Regional workshop to use the findings from operations research to increase the access, quality and integration of contraceptive services in Latin America and the Caribbean

In October 2007, the Frontiers in Reproductive Health (FRONTIERS) program held a three-day regional workshop in La Antigua, Guatemala, to disseminate results of its operations research projects. During the workshop, participants received contraceptive technology updates, and learned about effective strategies tested by FRONTIERS to increase access to the IUD and vasectomy; and about integration of family planning with postpartum, postabortion, and PMTCT. Researchers discussed study results, program managers explained how they were used, and practitioners talked about implementing the interventions—a combination of perspectives that successfully transmitted the message that the interventions were not difficult to apply, could have a great impact, and, as one participant wrote on the evaluation form, that “small changes could lead to great results.” Participants prepared plans, outlined in this report, to put into practice lessons learned at the workshop

Assessing the need and opportunities for improved linkages between conditional cash transfers and reproductive health programs in Latin America and the Caribbean

The objective of this project was to document the structure and functioning of conditional cash transfer (CCT) programs in Latin America and the Caribbean, to assess opportunities for improved linkages between CCTs and reproductive health programs, and to explore the role that operations research may have in the improvement of CCT programs. Activities were conducted in the Dominican Republic, El Salvador, Honduras, Jamaica, Nicaragua, and Peru. Operational problems identified by CCT programs included the targeting and selection of beneficiaries, monitoring compliance with conditions for receiving cash transfers, the systems used to provide the transfers, and management weaknesses. Recommendations are made for operations research and other interventions to overcome the operational problems found with CCTs. These include conducting diagnostic research on the perceptions of the participants, using illiteracy as a criterion for eligibility in the program, testing interventions to improve scholastic achievement, and conditioning payments in other programs

Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in the Dominican Republic

A diagnostic study of the provision and use of contraception in postpartum, postabortion, and prevention of mother-to-child transmission (PMTCT) programs in the Dominican Republic was conducted with funding from USAID. The objectives of the study were to assess the contraceptive knowledge, attitudes, and behaviors of providers and clients; the degree to which information, counseling, and delivery are implemented in postpartum, postabortion, and PMTCT services; the quality of these services; and the readiness of postpartum, postabortion, and PMTCT services to offer contraceptive services. The report finds that family planning services are linked to antenatal, delivery, and postpartum care in most of the health units visited and, to a lesser degree, to the integral care provided for persons living with HIV. These and other key findings were shared with the MOH directors of maternal and child health services and other stakeholders. Based on this project’s findings, the report lists key recommendations to improve postpartum and postabortion family planning services in the Dominican Republic

Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in Haiti

This report presents the results of a situation analysis of the provision and use of contraception in postpartum, postabortion, and Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in Haiti. FRONTIERS provided the Centre d’Évaluation et de Recherche Appliqueé (Center for Evaluation and Applied Research or CERA) with technical assistance for the data collection, cleaning, and entry processes. The study found that there is a substantial unmet need for family planning services among postpartum women and many missed opportunities to provide these services during the pregnancy-extended postpartum period continuum. Most outpatient services have adequately implemented HIV counseling for pregnant women, and at least three-quarters of the private and mixed facilities were offering HIV testing, but there is a need to strengthen HIV testing in public establishments. Based on the findings, a number of recommendations are proposed, including efforts to link family planning services to the health care of women living with HIV

Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in Nicaragua

Between September 2005 and April 2007, FRONTIERS and Alva, a Nicaraguan consulting firm, conducted a situation analysis of the provision and use of contraceptive services in postpartum, postabortion and prevention of mother-to-child transmission of HIV (PMTCT) programs. The project‘s objective was to assess the degree to which contraceptive services were linked to postpartum, postabortion and PMTCT services and if this allowed the programs to meet the contraceptive needs of their clients. The project proposes recommendations for improving the quality of these programs

Assessing Integration Methodology (AIM): A Handbook for Measuring and Assessing the Integration of Family Planning and Other Reproductive Health Services

Several international statements over the past two decades have endorsed the integration of family planning (FP) services with other reproductive health (RH) services as a means of expanding availability and access for potential users. Many rationales underlie the move toward integrating FP with other services. First is that it provides benefits to the client and the program. Moreover, there is the expectation that the costs to the health system of configuring two or more services will cost less than providing them independently. However, there is still little empirical evidence available about integration of services. Over time, a number of methodologies for undertaking health facility assessments of service delivery have been developed and field-tested, but none focus specifically on measurement of the integration of services. This handbook presents a methodology that seeks to address this gap. It has been developed from experience gained by the Population Council in undertaking assessments of various combinations of integrated services in many developing countries, mostly undertaken through the FRONTIERS program

Taller regional de utilización de resultados de investigación operativa para incrementar el acceso, la calidad e integración de los servicios anticonceptivos en América Latina y el Caribe

En octubre de 2007, el programa Fronteras de la Salud Reproductiva (FRONTERAS) realizó un taller regional de tres días en La Antigua, Guatemala, para difundir los resultados de sus proyectos de investigación operativa. Durante el taller, los participantes escucharon los avances en la metodología anticonceptiva y escucharon las estrategias efectivas que probó FRONTERAS para incrementar el acceso al DIU y la vasectomía; la integración de la planificación familiar con los servicios posparto, postaborto y PTMI. Los investigadores habloaron sobre los resultados de los estudios, los gerentes de los programas explicaron cómo se usaban los instrumentos y se habló de la implementación de las intervenciones. Esta combinación de perspectivas transmitieron de manera exitosa el mensaje de que las intervenciones no eran difíciles de aplicar, que podrían tener gran impacto, y como escribió uno de los participantes en la evaluación: los pequeños cambios podrían llevar a grandes resultados. Los participantes prepararon planes, descritos en este informe, para poner en práctica lo aprendido en el taller. -- In October 2007, the Frontiers in Reproductive Health (FRONTIERS) program held a three-day regional workshop in La Antigua, Guatemala, to disseminate results of its operations research projects. During the workshop, participants received contraceptive technology updates, and learned about effective strategies tested by FRONTIERS to increase access to the IUD and vasectomy; and about integration of family planning with postpartum, postabortion, and PMTCT. Researchers discussed study results, program managers explained how they were used, and practitioners talked about implementing the interventions—a combination of perspectives that successfully transmitted the message that the interventions were not difficult to apply, could have a great impact, and, as one participant wrote on the evaluation form, that “small changes could lead to great results.” Participants prepared plans, outlined in this report, to put into practice lessons learned at the workshop

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts