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Full-Text Articles in Women's Health

Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council Jan 2008

Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council

Reproductive Health

The Kenyan government’s reproductive health policy highlights service integration and quality of care. While integrating counseling and testing (C&T) for HIV into family planning (FP) can potentially increase the range of services to clients at risk from sexually transmitted infections (STIs) including HIV, few studies have documented the feasibility, effects, or costs of such integration. From 2005–07, the Population Council worked with the Kenyan Ministry of Health to test the feasibility of two models for integrating C&T into existing FP services. Both models featured client education on HIV prevention during FP visits. Providers were trained to routinely use the Balanced …


Community-Based Approaches To Prevention Of Mother-To-Child Transmission Of Hiv: Findings From A Low-Income Community In Kenya, Susan Kaai, Carolyn Baek, Scott Geibel, Peter Omondi, Benson Ulo, Grace Muthumbi, Carol Nkatha, Naomi Rutenberg Jan 2007

Community-Based Approaches To Prevention Of Mother-To-Child Transmission Of Hiv: Findings From A Low-Income Community In Kenya, Susan Kaai, Carolyn Baek, Scott Geibel, Peter Omondi, Benson Ulo, Grace Muthumbi, Carol Nkatha, Naomi Rutenberg

HIV and AIDS

The Horizons program, in partnership with International Medical Corps and Steadman Research Services International, conducted an intervention study in Kibera, an urban slum in Nairobi, Kenya to determine what effect three different community-based activities had on utilization of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants and peer counselors as PMTCT promoters. Data from the study showed that there were positive trends during the study period in most of the PMTCT indicators, including knowledge of MTCT, …


Kenya: Mobilize Health Care Providers To Advocate Against Fgm/C, Frontiers In Reproductive Health Jan 2007

Kenya: Mobilize Health Care Providers To Advocate Against Fgm/C, Frontiers In Reproductive Health

Reproductive Health

Female genital mutilation/cutting (FGM/C) is illegal in Kenya. The practice has declined slightly, yet it is nearly universal among the Abagusii, a relatively affluent ethnic group residing in the Nyanza province in western Kenya. Half of cut women reported that they had been cut by a health worker, however providers express willingness to advocate against the practice. This study, launched in 2004 by the Population Council’s FRONTIERS Program, examined the role of health providers in FGM/C in Kenya’s Abagusii community. As noted in this brief, the objectives were to understand the motivations behind the medicalization of FGM/C and determine the …


Contributing Towards Efforts To Abandon Female Genital Mutilation/Cutting In Kenya: A Situation Analysis, Humphres Evelia, Maryam Sheikh Abdi, Carolyne Njue, Ian Askew Jan 2007

Contributing Towards Efforts To Abandon Female Genital Mutilation/Cutting In Kenya: A Situation Analysis, Humphres Evelia, Maryam Sheikh Abdi, Carolyne Njue, Ian Askew

Reproductive Health

The Kenyan Ministry of Gender, Sports, Culture and Social Services, with support from UNFPA/Kenya, commissioned the Population Council to conduct a situation analysis of female genital mutilation/cutting (FGM/C) programs in Kenya, with the overall objective of documenting the current status of and trends in FGM/C programming and to help identify crucial elements that need to be prioritized for support. Results show marked declines in prevalence nationally between generations, suggesting a decline in the practice as well as trends toward “medicalization” in recent years. The practice still continues for different reasons, such as rite of passage, for marriageability, controlling sexuality, religious …


Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health Jan 2007

Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health

Reproductive Health

Female genital cutting is strongly supported among the Somali ethnic community in Kenya, and the severest form (infibulation) is primarily practiced. This type of cut is associated with increased incidence and seriousness of obstetric and gynecological problems relative to uncut women and those with less severe forms of FGM/C. As stated in this brief, efforts to encourage abandonment should begin with community discussion about the socio-cultural reasons for cutting. Simultaneously, health-care providers need training in how to manage complications of FGM/C. In 2004, FRONTIERS collaborated with UNICEF on a four-month diagnostic study on FGM/C practices among the Somali community in …


Reproductive Health Update Trainings For Health Workers In North Eastern Province, Garissa, Kenya Ministry Of Health, Population Council Jan 2006

Reproductive Health Update Trainings For Health Workers In North Eastern Province, Garissa, Kenya Ministry Of Health, Population Council

Reproductive Health

The Somali community living in Kenya has practiced the severest form of female genital mutilation/cutting (FGM/C), infibulation, for centuries. To understand the context within which the practice takes place, and how its complications are managed, FRONTIERS undertook a diagnostic study in North Eastern Province and in the Eastleigh area of Nairobi. The study found that the health system is ill equipped to serve women who have been cut, and particularly infibulated women who are pregnant and delivering, stemming from an overall weakness in the availability and quality of maternal and neonatal heath services. Specific recommendations could strengthen these services so …


Acceptability And Sustainability Of The Who Focused Antenatal Care Package In Kenya, Harriet Birungi, Washington Onyango-Ouma Jan 2006

Acceptability And Sustainability Of The Who Focused Antenatal Care Package In Kenya, Harriet Birungi, Washington Onyango-Ouma

Reproductive Health

The objectives of this study were to assess the Kenyan Ministry of Health’s capacity to adapt focused antenatal care (ANC) at the service delivery level so that it can be sustained, and to examine the extent to which adaptation of the package has increased coverage and quality of key ANC services and the overall quality of care received by pregnant women. The study showed that focused ANC is acceptable to both clients and providers and the approach has also received tremendous support from both the government and health development partners. However, the sustainability of the focused ANC package is contingent …


Cost Analysis Of Reproductive Health Services In Pcea Chogoria Hospital, Kenya, Nzoya Munguti, Moses Mokua, Rick Homan, Harriet Birungi Jan 2006

Cost Analysis Of Reproductive Health Services In Pcea Chogoria Hospital, Kenya, Nzoya Munguti, Moses Mokua, Rick Homan, Harriet Birungi

Reproductive Health

Presbyterian Church of East Africa Chogoria Hospital is a faith-based nongovernmental organization providing a wide range of healthcare services. The organization faces a number of challenges related to sustainability: declining donor support (especially for reproductive health services), low cost recovery levels, and increasing poverty levels among its clientele. In response to these concerns, a team from Chogoria Hospital attended a one-week workshop on financial sustainability held in Ghana and developed a small-scale operations research project to determine the cost of providing a selected number of reproductive health (RH) services and to evaluate their cost recovery levels. The study found that …


Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru Jan 2005

Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru

Reproductive Health

The Somali community living in Kenya (and in their native Somalia) has practiced the severest form of female genital cutting (FGC)—infibulation—for centuries. To understand the context within which the practice takes place, and how its complications are managed, the Population Council’s Frontiers in Reproductive Health Program undertook a diagnostic study that confirmed that FGC is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice: religious obligation, family honor, and virginity as a prerequisite for marriage; an aesthetic preference for infibulated genitalia was also mentioned. The study also found that the health …


Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan Jan 2004

Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan

Reproductive Health

CARE International, with technical support from the Frontiers in Reproductive Health Program completed a study in Ethiopia and Kenya designed to test the effectiveness of education activities using behavior change communication (BCC) approaches and advocacy activities by religious and other key leaders to abandon female genital cutting (FGC). In Ethiopia, the increased knowledge of harmful FGC effects and human rights issues translated to a positive attitude in support of FGC abandonment and an intention not to cut their daughters in the future. In Kenya, the analysis indicated mixed results in attitude and intended behavior change.


Medicalization Of Female Genital Cutting Among The Abagusii In Nyanza Province, Kenya, Carolyne Njue, Ian Askew Jan 2004

Medicalization Of Female Genital Cutting Among The Abagusii In Nyanza Province, Kenya, Carolyne Njue, Ian Askew

Reproductive Health

This study sought to understand the role that health providers play in the medicalization of female genital cutting (FGC) among the Abagusii community in western Kenya, among whom the practice continues to be almost universal. Interviews with service providers and their clients revealed an overwhelming belief that FGC fulfills a traditional cultural obligation among the Abagusii, and that it limits a woman’s sexual desire and confers respect on girls. New approaches are needed within this community to present FGC as violating human rights and national laws, as well as threatening girls’ and women’s health. The study recommends measures such as …


Consistency In The Reporting Of Sexual Behavior Among Adolescent Girls In Kenya: A Comparison Of Interviewing Methods, Paul C. Hewett, Barbara Mensch, Annabel Erulkar Jan 2003

Consistency In The Reporting Of Sexual Behavior Among Adolescent Girls In Kenya: A Comparison Of Interviewing Methods, Paul C. Hewett, Barbara Mensch, Annabel Erulkar

Poverty, Gender, and Youth

This paper explores the consistency in reporting of sexual behavior in a household survey of adolescents aged 15-21 in the Kisumu district of Kenya. Respondents were randomly assigned to different interviewing modes: face-to-face interviews, paper-and-pencil self-administered interviews, and audio computer-assisted self-interviewing (ACASI). The analysis focuses on the reporting of sexual behavior by adolescent girls in the face-to-face and ACASI modes and compares responses to a variety of questions about sexual activity, including sexual initiation, risky sexual behavior, and coerced sex. All sexual behavior questions were asked of each adolescent girl even if she answered “no” to the initial question about …


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 …


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 …


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.


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 …


Kenia: Ofrezca Servicios De Planificación Familiar En Salas Hospitalarias, Frontiers In Reproductive Health Jan 2000

Kenia: Ofrezca Servicios De Planificación Familiar En Salas Hospitalarias, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


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 …


Kenia: La Identificación De Las Itr Sigue Siendo Un Problema: La Prevención Es Esencial, Frontiers In Reproductive Health Jan 2000

Kenia: La Identificación De Las Itr Sigue Siendo Un Problema: La Prevención Es Esencial, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


Kenya: L'Identification Des Iar Demeure Hasardeuse: La Prévention Est Primordiale, Frontiers In Reproductive Health Jan 2000

Kenya: L'Identification Des Iar Demeure Hasardeuse: La Prévention Est Primordiale, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


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 …


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 …


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 …


El Método Cope Para Mejorar El Cuidado De La Atención: La Experiencia De La Asociación Para La Planificación Familiar De Kenia, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia Jan 1998

El Método Cope Para Mejorar El Cuidado De La Atención: La Experiencia De La Asociación Para La Planificación Familiar De Kenia, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia

Poverty, Gender, and Youth

Esta es la primera de varias ediciones de Quality/Calidad/Qualité que describen métodos concebidos para ayudar tanto a los directores como al personal de los programas de planificación familiar a efectuar una evaluación propia de la calidad de los servicios que prestan. Estas herramientas dan a los patrocinadores de los programas la oportunidad de identificar las deficiencias en su entorno de servicio y proponer soluciones. El informe examina la experiencia de la Asociación Nacional de Planificación Familiar de Kenia, proporciona algunas lecciones aprendidas y demuestra que estos ejercicios de autoevaluación están, de hecho, dando como resultado una mejora de la calidad …


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 …


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). …


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. …