Family, Life Course, and Society Commons^™

Providing Maternal And Newborn Health Services: Experiences Of Auxiliary Nurse Midwives In Rajasthan, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

To better understand the experiences of auxiliary nurse-midwives (ANMs) in providing maternal and newborn health services and to obtain their perspectives on Janani Suraksha Yojana (JSY), the Population Council undertook an exploratory study of ANMs in two districts of the north-western state of Rajasthan, India. Findings show that the vast majority of the ANMs were aware of best practices related to the immediate care of the newborn. Nevertheless, the findings also suggested a number of priority areas for action, including increased investment in training, encouraging provision of services on a more regular basis, making special efforts to enable ANMs to …

Belize Coverage Exercise Study: Assessing The Status To Build A Portfolio Of Targeted Interventions For Vulnerable Girls, Joint Un Programme Of Adolescent Girls

Poverty, Gender, and Youth

The United Nation Children Fund, the United Nations Population Fund, and Population Council staff collaborated on a number of activities to generate evidence on the lives and experiences of adolescent girls in Belize. The goal of the collaboration was to establish targeted, evidence-based policies and programs sensitive to the unique needs of girls. The information presented in this report is of particular interest to program planners, policymakers, and decisionmakers from a wide range of institutions seeking to designate resources for programs and policies for vulnerable or marginalized subgroups of young people, particularly girls, in Belize. The report presents empirical evidence …

Training Manual On The Use Of Magnesium Sulphate In The Management Of Severe Pre-Eclampsia And Eclampsia [Trainee Version], Federal Ministry Of Health, Population Council

Reproductive Health

This training manual provides detailed, descriptive, and practical instructions and tips necessary to respond to obstetric emergencies (severe pre-eclampsia and eclampsia). The manual is an integral part of the collaborative efforts between the Federal Ministry of Health and the MacArthur Foundation to scale up the use of magnesium sulphate in the management of severe pre-eclampsia and eclampsia in Nigerian health facilities. Magnesium sulphate has been established as the gold standard in the management of severe pre-eclampsia and eclampsia, but lack of knowledge and necessary skill have been identified as some of the factors responsible for its limited use in Nigeria. …

Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …

Executive Summary—Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

This document contains the executive summary of “Family Planning Programs for the 21st Century: Rationale and Design.” The first half of the book makes the case for why increased funding and support for voluntary family planning programs are needed. The second half explains how reinvigorated voluntary family planning programs can be structured to operate more effectively. Family planning is one of the most successful development interventions of the past 50 years. It is unique in its range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs, Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs [Arabic], Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …

Résumé Exécutif—Les Programmes De Planification Familiale Du Xxie Siècle: Fondement Et Conception, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Ce document contient le résumé exécutif de «Les programmes de planification familiale pour le XXIe siècle: Fondement et conception». La première moitié de l'ouvrage explique pourquoi un financement et un soutien accrus en faveur des programmes de planification familiale volontaire sont nécessaires. La seconde moitié explique comment les programmes renforcés de planification familiale volontaire peuvent être structurés de manière à fonctionner avec plus d’efficacité. La planification familiale est l'une des interventions les plus réussies de développement de ces 50 dernières années. Elle est unique en termes d’avantages potentiels, et englobe le développement économique, la santé maternelle et infantile, …

Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey

Reproductive Health

An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and …

Country Mapping: Kenya, Francis Obare, Wilson Liambila, Harriet Birungi, Eseoise Itombra, Heather Clark, Saumya Ramarao

Reproductive Health

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and to develop a strategic plan for its introduction. This technical report presents the findings of the assessments in Kenya with specific focus on: (1) the country’s demographic profile; (2) the health systems, health policy, and family planning program context; and (3) stakeholder perspectives regarding the PVR. The findings suggest that the introduction of the PVR would fill a gap in the family planning needs of breastfeeding women in Kenya, and there is strong support from stakeholders …

Country Mapping: Nigeria, Salisu Mohammed Ishaku, Saumya Ramarao

Reproductive Health

The Population Council conducted a three-year acceptability study of the progesterone vaginal ring (PVR) in three sub-Saharan African countries. This technical report presents results from Nigeria, laying out the country’s demographics and high fertility rates; describing the family planning program and policy context; and, finally, revealing the stakeholder support thus far with a discussion on how best to proceed with introduction activities. This country mapping confirms the likelihood that the PVR would be well received in Nigeria and fill a large need in family planning. The PVR is a safe, long-acting, user-controlled product that can be easily inserted and removed …

Country Mapping: Senegal, Babacar Mane, Nafissatou Diop, Nancy Termini Lachance, Saumya Ramarao, Heather Clark

Reproductive Health

The Population Council embarked on a three-year project to explore the acceptability of the progesterone vaginal ring (PVR) among women in sub-Saharan Africa and its potential introduction. This technical report presents results from assessments undertaken to map the existing landscape of family planning programs and new contraceptive technologies in Senegal in an effort to identify national priorities and assess the level of interest in the PVR among stakeholders and to design appropriate preintroductory activities. This country mapping exercise confirms that Senegal is a promising context for the introduction of the PVR: the government is committed to repositioning family planning and …

Integration Of Family Planning Into Other Health Services In Ghana: Performance Needs Assessment At Four Facilities In The Ashanti And Eastern Regions, Amos Laar

Reproductive Health

With support from the Population Council, the Reducing Maternal Morbidity and Mortality Program worked with the Ghana Health Service to conduct a performance needs assessment on family planning (FP) integration in four facilities in two of the country’s regions. The purpose of this endeavor was ultimately to pilot a project to develop and implement interventions that would improve clients’ access to FP at these facilities, based on the current and desired FP service provision levels, from the viewpoint of facility staff themselves, while taking into account client preferences. This midterm survey sought to assess the status of the integration process …

Strengthening The Delivery Of Comprehensive Reproductive Health Services Through The Community Midwifery Model In Kenya, Wilson Liambila, Francis Obare, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Ruth Wayua Muia, Assumpta Matekwa

Reproductive Health

The overall objective of this project was to strengthen the delivery of family planning/reproductive health and HIV (FP/RH/HIV) services at the community level. The interventions included revision of existing guidelines and protocols for the community midwifery approach, training of providers, provision of equipment and supplies, and creating awareness on the use of community referral cards. In addition, cost analysis of community midwives’ services and willingness-to-pay assessments for various reproductive health services among current and potential users of community midwifery services were undertaken. The results showed that the community midwifery model improved clients’ access to a comprehensive package of RH/HIV including …

Increasing Parity Is Associated With Cumulative Effects On Memory, Laura M. Glynn

Psychology Faculty Articles and Research

BACKGROUND: The purpose of this investigation was to determine if reproductive experience is associated with cumulative effects on human memory performance during pregnancy and if these effects persist into the postpartum period.

METHODS: Verbal recall memory performance was assessed in 254 women four times during pregnancy and at 3 months postpartum. The relation between parity and memory function was evaluated with hierarchical linear modeling and analysis of covariance (ANCOVA).

RESULTS: The data indicate that the previously documented adverse effects of pregnancy on memory performance are compounded with successive pregnancies. During gestation and postpartum, multiparity was associated with poorer memory function, …

Economic Empowerment And Hiv Prevention Among Young Women And Girls In Kenya: Lessons From The Study Of Economic Empowerment Programs, Samantha Van Putten

Independent Study Project (ISP) Collection

One of the major issues facing Kenya is HIV/AIDS. With recognition by the global community that providing women with economic opportunities can help both those who are HIV positive, as well as in prevention for those who are not infected, programs combining microfinance and HIV education have started to emerge. While women in these programs 3 3 have shown preliminary signs of success, young girls did not respond as well in part due to lack of interest in the particular programs themselves. As such, this study examines two economic empowerment programs for girls and young mothers at the non-governmental organization …

Reproductive Realities: Fulani Women & Contraception, Corrina Regnier

Independent Study Project (ISP) Collection

This paper is the product of three weeks of research on contraception and the lives of married Fulani women in Ngaoundéré, Cameroon. Based on interviews with Fulani women, conducted both in French and in the Fulani language of Fulfulde with the aid of a French interpreter, I discuss the cultural and religious influences on women’s lives that impact their decisions or abilities to use contraception, as well as the ways these influences and realities have changed, are changing, and are expected to change in the future. I also look into the more practical concern of the availability and accessibility of …

The Perfect Storm: How Pro-Abortion Activists In The Netherlands Incite Social Change From International Waters, Julia Ellis‐Kahana

Independent Study Project (ISP) Collection

This project is a sociological ethnography of the Women on Waves foundation, founded in 1999 by Dr. Rebecca Gomperts. As an international non-profit organization, they employ a direct action method: sailing to countries where abortion is illegal and providing safe abortion access. Local women board the ship that then travels 12 miles to international waters, where Dutch law applies, and the abortion pill can be administered legally. Using a feminist perspective, I interviewed five of the women at the organization in addition to the ship’s captain in order to understand the ideological beliefs about the reproductive rights that have inspired …

La Etnia Y Las Cesáreas En Los Partos En El Hospital Público De Arica, Chile, Marisa Westbrook

Independent Study Project (ISP) Collection

The principal objective of this project was to explore the relationship between ethnicity and the causes for Caesarean section in the regional public hospital in Arica, Chile. All births recorded in the maternity register (n=907) were analyzed over a 4-month period in 2011. The regional public hospital had a 27% caesarean section rate, higher than the WHO-recommended 15%. Last names were analyzed and deemed to be either of Aymara descent (n=275) or of European descent (n=632) based on criteria used from CONADI, the National Corporation for Indigenous Development. The overall rate of Caesarean section did not differ between Aymara and …

When Mountain Bellies Grow Round: Localized Knowledge And Behaviors Facilitating Pregnancy And Childbirth In Phaphlu, Nepal, Cailin Marsden

Independent Study Project (ISP) Collection

In attempts to gain a level of understanding of a community’s localized experiences, beliefs, practices, and roles around pregnancy and childbirth, ethnographic fieldwork was conducted with the mothers and fathers of Phaphlu in the Solukhumbu district of Nepal. Aimed at the validation of diverse and localized ways of knowing revealed during the fieldwork period, this paper applies anthropologist Bridgette Jordan’s theoretical framework of authoritative knowledge to the emergent themes of subjectively understood childbirth (knowledge acquisition and flow, role of the husband, and protective behavior.)

Prenatal Smoking And Drinking Implications For Subsequent Child Maltreatment, Nicholas Alexander Adams

Sociology & Criminal Justice Theses & Dissertations

Prenatal smoking and drinking are very serious problems that have continued to plague society. They have multiple negative effects on the child both physically and cognitively. This study explored the relationship between prenatal abuse, i.e., prenatal smoking and prenatal drinking, and subsequent child physical abuse and official reports of child maltreatment. It was hypothesized that mothers who smoked or drank prenatally would be more likely to physically abuse their child postnatally and have official reports of child maltreatment. The sample included women participating in Wave III of the National Longitudinal Survey of Adolescent Health. N = 620 women who answered …

Strengthening The Delivery Of Comprehensive Reproductive Health Services At The Community Level In Kenya, Population Council

Reproductive Health

The Population Council APHIA II Operations Research Project collaborated with the Ministry of Public Health and Sanitation to improve the quality of services offered by community-based midwives in two districts in Western Kenya, to prepare them to offer more comprehensive maternal services through antenatal, obstetric, postpartum, and newborn care. The study found that community midwives can tremendously increase clients’ access to essential maternal health services and other reproductive health services. Therefore Ministry of Health and its partners should scale up community midwives’ activities to enable more women access these services. Furthermore, information campaigns are needed to promote the range of …

When Girls' Lives Matter: Ending Forced And Early Marriage In Cameroon, Sajeda Amin, Andrea Lynch

Poverty, Gender, and Youth

The program presented in this case study, the Association for the Struggle Against Violence Against Women (ALVF, from its name in French) in Cameroon, provides counseling, language and literacy training, economic support, and empowerment activities for girls who have fled (or been thrown out of) early or forced marriages to help them overcome their adversities. ALVF also seeks to bring about broader social change by highlighting in the public sphere—as well as among parents and husbands—the plight of girls who were married early and/or by force. Hence, ALVF’s prevention strategy is based on a broad understanding of the perceptions, expectations, …

Innovative Financing Through Pay-For-Performance For Providers To Improve Quality Of Care In Bangladesh: Transforming Research Into Action, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena

Reproductive Health

To improve access to and use of facility-based obstetric and newborn care, the Government of Bangladesh is implementing two innovative performance-based financing programs, namely demand-side financing (DSF) and pay-for-performance (P4P). With the purpose of identifying the lessons learned, limitations of the P4P and DSF models, and scopes for cross learning, a two-day workshop was organized in Dhaka. This workshop report, prepared by the Population Council, resulted in several recommendations to modify DSF and P4P schemes. In Bangladesh, the need for continuing performance-based financing programs to meet MDGs and other health indicators is beyond argument, but it is urgently required to …

Expanding Access To Safe Abortion And Post-Abortion Care: Recommendations Of A South Asia Regional Consultation, Population Council

Reproductive Health

A South Asia Regional Consultation, organized by the Population Council with representation from governments and key stakeholders of Bangladesh, India, Nepal, and Pakistan, was held in New Delhi, to discuss ways of expanding women’s access to safe abortion services. The Consultation deliberated on ways of expanding the provider base for safe induced abortion so as to overcome inadequate and inequitable access to safe abortion. They also looked to expand access to services for the management of incomplete abortion and complications of unsafe abortion that persist in the region and, thereby, to reduce morbidity and mortality resulting from unsafe abortion. In …

Community Health Workers And The Media Can Be Effective In Providing Health Information To Married Adolescent Girls In The Community, Population Council

Reproductive Health

Past research has found that married adolescent girls in Nyanza Province, Kenya, face higher risks of HIV infection than unmarried but sexually active girls their age in the province and other parts of the country. To address this challenge, the Population Council’s APHIA II Operations Research Project, in collaboration with Well Told Story and the Ministry of Public Health and Sanitation, developed a study to assess the effectiveness of an intervention designed to increase married adolescent girls’ access to comprehensive reproductive health and HIV information and services in Homa Bay and Rachuonyo districts. The study found that using interactive communication …

A Pay-For-Performance Innovation Integrating The Quantity And Quality Of Care In Maternal, Newborn And Child Health Services In Bangladesh, Laila Rahman, Ubaidur Rob, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Md. Noorunnabi Talukder, Md. Hafizur Rahman

Reproductive Health

The Population Council explored the possibilities of introducing a Pay-for-Performance (P4P) scheme in Bangladesh to improve maternal, newborn and child healthcare (MNCH) services. Based on the consultation and with guidance from the Government of Bangladesh, the Population Council and UNICEF provided technical assistance to the Directorate General of Health Services (DGHS) to test two P4P strategies for MNCH service providers to improve service volume and quality of care, and for poor clients to receive services subsidized through vouchers or coupons. The first strategy is a combination of pay-for-performance for providers and subsidized coupons for poor pregnant women, newborns, and under-five …

Levels, Trends And Determinants Of Contraceptive Use Among Adolescent Girls In Kenya, Francis Obare, Harriet Birungi, Chi-Chi Undie, Monica Wanjiru, Wilson Liambila, Ian Askew

Reproductive Health

In Kenya, recent trends in contraceptive use among currently married women aged 15–49 years show that after experiencing a stall between 1998 and 2003, the contraceptive prevalence rate (CPR) increased between 2003 and 2008–2009. Although the increase in CPR after 2003 is encouraging, there is limited understanding of how these changes affected adolescents, especially girls, given the unique sexual and reproductive health challenges that they face. This report is based on a secondary analysis of the Kenya Demographic and Health Surveys (KDHS) data to understand the trends, differentials, and determinants of contraceptive use among adolescent girls aged 15–19 years in …

Integrating Tuberculosis Case Finding And Treatment Into Postnatal Care, Charity Ndwiga, Harriet Birungi, Chi-Chi Undie, Shiphrah Kuria, Joseph Sitienei, Sam Ochola

Reproductive Health

Under the USAID funded FRONTIERS program, the Population Council conducted a study in six health facilities in Western Kenya that demonstrated that screening for TB within an antenatal care (ANC) setting is feasible and acceptable among the service providers. However, a major challenge remains: although TB detection is encouraged among ANC clients within the maternal and child health clinics in the country, providers in these settings fail to appreciate the need for a continuum of care from pregnancy through to the postnatal period. In order to address this gap, the APHIA II Operations Research Project developed and tested an intervention …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …