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Understanding Induced Abortion: Findings From A Programme Of Research In Rajasthan, India, Population Council Jan 2004

Understanding Induced Abortion: Findings From A Programme Of Research In Rajasthan, India, Population Council

Reproductive Health

In India, abortion has been legal for over 30 years, following the enactment of the Medical Termination of Pregnancy (MTP) Act in 1971. While the MTP Act permits abortion for a broad range of social and medical reasons, it also includes provisions regarding delivery of services that have proved to constrain access to safe and legal abortion for the great majority of women in India. Due in part to these constraints, up to 90 percent of the six million induced abortions estimated to occur annually in India are illegal—provided in uncertified settings and/or by uncertified providers. Many are unsafe and …


Unwanted Pregnancy And Induced Abortion In Rajasthan, India: A Qualitative Exploration, Batya Elul, Hillary J. Bracken, Shalini Verma, Rajani Ved, Rajesh Singhi, Karin Lockwood Jan 2004

Unwanted Pregnancy And Induced Abortion In Rajasthan, India: A Qualitative Exploration, Batya Elul, Hillary J. Bracken, Shalini Verma, Rajani Ved, Rajesh Singhi, Karin Lockwood

Reproductive Health

As part of a Population Council program of research on unwanted pregnancy and induced abortion in Rajasthan, the Council and Ibtada conducted a qualitative exploration of attitudes and behaviors regarding unwanted pregnancy and induced abortion in Alwar district. The study was intended to lay the groundwork for two quantitative studies on abortion undertaken subsequently in six districts of Rajasthan. The qualitative exploration shows that women, particularly those who are poor, turn to largely untrained community-level providers for abortion services. Additionally, women use home remedies in an often unsuccessful attempt to terminate unwanted pregnancies. Women with greater financial means obtain surgical …


Unwanted Pregnancy And Induced Abortion: Data From Men And Women In Rajasthan, India, Batya Elul, Sandhya Barge, Shalini Verma, Nayan Kumar, Hillary J. Bracken, Hemlata Sadhwani Jan 2004

Unwanted Pregnancy And Induced Abortion: Data From Men And Women In Rajasthan, India, Batya Elul, Sandhya Barge, Shalini Verma, Nayan Kumar, Hillary J. Bracken, Hemlata Sadhwani

Reproductive Health

This report is the result of a collaborative project between the Population Council and the Centre for Operations Research and Training, conducted as part of a Council program of research on unwanted pregnancy and induced abortion in Rajasthan, India. Designed as a complement to service-delivery activities being undertaken in Rajasthan by the Indian nongovernmental reproductive health service provider Parivar Seva Sanstha, the program of research aimed to provide a multifaceted picture of the on-the-ground realities related to unwanted pregnancy and abortion in six districts of Rajasthan. Detailed pregnancy histories yielded data on levels of unwanted pregnancy and induced abortion in …


Making Motherhood Safer In Egypt, Karima Khalil, Farzaneh Roudi-Fahimi Jan 2004

Making Motherhood Safer In Egypt, Karima Khalil, Farzaneh Roudi-Fahimi

Reproductive Health

Fewer Egyptian women die of maternal causes today than they did 10 or 15 years ago, due in large part to the national safe motherhood program. Nevertheless, maternal mortality is still relatively high, and the country faces challenges in reducing it further. Many of these challenges involve addressing the delays women face when they need essential obstetric care. In Egypt and other countries, most maternal deaths could be avoided if women had timely access to high-quality emergency obstetric services. Although Egypt’s level of maternal mortality is relatively high by international standards, recent evidence suggests that a woman’s lifetime risk of …


Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand Jan 2003

Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand

Reproductive Health

The Population Council has been providing technical assistance and conducting Operations Research (OR) studies in family planning and reproductive health for over two decades. These studies are designed to identify problems and test strategies to resolve those problems, providing program managers, administrators, and policymakers with the information they need to improve service-delivery systems. The ultimate goal is that strategies tested through OR will be adopted, leading to changes in policy or operational procedures at institutional, national, or international levels. These changes are what we refer to as impact. The purpose of the new approach to evaluation described in this Evaluation …


Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert Jan 2003

Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert

Reproductive Health

This paper presents the results of an extensive review of the literature pertaining to the relationship between vaginal lubrication and the acceptability of microbicides, spermicides, and male and female condoms. The review highlights the need for research that better elucidates norms, preferences, and practices regarding lubrication during sex within and across countries. The second part of the report presents the results of the first phase of a qualitative study on lubrication during sex showing that diverse personal and cultural factors shape preferences and practices and may ultimately affect the acceptability of microbicides. The immediate challenge is to provide women with …


Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta Jan 2002

Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta

HIV and AIDS

While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …


Frontiers Capacity Building: An Overview, James R. Foreit Jan 2002

Frontiers Capacity Building: An Overview, James R. Foreit

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program is a cooperative agreement with USAID to improve family planning and reproductive health service delivery through operations research (OR). Frontiers builds on more than 20 years of research to improve family planning service delivery programs. A major goal of Frontiers is to transfer skills in OR so that public and private agencies in developing countries can conduct OR and apply research findings to reproductive health programs and policies. OR addresses problems in operational effectiveness, access, quality, and efficiency by investigating facets of programs that managers can control and change. As concluded in …


Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline Jan 2002

Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline

Poverty, Gender, and Youth

The objective of this research is to examine the association between social organization and reproductive behavior in one setting in sub-Saharan Africa. The particular focus is on the effects of social organization on the diffusion of innovative reproductive ideas and behaviors. Social diffusion is assumed to be strongly affected by patterns of informal social interaction, and these in turn are assumed to be determined in part by the social organization of local communities (gender relations, employment activity, voluntary organizations). The research draws on data collected in six communities in southern Ghana. The analysis reveals a weaker than expected association between …


Training Service Providers On Emergency Contraception: Lessons Learned From An Or Study, M.E. Khan, Sharif M.I. Hossain Jan 2002

Training Service Providers On Emergency Contraception: Lessons Learned From An Or Study, M.E. Khan, Sharif M.I. Hossain

Reproductive Health

The Bangladesh Directorate of Family Planning in collaboration with the Population Council, Pathfinder International, and John Snow, Inc. is conducting an operations research project to test the feasibility of introducing emergency contraceptive pills (ECP) in the national family planning (FP) program and to answer operational questions on implementing the use of ECP efficiently. In Bangladesh, 1.2 million births are unplanned and the number of menstrual regulation/abortions is increasing. ECP could be a good reproductive health intervention for women since it gives them a chance to avoid unwanted pregnancy. ECP does not induce abortion. In fact, it helps in reducing the …


Best Practices In Cbd Programs In Sub-Saharan Africa: Lessons Learned From Research And Evaluation, Frontiers In Reproductive Health, Family Health International, Advance Africa Jan 2002

Best Practices In Cbd Programs In Sub-Saharan Africa: Lessons Learned From Research And Evaluation, Frontiers In Reproductive Health, Family Health International, Advance Africa

Reproductive Health

Community-based distribution (CBD) is the use of nonprofessional local distributors or agents to provide family planning (FP) methods—typically condoms, pills, and spermicides—and referral for other services. FP programs in Africa, Asia, and Latin America have implemented CBD programs for the past 30 years. There is a large body of evidence on the effectiveness, cost, and sustainability of CBD models. Most evidence supports using CBD where appropriate conditions exist. However, major changes have taken place in the context in which programs operate, including the onset of the HIV/AIDS pandemic, enhanced access to FP services, and increased demand for related reproductive health …


Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow Jan 2001

Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité discusses the Manuela Ramos Movement and its efforts to improve women’s health and well-being through a range of empowerment strategies in rural Peru. A joint project with USAID, named Reprosalud, demonstrates how combining the resources of an international donor with local women’s organizations allows a more organic and multifaceted family planning program to develop. Such programs can produce impressive improvements on a number of indicators, including contraceptive use.


West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health Jan 2001

West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health

Reproductive Health

To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …


Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health Jan 2001

Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health

Reproductive Health

El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …


Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain Jan 2001

Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain

Reproductive Health

Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC …


South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health Jan 2001

South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health

Reproductive Health

To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, …


South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health Jan 2001

South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health

Reproductive Health

In 2000, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and 7 affiliated peer education programs. The 12 centers, located in urban, peri-urban, and rural areas, offer very different services. The two centers of the KwaZulu-Natal Department of Health focus on providing reproductive health (RH) information and services to adolescents. The six centers of the Youth and Adolescent Reproductive Health Project provide a broader range of youth-friendly RH services, including counseling and life skills education, as well as modest recreational activities. The four centers run by loveLife have large …


Alone You Are Nobody, Together We Float: The Manuela Ramos Movement, Judith Bruce, Debbie Rogow Jan 2000

Alone You Are Nobody, Together We Float: The Manuela Ramos Movement, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

Quality/Calidad/Qualité, a publication of the Population Council, highlights examples of clinical and educational programs which bring a strong commitment, as well as innovative and thoughtful approaches, to the issue of quality care in sexual and reproductive health. The series is based on the philosophy that women and their partners have a fundamental right to respectful treatment, information, choice, and follow-up from reproductive health care providers. This issue discusses improving women’s health and well being through a range of empowerment strategies in rural Peru.


Burkina Faso And Mali: Female Genital Cutting Harms Women's Health, Frontiers In Reproductive Health Jan 2000

Burkina Faso And Mali: Female Genital Cutting Harms Women's Health, Frontiers In Reproductive Health

Reproductive Health

In collaboration with the Ministries of Health (MOH) of Burkina Faso and Mali, the Population Council conducted two studies in 1998 to describe the occurrence and severity of health problems related to female genital cutting (FGC). Study participants were consenting women who received a pelvic exam during prenatal, family planning (FP), obstetric, or gynecological consultations at MOH clinics. Providers were trained to observe the types and complications of FGC. To assess their potential role as change agents, providers in Mali also received training on the health effects of FGC and client counseling. In Burkina Faso, health providers recorded information on …


Burkina Faso Et Mali: L'Excision Compromet La Santé Des Femmes, Frontiers In Reproductive Health Jan 2000

Burkina Faso Et Mali: L'Excision Compromet La Santé Des Femmes, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.


Meeting Women's Health Care Needs After Abortion, Dale Huntington Jan 2000

Meeting Women's Health Care Needs After Abortion, Dale Huntington

Reproductive Health

Women who seek emergency treatment for abortion complications—bleeding, infection, and injuries to the reproductive tract system—should be a priority group for reproductive health care programs. These women often receive poor-quality services that do not address their multiple health needs. They may be discharged without counseling on postoperative recuperation, family planning (FP), or other reproductive health (RH) issues. Women who have had an induced abortion due to an unwanted pregnancy are likely to have a repeat abortion unless they receive appropriate FP counseling and services. Preventing repeat unsafe abortions is important for RH programs because it saves women's lives, protects women’s …


Intra-Household Decision-Making On Health And Resource Allocation In Borgou, Bénin, Pierre Ngom, Salome Wawire, Timothee Gandaho, Pierre Klissou, Toussaint Adjimon, Mbaye Seye, Emile Akouanou, Laurie Winter Jan 2000

Intra-Household Decision-Making On Health And Resource Allocation In Borgou, Bénin, Pierre Ngom, Salome Wawire, Timothee Gandaho, Pierre Klissou, Toussaint Adjimon, Mbaye Seye, Emile Akouanou, Laurie Winter

Reproductive Health

The African Population and Health Research Centre carried out this study, with support from FRONTIERS and USAID, in order to inform Benin’s Projet Intégré en Santé Familiale (Integrated Project on Family Health—PROSAF) about socio-cultural factors in Borgou that can impede health improvements. More specifically, the study aimed to identify key players in household decisionmaking processes, map out patterns of health-seeking behavior, elucidate how such patterns are associated with prevailing health services utilization, assess community valuation of existing health services and products, and recommend to PROSAF approaches to identified target groups for their intervention. The findings indicate that for all the …


Integrating Men Into The Reproductive Health Equation: Acceptability And Feasibility In Kenya, Esther G. Muia, Violet Kimani, Ann Leonard Jan 2000

Integrating Men Into The Reproductive Health Equation: Acceptability And Feasibility In Kenya, Esther G. Muia, Violet Kimani, Ann Leonard

Reproductive Health

This study’s objective was to improve understanding of Kenyan men’s actual and potential roles as supportive partners in various phases of reproductive health (RH), to help in the design of strategies to encourage men’s greater participation in a variety of RH initiatives in Kenya. The results of the study clearly show that, to a larger extent than anticipated, men in Kenya already participate in women-centered RH services. Overall the institutional barriers seemed to be more overwhelming than the cultural barriers, given that one of the reasons frequently given for nonparticipation was fear of non-acceptance by the health providers. Based on …


Rights, Technology, And Services In Reproductive Health: A Report From A Meeting, Marion Carter, C. Elizabeth Mcgrory Jan 2000

Rights, Technology, And Services In Reproductive Health: A Report From A Meeting, Marion Carter, C. Elizabeth Mcgrory

Reproductive Health

The Population Council’s Robert H. Ebert Program on Critical Issues in Reproductive Health convened a two-day meeting to explore some of the compelling issues at the intersection of technology, services, and rights. Nearly 70 professionals from the research, policy, service delivery, human rights, and advocacy fields came together to grapple with some of the political aspects of reproductive technologies. Participants also discussed how these technologies can facilitate or constrain rights, depending on the interests involved and the particular social, political, and economic contexts in which they are used. This report on the meeting concludes that in order for program managers …


Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias Jan 1999

Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias

Reproductive Health

As the world grapples with the HIV pandemic, the implementation of the agenda determined by the International Conference on Population and Development (1994) at Cairo, and the matter of providing health services of adequate quality in an ethical, gender-sensitive manner, new questions are arising about how to attend to reproductive tract infections, including sexually transmitted infections (STIs), among women. This paper reviews the results of validation studies of syndromic algorithms, other nonlaboratory clinically based tools, and risk scoring for finding women infected with chlamydia and gonorrhea, particularly among those attending family planning and antenatal clinics in developing countries. The results …


Expanding Men's Participation In Reproductive Health In Kenya, Bolaji M. Fapohunda, Naomi Rutenberg Jan 1999

Expanding Men's Participation In Reproductive Health In Kenya, Bolaji M. Fapohunda, Naomi Rutenberg

Reproductive Health

To increase men’s participation in family planning (FP) and reproductive health (RH) both for their own well-being and as gatekeepers to women’s health, the African Population Policy Research Center and the Population Council’s OR/TA Project II launched a study designed to explore best practices for delivering services to men. The study examined men’s knowledge, perceptions, and concerns about RH issues, including FP, and the social context of their knowledge. In sub-Saharan Africa, FP and reproductive health-care research and interventions place a disproportionate emphasis on women and largely ignore the role of men. As a result, male participation in FP and …


Integrating Sti And Mch/Fp Services, Population Council Jan 1999

Integrating Sti And Mch/Fp Services, Population Council

Reproductive Health

The integration of STI and HIV/AIDS information and services into existing MCH/FP programs has been strongly supported in recent years, following recommendations from the 1994 Cairo ICPD. Moreover, it is now widely accepted that early detection and management of STIs can reduce the incidence of HIV infection. Thus, there are powerful incentives to increase efforts to broaden the capacity of MCH/FP programs to provide STI prevention and management information and services for their clients, both as a comprehensive reproductive health service and as a preventive measure for reducing the transmission of HIV. As described in this brief, the Africa OR/TA …


Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council Jan 1999

Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council

Reproductive Health

The health status of women, men, and children in sub-Saharan Africa remains the poorest in the world. Moreover, virtually every country in the region is suffering mediocre economic growth or economic decline, thereby reducing the ability of their health care systems to respond adequately, and increasing dependence on external donor assistance. In terms of reproductive health (RH), the region is faced with high levels of unwanted fertility; high levels of maternal, child, and infant morbidity and mortality; and an almost exponential growth in HIV prevalence. Access to and quality of RH services remains poor in most countries, thereby maintaining unmet …


Reproductive Decisionmaking In The Context Of Hiv/Aids In Ndola, Zambia, Naomi Rutenberg, Ann E. Biddlecom, Frederick A.D. Kaona Jan 1999

Reproductive Decisionmaking In The Context Of Hiv/Aids In Ndola, Zambia, Naomi Rutenberg, Ann E. Biddlecom, Frederick A.D. Kaona

Reproductive Health

Family planning (FP) programs are increasingly being considered as a logical focal point for STD and HIV/AIDS prevention services because they serve large numbers of women at risk, address the sensitive issue of sexual behavior and fertility control, and the methods for preventing unwanted pregnancy and disease can be the same. FP programs, by providing contraceptive methods, are currently one of the few sources of assistance in the sub-Saharan African region for preventing perinatal transmission of HIV, while the promotion of barrier methods contributes to the prevention of heterosexual transmission. Given this potential, research is needed to understand how the …


Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan Jan 1999

Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan

Reproductive Health

This book on family planning in India includes detailed empirical data and analysis of the various dimensions of quality of care in different regions of the country. Focus areas include: women’s perceptions of the care they receive; observations of provider-client interactions; barriers to quality of service delivery; existing interregional variations; contraceptive choice and interpersonal relations; technical quality of care; and the effect of the target system on the work style of outreach staff. All elements of the quality-of-care framework elaborated by Judith Bruce are well documented and their relationships to broader program constraints are clearly identified. The overall impression one …