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Articles 871 - 900 of 1109
Full-Text Articles in Sociology
Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco)
Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco)
Reproductive Health
The Institute for Behavioral Studies and Research completed an operations research project entitled “Among Youth” targeting adolescents in the Mokolo neighborhood of Yaoundé, Cameroon. The results presented in this report show that adolescents in Mokolo, more often than their counterparts in the control site, adopted behavioral changes to prevent STI/HIV transmission and unwanted pregnancies as a result of the intervention. The report concludes that peer education combined with mass media campaigns form an important strategy for targeting youth with reproductive health and family planning messages and can help adolescents translate knowledge into healthy lifestyles. Integration of reproductive health messages into …
Reproductive Health Care In The Postnatal Period In Guatemala, Erika Jacobs, Carlos Brambila, Ricardo Vernon
Reproductive Health Care In The Postnatal Period In Guatemala, Erika Jacobs, Carlos Brambila, Ricardo Vernon
Reproductive Health
This operations research study aimed to develop and test a job aid to provide comprehensive care to mothers and children during the first year postpartum; to train physicians, nurses, auxiliary nurses, and social workers in its use; and to develop and test strategies and materials for training community health agents to promote services for new mothers during the first year postpartum. It also collected data to establish if these strategies were effective in improving the quality and comprehensiveness of the care received by mothers and children less than one year of age. Drawing from exit interviews, the intervention appeared to …
Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols
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
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 …
Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil
Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil
Reproductive Health
The Center for Development in Primary Health Care (CDPHC), in collaboration with the Population Council’s FRONTIERS program, developed a 19-month training program to strengthen and improve existing maternal and children’s health and family planning services and to promote the establishment of the standardized basic package of services at Pilot Health Project (PHP) clinic sites in the West Bank and Gaza. There were four key start-up activities, including: 1) an assessment of standards of care provided at PHP clinics; 2) a review of formative research; 3) the development of clinical training manuals and curricula; and 4) the development of behavior change …
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
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 …
Informed Consent: From Good Intentions To Sound Practices—A Report Of A Seminar, Susan Y. Wood, Barbara Friedland, C. Elizabeth Mcgrory
Informed Consent: From Good Intentions To Sound Practices—A Report Of A Seminar, Susan Y. Wood, Barbara Friedland, C. Elizabeth Mcgrory
Reproductive Health
This report is a summary of presentations and discussions at a seminar entitled “Informed Consent: From Good Intentions to Sound Practices.” This two-day seminar brought together 65 individuals from nine countries in May 2001 to discuss challenges of informed consent in research. The goal of the meeting was to put informed consent into historical and contemporary perspective and to explore ways that the barriers to effective implementation can be overcome. The underlying premise of the seminar was that, as the issues around doing ethical research in health will only grow in scope and complexity, even when those who sponsor and …
Anti-Trafficking Programs In South Asia: Appropriate Activities, Indicators And Evaluation Methodologies, Dale Huntington
Anti-Trafficking Programs In South Asia: Appropriate Activities, Indicators And Evaluation Methodologies, Dale Huntington
Reproductive Health
Throughout South Asia, men, women, boys, and girls are trafficked within their own countries and across international borders against their wills in what is essentially a clandestine slave trade. The Congressional Research Service and the U.S. State Department estimate that between 1 to 2 million people are trafficked each year worldwide with the majority originating in Asia. Root causes include extreme disparities of wealth, increased awareness of job opportunities far from home, pervasive inequality due to caste, class, and gender bias, lack of transparency in regulations governing labor migration, poor enforcement of internationally agreed-upon human rights standards, and the enormous …
Increasing Coverage Of Reproductive Health Issues In The Indonesian Print Media, Wanda Firmansyah, Sahar Hegazi, Siti Rokhmawati Darwisyah, Lila Amaliah
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 …
Power In Sexual Relationships: An Opening Dialogue Among Reproductive Health Professionals, Population Council, Interagency Gender Working Group (Igwg)
Power In Sexual Relationships: An Opening Dialogue Among Reproductive Health Professionals, Population Council, Interagency Gender Working Group (Igwg)
Reproductive Health
The discussions summarized in this report indicate that gender-based power inequalities hinder communication between partners, limit the ability of individuals and couples to talk about or achieve desired child spacing and family-size goals, limit effective use of reproductive health services, undercut men’s and women’s attainment of sexual health and pleasure, and increase substantially their vulnerabiliy to HIV/AIDS and other sexually transmitted infections. This report summarizes the proceedings of a meeting, co-sponsored by the Population Council and USAID’s Men and Reproductive Health Subcommittee, that responded to an increasing groundswell of interest in opening a dialogue on power in sexual relationships. The …
Comment Promouvoir L'Utilisation Des Résultats D'Une Analyse Situationnelle À L'Échelle Nationale: Expérience Du Sénégal, Adama Ndoye, Bineta M'Bow, Cheikh Bamba Diop, Mady Cisse, Macoumba Thiam, Diouratie Sanogo, Mbacke Niang
Comment Promouvoir L'Utilisation Des Résultats D'Une Analyse Situationnelle À L'Échelle Nationale: Expérience Du Sénégal, Adama Ndoye, Bineta M'Bow, Cheikh Bamba Diop, Mady Cisse, Macoumba Thiam, Diouratie Sanogo, Mbacke Niang
Reproductive Health
Avec cette dissémination des résultats de l’Analyse Situationnelle (AS) de 1998 le Ministère de la Santé réalise la troisième activité de ce genre. Au sortir de la dissémination, plusieurs enseignements sont tirés: Une bonne préparation de l’activité est nécessaire et, dans ce sens, la place de l’atelier de planification et l’établissement concerté d’un calendrier des activités par les niveaux national et régional sont prépondérants. L’organisation pratique des ateliers de dissémination doit compter avec l’utilisation des professionnels de la santé des régions et des médias locaux. Cette initiative a permis de crédibiliser les résultats ce qui a favorisé leur appropriation par …
Ecuador: Use Commercial Marketing To Increase Sustainability, Frontiers In Reproductive Health
Ecuador: Use Commercial Marketing To Increase Sustainability, Frontiers In Reproductive Health
Reproductive Health
Many nongovernmental organizations sell contraceptives through retail outlets to generate income and expand access to these products. In 1998 Centro Médico de Orientación y Planifación Familiar (CEMOPLAF) employed 25 sales agents in 14 cities throughout Ecuador. These agents sold products, including contraceptive methods and home pregnancy tests, to pharmacies, physicians, other distributors, and nontraditional outlets. Contraceptive sales were CEMOPLAF’s largest source of revenue in 1997. Sales had grown rapidly during 1996–97, but CEMOPLAF managers did not know whether product sales were profitable. With support from the Population Council and Family Health International, CEMOPLAF made a detailed analysis of product sales …
Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health
Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health
Reproductive Health
La Organización Mundial de la Salud ha estipulado que la detección y tratamiento de sífilis para todas las mujeres embarazadas resulta eficaz en función de los costos si al menos el 0.1 por ciento de ellas están infectadas. Para atender el problema de la alta tasa de sífilis entre mujeres embarazadas (6.5–7.3%), el Concejo de la Ciudad de Nairobi (CCN) introdujo en 1989 la detección y tratamiento de sífilis materna en sus clínicas de atención prenatal. Sin embargo, su enfoque centralizado—que requiere llevar las muestras de sangre recolectadas a un laboratorio central para hacer la prueba—era ineficiente. Por lo tanto, …
Influencing Reproductive Health Policy And Programs In The Philippines: Implementing An Advocacy Model For Utilization Of Operations Research, Saniata Masulit, Marilou P. Costello, Sahar Hegazi
Influencing Reproductive Health Policy And Programs In The Philippines: Implementing An Advocacy Model For Utilization Of Operations Research, Saniata Masulit, Marilou P. Costello, Sahar Hegazi
Reproductive Health
This project tested a model of operations research (OR) dissemination and utilization targeting program managers in Mindanao, the second largest island of the Philippines. The model combines capacity-building with the use of innovative advocacy approaches to disseminate OR results, by creating a network of policy champions who will advocate the use of OR findings through a variety of strategies after they have been provided with information on the advocacy issue and their presentation skills enhanced. The project demonstrated that this type of network could lead to significant program changes, but also revealed that there is no single strategy or approach …
Indonesia: Train Journalists To Write About Reproductive Health, Frontiers In Reproductive Health
Indonesia: Train Journalists To Write About Reproductive Health, Frontiers In Reproductive Health
Reproductive Health
After government control over the media was liberalized in 1998, Indonesian journalists had a new mandate to explore new issues and foster public debate. Several studies had found evidence that women’s health worsened from 1997–99, yet media coverage of this topic was limited. To increase press coverage of reproductive health (RH) topics, the Population Council conducted an 18-month media project in collaboration with the State Ministry for Women’s Empowerment and other key agencies. The project focused on improving RH knowledge and reporting skills among 22 print journalists. Project staff monitored RH coverage in 22 major newspapers, magazines, and tabloids. After …
Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed
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 …
A Case Study Of Nairobi City Council's Decentralised Syphilis Screening Programme In Antenatal Clinics, Baker Ndugga Maggwa, Ian Askew, Elizabeth Mugwe, Bilhah Hagembe, Rick Homan
A Case Study Of Nairobi City Council's Decentralised Syphilis Screening Programme In Antenatal Clinics, Baker Ndugga Maggwa, Ian Askew, Elizabeth Mugwe, Bilhah Hagembe, Rick Homan
Reproductive Health
It has long been known that syphilis is one of the more serious sexually transmitted infections (STI), especially during pregnancy when, if untreated, at least 60 percent of infected women will experience an adverse pregnancy outcome. There has been renewed interest in its control and prevention because of its proven link with HIV transmission. In 1992, the Nairobi City Council (NCC) pilot-tested a decentralized approach to syphilis screening and management in a sample of their antenatal clinics. A case study was carried out to assess the effectiveness, readiness, and cost effectiveness of the NCC’s antenatal care program, with a focus …
Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health
Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health
Reproductive Health
After initiating health sector reforms in 1994, the Bénin government established the Integrated Family Health Project, known as PROSAF. Funded by the U.S. Agency for International Development, PROSAF operates in the Borgou region, which is mostly rural and has the country’s most severe health problems. PROSAF managers wanted to understand why local people were not using health services, despite their poor health. As noted in this brief, managers requested that the African Population and Health Research Centre (APHRC) study the way households and communities make decisions on health care. In a study conducted in 2000 with support from the Population …
Benin: Diríjase A Los Hombres Para Aumentar El Uso De Los Servicios De Salud, Frontiers In Reproductive Health
Benin: Diríjase A Los Hombres Para Aumentar El Uso De Los Servicios De Salud, Frontiers In Reproductive Health
Reproductive Health
Después del inicio de las reformas del sector salud en 1994, el gobierno de Benin creó el Proyecto de Salud Familiar Integral, conocido localmente como PROSAF. Este proyecto opera en la región de Borgou, bajo el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Dicha región es en su mayoría rural y en ella se observan los problemas de salud más severos del país. Los gerentes de PROSAF deseaban entender por qué la gente no estaba utilizando los servicios a pesar de tener una salud deficiente, por lo que solicitaron al Centro Africano de Investigación en …
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
Reproductive Health
To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …
Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health
Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health
Reproductive Health
El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …
Ecuador: Utilice La Mercadotecnia Comercial Para Aumentar La Sustentabilidad, Frontiers In Reproductive Health
Ecuador: Utilice La Mercadotecnia Comercial Para Aumentar La Sustentabilidad, Frontiers In Reproductive Health
Reproductive Health
Muchas organizaciones no gubernamentales venden anticonceptivos a través de detallistas con el fin de generar ingresos y mejorar el acceso a estos productos. En 1998, el Centro Médico de Orientación y Planificación Familiar (CEMOPLAF) empleó a 25 agentes de ventas en 14 ciudades ecuatorianas; estos agentes vendieron productos, incluyendo métodos anticonceptivos y pruebas de embarazo de uso doméstico. Esos productos se vendieron a farmacias, médicos, otros distribuidores y a puntos de venta no tradicionales. La venta de anticonceptivos fue la principal fuente de ingresos de CEMOPLAF en 1997. Las ventas habían crecido rápidamente en el periodo 1996–97, pero los gerentes …
Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health
Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health
Reproductive Health
To support the Government of Ghana’s plan to expand community-based distribution (CBD) programs, the Planned Parenthood Association of Ghana (PPAG) and the Population Council conducted a study in 1999 of the CBD programs of 13 nongovernmental agencies. The study also assessed in depth PPAG’s CBD program, which is the country’s largest and oldest. Data sources included interviews with 301 CBD agents, 27 supervisors, and 20 clinicians in rural and urban areas in 16 districts; observations of 51 PPAG agents interacting with 6 clients each; and 15 focus group discussions with community members, former CBD agents, and CBD clients. CBD programs …
Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health
Honduras: Marketing New Reproductive Health Services Is Cost-Effective, Frontiers In Reproductive Health
Reproductive Health
In 1999, the Honduran Ministry of Health (MOH) revised national guidelines on women’s health services delivery to allow nurse auxiliaries to insert IUDs, give DMPA injections, and take Pap smears. This policy change addresses low contraceptive use among rural women and reflects findings from a 1998 Population Council study that showed that nurse auxiliaries can safely and successfully provide these services. Under the previous guidelines, rural women had limited access to long-term family planning methods. In 2000, the Population Council and the MOH assessed the effectiveness and cost of using a simple leaflet, distributed by nurse auxiliaries, to market the …
Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health
Honduras: Promover Nuevos Servicios De Salud Reproductiva Es Costo-Efectivo, Frontiers In Reproductive Health
Reproductive Health
En 1999, la Secretaría de Salud de Honduras (SSH) modificó las Normas de Atención Integral a la Mujer a fin de autorizar a las auxiliares de enfermería a prestar los servicios de inserción de DIU, aplicación del inyectable DMPA y toma de Papanicolaou. Este cambio en las normas aborda el problema de la baja prevalencia en el uso de anticonceptivos en áreas rurales. El cambio también refleja los hallazgos de un estudio anterior, realizado por el Population Council, que mostró que las auxiliares de enfermería pueden proporcionar estos servicios de manera segura y con buena calidad. Anteriormente, las mujeres en …
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Reproductive Health
Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …
Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health
Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health
Reproductive Health
Aproximadamente la mitad de los partos en Honduras son atendidos en un hospital. Sin embargo, los hospitales generalmente no ofrecen servicios de planificación familiar a las pacientes en el posparto o el postaborto. En 1999, la Secretaría de Salud de Honduras (SSH) y el Population Council iniciaron un proyecto de dos años con el fin de ampliar el acceso a la consejería y a los servicios de planificación familiar después de un parto o de haber recibido tratamiento por un aborto incompleto. La intervención se realizó basándose en un proyecto previo del Population Council que mostró que el 30 por …
Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Dale Huntington, Mary Philip Sebastian, Nirmala Sevlam, Barbara Mensch, Sahar Hegazi
Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Dale Huntington, Mary Philip Sebastian, Nirmala Sevlam, Barbara Mensch, Sahar Hegazi
Reproductive Health
The Population Council's Frontiers in Reproductive Health Program and the Policy and Research Division are collaborating with CARE India to conduct an operations research study to examine the feasibility and impact of adding livelihood counseling and training, savings activities, and follow-up support to the ongoing reproductive health program for adolescents. The short-term objective is to foster the development of alternative socialization processes for adolescent girls that encourage positive sexual and reproductive health behaviors. As noted in this project update, the study will produce a replicable model for CARE India and other agencies to use in adding livelihood activities to adolescent …
Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain
Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain
Reproductive Health
Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC …
Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health
Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health
Reproductive Health
The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of …