On-site provision of family planning services in factory settings in Egypt

Between February 2023 and May 2024, the Population Council, in partnership with the Egyptian Chamber of Apparel and Home Textile Industries (ECAHT) and with support from the Ministry of Health and Population (MOHP) and the Embassy of the Kingdom of the Netherlands in Cairo, assessed the acceptability, effectiveness and cost of an intervention that combines raising awareness of family planning/reproductive health with on-site provision of family planning services. The intervention, known as the “Our Health is Our Capital” project, was implemented in 10 garment factories in El Amereya Free Investment Zone. Results showed that this model of public–private partnership is acceptable to both workers and factory managers/line supervisors, is effective in addressing workers’ family planning needs, and is a smart investment for businesses. A number of recommendations for scaling up this intervention to the national level are provided in the report

Improving possible serious bacterial infection (PSBI) management in young infants when referral is not feasible: Lessons from embedded implementation research in Ethiopia and Kenya

Background: Sepsis is a leading cause of neonatal mortality, despite the availability of effective treatment of possible serious bacterial illness (PSBI), including when referral to a hospital is not feasible. Gaps in access and delivery worsened during COVID-19. We conducted embedded implementation research in Ethiopia and Kenya aimed at mitigating the impact of COVID-19 and addressing various implementation challenges to improve PSBI management. Methods: The implementation research projects were implemented at the subnational level in Ethiopia and Kenya between November 2020-June 2022 (Ethiopia) and December 2020-August 2022 (Kenya). Guided by the implementation research frameworks, both projects conducted mixed formative quantitative and exploratory research from April to May 2021, followed by summative evaluations conducted between June and July 2022. Frameworks encompassed Consolidated Framework for Implementation Research (CFIR), Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM), as well as health systems framework that incorporates cascades of care and World Health Organization Health Systems Building Blocks. Results were synthesized across the projects through document review and sharing cross-project measures and strategies through a project community of practice. Results: Despite differences in settings across the projects, cross-cutting facilitators included community health worker program and support, and existence of guidelines for PSBI management at primary care levels. Barriers included community attitudes towards seeking care for sick newborns, COVID-19 risks and fear, and lack of health care worker competence. Country-specific contextual barriers included supply chain issues, civil conflict (Ethiopia), and labor strikes (Kenya). Strategies chosen to mitigate barriers and support implementation and sustainability in both settings included leveraging community health workers to address resistance to care-seeking, health workers’ training, COVID-19 infection prevention measures, stakeholder engagement, and advocacy to integrate PSBI management into existing programs, policies, and training. Other strategies addressing emerging project-specific barriers, included improving follow-up through a community health desk and PSBI mobile app (Kenya) and supply chain strengthening (Ethiopia). Both projects improved PSBI management coverage, increased adoption and uptake, and informed national policy changes supporting potential for sustainability. Conclusions: Pragmatic embedded implementation research effectively supports the identification of barriers and mapping to strategies designed to increase effective coverage of PSBI management when referral is not feasible during the COVID-19 pandemic. Despite differences in context, cross-cutting strategies identified could inform broader scale-up in the region, including during future health system shocks

Our Health Is Our Capital

A documentary film summarizing the intervention and impact of the project titled Offering Family Planning Services in Factory Settings in Egypt: Examining Feasibility, Acceptability, and Cost which was implemented in 10 garment factories in El-Amereya Industrial Zone in Alexandria, Egypt

Gender and education in Kenya

The Kenya Gender and Education Roadmap is a series of four evidence briefs designed to provide a comprehensive analysis of the gender and education landscape in Kenya. Drawing from a variety of key data sources, including the Population Council’s Evidence for Gender and Education Resource (EGER) Database, DHS and national-level datasets, and recent literature from East Africa the series provides data-driven insights into gender-related barriers to schooling, especially for girls. By combining needs assessments, current evidence, and practice-based research, the series sheds light on the alignments and gaps in Kenya’s efforts to achieve gender equity in education. This final brief of our Kenya Roadmap series pulls insights from the other briefs and highlights the alignment—or disconnects—between needs, evidence, and practice in the Kenya gender and education sector

Support for healthcare provider education—Overview

This document provides an overview of the Population Council’s Healthcare Provider (HCP) education resources to support healthcare providers and other key stakeholders to raise awareness for, prescribe and support women to use of the dapivirine vaginal ring (DVR, also known as the PrEP ring)

COVID-19 pandemic and women\u27s age at marriage: New evidence From India

A rich literature has documented the relationship between age at marriage and girls’ health and educational outcomes. The upheaval caused by the pandemic on household decision-making has been hypothesized to have influenced the age of marriage, but the direction of impact is unclear. On the one hand, the pandemic may have increased the age at marriage if lockdown policies and negative income shocks to families placed a burden on household wealth and the ability to pay for weddings. On the other hand, the age of marriage could have decreased during the pandemic due to school closures that kept girls out of school, parental deaths that encouraged families to expedite weddings, and lower wedding costs because of government mandates to have smaller weddings. Using data from the National Family Health Survey of 2019–2021 of India, we explore how the pandemic impacted age at marriage for women using district and household fixed effects models. After accounting for secular trends in the age of marriage and contingent on the model and specification, we find a significant increase in age at marriage for women who got married during the pandemic by 1.1–1.2 years as compared with those married before the pandemic

Spousal concordance in attitudes toward intimate partner violence (IPV) and its association with physical IPV against women: A cross-sectional study among young married couples in rural India

This study aimed to assess couple concordance in attitudes toward intimate partner violence (IPV) and its association with physical IPV against women. A cross-sectional survey was conducted with 1,201 nonsterilized women aged 18–29 years and their husbands. It was found that husbands were significantly more likely (69.9%, 95% Confidence Interval (CI): 67.3%, 72.5%) to justify IPV than wives (56.5%, 95% CI: 53.7%, 59.3%). Couples who both hold attitudes justifying IPV against women (Adjusted Odds Ratio (AOR): 3.5; 95% CI: 1.57%–8.00%) and couples where women hold these attitudes, but men do not (AOR: 2.93; 95% CI: 1.18–7.28), were more likely to report male-perpetrated IPV against women in the prior 12 months

Analysis of anthropometric outcomes in Indian children during the COVID-19 pandemic using National Family Health Survey data

Background: Disruptions in food, health, and economic systems during the COVID-19 pandemic may have adversely affected child health. There is currently limited research on the potential effects of the COVID-19 pandemic on stunting, wasting, and underweight status of young children. Methods: We examine the short-term associations between the pandemic and anthropometric outcomes of under-5 children (n = 232,920) in India, using data from the National Family Health Survey (2019–2021). Children surveyed after March 2020 are considered as the post-COVID group, while those surveyed earlier are considered as pre-COVID. Potential biases arising from differences in socioeconomic characteristics of the two groups are mitigated using propensity score matching methods. Results: Post-COVID children surveyed in 2020 and 2021 have 1.2% higher underweight rates, 1.2% lower wasting rates, 0.1 lower height-for-age z-scores (HAZ), and 0.04 lower weight-for-height z-scores as compared with matched pre-COVID children. Post-COVID children surveyed in 2020 have 1.6%, 4.6%, and 2.4% higher stunting, underweight, and wasting rates, respectively, and 0.07 lower HAZ, as compared with matched pre-COVID children. Reductions in nutritional status are largest among children from households in the poorest wealth quintiles. Conclusions: These findings indicate a trend towards a recovery in child anthropometric outcomes in 2021 after the initial post-pandemic reductions. The resilience of health and food systems to shocks such as COVID-19 should be strengthened while immediate investments are required to decrease child malnutrition and improve broader child health outcomes