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South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health Jan 2007

South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health

Reproductive Health

South Africa’s medical infrastructure is relatively well developed, but its maternal mortality rate remains high and numerous studies document poor maternal care. Shortages in nursing staff are a major factor in quality-of-care problems on maternity wards. A Population Council FRONTIERS study of antenatal care in rural clinics in Kwa-Zulu Natal showed that between one-third and one-half of providers interviewed had worked at their clinics for less than a year. In 2004, FRONTIERS followed up on the Kwa-Zulu Natal study to document factors affecting the tenure, motivations, and working conditions of maternal-health nursing staff in three South African provinces. The study …


South Africa: Youth Centers: A Costly Way To Provide Reproductive Health Services, Frontiers In Reproductive Health Jan 2007

South Africa: Youth Centers: A Costly Way To Provide Reproductive Health Services, Frontiers In Reproductive Health

Reproductive Health

Numerous reproductive health programs sponsor youth centers, which provide recreation and job-skills training as a means of attracting young people to seek reproductive health services or information. However, the productivity, cost, and cost-effectiveness of this approach are not clearly documented. In 2000, FRONTIERS conducted a cost analysis as part of a larger study on the effectiveness of three different youth center models in South Africa. The study focused on 8 of the 12 centers included in the larger study, chosen to be representative of each model. All the selected centers offered clinical services, seven also offered reproductive health information or …


Guatemala: On-Site Training And Outreach Increases Demand For And Provision Of Vasectomy, Frontiers In Reproductive Health Jan 2007

Guatemala: On-Site Training And Outreach Increases Demand For And Provision Of Vasectomy, Frontiers In Reproductive Health

Reproductive Health

About one-third of Guatemalan women use modern contraceptives and half of these use female sterilization. Despite the strong demand for permanent methods, vasectomy is used by less than 1 percent of all couples. An ineffective service introduction model contributes to the low use of vasectomy. In the traditional model, doctors are sent to a hospital (often abroad) where a relatively high number of vasectomies are performed, and the trainee performs at least five supervised vasectomies. In their home practice, however, trained doctors frequently find a low demand and, unable to routinely perform vasectomies, soon lose their enthusiasm and surgical skills. …


How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit Jan 2007

How Much Will It Cost To Scale Up A Reproductive Health Pilot Project?, Barbara Janowitz, John H. Bratt, Rick Homan, James R. Foreit

Reproductive Health

Most service-delivery interventions begin as pilot projects. When a pilot study of an intervention is successful, managers begin to think about scaling up the project to new areas. Cost is a critical factor influencing the extent and pace of scale-up. This brief explains how to adapt and modify cost information obtained from a pilot project to estimate scale-up costs. The brief shows why the costs of a pilot project alone are not sufficient to predict costs of scale-up and gives examples of how costs are influenced by factors like economies and diseconomies of scale, resource substitution, and intervention modification. The …


Achieving Synergies In Prevention Through Linking Sexual And Reproductive Health And Hiv Services, Ian Askew Jan 2007

Achieving Synergies In Prevention Through Linking Sexual And Reproductive Health And Hiv Services, Ian Askew

Reproductive Health

Integration, linkages, and synergies are widely used terms among those interested in strengthening the relationship between sexual and reproductive health services and HIV prevention. These conference proceedings explore the terms conceptually and review the wide range of combinations of SRH and HIV prevention services that have been linked or integrated. Several different combinations have proven feasible and acceptable in pilot situations, but there remains a lack of evidence as to their effectiveness in changing behaviors, including preventing HIV transmission. There is also limited experience with scaling up successful models and a need to move beyond a focus on services to …


Hiv/Aids Programming And Sexuality Of Young People Perinatally Infected With Hiv, Harriet Birungi Jan 2007

Hiv/Aids Programming And Sexuality Of Young People Perinatally Infected With Hiv, Harriet Birungi

Reproductive Health

These conference proceedings draw on preliminary data from an ongoing project implemented by TASO Uganda and the Population Council that contributes to the promotion of sexual and reproductive health rights of young people aged 10–19 years perinatally infected with HIV. The key argument is that HIV/AIDS programming in Uganda and elsewhere in Africa will need to acknowledge that the population of young people perinatally infected with HIV is growing and to specifically target that population. HIV/AIDS programming will also address the sexual desires of young people perinatally infected with HIV by providing them with information and practical support to understand …


Mainstreaming And Scaling Up The Kenya Adolescent Reproductive Health Project, Ian Askew, Humphres Evelia Jan 2007

Mainstreaming And Scaling Up The Kenya Adolescent Reproductive Health Project, Ian Askew, Humphres Evelia

Reproductive Health

From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research (OR) projects to address the reproductive health (RH) needs of adolescents in four countries—Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in two districts of Western Province in Kenya and was known as the Kenya Adolescent Reproductive Health Project (KARHP). The project supported a public sector, multisectoral intervention to enhance young people’s knowledge and behavior regarding HIV prevention and RH. Implemented jointly with PATH, this OR project demonstrated that such an intervention could be implemented by the public sector, that it was acceptable to communities, that its influence …


Mainstreaming Adolescent Reproductive Health In Senegal: Enhancing Utilization Of The Findings From The Youth Reproductive Health Project, Nafissatou J. Diop, Anta Fall Diagne Jan 2007

Mainstreaming Adolescent Reproductive Health In Senegal: Enhancing Utilization Of The Findings From The Youth Reproductive Health Project, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research projects to address the reproductive health (RH) needs of adolescents in four countries—Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in urban areas of Saint-Louis and Louga, in northwestern Senegal, and was known as Improving the Reproductive Health of Youth in Senegal. The project supported a public-sector, multisectoral intervention to enhance young people’s knowledge and behavior regarding HIV prevention and RH, and systematically tested its feasibility, acceptability, effectiveness, and cost. The intervention had a significant positive impact on young people’s awareness and understanding of RH issues. The pilot …


Assessment: Frontiers Small Grants Program, Koli Banik Jan 2007

Assessment: Frontiers Small Grants Program, Koli Banik

Reproductive Health

This report reviews the Small Grants Program (SGP) implemented by FRONTIERS. It assesses the SGP’s areas of achievements and challenges, and explores the feasibility of using this approach to build capacity in operations research. The report provides ideas for implementing a successful SGP that can deliver high-quality, relevant, and timely information for program design. Although capacity building was not an objective in the FRONTIERS SGP, it did produce some increased capacity after two years. As was found with other small grants programs, the FRONTIERS experience suggests that considerable resources are required to produce good quality research and final products. Program …


Exploring The Choices Of Contraception And Abortion Among Married Couples In Tret, Rural Punjab, Pakistan, Muhammad Shafique Arif, Iram Kamran Jan 2007

Exploring The Choices Of Contraception And Abortion Among Married Couples In Tret, Rural Punjab, Pakistan, Muhammad Shafique Arif, Iram Kamran

Reproductive Health

In Pakistan, the contraceptive prevalence rate is 28 percent, unmet need for family planning services is 33 percent, and unwanted pregnancies are on the rise. A national study showed a fairly high induced abortion rate of 29 per 1,000 married women of reproductive age, and 1 out of 6 pregnancies resulted in induced abortion. This study explored how contraception and induced abortion are perceived as options for avoiding unwanted births by Pakistani men and women, to what extent they deliberately choose one over the other, and the language they use to talk about reproductive behavior decision-making. As noted in this …


Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Bagh District, Munir Afridi, Saman Naz, Nayyer Munir Jan 2007

Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Bagh District, Munir Afridi, Saman Naz, Nayyer Munir

Reproductive Health

The Primary Healthcare Revitalization, Integration, and Decentralization in Earthquake-affected Areas (PRIDE) program is designed to improve primary health-care services and health outcomes for populations in Bagh and Mansehra districts in northern Pakistan that were affected by the devastating earthquake that struck on October 8, 2005. The project aims to strengthen the financial and human resource management capacities of district health authorities and primary health-care providers. Access to and quality of primary health-care services will be improved through an essential package of health services and improved skills of primary health-care personnel. Community demand for quality services will be improved through an …


Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Mansehra District, Munir Afridi, Saman Naz, Nayyer Munir Jan 2007

Knowledge, Practice, And Coverage (Kpc) Survey: Baseline Report, Mansehra District, Munir Afridi, Saman Naz, Nayyer Munir

Reproductive Health

The Primary Healthcare Revitalization, Integration, and Decentralization in Earthquake-affected Areas (PRIDE) program is designed to improve primary health-care services and health outcomes for populations in Bagh and Mansehra districts in northern Pakistan that were affected by the devastating earthquake that struck on October 8, 2005. The project aims to strengthen the financial and human resource management capacities of district health authorities and primary health-care providers. Access to and quality of primary health-care services will be improved through an essential package of health services and improved skills of primary health-care personnel. Community demand for quality services will be improved through an …


Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi Jan 2007

Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi

Reproductive Health

The objective of this paper is to explore the experiences of women undergoing a particular form of fertility regulation, namely sterilization or tubal ligation, in a variety of facilities in Chennai, India. The paper examines specifically the nature of information provided to clients, the consent-taking process, the nature of its documentation, and the extent to which clients made an informed choice. The findings underscore that although all the women respondents did wish to practice a method of contraception, and did want to adopt sterilization, several limitations were noted in the process of providing informed consent: inadequate information was provided to …


Young People's Sexual And Reproductive Health In India: Policies, Programmes And Realities, K.G. Santhya, Shireen J. Jejeebhoy Jan 2007

Young People's Sexual And Reproductive Health In India: Policies, Programmes And Realities, K.G. Santhya, Shireen J. Jejeebhoy

Reproductive Health

This paper presents an overview of key policies and government programmes intended to reduce HIV vulnerability and improve sexual and reproductive health among young people in India, and identifies the extent to which these policies and programmes have addressed the gamut of unique sexual and reproductive needs of young women and men. It also explores the extent to which programmes have been adapted to accommodate state-level differences in the sexual and reproductive vulnerability of youth; the review takes the examples of two states, namely, Andhra Pradesh, characterised by both early marriage and high HIV prevalence, and Madhya Pradesh, characterised by …


Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health Jan 2007

Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health

Reproductive Health

Female genital cutting is strongly supported among the Somali ethnic community in Kenya, and the severest form (infibulation) is primarily practiced. This type of cut is associated with increased incidence and seriousness of obstetric and gynecological problems relative to uncut women and those with less severe forms of FGM/C. As stated in this brief, efforts to encourage abandonment should begin with community discussion about the socio-cultural reasons for cutting. Simultaneously, health-care providers need training in how to manage complications of FGM/C. In 2004, FRONTIERS collaborated with UNICEF on a four-month diagnostic study on FGM/C practices among the Somali community in …


Senegal: Mainstreaming Adolescent Health: Building On Local Support Systems, Frontiers In Reproductive Health Jan 2007

Senegal: Mainstreaming Adolescent Health: Building On Local Support Systems, Frontiers In Reproductive Health

Reproductive Health

In 1999, FRONTIERS began a three-year collaboration with the World Health Organization, the Center for Research and Training, the Population Training Group, and the Ministries of Health, Education, and Youth to test the feasibility, effectiveness, and cost of school-, clinic-, and community-based interventions to improve the reproductive health of youth aged 10–19. This adolescent reproductive health (ARH) study showed that the multisectoral, multidisciplinary approach increased knowledge about youth reproductive health among young people, the community, schools, and health-care providers. As noted in this brief, one of the guiding principles of the ARH study was to build sustainability through existing institutions, …


Baseline Household Survey: Jhelum District, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Household Survey: Jhelum District, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development (USAID). PAIMAN is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health issues. USAID has provided a grant to implement PAIMAN in ten districts of Pakistan’s four provinces. The goal of the project is to reduce maternal, newborn, and child mortality. The project calls for a multipronged and integrated strategic approach combining individual health care with public health and community-based interventions. To ensure that success is properly …


Baseline Survey: Summary Report Of District Sukkur, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Survey: Summary Report Of District Sukkur, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

This summary report presents some of the key findings of a 2005 baseline household survey in Sukkur district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …


Baseline Household Survey: Jaffarabad District, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Household Survey: Jaffarabad District, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development (USAID). PAIMAN is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health issues. USAID has provided a grant to implement PAIMAN in ten districts of Pakistan’s four provinces. The goal of the project is to reduce maternal, newborn, and child mortality. The project calls for a multipronged and integrated strategic approach combining individual health care with public health and community-based interventions. To ensure that success is properly …


Baseline Survey: Summary Report Of District Khanewal, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Survey: Summary Report Of District Khanewal, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

This summary report presents some of the key findings of a 2005 baseline household survey in Khanewal district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …


Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz Jan 2006

Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz

Reproductive Health

Female genital mutilation (FGM) is a traditional practice that affects women and girls in several African countries. It is practiced in a variety of ways, classified by WHO into four broad types all found in Kenya. In some communities it is associated with passage into maturity; in others, it is considered a symbol of ethnic identity, a religious obligation, or a necessary prerequisite for marriage, either through symbolizing attainment of womanhood or as a means of preserving and demonstrating virginity. FGM is considered a harmful traditional practice because it may be associated with a variety of short- and long-term health …


Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller Jan 2006

Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller

Reproductive Health

Maternal mortality in Pakistan is believed to be quite high, at about 350–500 maternal deaths per 100,000 live births. Reducing maternal mortality is one of the major objectives of the Government of Pakistan. Interventions required to address maternal mortality include safe motherhood, which means a woman’s ability to have a safe and healthy pregnancy and delivery. The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal and neonatal mortality in a predominantly rural district of Pakistan. The vast majority of maternal deaths are attributed to delays in …


Assessment Of District Health Supervisory System, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Assessment Of District Health Supervisory System, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project designed to reduce the country's maternal and neonatal mortality by making sure women have access to skilled birth attendants during childbirth and throughout the postpartum period. PAIMAN developed a community-based approach that provides a continuum of care to mothers and newborns through supportive linkages from home care to hospital-based care. Various assessments of the district health system suggest that it suffers from weaknesses that impair its efficiency, quality, and impact. Inefficient and ineffective supervision is one of the most important factors for the health sector’s poor performance. Effective, …


Baseline Survey: Summary Report Of District Buner, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Survey: Summary Report Of District Buner, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

This summary report presents some of the key findings of a 2005 baseline household survey in Buner district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …


Baseline Household Survey: Buner District, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Household Survey: Buner District, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development (USAID). PAIMAN is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health issues. USAID has provided a grant to implement PAIMAN in ten districts of Pakistan’s four provinces. The goal of the project is to reduce maternal, newborn, and child mortality. The project calls for a multipronged and integrated strategic approach combining individual health care with public health and community-based interventions. To ensure that success is properly …


Baseline Survey: Summary Report Of District Jhelum, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Survey: Summary Report Of District Jhelum, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

This summary report presents some of the key findings of a 2005 baseline household survey in Jhelum district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …


Baseline Survey: Summary Report Of District Dg Khan, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Survey: Summary Report Of District Dg Khan, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

This summary report presents some of the key findings of a 2005 baseline household survey in Dera Ghazi Khan (DG Khan) district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a …


Baseline Survey: Summary Report Of District Lasbela, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Survey: Summary Report Of District Lasbela, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

This summary report presents some of the key findings of a 2005 baseline household survey in Lasbela district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …


Baseline Household Survey: Lasbela District, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Household Survey: Lasbela District, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development (USAID). PAIMAN is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health issues. USAID has provided a grant to implement PAIMAN in ten districts of Pakistan’s four provinces. The goal of the project is to reduce maternal, newborn, and child mortality. The project calls for a multipronged and integrated strategic approach combining individual health care with public health and community-based interventions. To ensure that success is properly …


Baseline Survey: Summary Report Of District Rawalpindi, Pakistan Initiative For Mothers And Newborns (Paiman) Jan 2006

Baseline Survey: Summary Report Of District Rawalpindi, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

This summary report presents some of the key findings of a 2005 baseline household survey in Rawalpindi district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …