproductive Health

Reproductive Health

Until recently, the practice of female genital cutting (FGC) has been nearly universal in Egypt. However, a 1998 national survey found the first signs of a decline in the practice among adolescents since 1994. Nongovernmental organizations (NGOs) working in community development, health, and women’s rights have played a leading role in advocating eradication of FGC in Egypt. To document and assess the impact of anti-FGC programs, the Population Council conducted an assessment from August 1999 to February 2000. Researchers telephoned numerous Egyptian NGOs to identify those most actively involved in anti-FGC programs. Then they conducted in-depth interviews with officials of …


Mali: Fgc Excisors Persist Despite Entreaties, Frontiers In Reproductive Health Jan 2000

Mali: Fgc Excisors Persist Despite Entreaties, Frontiers In Reproductive Health

Reproductive Health

About 94 percent of Malian women aged 15–49 have experienced female genital cutting (FGC). In Mali, FGC is associated with serious gynecological and obstetric complications. In 1998, the National Center of Scientific and Technological Research of the Mali Ministry of Secondary and Higher Education and Scientific Research conducted an evaluation of programs to eradicate FGC. The study assessed the work of three national nongovernmental organizations working in Bamako and five regions of Mali. These NGOs had attempted to persuade traditional practitioners of FGC (“excisors”) to abandon the practice. All three NGOs employed outreach workers to educate excisors and community members …


Meet Women's Health Needs With Postabortion Care, Frontiers In Reproductive Health Jan 2000

Meet Women's Health Needs With Postabortion Care, Frontiers In Reproductive Health

Reproductive Health

Worldwide, one in eight pregnancy-related deaths result from complications of unsafe abortion such as bleeding, infection, or internal injuries. Many of these deaths could be prevented if women had the means to avoid unplanned pregnancy. At the 1994 United Nations International Conference on Population and Development, 180 governments identified postabortion care (PAC) as a high-priority public health issue. As part of the resulting global PAC initiative, the Population Council and other international organizations collaborated with governments and nongovernmental organizations in a worldwide program of operations research on interventions to improve postabortion care. This brief highlights the major findings of this …


Meeting Women's Health Care Needs After Abortion, Dale Huntington Jan 2000

Meeting Women's Health Care Needs After Abortion, Dale Huntington

Reproductive Health

Women who seek emergency treatment for abortion complications—bleeding, infection, and injuries to the reproductive tract system—should be a priority group for reproductive health care programs. These women often receive poor-quality services that do not address their multiple health needs. They may be discharged without counseling on postoperative recuperation, family planning (FP), or other reproductive health (RH) issues. Women who have had an induced abortion due to an unwanted pregnancy are likely to have a repeat abortion unless they receive appropriate FP counseling and services. Preventing repeat unsafe abortions is important for RH programs because it saves women's lives, protects women’s …


Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk Jan 2000

Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk

Reproductive Health

This paper is part of the Policy Series in Reproductive Health, which shares research undertaken by the Reproductive Health Working Group (RHWG). It describes the Reproductive Health Intervention Study, which designed and tested a model of essential reproductive health (RH) services. RHWG was established in 1988 as part of a special program on the health of women and children within the context of the family and community initiated by the Population Council’s Regional Office for the West Asia and North Africa region. The paper identifies a framework of basic service components that address RH and shows that their delivery is …