Reproductive Health

Communication Action Groups: Promoting Broader Discussion of Reproductive Health

In 1996, the REWARD Project identified a need for effective interventions to increase women’s communication about reproductive health among themselves and with their husbands. Project staff formed women’s groups, called Communication Action Groups (CAGs), in three rural districts. The project provides group leaders with training on communication, leadership, group dynamics, condom use, condom negotiating skills, and HIV/AIDS and sexually transmitted infections (STIs).

Malawi Case Study: Choice, Not Chance: a Repositioning Family Planning Case Study

This report evaluates the success of a program to improve family planning services in Malawi. It discusses the importance of community-based distribution, i.e. mobile clinics and community health workers, to the success of family planning in the country since so much of the population is rural.

Reproductive Health Training for Primary Providers: A SourceBook for Curriculum Development

This modular training resource intended to help trainers integrate aspects of reproductive health (RH) into training curricula.

Sexual and Reproductive Health for HIV-Positive Women and Adolescent Girls: Manual for Trainers and Programme Managers

The goal of this training is to enable health workers to address the sexual and reproductive health (SRH) needs of HIV-positive women and adolescent girls by offering comprehensive SRH services within their own particular service-delivery setting. [from introduction]

Reproductive Health Manual for Trainers of Community Health Workers

This manual was developed to help organizations who provide reproductive health services through the community-based distribution approach to train their community health workers in reproductive health.

Gender Sensitivity Assessment Tool for FP/RH Curricula

A tool designed to help program and training managers, curriculum designers and trainers facilitate the operationalization and assessment of gender sensitivity during pre- and in-service training of service providers.

Understanding the Impact of Decentralization on Reproductive Health Services in Africa (RHD): South Africa Report

The development of the delivery of reproductive health services is continually confronted by challenges from a changing environment, an important element of which is health sector reform, in particular decentralization, which is being undertaken by most governments in Africa. The general objective of this research is to make health sector decentralisation more effective in the development of appropriate reproductive health services. In Chapter 8 human resource management and development as it has been affected by decentralization is discussed. [adapted from introduction]

Choices in Family Planning: Informed and Voluntary Decision Making

The guides in this toolkit are intented to be used to facilitate a broad discussion of the elements and conditions that underpin the concept of informed and voluntary decision making, help users assess the status of sexual reproductive health decision making in a given program by identifying the challenges and supporting factors at the individual/community, service-deliver, and policy levels, and to help users plan strategies to strengthen supports for clients’ reproductive health decision making.

Impact of an In-Built Monitoring System on Family Planning Performance in Rural Bangladesh

This article assesses interventions aimed at improving family planning mechanisms and reviewing the problem-solving processes to build an effective monitoring system of the interventions at the local level of the overall system of the Ministry of Health and Family Welfare of the Government of Bangladesh. [adapted from author]

Postpartum and Newborn Care: a Self-Study Manual for Trainers of Traditional Birth Attendants and Other Community-Level Maternal and Child Health Workers

The purpose of this self-study manual is to provide accurate and accessible information on postpartum and newborn care to trainers of Traditional Birth Attendants (TBAs) and other community-level Maternal and Child Health (MCH) Workers.* The information can be integrated into existing training curricula and materials or it can be adapted into additional units for an ongoing program of instruction for TBAs. [from introduction]

Effect of Community Nurses and Health Volunteers on Child Mortality: the Navrongo Community Health and Family Planning Project

This report presents the child mortality impact of a trial of primary healthcare service delivery strategies in rural Ghana. After adjustment for sociodemographic factors, underfive mortality in areas with village-based community-nurse services fell by 16 percent during the five years of program implementation compared with mortality before the intervention. [from abstract]

Birth Spacing

To improve birth spacing services in Cambodia, the development of the communication and counselling skills of all providers is critical. A a large part of this issue focuses on these skills. [editor’s description]

Documentation and Assessment of the Reproductive and Child Health Alliance (RACHA) Program: an External Assessment

This assessment evalutes the RACHA program in Cambodia which was intended to strengthen the capacity and sustainability of the public and private sectors to deliver quality reproductive health and child survival services. The five technical intervention areas were birth spacing, STD/HIV prevention, safe motherhood, childhood diarrhoeal diseases and micronutrient deficiences. One of the key intermediate results identified within these areas was inproved human resource capacity to address these issues. [adapted from author]

Strategic Assessment of Reproductive Health in the Lao People's Democratic Republic

This report describes an assessment of reproductive health needs in LAO People’s Democratic Republic. Chapter 2 focuses on birth spacing and the health worker’s role. There is a great demand for and interest in birth spacing among women and men in the community. Training of health providers on the different contraceptive methods seemed adequate where the program had been introduced, but client counselling (for new and repeated clients) was limited.

Social Franchising of Sexual and Reproductive Health Services in Honduras and Nicaragua

This document outlines the outcome of three franchising projects implemented by Partners of Marie Stopes International (MSI) in Honduras and Nicaragua. The projects were designed to pilot full and partial social franchising models as part of an initiative to test and develop alternative forms of delivering quality sexual and reproductive health (SRH) services by a non government organisation (NGO). [abstract]

Creating Conditions for Greater Private Sector Participation in FP/RH: Benefits for Contraceptive Security

Contraceptive security requires comprehensive and integrated approaches that go beyond the public sector. Private sector involvement is critical not only in helping respond to growing market demand but also in ensuring equity in the contraceptive market. Redirecting well-off clients to the private sector will free up scarce donor and public resources for those most vulnerable and in need. Governments and donors cannot mandate private sector expansion and roles; however, they can create favorable conditions that induce private providers to enter the FP/RH market. [author’s description]

Introducing Client-Centered Reproductive Health Services in a Pakastani Setting

Typically, provider–client interactions are brief, and providers often behave condescendingly toward clients. As a result, clients are unable to express their concerns or describe the limitations they face in trying to implement the providers’ suggested course of action. A training intervention was developed for providers that focused on addressing the problems inherent in this dynamic. This research was undertaken to assess whether providers in the experimental area delivered services in a different manner than they had prior to the training intervention. [adapted from author]

Quality of Care Management Center in Nepal: Improving Services with Limited Resources

This working paper evaluates th success of the Quality of Care Management Center in Nepal and highlights the fact that even in resource-poor settings, quality of care in health service delivery can be achieved. This model for a quality of care center that provides timely, appropriate, and ongoing support to clinical facilities may be especially useful in countries where centralized systems are in place for allocation of resources or where maintenance and supply capacity is limited to central locations.

Ensuring Privacy and Confidentiality in Reproductive Health Services: a Training Module and Guide

This [training] guide considers the constraints to protecting privacy in low-resource settings and provides an evidence-based rationale that services will be more effective if resources are invested in ensuring the privacy rights of clients. [This guide] is designed to enable clinic staff, service providers, and supervisors to better support and protect the right of clients to privacy and confidentiality.

Increasing Access to Reproductive Health Services Through Pharmacists

This issue of Outlook explores the role of pharmacists and non-pharmacist counter staff in primary health care, with a specific emphasis on reproductive health. It also presents programs that build the capacity of pharmacists to provide expanded services, thus improving access to quality reproductive health services. [author’s description]

Integrating Counseling and Testing into Family Planning Services: What Happens to the Quality of FP

This presentation details a program to implement and evaluate the feasibility, acceptability, effectiveness and cost of two models of integration of HIV prevention information, and routine offer of provider initiated counselling and testing for HIV into family planning (FP) services in 18 health facilities in North West Province, South Africa. [adapted from abstract]

Integrating FP Services in VCT and PMTCT Sites: the Experience of Pathfinder International-Ethiopia in the Amhara Region

To maximize program impact with current resources, integration of Family Planning into existing HIV/AIDS programs is a very cost effective and an excellent point of entry. This is a study of an intervention program focused on initiating and also strengthening existing integration of FP into functional VCT, ART and PMTCT sites. The intervention encompassed an orientation on integration benefits to heads of health facilities; identification of challenges of integration and drawing of plan of action on how to overcome the challenges and improve integration.

IUD Training Site Assessment for Key Social Marketing Project, Pakistan

This IUD assessment tool provides performance standards for IUD provision based on type of visit-new client or revisit. It may be used as part of a programmatic performance improvement initiative, by the site or individual providers to self-assess or by external evaluators to assess achievement of the standards. Often, performance standards are used to affect change at multiple sites. [author’s description]

Strategies for Building RH/FP Champions: the Role of Private Midwives

This presentation was part of the 2006 Global Health Mini-University. This session will provide an overview of factors that support or constrain the delivery of expanded services by midwives. It will discuss successful case studies to build sustainable practices. This includes a program to promote business training and access to financing to grow and improve private midwife practices in the Philippines. Presenters will also discuss the use of networks for private midwives for service expansion, quality improvement, and sustainability in Kenya. [adapted from publisher’s description]

Organizing Work Better

Family planning and other health care organizations in developing countries increasingly must do more with the same resources, and sometimes with fewer. Reorganizing work processes offers one common-sense way to help staff members at all levels cope with growing demands. [author’s description]

Cost-Effectiveness of Self-Assessment and Peer Review in Improving Family Planning Provider-Client Communication in Indonesia

This cost analysis is based on QAP research on the effectiveness of two interventions (self-assessment and peer review) in sustaining or increasing the effectiveness of interpersonal communications training that midwives had taken. The research had measured the effectiveness of the interventions in terms of the number of utterances midwives made during family planning consultations, and this case study followed on, measuring the cost of each intervention in terms of the number of utterances generated.

Coping with Crisis: How to Meet Reproductive Health Needs in Crisis Situations

People caught in crisis situations have crucial reproductive health needs. The needs of pregnant women are most urgent. Complications of labor and delivery can be life-threatening when women lack adequate care. Risk for HIV/AIDS, other STIs, and unwanted pregnancy increases, particularly when disorder provides cover for rape and other sexual coercion. Health care providers understand people’s needs and have experience meeting them, but few have worked in humanitarian relief.

Checklists Reduce Medical Barriers to Contraceptive Use

Contraceptive provision in many settings continues to be based on outdated medical information, unproven theoretical concerns, and provider biases. Studies have found that in some developing countries 25-50% of women seeking contraceptives are refused services until they are menstruating. Coupled with effective training, checklists can be important tools for health care workers at various levels to apply the latest WHO medical eligibility criteria and guidelines for contraceptive use.

Client-Centered Approach to Reproductive Health: a Trainer's Manual

This manual provides useful information to help the trainer conduct a training program in the client-centered approach to reproductive health. In addition to the modules covering the step-by-step activities that will help participants master different concepts, the information presented ranges from a practical listing of the tools required to short presentations on topics that the trainer will want to be familiar with during the training. [from introduction]

Family Planning Manager's Handbook

The Family Planning Manager’s Handbook is a standard text in management training courses around the world and has received wide recognition as a practical guide for managers of health and family planning programs. [publisher’s description]