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Feasibility And Acceptability Of Community Health Extension Workers To Identify And Treat Hypertension Associated With Pregnancy: Implementation Research Report, Emmanuel Nwala, Udochisom Anaba, Pooja Sripad, Salisu Mohammed Ishaku, Charlotte E. Warren 2019 Population Council

Feasibility And Acceptability Of Community Health Extension Workers To Identify And Treat Hypertension Associated With Pregnancy: Implementation Research Report, Emmanuel Nwala, Udochisom Anaba, Pooja Sripad, Salisu Mohammed Ishaku, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy, experienced by 10 percent of women globally, are major contributors to maternal and newborn mortality, morbidity, and disability. Task shifting essential health services to mitigate insufficient human resources is recommended to strengthen and expand the health workforce and rapidly increase access to quality services. Nigeria’s task-shifting policy recommends that community health extension workers administer a loading dose of magnesium sulphate for severe pre-eclampsia or eclampsia prior to referral to a higher-level facility. This study tested the feasibility and acceptability of community health extension workers at primary health care facilities in Ebonyi state in detecting and managing …


Implementing Components Of The Primary Health Care Pre-Eclampsia/Eclampsia Model In Bangladesh: A Cost Analysis, Sharif M.I. Hossain, Pooja Sripad, Sara Chace Dwyer 2019 Population Council

Implementing Components Of The Primary Health Care Pre-Eclampsia/Eclampsia Model In Bangladesh: A Cost Analysis, Sharif M.I. Hossain, Pooja Sripad, Sara Chace Dwyer

Reproductive Health

Between 2016 and 2018, the Population Council, in collaboration with the Directorate General of Family Planning and Obstetrical and Gynecological Society of Bangladesh, implemented an intervention to confront pre-eclampsia/eclampsia (PE/E). This was part of the Ending Eclampsia project, a five-year USAID investment that implemented aspects of the Primary Health Care (PHC) PE/E Model in Bangladesh, Nigeria, and Pakistan. The intervention in Bangladesh comprised two components of the PHC for PE/E Model: 1) Task sharing to detect and manage PE/E (MgSO4 and referral) with PHC providers (Family Welfare Visitors, Sub-Assistant Community Medical Officers, and Nurse-Midwives), and 2) Introducing antihypertensive drug provision …


Implementing Components Of The Phc For Pe/E Model In Nigeria: A Cost Analysis, Pooja Sripad, Sara Chace Dwyer, Gloria Adoyi 2019 Population Council

Implementing Components Of The Phc For Pe/E Model In Nigeria: A Cost Analysis, Pooja Sripad, Sara Chace Dwyer, Gloria Adoyi

Reproductive Health

Between 2016 and 2018, the Population Council, in partnership with the Nigerian Federal and State Ministries of Health, implemented an intervention to confront pre-eclampsia/eclampsia (PE/E) in three states—Cross River, Ebonyi, and Kogi. This was part of the Ending Eclampsia project, a five-year USAID investment that implemented aspects of the Primary Health Care (PHC) PE/E Model in Bangladesh, Nigeria, and Pakistan. The intervention in Nigeria was comprised of five components of the PHC for PE/E Model: 1) Task sharing to detect and manage PE/E (MgSO4 and referral) with PHC providers; 2) Introducing antihypertensive drug provision at the PHC level; 3) Engaging …


Fgm/C And Ecm: Drawing Lessons From Research, Jacinta Muteshi-Strachan 2019 Population Council

Fgm/C And Ecm: Drawing Lessons From Research, Jacinta Muteshi-Strachan

Reproductive Health

No abstract provided.


"No To Circumcision": The Road To Effective Social Marketing Campaigns In Egypt, Salma Abou Hussein, Sarah Ghattass 2019 Population Council

"No To Circumcision": The Road To Effective Social Marketing Campaigns In Egypt, Salma Abou Hussein, Sarah Ghattass

Reproductive Health

To inform the design and scale up of initiatives that can drive a change in attitudes and behaviors toward FGM/C abandonment, there is a rising need to understand the perspectives of individuals who are exposed to social marketing campaigns (SMCs), which are a key intervention to promote the abandonment of the practice. This working paper presents the findings of a study that sought to understand how, where, and why SMCs for FGM/C abandonment are working, and with what impact, to inform design and scale-up of campaigns that can foster new perspectives, expectations, and behaviors.


Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara 2019 Population Council

Associations Between Fgm/C And Hiv In Ethiopia, The Gambia, Kenya, And Sierra Leone: A Limited Analysis Of Demographic And Health Survey Data, Yetunde A. Noah Pinheiro, Zhuzhi Moore, David Gathara

Reproductive Health

Studies investigating the association between male circumcision and HIV have demonstrated the protective effect of male circumcision. In some settings, FGM/C and male circumcision are considered “equivalent” procedures. This working paper presents findings of a study that investigates the effect of FGM/C on the likelihood of HIV infection for women in practicing communities in Ethiopia, Gambia, Kenya, and Sierra Leone.


Expanding Services To Detect, Manage, And Prevent Pre-Eclampsia And Eclampsia In Tando Allahyar District Of Sindh Province, Pakistan, Ali M. Mir, Irfan Masood, Mumraiz Khan, Sharif M.I. Hossain, Tracy McClair, Pooja Sripad, Charlotte E. Warren 2019 Population Council

Expanding Services To Detect, Manage, And Prevent Pre-Eclampsia And Eclampsia In Tando Allahyar District Of Sindh Province, Pakistan, Ali M. Mir, Irfan Masood, Mumraiz Khan, Sharif M.I. Hossain, Tracy Mcclair, Pooja Sripad, Charlotte E. Warren

Reproductive Health

This endline report documents a USAID-supported implementation research project carried out by the Population Council in one district in Sindh province, as part of the global—Bangladesh, Ethiopia, Kenya, Nigeria, Pakistan—Ending Eclampsia initiative. This project assessed community midwives’ (CMWs) abilities to screen and detect pre-eclampsia/severe pre-eclampsia/eclampsia (PE/SPE/E) in pregnant and postnatal women and provide a loading dose of magnesium sulfate (MgSO4) to clients suffering from SPE/E and referrals to facilities for further management. This study also explored opportunities to enhance collaboration between CMWs and lady health workers (LHWs), encouraging LHWs to refer pregnant women for group antenatal care (ANC) and postnatal …


Post-Intervention Analysis Of Pre-Eclampsia And Eclampsia In Three Nigerian States, Salisu Mohammed Ishaku, Emmanuel Nwala, Gloria Adoyi, Charles Nwigwe, Solomon Kongyamba, Udochisom Anaba, Caroline Johnson, Karen Kirk, Pooja Sripad, Charlotte E. Warren 2019 Population Council

Post-Intervention Analysis Of Pre-Eclampsia And Eclampsia In Three Nigerian States, Salisu Mohammed Ishaku, Emmanuel Nwala, Gloria Adoyi, Charles Nwigwe, Solomon Kongyamba, Udochisom Anaba, Caroline Johnson, Karen Kirk, Pooja Sripad, Charlotte E. Warren

Reproductive Health

In the last three decades, global maternal mortality has decreased by almost 45 percent, but approximately 830 women still die daily from largely preventable pregnancy complications. Since 2015, the Ending Eclampsia project, with support from USAID, has been working to expand proven, underutilized interventions and commodities for pre-eclampsia/eclampsia (PE/E) prevention, early detection, and treatment, and to strengthen global partnerships for care of hypertensive disorders in pregnancy (HDP), of which PE/E are the severest forms. A systematic review of the literature identifies a number of articles reporting PE/E burdens within set populations, common risk factors, adverse outcomes, and mortality rates, but …


Assessing Quality Of Care And Outcomes For Women And Their Infants In Nigeria After Pregnancies Complicated By Hypertensive Disorders, Salisu Mohammed Ishaku, Gloria Adoyi, Innocent Agbo, Karen Kirk, Pooja Sripad, Charlotte E. Warren 2019 Population Council

Assessing Quality Of Care And Outcomes For Women And Their Infants In Nigeria After Pregnancies Complicated By Hypertensive Disorders, Salisu Mohammed Ishaku, Gloria Adoyi, Innocent Agbo, Karen Kirk, Pooja Sripad, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy (HDPs) are the leading cause of maternal mortality in Nigeria—now killing more women than postpartum hemorrhage. Various factors, including lack of capacity among lower-level health-care providers to detect, manage, and refer complications, have been indicated as reasons for most of these deaths. A landscape analysis of pre-eclampsia/eclampsia (PE/E) in Nigeria identified a lack of further information after delivery about the women who experienced HDPs. In this study, the Ending Eclampsia project recruited women with HDPs around the time of childbirth, and prospectively followed them for up to one year postpartum. The study evaluated the care these …


Hypertensive Disorders In Pregnancy: Assessing Postnatal Quality Of Care And Outcomes For Women And Their Infants In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Salma Rouf, Rabeya Akter, Shongkour Roy, Sumaiya Anwar, Karen Kirk, Charlotte E. Warren 2019 Population Council

Hypertensive Disorders In Pregnancy: Assessing Postnatal Quality Of Care And Outcomes For Women And Their Infants In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Salma Rouf, Rabeya Akter, Shongkour Roy, Sumaiya Anwar, Karen Kirk, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy (HDPs) are the second leading cause of maternal mortality in Bangladesh, responsible for 24 percent of maternal deaths. Various factors, such as lack of health-care provider capacities for detecting, preventing, and managing pre-eclampsia and eclampsia (PE/E), late referrals, late (or lack of) antenatal care (ANC), and poor awareness of PE/E, are factors in most of these deaths. While some information was available on the prenatal and postnatal periods, an evidence gap existed in information after delivery through the first year postnatal, and beyond. In this prospective cohort study, the Ending Eclampsia project recruited married women ages …


Assessing The Feasibility Of Primary Health Care Provider Prescription Of Anti-Hypertensive Medication To Pregnant Women In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Shongkour Roy, Pooja Sripad, Charlotte E. Warren 2019 Population Council

Assessing The Feasibility Of Primary Health Care Provider Prescription Of Anti-Hypertensive Medication To Pregnant Women In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Shongkour Roy, Pooja Sripad, Charlotte E. Warren

Reproductive Health

Hypertensive disorders of pregnancy (HDPs)—which are major contributors of maternal and newborn mortality, morbidity, and disability—are preventable. About 24 percent of maternal deaths in Bangladesh each year are due to pre-eclampsia and eclampsia (PE/E). A known cause of death in women with PE/E is cerebrovascular accident, which occurs due to rapidly increasing blood pressure (BP). Elevated BP associated with pregnancy should be detected and appropriately managed before onset of convulsions (eclampsia) and other life-threatening complications. For women presenting with severe PE/E, magnesium sulphate (MgSO4) is the recommended drug for convulsion management. Anti-hypertensive medicines are also recommended for control of high …


Situation Analysis Of Reproductive Health Of Adolescents And Youth In Pakistan, Iram Kamran, Rehan M. Niazi, Kiren Khan, Faisal Abbas 2019 Population Council

Situation Analysis Of Reproductive Health Of Adolescents And Youth In Pakistan, Iram Kamran, Rehan M. Niazi, Kiren Khan, Faisal Abbas

Reproductive Health

This report presents a situation analysis of the reproductive health of adolescents and youth in Pakistan. It is intended to contribute to evidence-based policies and programs for realizing reproductive rights and choices for young people through health information and services, education programs, and strategic partnerships. The study included a literature review, secondary analysis of data from the Pakistan Demographic Health Surveys and Multiple Indicator Cluster Surveys, and a qualitative study of perspectives of unmarried adolescent boys and girls (aged 15–19), including both school-going and out-of-school individuals, as well as boys and girls with disabilities, in peri-urban areas of Islamabad, Lahore, …


Implementing Components Of The Phc For Pe/E Model In Pakistan: A Cost Analysis, Ali M. Mir, Mumraiz Khan, Pooja Sripad, Sara Chace Dwyer 2019 Population Council

Implementing Components Of The Phc For Pe/E Model In Pakistan: A Cost Analysis, Ali M. Mir, Mumraiz Khan, Pooja Sripad, Sara Chace Dwyer

Reproductive Health

Pre-eclampsia/Eclampsia (PE/E) is the third leading cause of maternal mortality in Pakistan. Women with PE are at increased risk for organ damage or failure, pre-term birth, loss of pregnancy, and stroke. PE can progress to eclampsia, which is characterized by seizures, and may be associated with kidney and liver damage, as well as maternal death. The risks of PE/E can be mitigated with regular screening during antenatal care and the postnatal period. Regular monitoring of PE can lessen progression to severe PE/E, and severe PE/E can be managed through administration of magnesium sulfate and antihypertensive drugs. Between 2016 and 2018, …


Meeting Report Of The International Conference On The Great Lakes Region's Regional Training Facility: Working With The Police Sector To Meet The Needs Of Sexual Violence Survivors In The Great Lakes Region, Nathan Byamukama, Chi-Chi Undie, Sharon Asiimwe, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo 2019 Population Council

Meeting Report Of The International Conference On The Great Lakes Region's Regional Training Facility: Working With The Police Sector To Meet The Needs Of Sexual Violence Survivors In The Great Lakes Region, Nathan Byamukama, Chi-Chi Undie, Sharon Asiimwe, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

For over a decade, the Population Council and its partners (the Africa Regional SGBV Network) have provided technical assistance and conducted research to strengthen the evidence base of sexual and gender-based violence (SGBV) programming in Africa’s East, Horn, and Great Lakes regions. Under the Africa Regional SGBV Network, the Council and partners developed and tested an intervention including police response to sexual violence survivors, with police provision of emergency contraception (EC) for survivors and referrals to health facilities. This model has been successfully tested in Zambia and Malawi. Studies reveal that EC provision by trained police to sexual violence survivors …


Storytelling And Policy Change In Africa's Great Lakes Region, Chi-Chi Undie, Nathan Byamukama, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo 2019 Population Council

Storytelling And Policy Change In Africa's Great Lakes Region, Chi-Chi Undie, Nathan Byamukama, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

In April 2019, the International Conference on the Great Lakes Region’s Regional Training Facility (ICGLR-RTF) organized a regional meeting entitled “Sensitization Meeting for Police Chiefs and National Reproductive Health Heads in the Great Lakes Region.” Held in Kigo, Uganda, the meeting brought together chiefs of police and heads of reproductive health departments (Ministries of Health) from nine ICGLR member states, namely: Burundi, Central African Republic, Democratic Republic of Congo, Kenya, Republic of Congo, South Sudan, Sudan, Uganda, and Zambia. The meeting was sponsored by the Population Council, Kenya. Sauti/VOICE Program Brief 2 describes the preamble to ICGLR-RTF’s meeting resolutions and …


Practice-Based Learning: Observations On One-Stop Centers In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Joanina Karugaba 2019 Population Council

Practice-Based Learning: Observations On One-Stop Centers In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Joanina Karugaba

Reproductive Health

One-Stop Centers’ (OSCs) have grown in popularity for responding to sexual and gender-based violence (SGBV) in the East, Horn, and Great Lakes regions of Africa. OSCs attempt to provide an integrated, multisectoral response to SGBV survivors’ needs in one location. In resource-constrained settings, the most common services offered at OSCs include health care, psycho-social support, police and judicial services, as well as social support. Studies demonstrate that health-facility-based OSCs that are owned and run by health-facility staff are more effective than NGO-run OSCs in achieving the broadest range of desired health and legal outcomes for SGBV survivors. In collaboration with …


Mise En Œuvre Des Composantes Du Modèle Ssp Pour La Pe / E Au Nigéria : Une Analyse Des Coûts, Pooja Sripad, Sara Chace Dwyer, Gloria Adoyi 2019 Population Council

Mise En Œuvre Des Composantes Du Modèle Ssp Pour La Pe / E Au Nigéria : Une Analyse Des Coûts, Pooja Sripad, Sara Chace Dwyer, Gloria Adoyi

Reproductive Health

Entre 2016 et 2018, le Population Council, en partenariat avec les Ministères de la Santé fédéraux et des États du Nigéria, a mis en œuvre une intervention visant à lutter contre la pré-éclampsie/éclampsie (PE/E) dans trois États: Ebonyi, Cross River et Kogi. C’était dans le cadre du projet Ending Eclampsia, un investissement quinquennal de l'USAID qui a mis en œuvre des aspects du modèle de soins de santé primaires (SSP) pour le modèle PE/E au Bangladesh, au Nigéria et au Pakistan. L'intervention au Nigéria comprenait cinq composantes de SSP pour le modèle PE/E: 1) le partage des tâches avec des …


Prévention Du Mariage D’Enfants Dans La Région De L’Est, Burkina Faso, Gisele Kaboré, Julien Ouedraogo, Annabel Erulkar, Sara Chace Dwyer 2019 Population Council

Prévention Du Mariage D’Enfants Dans La Région De L’Est, Burkina Faso, Gisele Kaboré, Julien Ouedraogo, Annabel Erulkar, Sara Chace Dwyer

Reproductive Health

En collaboration avec la Direction Provinciale de la Femme, de la Solidarité Nationale et de la Famille du Burkina Faso et des partenaires communautaires de la région orientale du Burkina Faso, le Projet Evidence a mis à l'échelle des approches éprouvées pour retarder le mariage des jeunes filles en sensibilisant aux effets négatifs du mariage précoce. Les approches étaient basées sur des preuves produites dans une étude menée par le Population Council de 2013 à 2016 dans la province de Léraba. Dans cette étude, le report de l'âge du mariage pour les filles de 15 à 17 ans et la …


An Assessment Of Human Resources For Health Hiring, Deployment And Retention, Procedures And Practices In Cross River And Bauchi States, Nigeria, Osasuyi Dirisu, Akinwumi Akinola, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril, George I. Eluwa 2019 Population Council

An Assessment Of Human Resources For Health Hiring, Deployment And Retention, Procedures And Practices In Cross River And Bauchi States, Nigeria, Osasuyi Dirisu, Akinwumi Akinola, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril, George I. Eluwa

Reproductive Health

Primary health care (PHC) is the first contact in a healthcare system and, at its core, includes access to basic interventions that address health needs at the community level. These basic interventions are provided by key frontline health workers—nurses, midwives, and community health extension workers—critical for facilitating immediate access to maternal, newborn, and child health services at PHC facilities. Despite the critical roles of these healthworker cadres, their distribution is uneven and skewed—geographic and within levels of care and governments, in addition to poor distribution of skills—compounded by high attrition due to poor human resources for health (HRH) management and …


Assessment Of In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers In Bauchi And Cross River States, Nigeria, Ekechi Okereke, Iliyasu Zubairu, Udoh Nsekpong, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril 2019 Population Council

Assessment Of In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers In Bauchi And Cross River States, Nigeria, Ekechi Okereke, Iliyasu Zubairu, Udoh Nsekpong, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

Training contributes tremendously to the development and sustenance of health workers’ competencies for quality healthcare services. Although Nigeria has a higher stock of human resources for health compared to other African countries, the World Health Organization argues that its distribution is highly skewed toward urban areas. Building and maintaining staff capacities requires continuing professional development through in-service training (IST) and continuing education (CE). This study assesses current IST and CE for health workers in Bauchi and Cross River states to provide evidence to inform policy and planning and improve implementation of capacity-building for health workers in Nigeria.


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