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Articles 181 - 210 of 242
Full-Text Articles in Medicine and Health
An Assessment Of Sexual And Gender Based Violence In Wajir District, North Eastern Kenya, Gladys K. Mwangi, Guyo W. Jaldesa
An Assessment Of Sexual And Gender Based Violence In Wajir District, North Eastern Kenya, Gladys K. Mwangi, Guyo W. Jaldesa
Reproductive Health
A 2006 baseline survey conducted by CARE Kenya indicated that sexual and gender-based violence (SGBV) is widespread throughout Kenya’s North Eastern Province. Other findings revealed that high levels of stigma and gender imbalances are associated with sexual violence and female genital mutilation (FGM) and that a coordinated approach to responding to the service needs of survivors is missing. As noted in this report, there is limited awareness of the legal mechanisms available to survivors. The Population Council’s study in Wajir District ascertained the need for and possible components of an integrated and comprehensive services model that could meet the needs …
Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan
Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan
HIV and AIDS
This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction …
If You Build It, Will They Come? Kenya Healthy Start Pediatric Hiv Study: A Diagnostic Study Investigating Barriers To Hiv Treatment And Care Among Children, Karusa Kiragu, Katie D. Schenk, Julie Murugi, Avina Sarna
If You Build It, Will They Come? Kenya Healthy Start Pediatric Hiv Study: A Diagnostic Study Investigating Barriers To Hiv Treatment And Care Among Children, Karusa Kiragu, Katie D. Schenk, Julie Murugi, Avina Sarna
HIV and AIDS
In Kenya the proportion of eligible HIV-positive children receiving ART treatment is only 11 percent. This study explored and documented possible barriers in the community to accessing pediatric HIV testing and treatment, to guide the development of new interventions to encourage uptake. The study identified barriers such as cost, use of traditional healers, low knowledge of treatment options, attitudinal barriers, stigma, unique treatment issues, and dissatisfaction with available services. Additionally, healthcare workers missed opportunities to provide services and cited numerous service-side challenges. The study recommends prioritizing community awareness, mobile clinics, strengthening capacity of healthcare workers, supporting family-based HIV testing, and …
Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon
Meeting The Family Planning Needs Of Postpartum Women, Ricardo Vernon
Reproductive Health
The first days, weeks, and months after a delivery represent a period of substantial information and service needs for both mother and child, including treatment of hemorrhage and infections, breastfeeding information and support, nutritional complements and micronutrients, immunizations for children and mothers, counseling for managing intimate partner violence and depression, and, most importantly, contraception. In areas of high HIV prevalence, contraceptives and antiretroviral therapy are especially critical elements of postpartum care. Yet despite its strategic importance, few organizations have made it a priority to address women's reproductive health and fertility needs during the year following delivery. The situation is compounded …
Manual For Building Capacity Of Trainers And Program Managers In Emergency Contraception, Sharif M.I. Hossain, M.E. Khan, Mary Philip Sebastian, Sohini Roychowdhury
Manual For Building Capacity Of Trainers And Program Managers In Emergency Contraception, Sharif M.I. Hossain, M.E. Khan, Mary Philip Sebastian, Sohini Roychowdhury
Reproductive Health
This manual equips trainers with appropriate knowledge on emergency contraceptive pills (ECPs). Emergency contraception (EC) refers to any method of contraception that can be used by a woman to prevent an unwanted pregnancy within three days of unprotected intercourse or a contraceptive accident such as condom leakage. This manual discusses ECPs and the provision of related services. After a day’s training, trainers have the knowledge and skills necessary to train service providers and workers on ECPs. The manual is divided into four sessions. The first provides an overview of the demographic and reproductive health (RH) situation in South and South …
Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council
Dominican Republic, Haiti, Nicaragua: Promoting Family Planning During The Postpartum Period Can Increase Contraceptive Acceptance, Population Council
Reproductive Health
The World Health Organization recommends that women receive information on family planning (FP) during antenatal care (ANC), immediately after birth, and during postpartum and well-baby care. However, few studies have assessed the effect of information during each of these stages on women’s use of contraceptive methods. Data collected by FRONTIERS in the Dominican Republic, Haiti, and Nicaragua have been analyzed to answer this question. Use of maternal care services, exposure to FP information, and use of postpartum contraception varies among countries. All women interviewed in the Dominican Republic attended ANC services and delivered in a facility; ANC use and institutional …
Romance And Sex Before Marriage Among Young Women And Men In Maharashtra, International Institute For Population Sciences (Iips)
Romance And Sex Before Marriage Among Young Women And Men In Maharashtra, International Institute For Population Sciences (Iips)
Poverty, Gender, and Youth
Premarital partnerships among youth are widely discouraged in India. Indeed, there is a widespread perception that youth do not find opportunities to mix and form romantic relationships, and that premarital sex is negligible. These kinds of perceptions are often cited to argue against the provision of sexuality or family life education and sexual and reproductive health services to unmarried young people. While several small studies have noted that sizable proportions of young people, particularly young men, are sexually active before marriage, the lack of rigorous evidence on the levels and patterns of intimate partnerships among youth continues to hamper the …
Sexuality Education For Youth In Maharashtra: Yes Or No?, International Institute For Population Sciences (Iips)
Sexuality Education For Youth In Maharashtra: Yes Or No?, International Institute For Population Sciences (Iips)
Poverty, Gender, and Youth
Serious reservations have been expressed in Maharashtra about the sexuality component of programs intended to build awareness of safe and healthy behaviors for school-going youth. This policy brief answers: Is there a need for sexuality education in school and out-of-school in Maharashtra? Are the concerns expressed supported by evidence? Evidence was obtained from the Youth in India: Situation and Needs study conducted in Maharashtra, which explored young people’s awareness of sexual and reproductive matters, sexual experiences of youth, parent–child communication on sexual and reproductive matters, and experience and acceptability of sexuality education programs. Parents were asked whether they had discussed …
Female-Initiated Prevention Methods (Fipm) In Kenya: Focus On The Female Condom, Martha Brady
Female-Initiated Prevention Methods (Fipm) In Kenya: Focus On The Female Condom, Martha Brady
Poverty, Gender, and Youth
As noted in this brief, the female condom (FC) is the only female-initiated prevention product that provides simultaneous protection against pregnancy and sexually transmitted infections, including HIV. Although available for more than a decade, the FC remains limited in supply, not readily available, and underutilized. Obstacles to widespread availability and use are often generalized (e.g., high costs, resistance of partners, or unavailability). With the upcoming second generation of FCs—and ultimately microbicides—being added to female-initiated prevention methods, the need to overcome these impediments with concrete solutions is critical. Government and donor commitment to long-term, sustained supply and program support is essential. …
The Female Condom In Ghana: Exploring The Current State Of Affairs And Gauging Potential For Enhanced Promotion, Reshma Naik, Martha Brady
The Female Condom In Ghana: Exploring The Current State Of Affairs And Gauging Potential For Enhanced Promotion, Reshma Naik, Martha Brady
Poverty, Gender, and Youth
The female condom (FC) is the only safe and effective female-initiated method that provides simultaneous protection against unintended pregnancy as well as sexually transmitted infections, including HIV. An exploratory exercise was conducted by the Population Council to gain an understanding of the current and historical landscape of FC procurement, distribution, and programming in Ghana and to explore the viability of enhancing national FC promotion. The exercise revealed that a large-scale launch of the FC occurred in Ghana in 2000 and was largely successful in raising product awareness; however, uptake remained low. Momentum has waned since the initial launch and financial …
Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu
Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu
Reproductive Health
In Uganda, HIV/AIDS treatment, care and support programs are still organized around either adult or pediatric care and fail to adequately address the needs of adolescents, specifically perinatally-infected adolescents. This study, implemented jointly by the Population Council's Frontiers in Reproductive Health (FRONTIERS) program and the AIDS Support Organization (TASO), aimed to better understand the reproductive health and sexuality of this population group, and to identify anxieties or fears they have around entering social stages of adulthood. This study confirms that wide programmatic gaps exist in addressing the sexual and reproductive health needs of young people perinatally infected with HIV who …
South Africa: Integrated Approach Improves Quality Of Post-Rape Care, Population Council
South Africa: Integrated Approach Improves Quality Of Post-Rape Care, Population Council
Reproductive Health
In South Africa, an integrated model for post-rape care by nurses in a rural district hospital, which included a designated room for medical management and guidelines for providing reproductive health and HIV services, improved the quality of care provided. However, nurses remained reluctant to collect forensic evidence that could be used for prosecuting perpetrators. South Africa has developed a strong policy framework outlining medical management of rape survivors, which includes provision of HIV testing and post-exposure prophylaxis and emergency contraception, ideally within 72 hours. However, implementation has been hampered by numerous obstacles, both in health care infrastructure and policy, and …
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Bolivia: A Gender Focus In Service Delivery Improves Quality Of Care, Population Council
Reproductive Health
A program to operationalize and institutionalize a gender perspective in reproductive health services in Bolivia resulted in a significant reduction in unmet need for contraception, increased client satisfaction, and improved communication between partners. Bolivia’s Integral Health Coordination Program (PROCOSI) encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their RH programs. In 2005, FRONTIERS collaborated with PROCOSI to test the feasibility and costs of a system for certifying that its member organizations provided gender-sensitive RH services. The two-year project followed a 2000 intervention to incorporate gender perspectives in PROCOSI clinics that led …
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Burkina Faso: Political Will, Law Enforcement, And Educational Campaigns Appear To Be Reducing Fgm/C, Population Council
Reproductive Health
In 2006, FRONTIERS collaborated with the National Committee Against the Practice of FGM/C on an analysis of recent trends in female genital mutilation/circumcision (FGM/C) in rural and urban Burkina Faso. The study, conducted to help develop policies and programs for FGM/C abandonment in Burkina Faso and more widely in Africa, had three components: a description of the institutional, political, and programmatic environment in Burkina; a secondary analysis of data from existing studies; and an assessment of the community’s perceptions and behavior regarding FGM/C, as well as the factors that contribute to abandonment or continuation of the practice. For the policy …
Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council
Kenya: Training Can Enhance Providers' Management Of Fgm/C And Willingness To Advocate Against The Practice, Population Council
Reproductive Health
In 2004, FRONTIERS collaborated with UNICEF on a study of female genital mutilation/cutting (FGM/C) in Kenya’s Somali community and on ways of managing maternal care for cut women. The study showed that the health-care system in North Eastern Province, where many Somalis live, is ill prepared to deal with women who have been cut, particularly infibulated women who are pregnant or delivering. The study recommended improving providers’ ability to counsel and treat pregnant cut women as part of an overall improvement of maternal care, and strengthening providers’ role as behavior change agents within communities. In 2005, FRONTIERS launched an intervention …
Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council
Malaria In Pregnancy Pilot Projects Nationally Adopted In Kenya And Malawi, Population Council
Reproductive Health
Kenya and Malawi have developed national policies to prevent malaria in pregnancy. Measures to prevent malaria among antenatal clients were shown to be sustainable several years after pilot interventions ended. In Malawi, the approach has been expanded nationwide. In most malaria-endemic areas of Africa, women in their first and second pregnancies have the highest risk of acquiring malaria and, consequently, of malaria-associated anemia and low birth-weight. Two USAID-funded interventions aimed at strengthening the prevention and management of malaria in pregnancy were pilot-tested at the district level in Kenya (1998–2002) and Malawi (1998–2004). As noted in this brief, the goal was …
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Senegal: Education And Public Declarations Contribute To Tostan's Success, Population Council
Reproductive Health
In 1998, the nongovernmental organization Tostan implemented a village empowerment program in southern and western Senegal to help communities, especially women, improve living and health conditions in their villages, and to mobilize villages to hold public declarations supporting abandonment of harmful practices, particularly female genital mutilation/cutting (FGM/C) and child marriage. The program included modules on hygiene, literacy and numeracy, human rights, and children’s and women’s health. The Tostan approach has since been implemented more broadly in Senegal and in Burkina Faso, Guinea, and Sudan. In 2005–06, FRONTIERS evaluated the long-term impact of the program, focusing on the abandonment of FGM/C …
Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi
Adapting Focused Antenatal Care: Lessons From Three African Countries, Harriet Birungi
Reproductive Health
In 2001, the World Health Organization issued guidance on a new model of antenatal care (ANC) called goal-oriented or focused antenatal care (FANC), for implementation in developing countries. The new model reduces the number of required antenatal visits to four, and provides focused services shown to improve maternal outcomes. FANC emphasizes helping women maintain normal pregnancies by identifying existing health conditions, detecting emerging complications, promoting health, preparing for a healthy birth, and educating clients on postpartum care including nutrition, breastfeeding, and family planning. Trials conducted in Argentina, Cuba, Saudi Arabia, and Thailand proved that FANC was safe and was a …
Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia
Multisectoral Youth Rh Interventions: The Scale-Up Process In Kenya And Senegal, Stephanie Joyce, Ian Askew, Anta Fall Diagne, Nafissatou J. Diop, Humphres Evelia
Reproductive Health
As in many developing countries, young people in Kenya and Senegal (aged 10–20) account for about 25 percent of the population. To ensure their future contribution to their countries, it is of vital strategic importance to safeguard their welfare. Rapid social change in both countries exposes youth to sexual and reproductive health (RH) risks, including unintended pregnancy, sexually transmitted infections including HIV, and sexual violence. Beginning in 1999, the Population Council’s FRONTIERS program conducted operations research studies that tested the feasibility, acceptability, and cost of a public-sector, multisectoral intervention to enhance young people’s RH knowledge and behavior. Study findings showed …
South Africa: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council
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
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
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
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
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
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
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
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)
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)
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
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 …