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Day Of Dialogue: Mainstreaming Emergency Contraception In The National Family Welfare Program, Population Council

Reproductive Health

The Population Council, in collaboration with the Family Planning Association of India, hosted a Day of Dialogue which addressed issues related to access, availability and use of emergency contraception pills (ECP). Some of the key issues addressed in this consultation included: provider knowledge on mechanism of action and attitudes toward easy access to ECP and its link to premarital sex and promiscuity, repeated use of ECP, and lack of information about ECP among potential users. The Population Council shared key findings of a recent study on knowledge, attitudes, and opinions of gynecologists and pharmacists on ECP use. The one-day consultation …

Day Of Dialogue: Expanding Opportunities For Increased Access To Emergency Contraception (Ec) In Nigeria, Population Council

Reproductive Health

In order to create a supportive policy and service delivery environment for emergency contraception (EC) and improve uptake in Nigeria, the Population Council conducted a survey of service providers’ knowledge, attitudes, and practices regarding EC, supplemented by in-depth interviews with key opinion leaders regarding their perceptions. This study revealed gaps that have implications for policy and programming. In collaboration with the International Consortium for Emergency Contraception, the Population Council convened a “Day of Dialogue” on EC to discuss the key research findings and to recommend strategic considerations for repositioning EC within the country's family planning program. This report describes the …

Do Public Health Services In Egypt Help Women Exercise Their Reproductive Rights?, Nahla G. Abdel-Tawab

Reproductive Health

These slides present results from a Population Council study conducted in Egypt aimed at identifying factors that prevent Egyptian couples from attainment of their reproductive goals using a rights-based, gender-sensitive analysis of family planning service demand and supply. The analysis focused on six aspects of clients’ rights: clinic/provider readiness, accessibility and affordability, privacy and confidentiality, choice and autonomy, informed decisionmaking, and the right to complain. The presentation concludes with recommendations for closing gaps that exist with regard to protection of clients’ rights to autonomy, choice, informed decisionmaking, privacy, and confidentiality.

Feasibility Of Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Ian Askew

Reproductive Health

This Population Council study tested the feasibility of implementing intimate-partner violence (IPV) screening protocols in healthcare settings in Kenya where sexual and gender-based violence service referrals could be executed. Providers drawn from these sites were trained to routinely screen for IPV and to refer IPV-positive clients identified through this process for further care. This study demonstrates that providers, given the training, are willing and able to incorporate IPV screening into their practice—one that they perform in a severely resource-constrained context. Likewise, the findings indicate that incorporating IPV screening questions into client intake forms in a variety of public healthcare settings …

Journee De Dialogue Sur La Contraception D'Urgence (Cu), Population Council, International Consortium For Emergency Contraception

Reproductive Health

Le Population Council en collaboration avec le Consortium International sur la Contraception d’Urgence, a organisé, une journée de dialogue sur la contraception d’urgence (CU) au Sénégal, en partenariat avec le Ministère de la Femme, de l’Enfant et de l’Entreprenariat Féminin; le Ministère de la Santé et de l’Action Sociale; et le Ministère de la Jeunesse, de l’Emploi et de la Promotion des Valeurs Civiques. L’objectif principal de la journée était de développer un plan d’actions pour la création d’un environnement politique et juridique plus favorable à l’offre de CU, et pour la vulgarisation de la CU auprès des communautés. Suite …

Gender-Based Violence: A Qualitative Exploration Of Norms, Experiences And Positive Deviance, Shireen J. Jejeebhoy, K.G. Santhya, Shagun Sabarwal

Reproductive Health

This report presents the findings of formative research the Population Council conducted, with support from UK aid, in the district of Patna, India that aimed to better understand the context of violence—physical, emotional, and sexual—against women and girls, and notably, the prevailing norms about men’s entitlement and women’s acquiescence to violence. Findings suggest that violence against women and girls is widespread and widely justified, that women are perceived as having few options but to tolerate violence, and that the most common response to violence is silence. At the same time, many women and some positive deviant men recognize the injustice …

Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu

Reproductive Health

Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The specific objectives of the initiative were to: increase knowledge, awareness, and use of EC among Kenyan women; increase knowledge and awareness of EC among health providers; and strengthen EC provision in both the private and public sectors. This policy brief describes a toolkit designed for policymakers and service providers which draws on the achievements, lessons learned, and experiences from this project.

Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community

Reproductive Health

The East, Central and Southern Africa (ECSA) Health Community, which prioritizes gender-based violence and child sexual abuse as regional health concerns, partnered with the Population Council to convene a pre-conference Expert Committee meeting of the Research, Information and Advocacy Programme. The conference marked a major milestone in the ECSA Health Community’s commitment to promote and support region-wide sharing and utilization of health research and policy information among its member states. This report summarizes the deliberations of the two-day workshop and the recommendations for implementing an advocacy plan to address this important facet of the region’s development agenda.

Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes

Reproductive Health

Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …

Reviewing The Evidence And Identifying Gaps In Family Planning Research: The Unfinished Agenda To Meet Fp2020 Goals, Ian Askew, Martha Brady

Reproductive Health

The Population Council produced this paper to help guide discussions and considerations regarding the key evidence gaps and research investments needed to achieve the FP2020 goal and objectives. The paper focuses primarily on the social science, implementation, and operations research that will be needed to achieve the first three objectives. Research shows that through high-quality voluntary family planning (FP) programs, governments can reduce fertility and generate substantial improvements in health, wealth, human rights, and education. Family planning programs for the 21st century will require thoughtful design—engaging both public and private sectors—to meet the growing need for safe and effective FP …

Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

Un profil pays a été préparé pour le Sénégal pour compiler et synthétiser les informations disponibles sur la santé de la reproduction, en particulier les grossesses non désirées et par conséquent les besoins non satisfaits en matière de planification familiale. D’importants efforts ont été consentis par l’Etat sénégalais, mais de nombreux obstacles continuent de freiner les progrès réalisés. Un programme national plus cohérent et ciblé est donc nécessaire pour réduire ces obstacles. Dans le même temps, les acteurs non-gouvernementaux devraient poursuivre leurs efforts pour renforcer leur programmation pour produire des effets plus immédiats, tout en assurant une meilleure coordination entre …

Analyse Des Besoins Non Satisfaits Au Sénégal, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Cette étude vise à établir l’importance relative d’un manque d’accès et d’attitudes de résistance envers l’utilisation de la contraception dans les strates géographiques et de population du Sénégal. Elle est destinée à informer les décideurs politiques sur la priorité à accorder à la communication pour le changement de comportement ou pour l’amélioration de l’accès/de l’information, et également à aider lors de la conception d’interventions pour réduire les inquiétudes par rapport à la santé et la peur des effets secondaires, tels que la provision d’une gamme de méthodes plus élargie et le counseling amélioré. Plus de la moitié des femmes ayant …

International Seminar On "Is Access Enough? Understanding And Addressing Unmet Need For Family Planning", Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with STEP UP and AFIDEP, held a seminar in Nanyuki, Kenya, in May 2013. The seminar brought together 44 scientists, policymakers, and program managers to present and discuss a range of issues relating to the definition, determinants, and consequences of unmet need for family planning and program interventions designed specifically to reduce unmet need in groups at high risk. Based on discussions and presentations, unmet need (and family planning in general) should be looked at both from a development perspective and from a service-delivery and health-sector perspective. Overall, the seminar papers, …

Introducing Medical Mr In Bangladesh: Mrm Final Report, Ismat Ara Hena, Ubaidur Rob, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed

Reproductive Health

The Population Council Bangladesh, in collaboration with the Directorate General of Family Planning and Marie Stopes Bangladesh, with funding from the World Health Organization and the DFID-supported STEP UP project, conducted an 18-month operations research study from January 2012 to June 2013. This operations research tested the feasibility of introducing menstrual regulation with medication (MRM) in Bangladesh and assessed accessibility of the combination regimen of mifepristone and misoprostol in urban and rural health facilities. Based on this study’s results, the feasibility of introducing MRM services in Bangladesh is clear, and women receiving MRM were satisfied with their overall quality of …

Understanding Unintended Pregnancy In Bangladesh: Country Profile Report, Fauzia Akhter Huda, Sabiha Chowdhuri, Yolande Robertson, Noushin Islam, Bidhan Krishna Sarker, Ashrafi Jahan Azmi, Laura Reichenbach

Reproductive Health

The objective of this report is to identify the determinants of unintended pregnancy and unmet need for family planning in Bangladesh and therefore provide a strong body of evidence that will contribute to issue identification, evidence generation, and communication for use of evidence in policy and programming. The evidence generated can be used to find ways to reduce the rate of unintended pregnancy and hence reduce the risk of abortion-related morbidity and mortality; ultimately this will aid Bangladeshi couples in reaching their fertility goals. Results demonstrate that Bangladesh has shown progress and promise in several areas of family planning and …

Insights Into Unmet Need In Ghana, Kazuyo Machiyama, John C. Cleland

Reproductive Health

This study aims to establish the relative importance of lack of access and attitudinal resistance toward use of family planning for different population and geographical strata in Ghana. It is intended to inform policymakers on the priority that should be given to behavior change communication or improved access/information, and also helpful to interventions to reduce health concerns and fear of side effects, such as provision of broader method mix and better counseling. The most far reaching implication concerns the reproductive behavior of the best educated women and those living in the capital or surrounding areas. The results suggest an enduring …

Insights Into Unmet Need In Senegal, Kazuyo Machiyama, John C. Cleland

Reproductive Health

Results presented in this STEP UP Research Report show that over half of women having unmet need for family planning in Senegal did not intend to use family planning in the future and this was consistent across all population strata. Reasons for non-use confirm the existence of widespread opposition to the use of modern contraception. Unfamiliarity and lack of information is likely to be a reason for such opposition; initial suspicion of contraception has also been documented. Thus a first policy priority, and one that is relatively easy to achieve, is to increase knowledge through the mass media and localized …

Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew

Reproductive Health

Prevention of unintended pregnancy is often considered the key outcome of reducing unmet need; it is the basic right of women and couples to become pregnant only when intended. This paper explores this relationship by reviewing the definition and measurement of unintended pregnancy, identifying key trends in its distribution within and between populations, and analyzing the relationship between unintended pregnancy, demand for family planning, and family planning program performance. The determinants and consequences of unintended pregnancy are reviewed to further understand the implications of using it as a policy and programming goal. The paper concludes by reviewing the broader policy …

Does Breastfeeding Offer Protection Against Maternal Depressive Symptomatology? A Prospective Study From Pregnancy To 2 Years After Birth, Jennifer Hahn-Holbrook, Martie G. Haselton, Christine Dunkel Schetter, Laura M. Glynn

Psychology Faculty Articles and Research

Depression is the leading cause of disability in women (Nobel 2005) and is the most prevalent of all childbearing-related illnesses, affecting approximately 13% of women worldwide within the first 12 [...] Mothers who breastfeed typically exhibit lower levels of depressive symptomatology than mothers who do not. However, very few studies have investigated the directionality of this relationship. Of the prospective studies published, all but one focus exclusively on whether maternal depression reduces rates of subsequent breastfeeding. This study again examines this relationship, but also the reverse--that breastfeeding might predict lower levels of later depression. Using multilevel modeling, we investigated the …

Sexual And Reproductive Health Care Access And Utilization By Mexican Immigrant Women In New York City – A Descriptive Study, Gabriela Betancourt

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines reproductive health care access and utilization by Mexicans in New York City.

Methods: This report uses data collected by Planned Parenthood of New York City (PPNYC) as part of a larger sexual and reproductive health (SRH) needs assessment. We analyzed various demographic factors and barriers to describe SRH access and utilization of services among Mexican immigrant women residing in New York City (NYC). We purposely sampled 151 adult women seeking assistance from the Mexican Consulate of New York City and other community-based organizations (CBOs). Women choosing to participate were administered an anonymous survey. Data collected included …

Le Consensus De Bellagio : Recommandations Pour Améliorer L'Accès Aux Méthodes De Contraception Efficaces, Réversibles À Longue Durée D'Action, Population Council

Reproductive Health

Ce communiqué et cette déclaration proposent des recommandations pour améliorer l'accès aux méthodes de contraception efficaces, réversibles à longue durée d'action (LARC) et accélérer les progrès vers la réalisation de l'Objectif du Millénaire pour le développement relatif à l'accès universel aux services de santé reproductive.

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This brief and statement offers recommendations for action to increase access to highly effective, long-acting, reversible contraception (LARCs) and accelerate progress toward meeting the Millennium Development Goal of universal access to reproductive health services.

Expanding Access To Comprehensive Reproductive Health And Hiv Information And Services For Married Adolescent Girls In Nyanza Province, Chi-Chi Undie, Harriet Birungi, Francis Obare, Ben Ochieng, Wilson Liambila, Erick Oweya, Ian Askew, Rob Burnet, Bridget Deacon, Aisha Mohamed

Reproductive Health

The objectives of this operations research study, conducted by the Population Council’s APHIA II Operations Research Project in Kenya, were to: 1) identify and design a set of interventions that promote the uptake of comprehensive reproductive health (RH)/family planning (FP) and HIV prevention services and information among married adolescent girls; and 2) expand access to comprehensive RH/FP and HIV prevention services and information among this population. The study demonstrated that the combined use of interactive media and community health worker visitation, health information provision, and referrals, is an effective means of reinforcing RH/FP and HIV messages, and of increasing access …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In India: Final Survey Report, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECPs) among providers in public and private facilities and pharmacies in India. This study’s objectives were: 1) to assess providers’ knowledge of ECP’s biological mechanism; 2) to understand providers’ knowledge and attitudes about ECP’s safety, effectiveness, and availability as an over-the-counter drug; and 3) to identify providers’ definitions of “repeated use” and profiling of women who are “repeated users” of ECP. The study recommends intervention programs and advocacy strategies to increase knowledge and access to ECP.

The Reproductive Health Of Young People In Egypt, Nahla G. Abdel-Tawab, Noha Roushdy, Maia Sieverding

Poverty, Gender, and Youth

This Population Council brief presents results from the Survey of Young People in Egypt (SYPE) on reproductive health (RH). The SYPE results underscore the need for: the assessment of state and civil society initiatives to transmit RH information; a national, comprehensive, age-appropriate reproductive health module to be integrated into the educational program; a national campaign on HIV/AIDS and other sexually transmitted infections that targets young people of reproductive age; the integration of female circumcision into a broader approach to youth reproductive health and bodily rights; specialized reproductive health services for married adolescent girls; and further research on sexuality and reproductive …

The Health Of Vulnerable Adolescent Girls: A Strategic Investment For Double Return, Jennifer Catino

Poverty, Gender, and Youth

Worldwide there are 1.2 billion adolescents between the ages of 10 and 19. Nearly 90 percent of them live in developing countries, and approximately 600 million are female. While adolescence is normally a time of good health, numerous developmental and social changes occur during this period, many of which have health implications, especially for girls. Most of the girls and young women in the developing world live in conditions that make them vulnerable to health and social risks. They are often poor, out-of-school, married, migrants, members of ethnic minorities, or engaged in unsafe labor. Girls from many of the poorest …

Filles Eveillées ('Girls Awakened'): A Pilot Program For Migrant Adolescent Girls In Domestic Service In Urban Burkina Faso, Sarah Engebretsen, Gisele Kaboré, Leah Jarvis

Poverty, Gender, and Youth

Young people in Burkina Faso, especially adolescent girls, have few economic opportunities, particularly in rural areas. This drives migration to urban areas in search of employment. In 2010, the Population council conducted formative research on migrant adolescent girls in domestic service in urban Burkina Faso. Findings revealed that girls typically live with their employers and spend long days performing arduous work, leaving little time for schooling, building social networks, and developing skills necessary for adulthood. Most programs designed for this population intervene after something has gone wrong rather than building girls’ protective assets. In response to these findings, the Population …

Baseline And Endline Findings Of Filles Eveillées ('Girls Awakened'): A Pilot Program For Migrant Adolescent Girls In Domestic Service. Cohort 1 (2011–2012), Bobo-Dioulasso, Sarah Engebretsen

Poverty, Gender, and Youth

Burkina Faso has the tenth youngest population in the world, with 45 percent of the population below the age of 15. Young people in Burkina Faso, especially adolescent girls, have few economic opportunities, particularly in rural areas. This drives migration to urban areas in search of employment. On their own, girls are physically and economically vulnerable and many are at heightened risk for gender-based violence. The Population Council conducted formative research in 2010 to better understand the situation of migrant adolescent girls in domestic service in urban Burkina Faso, and subsequently designed a safe spaces intervention. The Filles Éveillées (“Girls …

Recours Aux Données Pour Révéler Et Sélectionner Les Adolescentes Les Plus Vulnérables, Sarah Engebretsen

Poverty, Gender, and Youth

Il est crucial d’investir dans les adolescentes du monde en développement, où une proportion déjà importante et grandissante de la population tombe dans la catégorie des moins de 24 ans. Il est essentiel pour protéger les droits à la scolarité, à l'intégrité corporelle et au mariage légal et choisi, et pour réduire la fertilité tout en augmentant la capacité de production. Il est essentiel de rendre les filles visibles si l’on veut que l’investissement soit ciblé sur les groupes qui présentent le plus grand risque de bilans non favorables. Tel est le principe de ce compte rendu: son but est …

Observations Initiales Et Finales De Filles Eveillées : Programme Pilote De Renforcement Des Compétences Des Adolescentes Migrantes Employées De Maison. Cohorte 1 (2011–2012), Bobo-Dioulasso, Sarah Engebretsen

Poverty, Gender, and Youth

Le Burkina Faso abrite la dixième population la plus jeune du monde, avec 45% de la population de moins de 15 ans. Les jeunes au Burkina Faso, en particulier les adolescentes, ont peu d'opportunités économiques, en particulier dans les zones rurales. Cela alimente la migration vers les milieux urbaines à la recherche de travail. Seules, les filles sont physiquement et économiquement vulnérables et beaucoup courent un risque élevé de violence sexiste. Le Population Council a mené une recherche formative en 2010 dans le but de mieux comprendre la situation des adolescentes migrantes employées de maison au Burkina Faso urbain, et …

Évaluation De Processus : Programme Filles Eveillées Pour Adolescentes Migrantes Employées De Maison Au Burkina Faso Urbain 2012, Leah Jarvis, Gisele Kaboré

Poverty, Gender, and Youth

Le programme «Filles Éveillées» a été conçu pour apporter aux adolescentes migrantes employées de maison les compétences, les connaissances et le capital social qui leur permettent de réduire leurs vulnérabilités et de s’ouvrir de nouveaux débouchés. Les observations tirées de la collecte de données quantitatives et qualitatives ont révélé le succès considérable du programme: il est largement apprécié et a été bien reçu par les participantes, les mentors, les membres de la communauté et tous les autres intéressés. En sa qualité de programme pilote, les obstacles à une mise en œuvre sans incidents auraient été inévitables, mais par leur détermination …