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Management Support For Postabortion Operations Research At The Egyptian Fertility Care Society, Population Council Jan 1998

Management Support For Postabortion Operations Research At The Egyptian Fertility Care Society, Population Council

Reproductive Health

The ANE OR/TA Project started its first five-year phase in 1991 addressing increased choice and accessibility of contraceptive use, promoting quality of family planning (FP) services in Asia and the Near East, and promoting the use of operations research (OR) to solve service-delivery problems. The first phase emphasized human resource development. During the years leading up to the 1994 International Conference on Population and Development, there was increased global attention to issues related to reproductive health (RH), and in particular the adverse health implications of harmful RH practices, including unsafe abortion. OR was being called upon to help implement this …


An Assessment Of Community-Based Family Planning Programs In Kenya, Jane Chege, Ian Askew Jan 1997

An Assessment Of Community-Based Family Planning Programs In Kenya, Jane Chege, Ian Askew

Reproductive Health

Kenya has a long history of using community-based distribution (CBD) as an integral part of its family planning (FP) program. The purpose of this study was to assess the role of CBD programs in terms of providing information and services, to learn more about the determinants of program effectiveness, and to attempt to compare the programs’ cost-effectiveness. Fieldwork was undertaken in mid-1995 when data were collected from seven of the major CBD programs in Kenya. Four rural and three urban programs were included, as were programs that remunerated their agents and those that did not, and programs that had full-time …


Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings Jan 1997

Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings

Reproductive Health

In Kenya, as throughout the world, the health consequences of unsafe abortion for women of reproductive age are significant. Hospital-based studies in Nairobi have shown that unsafely induced abortion accounts for as much as 35 percent of pregnancy-related mortality and at least 50 percent of hospitals’ gynecological admissions. The concept of postabortion care (emergency treatment, postabortion family planning counseling and services, links between emergency abortion treatment services and comprehensive reproductive health care) has gained wide acceptance as one model of providing comprehensive care to women suffering from abortion complications. Integration of these three components is rarely found in public health …


Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Nakuru Municipal Council's Project On Strengthening Std/Aids Control, James Kariba Wabaru, Bedan Kiare Kariuki, Baker Ndugga Maggwa Jan 1997

Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Nakuru Municipal Council's Project On Strengthening Std/Aids Control, James Kariba Wabaru, Bedan Kiare Kariuki, Baker Ndugga Maggwa

Reproductive Health

Kenya’s Nakuru Municipal Council (NMC) operates five clinics located primarily in residential areas with high concentrations of people. The clinics provide basic antenatal, child welfare, STI, and other curative services, and family planning services are available at four of the clinics. One provincial referral hospital operated by the Ministry of Health also provides MCH-FP and HIV/STI services in a special STI treatment clinic. The seven public health facilities in Nakuru Municipality are participating in a collaborative project with the Department of Community Health at the University of Nairobi, the University of Manitoba in Canada, and the Nairobi Municipal City Council. …


Scaling-Up Improved Postabortion Care In Egypt: Introduction To University And Ministry Of Health And Population Hospitals, Laila Nawar, Dale Huntington, Ezzeldin Osman Hassan, Hala Youssef, Nahla G. Abdel-Tawab Jan 1997

Scaling-Up Improved Postabortion Care In Egypt: Introduction To University And Ministry Of Health And Population Hospitals, Laila Nawar, Dale Huntington, Ezzeldin Osman Hassan, Hala Youssef, Nahla G. Abdel-Tawab

Reproductive Health

In Egypt, the legal, religious, and societal restrictions on abortion have constrained the provision of high-quality emergency health care services provided to postabortion patients, including links with family planning (FP) services. In 1994, a small-scale pilot study was conducted by the Egyptian Fertility Care Society and the Population Council's ANE OR/TA Project (1995) to improve postabortion care in Egypt. The study intervention included an intensive training program for physicians on the use of Manual Vacuum Aspiration instruments under local anesthesia. Physicians were also instructed in infection-control practices and counseling postabortion patients about their medical condition and FP. The study findings …


Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend Jan 1997

Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend

Reproductive Health

Evidence from community studies indicates that significant proportions of Indian women (30 percent) may have reproductive tract infections (RTIs). Given that women are in general asymptomatic and that even symptomatic women may not seek care, the estimates are the minimum levels of prevalence. Most women do not seek treatment for RTIs for such reasons as lack of awareness, acceptance that RTIs are part of women's lives, and lack of treatment facilities. On the supply side, in the public sector the treatment for RTIs is limited with most services provided through STD clinics in urban areas. Seeking treatment at STD clinics …


Sexual Violence Within Marriage: A Case Study Of Rural Uttar Pradesh, M.E. Khan, John Townsend, Ranjana Sinha, Seema Lakhanpal Jan 1997

Sexual Violence Within Marriage: A Case Study Of Rural Uttar Pradesh, M.E. Khan, John Townsend, Ranjana Sinha, Seema Lakhanpal

Reproductive Health

Until recently the study of sexual behavior, despite being a very important area of human behavior, has remained an untouchable subject. The sensitivity of the subject and difficulties collecting required information discouraged social scientists from venturing into this area of human behavior. However, the advent of AIDS and its rapid spread in India has changed the scenario. Today the study of sexual behavior is an important subject and both national and international agencies, as part of the AIDS control program, are encouraging research on the subject. This paper addresses a totally neglected area, which is sexual coercion within marriage. The …


Improved Reproductive Health And Std Services For Women Presenting To Family Planning Services In North Jakarta. Final Report Of Activities, Meiwita B. Iskandar, Catherine Vickers, Subadra Indrawati, Siti Nurul Qomariyah Jan 1997

Improved Reproductive Health And Std Services For Women Presenting To Family Planning Services In North Jakarta. Final Report Of Activities, Meiwita B. Iskandar, Catherine Vickers, Subadra Indrawati, Siti Nurul Qomariyah

Reproductive Health

The overall goal of this study was to develop an integrated program of reproductive tract infection/sexually transmitted disease (RTI/STD) clinical services within two family planning clinics in low-income neighborhoods in North Jakarta. Multiple training programs to introduce a standardized clinical evaluation for the detection, treatment, and management of RTI/STDs were conducted. Prior and subsequent to training, observations of health care provider (HCP) and client interactions were conducted to evaluate behavior changes among HCPs. Each consenting client received a standardized reproductive health history, a pelvic exam, and provided specimens for laboratory testing to detect RTIs. Through universal screening of the participants …


Emergency Contraception As An Element In The Care Of Rape Victims, Ricardo Vernon, Raffaela Schiavon, Silvia Elena Llaguno Jan 1997

Emergency Contraception As An Element In The Care Of Rape Victims, Ricardo Vernon, Raffaela Schiavon, Silvia Elena Llaguno

Reproductive Health

In most states in Mexico, abortion is excluded as a crime in pregnancies resulting from rape. However, legislation does not specify the norms by which women can obtain a legal abortion, which makes it difficult to choose this alternative. A partial solution to unwanted pregnancies from rape would be to provide emergency contraception (EC). Psychologists were trained to provide information on EC to women who reported a rape at four public ministry agencies specialized in sexual crime. In addition, 11 medical backup referral centers were established. To scale up the strategy, workshops were provided to representatives from State Attorney General …


Postabortion Case Load Study In Egyptian Public Sector Hospitals, Egyptian Fertility Care Society, Population Council Jan 1997

Postabortion Case Load Study In Egyptian Public Sector Hospitals, Egyptian Fertility Care Society, Population Council

Reproductive Health

There is an absence of reliable data on the incidence of incomplete abortion in Egypt. A diagnostic, descriptive study that neither tests an experimental intervention nor evaluates in a comprehensive manner the quality of postabortion medical care was undertaken to address this issue. The study is a cross-sectional observation of the volume and nature of the postabortion case load in Egyptian public-sector hospitals, and it responds to the following objectives: 1) Accurately estimate the number of women who present for postabortion treatment in ob/gyn in-patient facilities as a percentage of ob/gyn admissions in a representative sample of Egyptian public-sector hospitals …


Clinic-Based Investigation Of The Typology And Self-Reporting Of Fgm In Egypt, Population Council Jan 1996

Clinic-Based Investigation Of The Typology And Self-Reporting Of Fgm In Egypt, Population Council

Reproductive Health

This clinic-based study of female genital mutilation (FGM) was designed and carried out by the Egypt Fertility Care Society to gather detailed information on the types of FGM practiced in Egypt. The study involved interviews with clinic clients to elicit information about their experience and attitudes concerning FGM, and gynecological examinations by specially trained OB/GYN physicians. In all, 93% of the women in this study were found to have some type of FGM. The study's findings were incorporated in the final report of the 1995 Egyptian Demographic and Health Survey, with the aim of contributing to the scientific understanding of …


Reintroducing Dmpa To The Philippine Family Planning Program: A Longitudinal Study Of Continuing Users And Drop-Outs, Population Council Jan 1996

Reintroducing Dmpa To The Philippine Family Planning Program: A Longitudinal Study Of Continuing Users And Drop-Outs, Population Council

Reproductive Health

In 1994, the Population Council, Manila, conducted an operations research (OR) project entitled “DMPA Monitoring and Follow-up Studies.” The activity was undertaken to provide accurate and timely support to the DMPA Reintroduction Program of the Department of Health. Commonly known as Depo-Provera, DMPA stands for Depo-Medroxy Progesterone Acetate, an extremely effective injectable contraceptive given every three months. This report focuses on the survey component of these studies which aims to comprehensively examine the influence on DMPA use of factors classified into the following eight major areas: socioeconomic and demographic characteristics; reproductive history; contraceptive history; adoption of DMPA; quality of care …


Living On A Fault Line: Political Violence Against Women In Algeria, Leila Hessini Jan 1996

Living On A Fault Line: Political Violence Against Women In Algeria, Leila Hessini

Poverty, Gender, and Youth

This study raises three questions to better comprehend the crisis women face in Algeria today: how are the state and the opposition groups addressing and defining women’s contemporary status, what is the link between women’s status and violence against them, and what are the tactics both of resistance and accommodation that Algerian women are using to survive in such a context? Throughout this study, the term “Islamic Fundamentalists” refers to movements and people in Algeria who use the “recovery” of early principles of the Ideal Muslim Community to develop their idea of a future Islamic “social order,” with the ultimate …


Women's Perceptions Of Sexuality In Rural Giza, Hind Khattab Jan 1996

Women's Perceptions Of Sexuality In Rural Giza, Hind Khattab

Poverty, Gender, and Youth

This study on sexuality among women in rural Giza, Egypt, is part of a broader project on women's health and reproductive morbidity conducted by the Population Council’s Reproductive Health Working Group. Reproductive tract infections (RTIs) and other ailments associated with reproduction among women in the rural community surveyed suggest that a heavy burden of disease is being borne by women living in underprivileged areas in this region. This research on sexuality has been conducted within a conceptual framework that uses a socio-cultural approach to health and illness. The investigation is an assessment of women's perception of and knowledge about sexuality …


Dmpa Injectable Use: Findings From The 21-Month Dmpa Monitoring Study, Population Council Jan 1996

Dmpa Injectable Use: Findings From The 21-Month Dmpa Monitoring Study, Population Council

Reproductive Health

This report presents the results of the DMPA Monitoring Study undertaken by the Population Council, Manila, as a technical assistance project for the DMPA Reintroduction Program of the Department of Health. The primary objective is to provide data on DMPA utilization and continuation rates to project the logistical needs of the program during the next three years. Data on availability of DMPA supplies and IEC (information, education, and communication) materials relating to DMPA were also monitored to provide some measure of effectiveness of the program's distribution system. The study covers a 21-month observation period from April 1994 to December 1995 …


Addressing Women's Reproductive Health Needs: Priorities For The Family Welfare Programme, Shireen J. Jejeebhoy Jan 1995

Addressing Women's Reproductive Health Needs: Priorities For The Family Welfare Programme, Shireen J. Jejeebhoy

Reproductive Health

India's national family welfare program has two objectives—to address the needs of families, notably women and children, and to reduce population growth rates. In reality, the program has been disproportionately focused on achieving demographic targets by increasing contraceptive prevalence. In this process, women's needs have been overlooked, in terms of poor reproductive health (RH). There is a need to reorient program priorities to focus more holistically on RH needs and on woman-based services that respond to health needs in ways sensitive to the sociocultural constraints women and adolescent girls face in acquiring services and expressing health needs. This report presents …


Development Of Approaches To Community Based Family Planning Outreach In Egypt: Assessment Of Raidats Rifiats Program, Population Council Jan 1995

Development Of Approaches To Community Based Family Planning Outreach In Egypt: Assessment Of Raidats Rifiats Program, Population Council

Reproductive Health

Egypt’s family planning program officially began in 1965. Impressive gains in contraceptive use have been made since 1980, and the contraceptive prevalence rate increased from 24 percent in 1980 to 47 percent in 1992. Egypt’s National Population Policy addresses the nation’s population growth through multiple interventions designed to reduce fertility, including family planning (FP) services. FP accessibility is promoted through a network of public and NG0 FP clinics. A number of years ago, the Egyptian Family Planning Program began using the Raidats Rifiats program to extend services into rural communities. There is concern regarding the program’s ability to recruit women …


Families In Focus: New Perspectives On Mothers, Fathers, And Children, Judith Bruce, Cynthia B. Lloyd, Ann Leonard, Patrice L. Engle, Niev Duffy Jan 1995

Families In Focus: New Perspectives On Mothers, Fathers, And Children, Judith Bruce, Cynthia B. Lloyd, Ann Leonard, Patrice L. Engle, Niev Duffy

Poverty, Gender, and Youth

Despite the rhetoric of recent years lamenting the loss of the "traditional family," families have never fit nicely into any single model. "Family" may refer to people linked by marriage or kinship or to people claiming descent from common ancestors. People may form and extend families by adopting or fostering children, defining nonrelatives as family, or establishing consensual partnerships. Families are as adaptable as they are diverse, reconfiguring themselves over their life cycles and evolving to accommodate the myriad pressures of the external world. This book focuses on families with dependent children specifically—on the roles of mothers, fathers, and children, …


Doing More With Less: The Marie Stopes Clinics In Sierra Leone, Nahid Toubia, Grace Ebun Delano Jan 1995

Doing More With Less: The Marie Stopes Clinics In Sierra Leone, Nahid Toubia, Grace Ebun Delano

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité reports on the Marie Stopes Sierra Leone (MSSL) organization which pursues its goals with compassion and ambition, despite seemingly insurmountable economic hardships. MSSL has established a service model that many programs in richer countries should try to imitate. Several particularly important lessons emerged, including: creative, skillful management, well-organized and flexible financial administration, and human motivation and perseverance can enable an organization to overcome financial difficulties; family planning is an integral part of people's reproductive and general health concerns and can dovetail with concern for development in useful and practical ways; men appreciate being involved in the …


The Coletivo: A Feminist Sexuality And Health Collective In Brazil, Margarita Diaz, Debbie Rogow, Jose Barzelatto Jan 1995

The Coletivo: A Feminist Sexuality And Health Collective In Brazil, Margarita Diaz, Debbie Rogow, Jose Barzelatto

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité tells the story of a group of Brazilian women who came together in 1981 with the shared belief—not as widely understood then as it is now—that conventional approaches to women's health and family planning services were overly medicalized, incapable of dealing with the relationship between sexuality and contraception, and disempowering to clients. They started the Coletivo which runs a clinic, a training institute, and a public education program that has “given voice” to thousands of women, provided leadership to the Brazilian government and women’s health movement, and has been active in research and international policy affairs. …


What We Do And Do Not Know About The Menstrual Cycle Or, Questions Scientists Could Be Asking, Sioban D. Harlow, Sara A. Ephross Jan 1995

What We Do And Do Not Know About The Menstrual Cycle Or, Questions Scientists Could Be Asking, Sioban D. Harlow, Sara A. Ephross

Reproductive Health

The objective of this paper is to consider from a public health perspective the types of questions researchers might be asking about the relationship between menstrual function and women’s health, and to evaluate to the extent to which these questions have or have not been addressed by the scientific community. Based on the findings in this report, it is obvious that a comprehensive program of research is needed in order to begin filling the myriad gaps in scientific knowledge about the menstrual cycle. Given the lack of knowledge about many fundamental aspects of menstrual function and about linkages between the …


Sexual Coercion And Reproductive Health: A Focus On Research, Lori L. Heise, Kirsten Moore, Nahid Toubia Jan 1995

Sexual Coercion And Reproductive Health: A Focus On Research, Lori L. Heise, Kirsten Moore, Nahid Toubia

Reproductive Health

Gender-based violence is ignored or denied in most societies and neglected by health professionals and researchers, yet it persists in almost all societies, and, in some, it is on the increase. This report is aimed at those in the family planning/reproductive health field who desire to conduct research or implement programs to address sexual violence and its impact on women's reproductive health. Furthermore, it contributes to a better understanding of the context of sexual coercion as well as its causes and consequences. The ideas presented herein are derived largely from a two-day meeting jointly organized by the Ebert Program in …


Improving The Counseling And Medical Care Of Postabortion Patients In Egypt, Population Council, Egyptian Fertility Care Society Jan 1995

Improving The Counseling And Medical Care Of Postabortion Patients In Egypt, Population Council, Egyptian Fertility Care Society

Reproductive Health

This pilot study conducted in Cairo and Minya examined the effects of improving the medical care and counseling of post-abortion patients in Egypt. A pre-test/post-test, no control group study design was used to measure the effects of an intervention that upgraded physicians' clinical and interpersonal communication skills for the care of post-abortion patients, including counseling and family planning (FP). The study's surveys utilized direct interviews with staff working in the OB/GYN wards, structured observations of treatment procedures and counseling of post-abortion patients, and interviews with patients prior to discharge. Changes in the clinical management of post-abortion patients were introduced through …


Improving Community Based Family Planning Services And The Potential For Increasing Contraceptive Prevalence In Bangladesh, Amy Gale Dunston, Peter C. Miller Jan 1995

Improving Community Based Family Planning Services And The Potential For Increasing Contraceptive Prevalence In Bangladesh, Amy Gale Dunston, Peter C. Miller

Reproductive Health

This report contains descriptions of 13 family planning (FP) projects recently implemented in Bangladesh. The results in terms of the contraceptive prevalence rate (CPR) are analyzed to investigate the degree to which improved FP service delivery in Bangladesh can increase contraceptive use in the present status of demand, investigate the programmatic factors most associated with increased prevalence, and make these projects more widely known. Criteria for inclusion included coverage of a geographic area where household distribution of contraceptive supplies was available, and where at least one measurement of CPR has been made through credible survey efforts since July 1988. The …


Follow-Up Study Among Iud Acceptors Of Java, R. Hasan M. Hoesni, M. Hasan, Anthony Tan, Jayanti Tuladhar, Jusuf S. Effendi, Bantuk Hadijanto, Pudjo Hartono Jan 1995

Follow-Up Study Among Iud Acceptors Of Java, R. Hasan M. Hoesni, M. Hasan, Anthony Tan, Jayanti Tuladhar, Jusuf S. Effendi, Bantuk Hadijanto, Pudjo Hartono

Reproductive Health

As of April 1993, an estimated 5.3 million women in Indonesia were using IUDs. In 1991, the IUD was the second most commonly used family planning method in Indonesia (13.4 percent). According to the Indonesia Demographic and Health Survey, in 1994 it became the third most commonly used method among currently married women (10.3 percent), primarily on the islands of Java and Bali. The National Family Planning Coordinating Board (BKKBN), in collaboration with the Faculties of Medicine, Diponegoro University in Semarang, Airlangga University in Surabaya, and BKS-Penfin in Bandung, conducted a "Follow-up Study Among IUD Acceptors of Java,” from November …


Arab Women: A Profile Of Diversity And Change, Nahid Toubia, Amira Bahyeldin, Nadia Hijab, Heba Abdel Latif Jan 1994

Arab Women: A Profile Of Diversity And Change, Nahid Toubia, Amira Bahyeldin, Nadia Hijab, Heba Abdel Latif

Poverty, Gender, and Youth

The status of Arab women is the subject of much speculation, generalization, and stereotyping by those inside and outside the region. The paucity of objective, accessible information makes Arab women one of the least understood social groups. The aim of this book is to help correct misconceptions about Arab women by introducing systematic information for 21 Arab countries. Widely published international statistical data, mostly from the United Nations and the World Bank, were used for the comparisons. These datasets are compiled from country reports, national surveys, and aggregated smaller studies. They are by no means comprehensive or devoid of inaccuracies, …


Partnership For Prevention: A Report Of A Meeting Between Women's Health Advocates, Program Planners, And Scientists, Population Council Jan 1994

Partnership For Prevention: A Report Of A Meeting Between Women's Health Advocates, Program Planners, And Scientists, Population Council

Reproductive Health

In May 1994, the Population Council, in conjunction with the Pacific Institute for Women's Health and the International Women's Health Coalition, hosted a meeting for women's health advocates from around the world to discuss the development of microbicides. This process was the first step in building greater understanding and mutual respect among women's health advocates and Population Council staff and scientists with regard to the technology of microbicides. Participants hoped that the recommendations resulting from this initiative would have a positive influence not only on the development of microbicides, but on all reproductive health technologies. This report aims to reproduce …


The Development Of Microbicides: A New Method Of Hiv Prevention For Women, Christopher J. Elias, Lori L. Heise Jan 1993

The Development Of Microbicides: A New Method Of Hiv Prevention For Women, Christopher J. Elias, Lori L. Heise

HIV and AIDS

A critical review of current epidemiological trends and social science research demonstrates that there is an urgent need for expanding the range of female-controlled HIV prevention methods. Existing efforts to control the spread of HIV infection primarily through the encouragement of a reduction in the number of sexual partners, widespread condom promotion, and the control of other sexually transmitted infections are inadequate for many of the world's women. Underlying gender power inequities severely limit the ability of many women to protect themselves from HIV infection, especially in the absence of a prevention technology they can use, when necessary, without their …


Gente Joven/Young People: A Dialogue On Sexuality With Adolescents In Mexico, Magaly Marques, John M. Paxman, Judith Bruce Jan 1993

Gente Joven/Young People: A Dialogue On Sexuality With Adolescents In Mexico, Magaly Marques, John M. Paxman, Judith Bruce

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité describes the experience of one adolescent sexuality program, Gente Joven in Mexico. Gente Joven began by acknowledging reality: that the problems related to teenage sexuality will not go away simply by denying their existence. Along the way Gente Joven learned, and is continuing to learn, many lessons about how to build a successful program for adolescents. Here they share their experiences and the Afterword explores in greater depth one particular issue that Gente Joven has identified as its next major challenge: re-examining their work with young people from a gender perspective.


Rethinking Postpartum Health Care, Martha Brady, Beverly Winikoff Jan 1993

Rethinking Postpartum Health Care, Martha Brady, Beverly Winikoff

Reproductive Health

These proceedings come from papers and discussions as part of the Population Council invitational seminar entited "Rethinking Postpartum Health Care," in 1992. The seminar on postpartum reproductive health was the fifth in a series of seminars convened by the Population Council as part of its Robert H. Ebert Program on Critical Issues in Reproductive Health and Population. The program focuses on four topics: 1) improving and devising new approaches to postpartum care; 2) improving the quality of care in family planning and reproductive health services; 3) managing unwanted pregnancy and preventing the consequences of unsafe abortion; and 4) bringing attention …