Maternal and Child Health Commons^™

Costing And Economic Analysis Of Strengthening Union Level Facility For Providing Normal Delivery And Newborn Care Services In Bangladesh, Sushil Ranjan Howlader

Reproductive Health

For a long time, the reduction of the maternal mortality ratio has constituted a major challenge for the health, nutrition, and population sector of Bangladesh. The objectives of this Population Council study is to estimate the costs of the additional inputs required for strengthening Health and Family Welfare Centers (HFWC) for providing normal delivery and newborn care services, the cost-effectiveness, and the financial implications of the addition of capacity. Results clearly show that the benefit-cost ratio for the intervention will be quite high. Some additional measures on the demand side should thus adopted. Intensive behavior change communication activities including interpersonal …

Innovative Financing Through Pay-For-Performance For Providers To Improve Quality Of Care In Bangladesh: Transforming Research Into Action, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, Ismat Ara Hena

Reproductive Health

To improve access to and use of facility-based obstetric and newborn care, the Government of Bangladesh is implementing two innovative performance-based financing programs, namely demand-side financing (DSF) and pay-for-performance (P4P). With the purpose of identifying the lessons learned, limitations of the P4P and DSF models, and scopes for cross learning, a two-day workshop was organized in Dhaka. This workshop report, prepared by the Population Council, resulted in several recommendations to modify DSF and P4P schemes. In Bangladesh, the need for continuing performance-based financing programs to meet MDGs and other health indicators is beyond argument, but it is urgently required to …

Shaping Demand And Practices To Improve Family Health Outcomes In Northern India: A Framework For Behavior Change Communication, Population Council

Reproductive Health

An initiative from the Population Council could help in developing a comprehensive communication strategy to improve reproductive, maternal, newborn, and child health, and nutrition outcomes in Uttar Pradesh and other northern states of India. The identification of key barriers to and facilitating factors for selected target behaviors that have a direct bearing on maternal and child health could go a long way in packaging specific messages for different stakeholders, such as women, husbands, elder family members, opinion makers in the community, and frontline health workers. One of the key deliverables of this publication is to fill an important knowledge gap …

Survey Of Domestic And Work Life Experience And Reproductive Health Of Women Workers Of Selected Industrial Compounds In Ha Noi, Nguyen Thi Van Anh, Nguyen Hong Phuong

Reproductive Health

The Population Council Viet Nam and local stakeholders undertook a collaborative project in Ha Noi entitled “Improving the health care response to gender-based violence.” The study’s objectives were: 1) to assess the knowledge and experience of female workers about gender-based violence; 2) to assess knowledge and practice of women workers on reproductive health focusing on abortion; and 3) to make recommendation for the Ha Noi Health Service to improve the women workers’ knowledge on gender-based violence, choice of contraceptive method, reproductive health care, and abortion. The women factory workers, who have higher levels of education than their peers in the …

Expanding Access To Safe Abortion And Post-Abortion Care: Recommendations Of A South Asia Regional Consultation, Population Council

Reproductive Health

A South Asia Regional Consultation, organized by the Population Council with representation from governments and key stakeholders of Bangladesh, India, Nepal, and Pakistan, was held in New Delhi, to discuss ways of expanding women’s access to safe abortion services. The Consultation deliberated on ways of expanding the provider base for safe induced abortion so as to overcome inadequate and inequitable access to safe abortion. They also looked to expand access to services for the management of incomplete abortion and complications of unsafe abortion that persist in the region and, thereby, to reduce morbidity and mortality resulting from unsafe abortion. In …

Comprehensive Responses To Sexual Violence In East And Southern Africa: Lessons Learned From Implementation, Jill Keesbury, Ian Askew, Monica Wanjiru, Grace Chiyaba, Kate Wilson, Felly Nkweto Simmonds

Reproductive Health

The Population Council has provided technical assistance and conducted research to strengthen the evidence base on sexual and gender-based violence (SGBV) programming in sub-Saharan Africa, where countries have begun to recognize the importance of both preventing violence and responding to the needs of SGBV survivors. These activities have created an active network of partners from across sub-Saharan Africa, who are developing, implementing, and evaluating core elements of a comprehensive, multisectoral response model. This brief reports how network partners have significantly increased the evidence base on program responses: a range of successful approaches have been demonstrated for improving comprehensive services within …

Scaling Up The Provision Of Family Planning Messages In Antenatal And Postpartum Services In Upper Egypt, Nahla G. Abdel-Tawab, Sally Saher

Reproductive Health

An operations research study by the Population Council’s FRONTIERS program in 20 facilities in Upper Egypt showed that integration of birth spacing messages into antenatal and postpartum care was feasible, acceptable to women and their husbands, and was associated with increased postpartum contraception. This report describes the initial and scale-up phases, their outcomes, challenges, and recommendations for improvement. In addition to successfully scaling up the program, the main achievement was securing the support and investment of senior MoHP officials at the central level, as well as the support and commitment of managers and supervisors at governorate and district levels. The …

Community Health Workers And The Media Can Be Effective In Providing Health Information To Married Adolescent Girls In The Community, Population Council

Reproductive Health

Past research has found that married adolescent girls in Nyanza Province, Kenya, face higher risks of HIV infection than unmarried but sexually active girls their age in the province and other parts of the country. To address this challenge, the Population Council’s APHIA II Operations Research Project, in collaboration with Well Told Story and the Ministry of Public Health and Sanitation, developed a study to assess the effectiveness of an intervention designed to increase married adolescent girls’ access to comprehensive reproductive health and HIV information and services in Homa Bay and Rachuonyo districts. The study found that using interactive communication …

A Pay-For-Performance Innovation Integrating The Quantity And Quality Of Care In Maternal, Newborn And Child Health Services In Bangladesh, Laila Rahman, Ubaidur Rob, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Md. Noorunnabi Talukder, Md. Hafizur Rahman

Reproductive Health

The Population Council explored the possibilities of introducing a Pay-for-Performance (P4P) scheme in Bangladesh to improve maternal, newborn and child healthcare (MNCH) services. Based on the consultation and with guidance from the Government of Bangladesh, the Population Council and UNICEF provided technical assistance to the Directorate General of Health Services (DGHS) to test two P4P strategies for MNCH service providers to improve service volume and quality of care, and for poor clients to receive services subsidized through vouchers or coupons. The first strategy is a combination of pay-for-performance for providers and subsidized coupons for poor pregnant women, newborns, and under-five …

Levels, Trends And Determinants Of Contraceptive Use Among Adolescent Girls In Kenya, Francis Obare, Harriet Birungi, Chi-Chi Undie, Monica Wanjiru, Wilson Liambila, Ian Askew

Reproductive Health

In Kenya, recent trends in contraceptive use among currently married women aged 15–49 years show that after experiencing a stall between 1998 and 2003, the contraceptive prevalence rate (CPR) increased between 2003 and 2008–2009. Although the increase in CPR after 2003 is encouraging, there is limited understanding of how these changes affected adolescents, especially girls, given the unique sexual and reproductive health challenges that they face. This report is based on a secondary analysis of the Kenya Demographic and Health Surveys (KDHS) data to understand the trends, differentials, and determinants of contraceptive use among adolescent girls aged 15–19 years in …

Integrating Tuberculosis Case Finding And Treatment Into Postnatal Care, Charity Ndwiga, Harriet Birungi, Chi-Chi Undie, Shiphrah Kuria, Joseph Sitienei, Sam Ochola

Reproductive Health

Under the USAID funded FRONTIERS program, the Population Council conducted a study in six health facilities in Western Kenya that demonstrated that screening for TB within an antenatal care (ANC) setting is feasible and acceptable among the service providers. However, a major challenge remains: although TB detection is encouraged among ANC clients within the maternal and child health clinics in the country, providers in these settings fail to appreciate the need for a continuum of care from pregnancy through to the postnatal period. In order to address this gap, the APHIA II Operations Research Project developed and tested an intervention …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council

Reproductive Health

The Population Council’s APHIA II Operations Research Project in Kenya collaborated with Kendu Adventist Hospital and the Christian Health Association to launch a study to examine the effect of improved services and awareness-creation on the uptake of HIV testing and treatment services for children and infants exposed to HIV. The study showed that community education and improvements in individual case tracking can increase the proportion of infants exposed to HIV who are tested for HIV and put on appropriate treatment. The policy brief recommends that health facilities streamline services to ensure that as many exposed infants as possible are identified …

Increasing Access To Family Planning (Fp) And Reproductive Health (Rh) Services Through Task-Sharing Between Community Health Workers (Chws) And Community Mid-Level Professionals In Large-Scale Public-Sector Programs: A Literature Review To Help Guide Case Studies, James R. Foreit, Sarah Raifman

Reproductive Health

This literature review covers case studies related to community-based distribution of family planning programs, and community health worker (CHW) programs that included family planning and other reproductive health services. It offers essential processes and implications for additional operations research which look at constraints and factors critical to introducing new program procedures or strengthening existing ones.

Informe Años Dos Movil.Com: Evaluación De La Línea Final Resumen De Hallazgos Principales, Annik Sorhaindo, Xipatl Contreras, Kate S. Wilson, Sandra G. Garcia

Reproductive Health

This report highlights the findings of the endline evaluation of a two-year leadership project aimed at indigenous youth in Oaxaca, Mexico: Movil.com. Movil.com is a community project headed by peers and built on elements of other models. It is similar to a cascaded peer education and training model, in which nuclear leaders are trained who, in turn, train facilitators of larger groups. The Population Council office in Mexico evaluated the project at the request of the social organization that implements it, the Rosales Castellanos Women's Study Group, an NGO that has worked for more than 30 years with indigenous communities …

The Effect Of Female Education On Fertility And Infant Health: Evidence From School Entry Policies Using Exact Date Of Birth, Justin Mccrary, Heather Royer

Faculty Scholarship

This paper uses age-at-school-entry policies to identify the effect of female education on fertility and infant health. We focus on sharp contrasts in schooling, fertility, and infant health between women born just before and after the school entry date. School entry policies affect female education and the quality of a woman’s mate and have generally small, but possibly heterogeneous, effects on fertility and infant health. We argue that school entry policies manipulate primarily the education of young women at risk of dropping out of school.

In Search Of Wellness: Allied Health Professionals' Understandings Of Wellness In Childhood Disability Services, Lauren Breen, Helen Wildy, Sherry Saggers, Jeannine Millsteed, P Raghavendra

Research outputs 2011

Purpose. Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. Method. A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years …

Maternal Exposure To The Holocaust And Health Complaints In Offspring, Janine D. Flory, Linda M. Bierer, Rachel Yehuda

Publications and Research

Although the link between chronic stress and the development of cardiovascular and metabolic diseases of adulthood has been known for some time, there is growing recognition that early environmental influences may result in developmental programming via epigenetic mechanisms, thereby affecting the developmental trajectory of disease progression. Previous studies support the idea that offspring of Holocaust survivors may have been subjected to early developmental programming. We evaluated the relationship between parental exposure to the Holocaust and selfreported health ratings and disorders made by their adult offspring (i.e., second generation Holocaust survivors). A total of 137 subjects were evaluated. Regression analyses demonstrated …

Aplastic Anemia: Clinicohaematological Features, Treatment And Outcome Analysis, Rabia Wali, Zehra Fidoo, Salman Adil, Muhammad Ahmed Naqvi

Department of Pathology and Laboratory Medicine

Objective: To determine the clinicohaematological features, treatment and outcome of children diagnosed with aplastic anemia at a single institution.

Study Design: Observational study.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 1999 till December 2008.

Methodology: Medical records of children aged less than 15 years of age diagnosed with aplastic anemia were reviewed. Clinicohaematological features, treatment and its response to therapy and outcome were recorded. Results were described in percentages.

Results: Ninety patients were diagnosed to have aplastic anemia (AA); 65 were male during the study period. Age ranged from 1 to 15 years. Fever …