Reproductive Health

The mapping exercise illustrated in this report was conducted to inform and support the efforts of the Ugandan Ministry of Health to increase the contraceptive prevalence through enhanced community-based distribution (CBD) of family planning. The specific objectives of the exercise were to determine the historical and current coverage of CBD of family planning services in Uganda, by both governmental and nongovernmental programs, and to identify potential districts for scaling up these services. [adapted from summary]

This brief is a best practice model for improving the quality and accessibility of family planning and HIV services in rural communities in Zimbabwe. [from author]

This study evaluated biases in guideline untilization of evidence-based practice concerning contraception perscription. It was found that in India, Peru, and Rwanda, health care providers underutilize evidence-based practice guidelines as they prescribe contraceptives. This article ends with recommendations for providers to most effectively utilize evidence-based practice. [adapted from abstract]

This report details the impact of Pathfinder Interational’s community-based approach to reproductive health and family planning in Ethiopia.

The Capacity Project is applying an integrated strategy to strengthen family planning (FP) and reproductive health. The project is helping the Ministry of Health develop the capacity of the clinical workforce to provide a full range of FP methods and services at 13 hospitals and 146 health centers. [adapted from author]

This research study was undertaken to test the feasibility, acceptability, and effectiveness of two models of integrating family planning services with postabortion services.

This report assesses the business development needs, particularly financial and training, of private health care providers and distributors of reproductive health and family planning products and services in Romania. [adapted from author]

This paper looks at reproductive health and family planning programs in the Eastern Europe and Eurasian region. It includes: a methodology to analyze the RH/FP market; an overview of opportunities and constraints to the private sector region; a description of current practices in the region that foster a greater private sector role in the provision of FP services and products; and recommendations for leveraging and maximizing private sector contribution to RH/FP goals. [adapted from author]

This guide offers policymakers and researchers the latest evidence on private-provider networks and franchises, lessons learned in the field, and policy recommendations on how to mobilize private-provider networks and health franchises to help address reproductive health care needs in developing countries. [adapted from publisher]

Providing contraceptive services at VCT centers is an opportunity to prevent unintended pregnancies among clients whose needs may not be met through traditional family planning services. Operations research in Kenya suggests that integrating family planning into VCT services is feasible and acceptable. An integration intervention improved providers’ discussions about fertility desires and contraceptive methods with clients, without compromising the length of client-provider interaction or client waiting time.

The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government’s reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services. [from abstract]

The report aims to share findings from an assessment to explore how access to critical services for populations at risk of HIV and unintended pregnancy can be strengthened by converging HIV and sexual and reproductive health (SRH) services under the National Rural Health Mission (NRHM) and the National Aids Control Programme (NACP). The report provides information on the demand and opportunities for and the challenges of implementing HIV and SRH convergence in four states

In both Asia and Latin America, community-based health workers have been trained in safe injection techniques and routinely provide injectable contraception. However, the African continent still resists this service delivery mechanism with the rationale that it is unsafe for clients to receive injections from paramedical personnel. This argument is weakening, however, as non-reusable syringes become the norm and with the recent development of a checklist, based on the latest WHO Medical Eligibility Criteria, for safe provision of DMPA by community-based agents.

One of the most important steps in the Performance Improvement Approach is the performance needs assessment (PNA). The PNA focuses on understanding the environment in which service providers work, i.e. the different systems within an organization that affect their performance, as well as the client and community perspectives which influence their family planning access. The performance factors, or those elements that providers need to be able to perform well, are the framework that guides the PI approach and what the PNA is geared to capture. [author’s description]

Health care providers play a crucial role in determining access to reproductive health services and their influence is likely to be heightened in delivering services to HIV-infected women. We examined the attitudes of health care policy makers and providers towards reproductive decision- making among HIV-infected individuals. [from abstract]

Although misconceptions about family planning and cultural factors such as son preference presented some obstacles to progress, [two MSH] projects found that religion in Afghanistan is not a barrier to expanding family planning services. It was critical to engage clinicians and communities in culturally sensitive ways. Emphasizing the use of birth spacing to protect the health of mothers and children was especially effective. Activities to empower women

In much of sub-Saharan Africa, a significant portion of the population lives in rural areas, leaving many women with limited access to clinic-based family planning services. Thus CBD of contraceptives remains an important service delivery mechanism in this region. The primary aim of this study was to assess the safety, quality, and feasibility of Depo-Provera provision by community reproductive health workers.

The practical, up-to-date guidance in this new handbook will help to improve the quality of family planning services and maximize people’s access to them. It can help family planning providers to assist clients choosing a family planning method, to support effective use, and to solve clients’ problems. [from foreword]

Women with HIV have much the same reasons to have children or to prevent pregnancy as everyone else, but they have important additional issues to consider. These women’s health care providers have the responsibility to help them make well-informed and well-considered choices and carry out their decisions with the least risk.

This guide is intended for people responsible for in-service training at any first-level health facility dedicated to the care of persons with sexually transmitted infections (STIs). It aims to equip the user with the skills and information needed to train all relevant clinicians and service providers in the management of persons with STIs, including syndromic management. It also suggests a number of ways the training could be adapted to respond best to local needs. It provides practical advice and information to help you plan and execute the training and assess outcomes effectively

This manual is designed to be a resource for trainers who lead training-of-trainers courses in the field of reproductive health. It is designed to provide trainers with all of the instructions and materials they need to help learners strengthen their training, communication and facilitation knowledge and skills, and to enable them to plan and implement more effective training courses. [author’s description]

The nurse auxiliaries who work at the rural health centers (CESARs) of the Honduran Ministry of Health (MOH) are frequently the only source of reproductive health services in the communities they serve. In order to increase access to long-term family planning methods, the MOH and the Population Council’s INOPAL III Project conducted an operations research study from 1997 to 1998 to see if nurse auxiliaries could provide good quality IUD, Depo-Provera and vaginal cytology services without health risks for their clients.

This presentation is from PSP-One’s GHC Expert Panel - Expanding Health Service Access, Quality, and Equity in Developing Countries: The Role of the Private Sector. It presents franchise models for delivering family planning and reproductive health services by the private sector.

This document focuses on FP integration with HIV services, more specifically with HIV care and treatment services. It encourages supervisors or planners, service providers, and community-based personnel to consider opportunities for operationalizing client-responsive integration of FP and HIV services.

This report describes a performance needs assessment of family planning and other health care providers in three regions of Guinea. Its purpose was to identify performance gaps or problems and determine the most appropriate interventions to improve providers’ performance and clients’ and communities’ access to and use of long-term and permanent methods of contraception (LTPMs)—specifically, male and female sterilization and the intrauterine device (IUD). [adapted from author]

As strides are made in the prevention and treatment of HIV, it is important to take advantage of opportunities to expand and integrate reproductive health services. Integration is an approach that uses a client visit as an opportunity to address other health and social needs beyond those that prompted the current health visit.

A foundation of collaborative partnership, strong technical staff and field presence, and practical monitoring and evaluation anchored the PRIME II Project’s successful efforts to improve the performance of primary providers of family planning and reproductive health (FP/RH) services. PRIME II’s global achievements and lessons learned are summarized in the first section; an overview of project results in each technical leadership and focus area is presented in Chapter 2. [author’s description]

This case study examines the scale up of family planning services in Romania through primary care providers. It disucces the process, the challenges, the successful results and the lessons learned.

This training manual is designed for use as part of the comprehensive family planning and reproductive health training of service providers. It is designed to be used to train physicians, nurses, and midwives. Sessions in this Training of Trainers (TOT) module include discussions, identification of trainer’s own learning style, training exercises, conducting training needs assessments, developing action plans, developing visual aids, and training practice sessions which are videotaped and critiqued. [from purpose]

This training manual is designed to prepare trainers who already have skills as reproductive health trainers to proceed to a higher level of training implementation. This module prepares them to conduct a training needs assessment, develop detailed plans for training, develop and pilot test a training curriculum, conduct training using more advanced training techniques, conduct training follow up and evaluate training. [publisher’s description]