Integration of services in Senegal

With financial support from USAID and technical support from IntraHealth, The Population Council, Siggil Jigeen Network, and Helen Keller International, Senegal’s Ministry of Health and Prevention has built a package of integrated services called SMNI/PF/PALU. Integrating services allow women to access a wider range of information and care during the same visit and thus increases the utilization of services while also improving their quality and efficiency. Findings in this report indicate that integration of services is a central feature of SMNI/PF/PALU’s success. In conjunction with integrated service delivery models, program activities which strengthen systems and support efficient implementation of services are pertinent for successful integration and have demonstrated significant positive effect on the health of women and children in Senegal

Indicators for measurement and improvement of the quality of family planning programs: The Philippines, 1997–1998

Quality is a critical dimension of health service provision and this brief aims to highlight the creation and use of indicators for quality of care to enhance the achievement of the reproductive health goals in the Philippines and beyond. In response to the need for program managers to understand the quality of services at the field level, the Situation Analysis approach was developed. The research underscores the importance of a composite index when measuring quality. In the case of the Philippines, the evidence suggests the need for more quality-of-care monitoring in addition to expanded access to contraceptives. Investment in counseling of clients and training of providers will support the achievement of the goal of reaching 6 million women. The national Department of Health of the Philippines should continue to make improved FP a major public health priority, particularly in the face of continued opposition

The Africa Regional SGBV Network Learning Brief Series: Learning updates from Uganda (Brief #6)

Sexual and gender-based violence (SGBV) in humanitarian contexts is recognized by the UN Refugee Agency as a global concern and as a priority in its programming. Crisis-affected populations often face multiple forms of SGBV at multiple time periods (during conflict, during flight from conflict, and within post-conflict settings). The Africa Regional SGBV Network, set up in 2006, is addressing SGBV in humanitarian contexts in East and Southern Africa. This Learning Brief is one in a series of two that share critical findings on effective responses to the issue in Uganda. This brief notes that relatively higher screening, disclosure, referral, and referral adherence reveal a real need and demand for SGBV screening in humanitarian settings. The study led to four key recommendations for strengthening SGBV screening protocols, and for addressing gaps in SGBV programming more broadly in humanitarian contexts in the region

Promoting Respectful Maternity Care Resource Package—Debriefing sessions: Caring for the carers

Caring for the Carers is an activity aimed at reducing work-related stress—a major driver of disrespect and abuse (D&A) during facility-based childbirth. Pregnancy, labor, and delivery are expected to be joyous moments for the mother, her family, and the service providers. However, this is not always the case due to maternal complications or even death. Maternity units often have high workloads. This, coupled with lack of professional support for staff and providers, and poor governance and leadership, may lead to work-related stress. These critical incidents can accumulate and contribute to staff stress and emotional exhaustion, which ultimately prevents provision of quality care. Findings from a Kenya baseline survey in 13 health facilities showed that providers are working under stressful conditions. This brief is part of the Respectful Maternity Care (RCM) Resource Package developed by the Kenya Heshima Project, which tested the use of debriefing sessions as an approach to reduce stress-related drivers of D&A at the individual and team levels

Increasing access to family planning in Ghana through policy change: Task-sharing to enable auxiliary nurses to provide contraceptive implant services

Ghana has made significant progress toward reducing the maternal mortality ratio but the rate is still unacceptably high. Up to 26 percent of married Ghanaian women have unmet need for family planning and one in four currently married women is using a modern contraceptive method. Satisfying unmet need for family planning could cut the number of maternal deaths by almost a third. One factor contributing to low usage of modern methods is shortage of trained staff, particularly those skilled in providing long-acting reversible and permanent methods. Until recently, implant services were provided primarily by Ghana Health Service (GHS) trained midwives, but lower cadre health workers were restricted from inserting and removing implants. In 2008, the Population Council and partners collaborated with GHS to train 33 Community Health Nurses (CHNs) in insertion and removal of Jadelle to augment services provided by midwives. GHS, in collaboration with the Population Council, convened meetings to discuss experiences with training this group of CHNs, findings of the assessment, WHO task-sharing recommendations, and case study results. As noted in this policy brief, GHS announced in 2013 that reproductive health policy would be changed to allow CHNs to provide implant services

Population Briefs, Vol. 13, no. 1

IN THIS ISSUE: Chemical postmaster helps deliver contraceptive to testis | Complex role for marriage in HIV risk, studies find | Examining the rollout of pediatric antiretroviral treatment in South Africa | Focused antenatal care acceptable, tricky to implement | New book explores political dimensions of population growt

Marie Stopes International\u27s SIFPO Project—Strengthening international family planning organizations, October 2010–September 2015

The Population Council was a partner in the Strengthening International Family Planning Organizations (SIFPO) project implemented by Marie Stopes International. SIFPO’s mandate was to increase use of voluntary family planning (FP) services globally by strengthening selected international FP organizations with global reach and an extensive, multicountry network of FP clinics for achieving maximum program impact and synergies. This report outlines the Council’s role within the project: evaluate effectiveness of MSI’s FP programs to identify successful best practices and approaches; assist MSI to disseminate the findings of some or all evaluations; strengthen MSI’s internal research and metrics capacity with thematic workshops on research methodologies for MSI research staff based regionally and in MSI country programs; co-host, with MSI, a “community of practice” event or events on FP metrics convening other FP community stakeholders to agree on a common set of metrics for program effectiveness and impact; provide advice, and potentially research, along with other MSI SIFPO partners and consultants, for designing, supporting, and enhancing integration efforts in MSI service delivery; provide links with relevant Council research and forums by leveraging resources from similar activities

Baseline survey of Nigerian media coverage of youth sexual and reproductive health and HIV and AIDS related issues, January 1st–December 31st, 2012

To promote more informed public dialogue on youth vulnerabilities, responses to HIV/AIDS, and positive changes in relevant policies and programs via learning and advocacy interventions at the state and national levels in Nigeria, the Population Council commissioned a study of the print and electronic media’s coverage of HIV/AIDS and sexual and reproductive health–related issues among youth aged 15–24 years in Nigeria for the period January 1 to December 31, 2012. The study entailed a content analysis of four national and two regional newspapers, and an online forum that is one of the most frequently visited social media sites in Nigeria. Additionally, key informant interviews were conducted with editors and health correspondents of the studied newspapers. This report shows that the level and quality of reportage on SRH and HIV/AIDS in relation to adolescents and young people aged 15–24 years is very low among the newspapers analyzed. There is, therefore, an urgent need to remedy this gap as the media still have a significant role to play in educating, informing, and advocating for change in people’s attitudes and understanding of sexuality in Nigeria

Sexual and reproductive health and rights among young people living with HIV in Uganda: Findings from the Link Up baseline survey

An estimated 3.7 percent of young people aged 15–24 years are living with HIV in Uganda, and face unique challenges in navigating a wide array of social, health, and developmental challenges as they transition to adulthood. Like all young people, those who live with HIV are starting to learn about their sexuality, often beginning to have intimate relationships or marry. In addition, they confront a myriad of complex issues associated with HIV status disclosure, initiation of and adherence to antiretroviral therapy, and deeply entrenched HIV-related stigma and discrimination. Young women bear a disproportionate share of this burden. Compared with men in their age cohort, young Ugandan women are more than twice as likely to be living with HIV. Under the Link Up project in Uganda, the Community Health Alliance Uganda and Marie Stopes Uganda will lead the implementation of peer-outreach activities designed to increase access to HIV and SRHR services among young people living with HIV in Luwero and Nakasongola districts. The Population Council and Makerere University’s Child Health and Development Centre are leading an evaluation of these activities

Increasing access to magnesium sulphate in Nigeria

The World Health Organization recommends magnesium sulphate (MgSO4) as the most effective, safe, and low-cost drug for treating pre-eclampsia and eclampsia. To increase access to and use of MgSO4 in Kano State, Nigeria the Population Council trained lower-cadre healthcare providers in antenatal clinics to detect pre-eclampsia early and institute timely and appropriate management by administering the loading dose of MgSO4 and referring for follow-up care. This brief reports that the intervention, which was supported by the John D. and Catherine T. MacArthur Foundation, reduced the maternal mortality rate due to PE/E by 40 percent in project sites. Moving forward, the Council will modify the intervention by also training providers at primary healthcare facilities to manage hypertension by using antihypertensive drugs and will include a community component to increase awareness of signs and symptoms and information that details where and when to seek treatment