Reproductive Health

This paper summarizes the importance of improving maternal and reproductive health, the progress made to date and lessons learned, and the major challenges confronting programs today. The paper highlights the progress that some countries, including very poor ones, have made in reducing maternal mortality, but cautions that progress in many countries remains slow. Relying on evidence from the most recent research and survey information, the paper also analyzes the key determinants and evidence on effective interventions for attaining the maternal health MDG. [from abstract]


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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]

Pathfinder has provided community-based family planning and reproductive health services to women and men throughout the developing world for over 50 years. Partnerships with local governments and Nongovernmental Organizations (NGOs) allow Pathfinder access into
communities to provide information and services. These local organizations provide a solid, established network through which Pathfinder reaches people. Faith-Based Organizations (FBOs) are a vital extension of this network. [author’s description]


This report provides information on: the process of building relationships; partn

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.

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]

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). This study was designed to evaluate the effectiveness of the CAG program so that achievements and problems could be identified and program activities strengthened.

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.

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]

The Population Council and The Pubcomm Group, Inc. have developed simple, inexpensive, user-friendly computerized job aids to assist supervisors in improving the quality of family planning, maternity care, and postabortion care services. The software is free to download. [publisher’s description]

Government contracting of private organizations is an increasingly common tool to meet the growing demand for quality reproductive health care in developing nations. This guide brings together information about such contracting experiences in a way to serve the practical needs of World Bank staff and their government counterparts in developing countries interested in trying contracting. [introduction]

This primer introduces key aspects of contracting and summarizes key lessons from countries’ experiences in contracting-out. In doing so, it is intended to serve the practical needs of contracting practicioners in developing countries that are considering contracting as a way to deliver RH/FP services. Intended users include country-level decision makers, contract operation managers, and mission officers and advisers from donor agencies. [publisher’s description]

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. By learning more and being prepared, family planning providers and managers - whether at the community level or internationally-could help in several ways.

Presbyterian Church of East Africa (PCEA) Chogoria Hospital is a faith based non-governmental organization providing a wide range of healthcare services. The organization faces a number of challenges related to sustainability: declining donor support (especially for reproductive health services), low cost recovery levels, and increasing poverty levels among its clientele. In response to these concerns, a team from Chogoria Hospital attended a one-week workshop held in Ghana on financial sustainability and developed a small scale operations research project to determine the cost of providing a selected number of reproductive health (RH) services and to evaluate their cost recovery levels.

This research brief presents results from a cost analysis of an adolescent reproductive health intervention that found that using community health workers was less expensive than using doctors for provision of reproductive health services to young women. [from publisher]

The Christian Health Association of Ghana (CHAG) is a large faith-based NGO which currently serves an estimated 35 percent of the Ghanaian population, mainly in remote rural areas. CHAG’s financial sustainability is threatened due to declining donations from missionary groups and donor agencies, uncertain support from government, and low cost recovery in member facilities. Although knowledge of costs is essential to program management, CHAG members had no information on the costs of the services they provided. Thus, CHAG had no economic benchmarks for evaluating efforts to control costs, no denominator for calculating cost recovery for different services, and no empirical data on service costs that could be used to approach donors and the Ghanaian government with requests for funding.

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]

The competency-based approach used in JHPIEGO-supported training improves performance by ensuring that trainees go back to their worksites with the knowledge and skills required to provide FP services. Once back at the workplace, however, participants often face constraints that limit their ability to provide quality services. Factors that can affect the performance of the healthcare provider include: job expectations, performance feedback, supplies and equipment, motivation, possessing the knowledge and skills to provide services, and supervision. For these participants—and their colleagues in clinical settings—to perform well, it is essential that they have regular and supportive personal contact from supervisors… JHPIEGO proposes to address training-related supervision problems through the development of a supervision learning package. Before embarking on the development of the supervision learning package, JHPIEGO carried out a performance analysis that focused on reproductive health (RH) supervisors. [publisher’s description]

Under the USAID AIDS, Population and Health Integrated Assistance project, JHPIEGO has been working since 1995 with the Division of Primary Health Care (DPHC), the Nursing Council of Kenya (NCK) and the Division of Nursing (DON) to pioneer the development of an integrated clinical training system used for both preservice and inservice family planning (FP) training. JHPIEGO and its partners have strengthened both inservice training and preservice education systems cost-effectively by developing a core group of trainers, tutors and preceptors. In addition, training materials, for both student and participant use, have been supplied to a limited number of clinical facilities. [publisher’s description]

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]

This reference manual, part of a learning package developed through a collaboration between the World Health Organization and JHPIEGO, contains 12 modules on topics such as facilitating group learning, managing clinical practice, and preparing and using knowledge and skills assessments. The modules include examples related to maternal, reproductive and child health.

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]

A participatory assessment process is a valuable starting point for involving all community members, including young people, in YRH and HIV/AIDS program development. YRH and HIV/AIDS program workers need skills in facilitating participatory assessments, especially when youth involvement is a key component. Supporting facilitators to learn by doing is an effective strategy to build skills in using participatory learning and action (PLA) approaches and tools during participatory assessment and throughout the project cycle. This guide aims to provide easy-to-follow guidelines for carrying out a participatory assessment with young and adult community members, and to outline how these tools and methods can be applied throughout the project cycle.

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. It is divided into three parts: a training module, job aids and background document that provide extensive documentation and a list of resources related to privacy and confidentiality, as well as useful information for supervisors and policy makers who are responsible for developing and implementing organizational or government policies regarding private and confidential health services.

The goal of this paper is to describe the establishment of a self-sustaining Student Learning Center (SLC) employing humanistic anatomical models to aid in the teaching of family planning and reproductive health clinical skills to nursing students in Nepal.

JHPIEGO has been working since 1991 to support the development of a national integrated clinical training system used for both family planning/reproductive health (FP/RH) preservice education and inservice training in Turkey. In summary, this project has made substantial gains in meeting the USAID/Turkey results package from the Strategic Objective, Increased Utilization of FP/RH Services, through Intermediate Result 2, Expansion of High Quality FP/RH Services in the Public and Private Sectors, and two Sub-Results-2.1 Increased Availability of Postpartum and Postabortion FP Services and 2.3 Improved Job Performance of Health Providers, Trainers, and Administrators. It has been successful in assisting the MOH, medical institutions, and midwifery schools to establish a national, integrated training system capable of sustaining high-quality preservice education programs for interns and midwives. The inservice training system that has been established will support the MOH in their effort to expand FP/RH training to other provinces in coming years. The preservice education system will support all university-based midwifery school students by strengthening their FP/RH and maternal health skills as they progress toward their degree. [adapted from publisher]

In 1993, JHPIEGO initiated two new programs with the Association of Deans of Philippine Colleges of Nursing (ADPCN) and the Association of Philippine Schools of Midwifery (APSOM). These programs responded to the need to institutionalize clinical reproductive health/family planning (RH/FP) training, to develop a sustainable, decentralized national clinical training network for RH/FP services and to develop standardized training materials. This network was intended to increase the number of skilled graduating nurses and midwives available to meet the needs of the country. This study assessed the following outcomes in the project-affiliated schools of midwifery and colleges of nursing: institutionalization of FP training, quality of training (both classroom and clinical) and quality of services in the project-affiliated clinics. The plan also included an assessment of the institutionalization of RH/FP and the use of project training materials by all schools of midwifery and colleges of nursing. [publisher’s description]

Between 23 May and 2 June 1996, an evaluation of the infection prevention (IP) component of JHPIEGO’s project Strengthening Reproductive Health Services in Mali was conducted to monitor the project’s progress and help with decisions about expanding the project and refining its components. Evaluation objectives were to: document the IP strategy used in Bamako, Mali; document any changes in IP practices at selected sites in Bamako where Norplant

Beginning in 1992, JHPIEGO worked in close collaboration with the Bolivia Ministry of Health (MOH) to develop an integrated family planning/reproductive health (FP/RH) training network throughout the country. The focus of the assistance was the establishment of nine national training centers (NTCs) for inservice training conducted by physician-nurse teams and located at departmental maternity hospitals in departmental capitals. By 2000, the government of Bolivia and other stakeholders had shifted the training emphasis to preservice education efforts. JHPIEGO preservice assistance focused on improving FP/RH education in three medical and nine nursing schools, and the role of the training teams at the NTCs moved toward supporting the preservice education efforts.

The popularity of female sterilization often falls behind other FP methods due in partly because the method is permanent, but mostly because there is a lack of trained service providers who are competent in performing this procedure. Government hospitals and clinics are the primary service delivery points for FP services and, in fact, provide services to more than two-thirds of Kenyan women who use modern methods of contraception. There is, therefore, a strong need for appropriately trained service providers at these sites who can support the service provision system. [publisher’s description]

This training manual is designed to be used to prepare local government health teams to use evidence-based methods to develop long-term plans to strengthen their Reproductive Health (RH) programs. [from abstract]