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Findings From Landscape Analysis In Kogi On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Kogi. It is clear from the findings that at the state policy level, there is limited knowledge of what has been developed nationally; there is confusion about how policies, guidelines, and protocols reach not only the …

Findings From Landscape Analysis In Ondo On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Ondo. This landscape analysis identified the gaps in facilities’ and providers’ capacities for preventing, detecting, and managing PE/E. The brief concludes that a multi-pronged approach is required to address the systems issues that create barriers to …

Findings From Landscape Analysis In Sokoto On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Sokoto. This landscape analysis identified the gaps in facilities’ and providers’ capacities for preventing, detecting, and managing PE/E. The brief concludes that a multi-pronged approach is required to address the systems issues that create barriers to …

Increasing Access To Magnesium Sulphate In Nigeria, Population Council

Reproductive Health

The World Health Organization recommends magnesium sulphate (MgSO4) as the most effective, safe, and low-cost drug for treating pre-eclampsia and eclampsia. To increase access to and use of MgSO4 in Kano State, Nigeria the Population Council trained lower-cadre healthcare providers in antenatal clinics to detect pre-eclampsia early and institute timely and appropriate management by administering the loading dose of MgSO4 and referring for follow-up care. This brief reports that the intervention, which was supported by the John D. and Catherine T. MacArthur Foundation, reduced the maternal mortality rate due to PE/E by 40 percent in project sites. Moving forward, the …

Landscape Analysis Report On Pre-Eclampsia And Eclampsia In Pakistan, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Karen Kirk, Amy Dempsey, Charlotte E. Warren

Reproductive Health

This report presents the findings of a landscape analysis of the policy, programming, and service environment around prevention and treatment of pre-eclampsia and eclampsia (PE/E) in Pakistan. The primary aim of the landscape analysis was to identify the policy and program level of activities, as well as gaps and challenges around prevention and treatment of PE/E and the use of magnesium sulphate at the provincial and district levels in Pakistan. The study was carried out by the Population Council in 2016, with the support of the United States Agency for International Development (USAID) as part of the Project entitled “Ending …

Promoting Respectful Maternity Care Resource Package: Community Flipchart, Population Council

Reproductive Health

Progress toward the reduction of maternal and newborn morbidity and mortality has been slow because improvements require overcoming financial and geographical barriers to accessing skilled care, as well as the poor quality of care in maternity units. A little-understood component of the poor quality of care experienced by women during facility-based childbirth is the disrespectful and abusive behavior of healthcare providers and other facility staff. Acknowledgment of these behaviors by policymakers, program staff, civil society groups, and community members indicates the problem is widespread. This is a teaching aid for community health workers and other community-level resource persons to conduct …

Formative Research On Assessing Barriers To Fistula Care And Treatment In Nigeria, Charlotte E. Warren, Rachel Agbonkhese, Salisu Mohammed Ishaku

Reproductive Health

This report documents results of a systematic study of peer-reviewed and “grey” literature which identified studies relevant for understanding barriers to accessing obstetric fistula (OF) care in developing countries. To more comprehensively and holistically understand these barriers in Nigeria and potential enabling factors for alleviation, this study explored the perspectives of those involved in both identifying fistula and accessing care, such as family members and other community stakeholders including patriarchs, matriarchs, community leaders, and other opinion leaders. It also examines the cultural patterns, myths, and perspectives related to OF and how they influence women’s willingness and capacities to access surgical …

Barriers To Fistula Repair In Uganda: A Formative Study, Population Council

Reproductive Health

This brief describes a formative research study conducted in Uganda by the Population Council, building on the results of a systematic review, to better understand the barriers and enabling factors for fistula repair care delivery and access. Understanding how Ugandan women living with fistula decide to seek care, identify and reach medical centers, and receive adequate and appropriate care is integral and continues to influence the design of a larger implementation pilot. This study focuses on Fistula Care Plus project-supported treatment facilities where fistula camps are routinely held. Results show that while it is difficult to measure the relative influence …

Fact Sheet—How Does Quality Of Care Relate To A Rights-Based Approach To Family Planning Programs?, Jan Kumar

Reproductive Health

Because policymakers are challenged by numerous, overlapping definitions of quality of care, with uncertainty about which to adopt, there is a need for common understanding of each construct and its contribution to family planning (FP). This factsheet describes several definitions of quality in health care that are widely accepted. It concludes that improving and assuring quality of care is a legal, ethical, and practical imperative, and is instrumental in achieving outcomes that benefit women, children, and programs. If donors embrace, fund, and hold governments accountable to the fullness of a rights-based approach for FP with an explicit focus on assuring …

Measuring Quality Of Care: A Review Of Previously Used Methodologies And Indicators, Katherine Tumlinson

Reproductive Health

Despite successful efforts to increase financial and geographic access to family planning services in many parts of the developing world, large numbers of women with a desire to delay or limit future pregnancies are not using contraceptive methods. Several multi-country, large-scale facility surveys incorporate indicators for measuring the quality of family planning service delivery. These facility surveys use data collection tools such as facility audits, provider and client questionnaires, and third party observation guides. A limited body of research indicates that the validity of these tools is low, however, while large variations in analytical approaches inhibit use of existing literature …

Fact Sheet—Measuring Quality Of Care: A Review Of Methodologies And Indicators, Katherine Tumlinson

Reproductive Health

Broad support for the promotion of high-quality service delivery in family planning (FP) programs is rooted in the publication in 1990 of a formal framework outlining its essential elements. This framework, developed by Judith Bruce of the Population Council, defines FP service delivery quality through six critical elements: choice of methods, information provided to clients, interpersonal relations, provider competence, follow-up mechanisms, and appropriate range of services offered. This factsheet argues that despite widespread endorsement of the Bruce framework and development of standardized data collection instruments, obstacles to accurate measures of quality of care remain. It concludes that further discussion within …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Technical Brief, Population Council

Reproductive Health

Leader dans le domaine de la Planification Familiale (PF) en Afrique de l’Ouest francophone, le Sénégal a entrepris diverses initiatives pour atteindre ses objectifs, dont l’élaboration du Plan d’Action National de Planification Familiale (PANPF) 2012–15, basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où il arrivait à terme, et que l’élaboration d’un nouveau plan était envisagée, il était nécessaire de documenter l’approche, sa mise en œuvre, et ses réalisations. Le Population Council a mené cette étude en collaboration avec la Direction de la Santé de la Reproduction et de la Survie de l’Enfant du Ministère de la Santé et …

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Evaluation Of The Impact Of Strengthening Union Health And Family Welfare Centers For Providing 24/7 Normal Delivery Services In Bangladesh, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan, Mohammed Sharif, Forhana Rahman Noor, Surojit Kundu, Shongkour Roy, Afsana Fatema Noor, Ubaidur Rob

Reproductive Health

In Bangladesh, the majority of the infant deliveries in rural areas take place at homes where there is a higher risk of morbidity and mortality. Most Union Health and Family Welfare Centers (UHFWCs) are unable to provide 24-hour normal delivery services in close proximity to most rural women. With this point of view, the Population Council has provided technical assistance to the Directorate General of Family Planning to implement an operations research (OR) study in 24 UHFWCs to test the effectiveness of a model to strengthen UHFWCs so that they can provide such services. This report presents the findings of, …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Districts Haripur And Nowshera, Khyber Pakhtunkhwa, Population Council

Reproductive Health

Through its Reproductive Maternal and Neonatal Child Health project, GIZ Pakistan is assisting the Government of Pakistan in strengthening its health system’s capacities for ensuring effective, efficient, client-oriented, and affordable reproductive, maternal, newborn, and adolescent health care. GIZ engaged with senior national and provincial government officials who indicated their interest in applying the innovative Made-In/Made-For (Maternal Death, from Informants/Maternal Death, Follow On Review) methodology, a cost-effective alternative for generating reliable estimates of maternal mortality through community-based informant networks. This Population Council study in two pilot districts identified specific areas that need strong policy and programmatic interventions to improve maternal health …

Using The Community Informant-Based (Made-In And Made-For) Methodology To Estimate The Neonatal Mortality Rate (Nmr) In Nowshera, Khyber Pakhtunkhwa: A Feasibility Study, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, Rehan M. Niazi

Reproductive Health

Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

Organizing For Women And Children: Advocating For The ‘Reach Every Mother And Child’ Campaign, Laura E. Leslie

Capstone Collection

Every day families are left without mothers and children. Not only does this affect the family but it can have ramifications on the community. There is a link between the wellbeing of moms and that of their children, yet we lose thousands of women to maternal complications each year. Moreover, each day, thousands of children die before reaching their fifth birthday. The most tragic part is that most of these deaths are preventable. While these deaths have been halved in the last 15 years, there is still a lot of work to be done. There have been several initiatives which …

Cross-Cultural Childbirth: Prioritizing The Healthcare Experiences Of Migrant Women In Competent Models Of Care, Emma Hall

Independent Study Project (ISP) Collection

In the context of the feminization of increasing global migration, it is impossible to understand maternal and child health in a given country without considering the experience of female migrants. As the total migrant population increases in the European Union, migration and its effects on health care provision in receiving countries and the experiences of immigrant populations must be recognized. Past research exposes an increased risk of complications and maternal mortality in migrant populations, but little information exists on the tangible programs that could respond to disparity. According to the World Health Organization, maternal health refers to the health of …

La Santé Maternelle À Antsiranana Selon La Médicine Occidentale Et La Médicine Traditionnelle : Une Étude Des Traitements Opposés Pour Les Femmes Enceintes, Lauren Nguyen

Independent Study Project (ISP) Collection

Dans un pays comme le Madagascar, où des coutumes traditionnelles et le lien avec les ancêtres demeurent une grande partie de la culture, l’introduction des aspects « occidentales » présente un peu du désaccord. Cela est vu avec l’introduction de la médecine « occidentale », et le choix que font des Malagasy pour leurs soins médicaux. Spécifiquement dans le secteur de la médecine, la tension entre des pratiques occidentales et des pratiques traditionnelles est significative.

La présence des guérisseurs traditionnels et de la médecine traditionnelle sur l’île existait bien avant l’introduction de la médecine occidentale. Bien que de plus en …

Ouch, That Hurts: Childbirth-Related Pain Management And The Inappropriate Replacement Of Traditional Obstetrical Knowledge In Kumaon, Uttarakhand, India, Sabrina Zionts

Independent Study Project (ISP) Collection

Throughout India, obstetrical knowledge and practice has been developed and passed down by generations of women. In many Indian societies, traditional birth attendants, or dais, remain the gatekeepers of childbirth-related knowledge. Yet with the push towards institutional delivery, traditional knowledge and practices are being increasingly replaced with modern and Western ones. While the trend of hospital deliveries has yielded positive health outcomes, its socio-cultural consequences remain unclear. Situated in Uttarakhand’s Kumaon Himalayas, this study employs a bio-social framework and begins to reveal these consequences. Using labor pain management as an entry point, this study argues that the push towards institutional …

Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council

HIV and AIDS

Nigeria, home to over 170 million people, has a disproportionately heavy youth population of 32 percent whose well-being is intricately tied to the country’s prospects for sustainable development. Nigeria has an HIV prevalence of 3.4 percent, the second highest number of infections in the world. In 2013, it was estimated that 160,000 adolescents in Nigeria were living with HIV. Although Nigeria has developed a national HIV strategic plan that forms a basis for the HIV response, national AIDS and related policies contain few youth-centered provisions. Overall, the national strategic plan targets youth as part of the general population. To fill …

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …

The Effect Of Integrating Hiv Services On Quality Of Postnatal Care, Integra Initiative

Reproductive Health

Addressing the postnatal needs of new mothers is a neglected area of care throughout sub-Saharan Africa. Unintended pregnancies during the first 12 months following delivery, and vertical transmission of HIV during labor and delivery, are some of the challenges faced by women during the extended postpartum period. Many women want to delay or avoid another pregnancy, but are not using a modern contraceptive method. Few developing countries ensure that mothers and newborns are assessed early and monitored during the initial six-week period as recommended by WHO, which contributes to discontinuity of services received during pregnancy and delivery and limits linkages …

Reducing Maternal And Child Mortality In Punjab: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Punjab’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 45 percent of maternal deaths, 26 percent of infant deaths, and 76 percent of young child deaths. FP’s wider health …

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …

Education, Numeracy, And Literacy: Baseline Findings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10–19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. The program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers, and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and are being followed over four years—including the two years of the program and two years after. This brief describes the characteristics of these girls at baseline. Of the girls who are currently in school, …

Reproductive Health Needs Of Married Girls In Assuit And Sohag Governorates [Arabic], Population Council

Poverty, Gender, and Youth

No abstract provided.

Gender-Biased Sex Selection In South Asia: The Situation And Promising Approaches To Restore Balance, Population Council

Poverty, Gender, and Youth

This project summary indicates that sex ratios at birth in South Asia vary considerably. While the sex ratios at birth in Bangladesh and Pakistan have been normal at the country level (103 and 102.5 males per 100 females, respectively), Nepal is showing signs of disturbed sex ratios at birth, with a sex ratio of 106 males per 100 females, and the situation in India is particularly adverse, with a sex ratio at birth of 110 males per 100 females. In all of these countries, preconditions for a deterioration of the sex ratio at birth are evident. Preferences are expressed for …

Anneau Vaginal À Progestérone: Évite Les Grossesses, Population Council

Reproductive Health

Cette fiche de renseignements fournit des informations sur l’utilisation de l’anneau contraceptif vaginal à la progestérone pour prévenir la grossesse. L'anneau vaginal à progestérone (AVP) offre une nouvelle manière de fournir un moyen de contraception. Il a été prouvé qu'il s'agit d'une méthode contraceptive sûre et efficace pour les femmes qui allaitent. Utilisé par ces femmes, l'AVP évite les grossesses en inhibant la croissance folliculaire et, par conséquent, empêchant l'ovulation; renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation; étendant l'aménorrhée post-partum; et épaississant la glaire cervicale, et donc en empêchant les spermatozoïdes d'atteindre l'ovule. L'AVP donc étend la gamme …