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

Reproductive Health

The South African government wishes to expand availability and use of counseling and testing (C&T) for HIV. One option is to integrate C&T into well-attended services, such as family planning (FP). In 2004, the Population Council began a three-year study with the Department of Health in North West Province. The study tested the feasibility, acceptability, and cost of two models for integrating HIV prevention services within established FP programs, and evaluated their quality against standard practice. In the testing-model clinics, providers provided C&T services at the same consultation; in the referral-model clinics, providers offered HIV counseling and referred clients to …

Increasing Women's Use Of The Iud For Family Planning, Ricardo Vernon

Reproductive Health

The intrauterine device (IUD) is highly effective, easy to use, and has few side effects. The device costs the provider about US$2 and offers a duration of protection that makes it the most cost-effective of the temporary methods if used for two years or more. The IUD's many advantages also make it a good alternative for reducing unmet need for long-term contraception around the world. Between 5 and 17 percent of all married women of reproductive age in 53 less developed countries do not want to have more children but are not using a contraceptive method. Because the IUD can …

Assessing Integration Methodology (Aim): A Handbook For Measuring And Assessing The Integration Of Family Planning And Other Reproductive Health Services, M. Estela Rivero-Fuentes, Saumya Ramarao, Ricardo Estrada, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Harriet Birungi, John Townsend, Susana Medina

Reproductive Health

Several international statements over the past two decades have endorsed the integration of family planning (FP) services with other reproductive health (RH) services as a means of expanding availability and access for potential users. Many rationales underlie the move toward integrating FP with other services. First is that it provides benefits to the client and the program. Moreover, there is the expectation that the costs to the health system of configuring two or more services will cost less than providing them independently. However, there is still little empirical evidence available about integration of services. Over time, a number of methodologies …

Financial Capacity Building For Ngo Sustainability, John H. Bratt, Rick Homan, Barbara Janowitz, James R. Foreit

Reproductive Health

While demand for family planning and reproductive health services is increasing worldwide, a number of recent trends threaten the financial sustainability of donor-supported NGOs that provide these services. First, the U.S. Agency for International Development has seen its funding for population assistance decline since 1995. A second reason is the growth of government-funded programs that provide these services for low-income clients, which reduced the need for NGOs to focus programs entirely on the poor. Health-sector reform has created opportunities for NGOs via public–private partnerships in some countries, but sustained public-sector support is unlikely given limited economic growth in domestic economies …

Family Planning And Comprehensive Abortion Care Handbook For Medical Students And House Officers, Population Council

Reproductive Health

The persistently high maternal mortality and morbidity in Ghana is partly due to high rates of unwanted fertility, unsafe abortion, and relatively low use of modern contraception. In 2006, a consortium of agencies, including the Population Council, initiated the Reducing Maternal Mortality and Morbidity program. The program provides financial and technical resources that will enable the government to significantly expand women's access to modern family planning, contraception, and comprehensive abortion care (CAC) to reduce maternal mortality in Ghana. This handbook on FP and CAC was developed as part of the program. It updates a previous document produced more than ten …

Dissocier Les Mutilations Génitales Féminines De L'Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi

Reproductive Health

Les mutilations ou excisions génitales féminines (MGF/E) sont pratiquées dans au moins 28 pays d'Afrique subsaharienne, quelques pays du Moyen-Orient et d'Asie, et parmi les populations immigrées de ces pays en Europe, en Amérique du Nord et en Australie. Dans le monde, on estime que 100 à 140 millions de filles et de femmes ont subi cette pratique, et au moins trois millions de filles sont à risque chaque année. La communauté ethnique somalienne au Kenya ainsi qu'en Somalie, à Djibouti et en Éthiopie pratique l'excision depuis des siècles et la pratique semble être restée largement inchangée. Le programme FRONTIERS …

Africa Regional Sexual And Gender-Based Violence Network Consultation: Technical Exchange And Planning Meeting, Population Council

Reproductive Health

In March 2008, the Population Council brought together members of the Africa Regional Sexual and Gender Based Violence (SGBV) Network for a South-South technical exchange meeting. The objectives were to identify best practices from existing programs, provide an evidence base for new programming, and develop mechanisms for South-South technical assistance. As detailed in this report, discussions covered the medical, legal, and psychosocial issues associated with SGBV prevention and response activities. Participants identified the following: Protocols and guidance documents are essential for ensuring comprehensive, quality response at all levels. Enabling access and utilization of the full range of medical services remains …

Study Of Sexually Transmitted Infections Among Urban Men In Pakistan: Identifying The Bridging Population, Ali M. Mir, Laura Reichenbach, Abdul Wajid, Mumraiz Khan

Reproductive Health

Pakistan currently has low levels of HIV infection, however the country is considered at high potential risk for an HIV epidemic. In major cities there are large concentrations of individuals whose behaviors make them extremely vulnerable to the rapid spread of HIV and of classical sexually transmitted infections (STIs), including male and female sex workers, men who have sex with men, and injecting drug users. HIV can spread to the general population through individuals who have contact with both high-risk groups and the general heterosexual population (the “bridging population”). Identifying the bridging population and bridging behaviors among urban men and …

Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The World Health Organization estimates that 585,000 women die from pregnancy-related conditions each year. Pregnancy-related conditions, including dysfunctional labor, hemorrhage, infection, toxemia, and unsafe abortion, are the leading cause of death among women of reproductive age in many developing countries. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan, through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to …

Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to the hospital. PAIMAN is compiling data from three data sources and making efforts to improve the functioning of these Health Information Systems (HISs) for efficient management of health services at the district level through generation of quality data and their …

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

Reproductive Health

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

Profile Of Abortion Seekers In Ghana And Their Decision-Making Processes, Philomena Nyarko, Cletus Adohinzin, Saumya Ramarao, Placide Tapsoba, Ayorinde Ajayi

Reproductive Health

In 2006, a consortium of agencies, including the Population Council, came together to provide technical and financial support to the Government of Ghana in the rollout of comprehensive abortion care (CAC) services. The consortium collaborated with the government in expanding women’s access to modern family planning and CAC. The consortium’s program, Reducing Maternal Mortality and Morbidity (R3M), aims to reduce unwanted pregnancy and severe complications and deaths caused by unsafe abortion. The formative research in this report was undertaken to provide a profile of beneficiaries, their needs for information and services, their decision-making process in seeking care, and the quality …

Delinking Female Genital Mutilation/Cutting From Islam, Ibrahim Lethome Asmani, Maryam Sheikh Abdi

Reproductive Health

Female genital mutilation or cutting (FGM/C) is practiced in at least 28 countries in sub-Saharan Africa, a few countries in the Middle East and Asia, and among immigrant populations from these countries in Europe, North America, and Australia. Worldwide, an estimated 100 to 140 million girls and women have undergone the practice, and at least three million girls are at risk each year. The Somali ethnic community in Kenya as well in Somalia, Djibouti, and Ethiopia, has practiced female genital cutting for centuries and the practice appears to have remained largely unchanged. The Population Council’s FRONTIERS program carried out two …

Provider Perspectives On Informed Consent In Female Sterilisation Services: Findings From A Facility-Based Study In Chennai, Raja Lakshmi

Reproductive Health

The objective of this paper is to explore the perceptions and experiences of providers with regard to the process of informed consent in the provision of female sterilization services in Chennai, south India. It describes the quality of information provided to clients of sterilization, providers’ attitudes toward clients and the quality of decisionmaking, as well as the quality of the consent-taking process in this setting. In addition, providers’ perceptions of the importance of informed consent are discussed. Findings strongly suggest the need to train and sensitize providers in public as well as private facilities on their ethical responsibilities of ensuring …

Developing Regional Operations Research Training Capacity In South Asia, M.E. Khan, James R. Foreit, Sohini Roychowdhury, F. Ram, Chander Shekhar

Reproductive Health

This project’s overall objective was to create a self-sustaining regional operations research (OR) training and research center for South Asia at the International Institute of Population Sciences (IIPS), in Mumbai, India. The goal was to institutionalize operations research (OR) in IIPS by building the teaching and research capabilities of the faculty and research team. Capacity building was accomplished through a training of trainers that included an OR workshop in Nepal, two four-day OR workshops for program managers, one ten-day OR workshop for researchers, and a four-day scientific-writing course for researchers and program managers to provide guidelines for preparing research articles …

Situation Analysis Of The Sexual And Reproductive Health And Hiv Risks And Prevention Needs Of Older Orphaned And Vulnerable Children In Nyanza Province, Kenya, Milka Juma, Ian Askew, Alan Ferguson

Reproductive Health

The increasing number of children in Kenya who are orphaned or made vulnerable (OVC) from HIV/AIDS and other factors calls for a holistic understanding of their situation so that effective programs to address their needs can be designed. This is especially important for those areas hardest hit by the HIV/AIDS pandemic, such as Nyanza Province. Little is known about the vulnerabilities of older orphans to risky sexual behavior, and whether they are more vulnerable than nonorphans. The Department of Children’s Services has initiated a cash transfer program to households taking care of OVC. The main objective is to provide a …

Emergency Contraception, Female Condoms And Iuds In Kenya's Public Sector: Findings From A National Diagnostic Assessment, Jill Keesbury, Benter Owino, Spike Bradford

Reproductive Health

In 2005, the Kenya Ministry of Health, Department of Reproductive Health (DRH), began an initiative to strengthen the provision of emergency contraception (EC) in the public sector. As a first step, 700,000 units of the dedicated EC product Postinor 2 were procured by UNFPA for use in government facilities and select providers were trained on its administration. In 2006, the DRH requested assistance from ECafrique, the African Forum on Emergency Contraception, to expand access to the product. This report documents the results of a diagnostic assessment conducted at the outset of this initiative. It examines the provision and utilization of …

Kenya: Multisectoral Engagement Increases Support For Adolescent Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

In 1999, FRONTIERS launched the Kenya Adolescent Reproductive Health Project (KARHP), testing a multisectoral approach to improving young people’s reproductive health knowledge and behavior at community, school, and health-facility levels in two pilot districts in the Western Province. The intervention involved three key government ministries—Education, Science and Technology, Health, and Gender, Sports, Culture, and Social Services—with input from community leaders, parents, and youth. Positive findings from the study convinced the three ministries and USAID to institutionalize and scale up selected elements from the pilot project. In 2003, FRONTIERS and PATH began providing technical assistance aimed at mainstreaming and expanding cost-effective …

Tuko Pamoja: A Guide For Peer Educators, Program For Appropriate Technology In Health (Path)

Reproductive Health

This guide was developed by Program for Appropriate Technology in Health (PATH) and is part of the Kenya Adolescent Reproductive Health Project’s Tuko Pamoja (We Are Together) series. Based on KARHP’s Adolescent Reproductive Health and Life Skills Curriculum, the guide is designed to help facilitate dialogue between adults and young people on issues related to adolescent reproductive health. It can be used to help peer educators share information and lead discussions with their peers on physical and emotional changes during adolescence, staying healthy, planning for the future, making good decisions, and preventing pregnancy and HIV and AIDS. The information can …

Grandir En Harmonie: Document De Références, Population Council

Reproductive Health

Ce document de référence fournit des informations pour accompagner les animateurs du curriculum « Grandir en harmonie » en santé de la reproduction. Il s’adresse principalement aux pairs éducateurs et aux assistants d’adolescent(e)s pour les aider à préparer les adolescents(e) à aborder la sexualité en connaissance de cause, de manière responsable et dans le respect des valeurs de leur communauté. Son contenu peut également être adapté pour les jeunes de 20 à 24 ans. Le document couvre des sujets tels que : lʼadolescence; les valeurs; le genre; les mutilations génitales féminines; comprendre son corps; le tabagisme, l’alcoolisme et la toxicomanie; …

Grandir En Harmonie: Guide De L'Utilisateur, Population Council

Reproductive Health

Ce guide de l’utilisateur fournit des informations pour aider les animateurs du programme « Grandir en harmonie » à jouer efficacement leur rôle d’éducateur pair. Le guide décrit la mission, les tâches et la cible des activités à faire avec les adolescent(e)s/jeunes. Ces activités leur permettent de renforcer leurs capacités à prendre des décisions afin de mieux se réaliser maintenant et dans le futur. Le guide aide les animateurs avec l’organisation, la méthodologie et le matériel de soutien pour les sessions.

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This user’s guide provides information to help “Growing in Harmony” curriculum facilitators effectively carry out their role of …

Grandir En Harmonie: Curriculum D'Animation Des Pairs-Éducateurs Et Des Aides-Ados Ou Jeunes Écoutant, Population Council

Reproductive Health

« Grandir en harmonie » est un curriculum d’animation en santé de la reproduction a l’intention des pair éducateurs et des aides-adolescent(e)s, principalement, pour préparer les adolescent(e)s à aborder la sexualité en connaisance de cause, de manière responsable et dans le respect des valeurs de leur milieu. Son contenu peut aussi être utilisé par les jeunes de 20 à 24 ans, mais avec des méthodes appropriées (panel, thé-débat, etc.). D’autre types d’utilisateurs l’ont expérimenté et ont trouvé que c’était une ressource utile pour la conduite de leurs activités: aides-adolescent(e)s, enseignants, prestataires de santé et autres encadreurs de jeunes. Leurs remarques …

Grandir En Harmonie: Les Questions/Réponses Les Plus Fréquentes Posées Par Les Adolescent(E)S, Population Council

Reproductive Health

Ce guide compile les questions les plus fréquemment posées par les adolescent(e)s au cours du curriculum « Grandir en harmonie » en santé de la reproduction. Il s’adresse principalement aux pairs éducateurs et aux assistants d’adolescent(e)s pour les aider à répondre aux adolescent(e)s au sujet de la sexualité en connaissance de cause, de manière responsable et dans le respect des valeurs de leur communauté. Le document couvre des sujets tels que : l’adolescence, la puberté et les changements des corps; la culture et la sexualité; la santé sexuelle et la sexualité à moindre risque; la contraception et les grossesses indésirées; …

Guías De Referencia: Para Instituciones Y Establecimientos De Salud Que Buscan Acreditar La Calidad Y Enfoque De Género De Sus Servicios, Patricia Riveros Hamel, Erica Palenque, Ricardo Vernon, Ignacio Carreno

Reproductive Health

Esta guía busca presentar todos los elementos para que las organizaciones de salud reproductiva puedan implantar un sistema para mejorar la calidad de los servicios y su sensibilidad a asuntos de género a través de una estrategia de acreditación. La estrategia de acreditación comienza con una evaluación de las condiciones y servicios que ofrece la clínica, lo que permite identificar los estándares de calidad que no son cumplidos. Posteriormente, el personal de la clínica toma como insumo esta información y elabora un plan de trabajo para resolver los problemas identificados. Si la clínica demuestra cumplir cuando menos el 80 por …

Management Of Complications, Pregnancy, Childbirth And The Postpartum Period In The Presence Of Fgm/C, Kenya Ministry Of Health

Reproductive Health

This reference manual is intended for health-care providers in Kenya working among communities that have a high prevalence of female genital mutilation/cutting (FGM/C) and those who encounter women and/or girls who have undergone the practice. It was designed particularly for use by nonspecialist clinicians, including nurses/midwives, clinical officers, district medical officers, postgraduate medical officers, and medical students. It is also a resource for medical and other health-service providers at primary, secondary, and tertiary levels, particularly those working in areas with a high prevalence of FGM/C. Since the evidence base for effective clinical practice is constantly evolving, readers are encouraged to …

Mainstreaming Emergency Contraception In Ethiopia's Public Sector: Final Project Report, Jill Keesbury, Hailegiorgis Aytenfisu, Spike Bradford

Reproductive Health

The Ethiopian Ministry of Health, the Ethiopian Society of Obstetricians and Gynecologists, and ECafrique launched a two-year project in 2004 to mainstream emergency contraception (EC) in the country’s public sector. The project aimed at improving reproductive health care among young women and reducing the country’s abortion rate by expanding access to EC. Overall, its goal was to demonstrate the feasibility of integrating EC within the public sector’s broader contraceptive mix and was guided by the following objectives: to scale-up and promote public sector EC services in five of Ethiopia’s most populated regions; to document the characteristics and use patterns of …

The Resolution Of Unintended Pregnancy Among Female Students At The University Of Ghana, Legon, Angela El-Adas

Reproductive Health

Little has been done to investigate the knowledge, attitudes, and practices of university students regarding unintended pregnancy likely because their middle-class status precludes their being considered a “deprived population.” Female students in tertiary institutions of higher learning are at an age and in a social context that makes them extremely susceptible to unintended pregnancy and the consequences of unsafe abortions. It is necessary to take steps to reduce the incidence of unwanted pregnancy and unsafe abortions among this group of “high risk” women. This study sought to investigate the extent of knowledge that female students at the University of Ghana, …

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

Reproductive Health

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

Bolivia: Marketing And Economic Analyses Help Ngos Develop Strategies For Sustainability, Frontiers In Reproductive Health

Reproductive Health

Many nongovernmental organizations (NGOs) face reduced funding for reproductive health services and are seeking ways to assess and enhance their ability to generate income to cover their service costs. In 2004, following a workshop on financial sustainability presented by the Population Council’s FRONTIERS Program, three Bolivian NGOs—Prosalud; the Center for Research, Education, and Services (CIES); and the Association of Rural Health Programs (APSAR)—developed operations research studies to improve their financial sustainability. The Prosalud and CIES studies included a cost-recovery study, a study measuring clients’ willingness to pay for services, and a market segmentation study to compare the NGOs’ services with …

Bangladesh: Rh Curriculum Enhances Vocational Students' Knowledge And Behavior, Frontiers In Reproductive Health

Reproductive Health

In 2004, the Population Council’s FRONTIERS Program and the Bangladesh Ministry of Youth and Sports collaborated on an intervention to introduce reproductive health education into government-run vocational-training courses. The training, offered to males and females aged 15–30, includes livestock husbandry, electronics, and secretarial work. The intervention built upon the positive results of the 1999 Bangladesh Youth Reproductive Health Study, which introduced a life-skills curriculum into secondary schools. The interactive reproductive health curriculum was modified to suit older adolescents and youth attending courses at vocational training centers. Topics included reproductive biology, family planning, pregnancy, sexually transmitted infections, critical thinking, and negotiation …