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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 …


Integrating Issues Of Sexuality Into Egyptian Family Planning Counseling, Nahla G. Abdel-Tawab, Laila Nawar, Hala Youssef, Dale Huntington Jan 2000

Integrating Issues Of Sexuality Into Egyptian Family Planning Counseling, Nahla G. Abdel-Tawab, Laila Nawar, Hala Youssef, Dale Huntington

Reproductive Health

The Population Council studied the acceptability of including sexuality issues in family planning (FP) in Egypt, a conservative society with social restrictions around discussions of sex. The study results showed that sexuality counseling is acceptable to family planning clients in Egypt; in fact, sexuality-related problems and concerns were found to be very common in the study group. Similarly, training family planning service providers on issues of sexuality is both feasible and acceptable to providers. The report offers recommendations for refining existing FP training programs and services including: integrating issues of sexuality into FP counseling, training FP service providers on the …


Increasing The Coverage Of Reproductive Health Issues In The Egyptian Press, Sahar Hegazi, Mona Khalifa Jan 2000

Increasing The Coverage Of Reproductive Health Issues In The Egyptian Press, Sahar Hegazi, Mona Khalifa

Reproductive Health

This project, based on previous experiments of the FRONTIERS and POLICY projects, aimed to widen media coverage in Egypt of critical reproductive health issues and to communicate related research findings in a more systematic manner. Increasing coverage in the Egyptian press first required an assessment of the current coverage. Second, a network was formed of about 20 journalists from newspapers and magazines of different publishing houses, followed by four roundtable discussions on critical reproductive health issues. The results of evaluation sheets from the roundtable discussions showed a general increase in the journalists’ knowledge about reproductive health issues, especially for important …


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 …


Informing Research On Hiv Prevention: A Consultation, Sharon Fonn, C. Elizabeth Mcgrory Jan 1999

Informing Research On Hiv Prevention: A Consultation, Sharon Fonn, C. Elizabeth Mcgrory

HIV and AIDS

According to a 1998 UNAIDS/WHO report, HIV infection among women is the fastest-growing segment of the AIDS pandemic, especially in developing countries. Unfortunately, the HIV-prevention strategies put forward by the public health community—monogamy, condom use, and treatment of sexually transmitted infections—are not feasible for many women. Women urgently need a means within their personal control to protect themselves against HIV. Recognizing this need, a number of international and nongovernmental organizations and government agencies have called for the development of microbicides, products that women could use vaginally to prevent infection with sexually transmitted infections, particularly HIV. The Population Council is one …


Improving The Management Of Stis Among Mch/Fp Clients At The Nakuru Municipal Council Health Clinics, Julie Solo, Baker Ndugga Maggwa, James Kariba Wabaru, Bedan Kiare Kariuki, Gregory Maitha Jan 1999

Improving The Management Of Stis Among Mch/Fp Clients At The Nakuru Municipal Council Health Clinics, Julie Solo, Baker Ndugga Maggwa, James Kariba Wabaru, Bedan Kiare Kariuki, Gregory Maitha

Reproductive Health

In an effort to address the global crisis of HIV/AIDS and to reduce the spread of other sexually transmitted infections (STIs), maternal and child health/family planning (MCH/FP) programs have attempted to integrate the management of STIs into their services. This integration was endorsed at the 1994 International Conference on Population and Development in Cairo. However, as noted in this report, programs have encountered a number of difficulties as they try to effectively manage STIs in an MCH/FP setting. In particular, the effective detection and treatment of STIs has proven difficult among MCH/FP populations. This current study was developed to help …


Review Of The Policy Process In Bangladesh Following Icpd, Nancy J. Piet-Pelon, Ubaidur Rob, Syeda Nahid Mukith Chowdhury, Abul Barkat, Sushil Ranjan Howlader, Sharif M.I. Hossain, Ismat Bhuiya, Siraj-Us- Saleheen Jan 1999

Review Of The Policy Process In Bangladesh Following Icpd, Nancy J. Piet-Pelon, Ubaidur Rob, Syeda Nahid Mukith Chowdhury, Abul Barkat, Sushil Ranjan Howlader, Sharif M.I. Hossain, Ismat Bhuiya, Siraj-Us- Saleheen

Reproductive Health

The International Conference on Population and Development (ICPD) in Cairo in 1994 was the culmination of months of national and international discussions. The issues had been crafted into a Program of Action, which represented a potential shift in thinking. Delegates left the conference espousing a new paradigm and a broad definition of what people, especially women, should expect from their national health services. Governments were encouraged to recognize that the improved health status of women could only be achieved by a life-cycle approach and that health depended not only on good family planning information and services but on women’s empowerment …


Testing Strategies To Improve Access To Emergency Contraception Pills: Prescription Vs. Prophylactic Distribution, John P. Skibiak, Yusuf Ahmed, M. Ketata Jan 1999

Testing Strategies To Improve Access To Emergency Contraception Pills: Prescription Vs. Prophylactic Distribution, John P. Skibiak, Yusuf Ahmed, M. Ketata

Reproductive Health

This report is the second in a series of research summaries produced in connection with the operations research project “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the project explores the many issues surrounding the introduction and delivery of emergency contraception services in a developing country context. The study described in this report compares two different approaches to overcoming barriers that prevent women from accessing emergency contraception during the 72-hour period when the first dosage of emergency contraception pills (ECPs) must be taken. In one approach, new family planning (FP) acceptors were …


Integrating Sti And Mch/Fp Services, Population Council Jan 1999

Integrating Sti And Mch/Fp Services, Population Council

Reproductive Health

The integration of STI and HIV/AIDS information and services into existing MCH/FP programs has been strongly supported in recent years, following recommendations from the 1994 Cairo ICPD. Moreover, it is now widely accepted that early detection and management of STIs can reduce the incidence of HIV infection. Thus, there are powerful incentives to increase efforts to broaden the capacity of MCH/FP programs to provide STI prevention and management information and services for their clients, both as a comprehensive reproductive health service and as a preventive measure for reducing the transmission of HIV. As described in this brief, the Africa OR/TA …


Estimating Costs Of Post-Abortion Services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico, Population Council Jan 1999

Estimating Costs Of Post-Abortion Services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico, Population Council

Reproductive Health

Health care systems around the world are facing problems providing quality care with increasingly constrained resources. While modern practices and diagnostic tests have made pregnancy a much less risky event than in the past, not all pregnancies have a favorable outcome. Spontaneous abortion occurs in 15–45% of all known pregnancies, and studies show that 25% of all obstetric/gynecology hospital admissions are for incomplete abortion. Given the high level of resources devoted to treating this condition, it is imperative to develop cost-effective methodologies to provide quality care. Unsafe abortion performed by untrained and inexperienced providers is the fourth leading cause of …


Zimbabwe: Rti Screening Methods For Women Are Not Cost-Effective, Population Council Jan 1999

Zimbabwe: Rti Screening Methods For Women Are Not Cost-Effective, Population Council

Reproductive Health

Reproductive tract infections (RTIs) are common in Zimbabwe. Many RTIs increase the risk of human immunodeficiency virus (HIV) infection. In 1998, the Zimbabwe National Family Planning Council (ZNFPC) conducted an operations research study to assess the feasibility of adding RTI diagnosis and treatment to its menu of services. The study population consisted of 1,634 clients at three ZNFPC clinics. Each client was asked about lower abdominal pain, vaginal discharge, and other RTI symptoms; examined for clinical signs of RTIs; and given laboratory tests to confirm the accuracy of diagnosis based upon symptoms and signs. Findings detailed in this brief were …


Reproductive Tract Infections: A Set Of Factsheets, Population Council Jan 1999

Reproductive Tract Infections: A Set Of Factsheets, Population Council

Reproductive Health

Reproductive tract infections (RTIs) are being increasingly recognized as a serious global health problem with impact on individual women and men, and their families and communities. RTIs can have severe consequences, including infertility, ectopic pregnancy, chronic pelvic pain, miscarriage, and increased risk of HIV transmission. For effective prevention and management of RTIs, accurate information is necessary and should be widely available. In addition to a brief introduction to RTIs, this document contains 13 factsheets addressing medical and social issues on a variety of topics related to RTIs. The document, produced by the Population Council with support from the Ford Foundation, …


The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council Jan 1999

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting, Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …


Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah Jan 1999

Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah

Reproductive Health

This report aims to explain the discrepancies in crisis-related research results in Indonesia, and to recommend methodologies to enhance future crisis-related monitoring and surveillance. The discussion aims to identify where the discrepancies are in the readily available data, and how these discrepancies can be explained. The report does not attempt to clarify the impact that the economic crisis is having on the health status of women and children in Indonesia. Recommendations are made to deal with the following findings: Aggregation of data may hide important crisis impacts; attribution of identified changes to the economic crisis may be misleading; differences in …


Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda Jan 1999

Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda

Reproductive Health

This project was designed to disseminate, expand use, and promote institutionalization of a program to train healthcare professionals to address domestic violence. The program was developed and implemented by the Instituto Mexicano de Investigación de Familia y Población (IMIFAP), a nongovernmental organization that promotes reproductive health. IMIFAP designed an 18-hour workshop, entitled “Health Services Respond to Domestic Violence,” to sensitize health professionals to domestic violence issues and develop strategies for recognizing and managing cases of domestic violence. Following the workshop, strong and significant increases in knowledge about domestic violence and its management in primary healthcare services were found. Workshop participants …


Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon Jan 1999

Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon

Reproductive Health

The goal of this project was to inform physicians, pharmacists, and female factory workers about emergency contraception (EC) through mailings of booklets and posters. These materials were developed in a previous operations research project conducted by the Instituto Mexicano de Investigación de Familia y Población and supported by the Population Council INOPAL III project with funding from USAID. The study found that recipients generally liked the print materials and welcomed information about EC. Within three weeks of receiving the materials, many reported that they had taken immediate action to make EC available and/or to educate others about EC. This project …


Reproductive Health Indicators: Moving Forward, Kelly Blanchard, Batya Elul, Saumya Ramarao Jan 1999

Reproductive Health Indicators: Moving Forward, Kelly Blanchard, Batya Elul, Saumya Ramarao

Reproductive Health

This report is designed to help researchers, program managers, policymakers, and advocates sift through and evaluate which potential indicators might be useful in a particular programmatic context. It was initially prepared as a background manuscript for a Population Council meeting on reproductive health indicators held in Cairo in March 1998. The manuscript has since been modified to incorporate ideas and comments expressed at that meeting, as well as to include input from other Population Council colleagues.


Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri Jan 1999

Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri

Reproductive Health

At the International Conference on Population and Development (ICPD) in 1994, the nations of the world agreed to give special attention to girls’ education, women’s health, infant survival, and women’s empowerment, and to provide comprehensive reproductive health (RH) services to enable couples to achieve their reproductive goals. The government of India launched a reproductive and child health program in October 1997. This book begins a review of the processes underway to operationalize the program. It brings together several important initiatives at various stages of development and examines key policy and program issues based on empirical research and field experience. The …


Comparing Alternative Products In The Provision Of Emergency Contraception, John P. Skibiak, Yusuf Ahmed, M. Ketata Jan 1999

Comparing Alternative Products In The Provision Of Emergency Contraception, John P. Skibiak, Yusuf Ahmed, M. Ketata

Reproductive Health

This report is the third in a series of summaries produced in connection with the operations research project “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the project explores the many issues surrounding the introduction and delivery of emergency contraception services in a developing country context. The study compares the introduction of two different emergency contraception pills—the combined oral contraceptive PC-4, introduced in Zambia in 1997, and the progestin-only contraceptive Postinor-2, introduced by this study in the following year. Client histories showed only minor differences in the attitudes of emergency contraception users …


Postabortion Care: Lessons From Operations Research, Dale Huntington, Nancy J. Piet-Pelon Jan 1999

Postabortion Care: Lessons From Operations Research, Dale Huntington, Nancy J. Piet-Pelon

Reproductive Health

This book focuses on one central but until now intransigent aspect of women’s health: How to reduce the toll of death and morbidity associated with unsafe abortion. For the first time in the history of international decision-making, Cairo established a consensus on abortion. This was reaffirmed in the 1999 United Nations General Assembly statement. Where abortion is illegal, many women use herbal remedies, take modern drugs in unsupervised ways, attempt to physically self-induce, or seek help from abortion providers working outside the law. Where abortion is illegal, women are exposed to painful, dangerous procedures and many fall so sick that …


Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew Jan 1998

Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew

Reproductive Health

The presence of certain STIs increases the risk of the sexual transmission of HIV. Thus, controlling STIs can reduce the incidence of HIV. Almost all women in the East and Southern African regions attend MCH/FP clinics regularly, and recent surveys have shown that the prevalence levels of many STIs, including HIV, can be high for women seeking FP and antenatal services, even though they are frequently asymptomatic. MCH/FP services are provided by medically trained staff with many of the same skills needed for managing STIs. Consequently, several MCH/FP programs have started looking for ways to integrate STI management strategies, such …


Emergency Contraception In Zambia: Setting A New Agenda For Research And Action, Yusuf Ahmed, M. Ketata, John P. Skibiak Jan 1998

Emergency Contraception In Zambia: Setting A New Agenda For Research And Action, Yusuf Ahmed, M. Ketata, John P. Skibiak

Reproductive Health

This report summarizes the activities and findings of the first phase of the operations research study, “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the study was designed to explore a broad range of issues relating to emergency contraception within a developing country context. With financial and technical support from the United States Agency for International Development, the World Health Organization, the Canadian Public Health Association, and the British Department for International Development (DFID), the study consists of an initial exploratory exercise and a subsequent research phase. The report is divided into …


The Impact Of Monetary Crisis And Natural Disasters On Women's Health And Nutrition, Meiwita B. Iskandar Jan 1998

The Impact Of Monetary Crisis And Natural Disasters On Women's Health And Nutrition, Meiwita B. Iskandar

Poverty, Gender, and Youth

This paper analyzes the short-term effects of the monetary crisis and natural disasters in Indonesia on women's health and nutritional status, and activities to monitor and address these problems. The monetary crisis which was announced in January 1998 hit the highest monthly inflation rate of 13 percent in February. Natural disasters that have plagued Indonesia since early 1997, including droughts and forest fires, have been projected to cause famines and an increased likelihood of infant and adult mortality. The economic crisis also directly impacts millions of workforce members threatened by the downsizing of thousands of businesses and factories, in the …


Covert Contraceptive Use: Prevalence, Motivations, And Consequences, Ann E. Biddlecom, Bolaji M. Fapohunda Jan 1998

Covert Contraceptive Use: Prevalence, Motivations, And Consequences, Ann E. Biddlecom, Bolaji M. Fapohunda

Poverty, Gender, and Youth

This paper examines women’s covert use of contraceptives, that is, use without the knowledge of their husbands. Covert use may highlight conflict between husbands and wives about family planning, or it may reflect behaviors that spouses find difficult to discuss together. This study addresses three questions: 1) How is covert use measured in different settings? 2) How prevalent is it? and 3) What are the factors underlying covert use? We examine these questions by drawing on existing studies and detailed survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and a subsample of …


Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia Jan 1998

Using Cope To Improve Quality Of Care: The Experience Of The Family Planning Association Of Kenya, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia

Poverty, Gender, and Youth

This is the first of several editions of Quality/Calidad/Qualité that describe methodologies designed to assist family planning program managers and staff to self-assess the quality of services they are providing. These tools give program sponsors an opportunity to identify shortfalls in their service environment and propose solutions. This issue focuses on AVSC International's COPE (client-oriented, provider-efficient) methodology, a self-assessment tool that has now been used in 35 countries around the world. The report examines the experience of the National Family Planning Association of Kenya, provides some lessons learned, and demonstrates that these self-assessment exercises are, in fact, resulting in system-wide …


Integrating Rti Service With Primary Health Care, Population Council Jan 1998

Integrating Rti Service With Primary Health Care, Population Council

Reproductive Health

The reproductive health (RH) movement worldwide has brought reproductive tract infections (RTIs) under sharp focus as an urgent health need of women. While RTIs are preventable or treatable, they are often the cause of infertility, ectopic pregnancy, cervical cancer, fetal loss, low birth-weight infants, infant blindness, and neonatal pneumonia. The adverse health effects of RTIs, particularly STIs, is much higher for women than men. Recent research has demonstrated that RTIs are closely linked to other areas of health care like family planning (FP), safe motherhood, child survival, and HIV prevention. Hence, each could significantly contribute to the reduction and control …


Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad Jan 1998

Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad

Reproductive Health

This paper offers a broad definition of quality of care and presents a comprehensive conceptual framework for the assessment of quality of reproductive health services and methodological approaches for its measurement. It presents three studies that were conducted between 1990 and 1991 by members of the regional Reproductive Health Working Group from Egypt, Jordan, and Tunisia. The studies provide examples of applications of the framework and its measurement using multiple data sources. Selected findings are presented to illustrate comparative results between countries. Based on the lessons learned from the studies, examples of reproductive health interventions that may improve the quality …


Increasing Demand For Reproductive Health Services In A Peruvian Clinic, Federico R. Leon, Anibal Velasquez, Lissette Jimenez, Alicia Calderon Jan 1998

Increasing Demand For Reproductive Health Services In A Peruvian Clinic, Federico R. Leon, Anibal Velasquez, Lissette Jimenez, Alicia Calderon

Reproductive Health

Over the past few years, well-established family planning (FP) organizations in developing countries, such as INPPARES, the IPPF affiliate in Peru, have strived to implement the Cairo Agenda. In the process of including reproductive health (RH) in FP care, they have dedicated human resources and infrastructure to provide RH services seldom offered in the past. The problem these organizations now face is to increase use of the newly available RH care. Currently, clients seeking FP services may leave clinics unaware of the other RH care provided. At a time when international donors are phasing out financial assistance, the partially idle …


Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health Jan 1998

Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health

Reproductive Health

The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …


Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga Jan 1998

Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga

Reproductive Health

Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …