Family planning success in two cities in Zaire

Both projects described here, Matadi and Kananga, helped health providers in those two cities offer clinical family planning services. But their approaches differed markedly. The family education program in Matadi concentrated on pioneering community-based distribution of contraceptives, with carefully supervised distributors. The Kanaga Project emphasized clinical supervision and pleasing the clients; introduced social marketing with loose supervision of retailers; and provided an information team skilled in face-to-face group meetings, plus a weekly radio program. Four factors common to both projects seemed to contribute to their success: The single-minded dedication of staff members to making family planning work. An uninterrupted supply of affordable contraceptive methods available through outlets at many locations. Enough organizational autonomy to be able to respond to problems as they arose. Such autonomy made project personnel identify more with project goals and feel responsible for achieving project objectives. Regular and supportive supervision of those responsible for service delivery. Both projects emphasized regular contact with clinic personnel - Matadi also included distributors. These contacts bolstered morale by showing that the project administration was closely following service providers'activities and by transmitting to providers the staff's enthusiam for project activities. Supervisory visits included administrative functions such as collecting service statistics and controlling inventory, but these activities were handled in a friendly, nonthreatening manner that encouraged service providers to perform their tasks well. The fourth factor is adequate funding. Both projects had special funding that allowed them to experiment with approaches for increasing contraceptive prevalence. That funding may partly explain their organizational autonomy and may have contributed to the sense of purpose and esprit de corps that developed among project staff. Larger-scale programs in Zaire have operated with significant financial constraints, so it would be unfair to compare them with these more successful projects. Special funding does not guarantee project success but may make it far more likely, conclude the authors.Health Monitoring&Evaluation,Adolescent Health,ICT Policy and Strategies,Early Child and Children's Health,Reproductive Health

Evaluating operations research utilization: Guidelines for assessing process and impact

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 Manual is to assess the magnitude of impact achieved by FRONTIERS in Reproductive Health, as well as the role of process and contextual factors. This document describes the FRONTIERS evaluation methodology and gives detailed instructions on its implementation. It is intended for use primarily by FRONTIERS project monitors, who will be conducting evaluations

Islam, Polygyny and Modern Contraceptive Use in Francophone sub-Saharan Africa

Francophone sub-Saharan African countries have among the highest fertility rates and lowest modern contraceptive prevalence rates worldwide. This analysis is intended to identify the factors driving contraceptive prevalence in this population.  In addition to testing the usual correlates, we have included three other variables potentially related to lower contraceptive use in the Francophone African context: being Muslim, being in a polygynous union, and participation in crucial decision-making processes. We obtained descriptive statistics for 11 Francophone African countries with DHS data collected since 2000 for relevant variables.  As expected, education, place of residence, age and number of children were significant for most countries in predicting modern contraceptive use.  The final three factors yielded inconclusive results. The conventional correlates were by far the most predictive of MCPR, although women’s participation deserves further analysis. These results dispel anecdotal evidence that being Muslim and in a polygynous union explain low CPR in this region

Executive summary—Family planning programs for the 21st century: Rationale and design

This document contains the executive summary of “Family Planning Programs for the 21st Century: Rationale and Design.” The first half of the book makes the case for why increased funding and support for voluntary family planning programs are needed. The second half explains how reinvigorated voluntary family planning programs can be structured to operate more effectively. Family planning is one of the most successful development interventions of the past 50 years. It is unique in its range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary family planning programs, governments can reduce fertility and produce large-scale improvements in health, wealth, human rights, and education. Substantial investments in promoting voluntary family planning programs and increasing access for all women should be a top priority

Family Planning Programs for the 21st Century: Rationale and Design

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary family planning programs, governments are able to reduce fertility and produce large-scale improvements in health, wealth, human rights, and education. This book is a comprehensive resource for policymakers and donors. It makes the case for increased funding and support of voluntary family planning, and details how to design programs to operate both ethically and effectively

Putting Management Capacity Building at the Forefront of Health Systems Strengthening Comment on “Management Matters: A Leverage Point for Health Systems Strengthening in Global Health”

The current limited focus on management in global health activities is highly problematic given the amounts of financial and human resources that are pouring into health system strengthening interventions and the complexity of clinical operations across settings. By ensuring that public health and healthcare practitioners in domestic and international settings receive management training in their educational programs and that we build management capacity among individuals already in the health workforce, we can begin to prepare for more effective health systems strengthening efforts. Rigorous evaluation of health systems strengthening and the impact of management capacity building is crucial to building evidence for the field

Voluntary Medical Male Circumcision: A Qualitative Study Exploring the Challenges of Costing Demand Creation in Eastern and Southern Africa

BACKGROUND: This paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation? METHODS AND FINDINGS: We conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to "trigger the decision" among eligible men. CONCLUSIONS: Based on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the total costs for VMMC scale-up in eastern and southern Africa

Electro- and Solar-Driven Fuel Synthesis with First Row Transition Metal Complexes.

The synthesis of renewable fuels from abundant water or the greenhouse gas CO2 is a major step toward creating sustainable and scalable energy storage technologies. In the last few decades, much attention has focused on the development of nonprecious metal-based catalysts and, in more recent years, their integration in solid-state support materials and devices that operate in water. This review surveys the literature on 3d metal-based molecular catalysts and focuses on their immobilization on heterogeneous solid-state supports for electro-, photo-, and photoelectrocatalytic synthesis of fuels in aqueous media. The first sections highlight benchmark homogeneous systems using proton and CO2 reducing 3d transition metal catalysts as well as commonly employed methods for catalyst immobilization, including a discussion of supporting materials and anchoring groups. The subsequent sections elaborate on productive associations between molecular catalysts and a wide range of substrates based on carbon, quantum dots, metal oxide surfaces, and semiconductors. The molecule-material hybrid systems are organized as "dark" cathodes, colloidal photocatalysts, and photocathodes, and their figures of merit are discussed alongside system stability and catalyst integrity. The final section extends the scope of this review to prospects and challenges in targeting catalysis beyond "classical" H2 evolution and CO2 reduction to C1 products, by summarizing cases for higher-value products from N2 reduction, C x>1 products from CO2 utilization, and other reductive organic transformations.Christian Doppler Research Association (Austrian Federal Ministry of Science, Research and Economy and National Foundation for Research, Technology and Development), the OMV Group, the Woolf Fisher Trust (New Zealand), the Cambridge Trust (University of Cambridge), the EPSRC (IAA Follow on Fund), the ERC Consolidator Grant “MatEnSAP” (GAN 682833) and a Blavatnik Fellowshi

The Bulletin, Off-Campus Courses and Extension Services 1964-1966, Volume 64, Number 4, June (1964)

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