Reproductive Health

The Outcome Report of the Global Consultation on Population Dynamics and the Post-2015 Development Agenda not only explains the linkages between today’s most pressing development challenges, population dynamics and sexual and reproductive health and rights, but also provides concrete recommendations on how to address these linkages in the post-2015 development agenda. To date, this report makes the clearest and strongest case for why population matters for the post-2015 development agenda and for why the ICPD Programme of Action must be firmly integrated into this new agenda. [from abstract]

Voluntary family planning is one of the most efficacious and cost-effective means of improving individual health,
gender equity, family well-being, and national development. Increasing contraceptive use and reducing unmet
need for family planning are central to improving maternal health (UN Millennium Development Goal 5).

Contraceptive implants are extremely effective, long acting, and suitable for nearly all women—to delay, space, or limit pregnancies—and they are increasingly popular. Now, markedly reduced prices and innovative service delivery models using dedicated non-physician service providers offer a historic opportunity to help satisfy women’s growing need for family planning. [from abstract]

High contraceptive discontinuation in the past has contributed tens of millions of cases of unmet need, and discontinuation among current users will contribute even more cases in the future. Enabling past users with unmet need to resume use and encouraging current users to continue use of the same or another method could be an effective strategy to reduce future unmet need. [from abstract]

This article aims to shed additional light on this issue by analyzing data drawn from recent Demographic and Health Surveys conducted in 63 developing countries. The first section reviews general levels and trends in unmet need, demand, and use over the course of the fertility transition. The second section presents different types of evidence of program effects, including results from a controlled experiment and from country case studies. The evidence indicates a program impact on both unmet need and demand.

This paper presents a practical approach for realizing human rights as part of voluntary, high-quality family planning programming. The framework provides a pathway for voluntary family planning programs to respect, protect, and fulfill human rights as they set out to improve health and achieve ambitious family planning goals. This comprehensive framework brings together human rights laws and principles with FP quality of care frameworks to assist policymakers, program managers, donors, and civil society with program design, implementation, and monitoring and evaluation.

This publication, which contains four different parts and was updated in June 2014, presents human rights agreements, treaties and policies that address maternal mortality, unwanted pregnancy and abortion as they relate to global reproductive rights work. Part 2: Statements from regional treaties, human rights commissions, Special Rapporteurs, and other intergovernmental bodies.

This publication, which contains four different parts and was updated in June 2014, presents human rights agreements, treaties and policies that address maternal mortality, unwanted pregnancy and abortion as they relate to global reproductive rights work. Part 1: Statements under UN human rights treaties and from treaty monitoring committees, Special Rapporteurs, regional human rights courts and commissions.

This publication, which contains four different parts and was updated in June 2014, presents human rights agreements, treaties and policies that address maternal mortality, unwanted pregnancy and abortion as they relate to global reproductive rights work. Part 3: Country-Specific Treaty Monitoring Committee Concluding Observations, Universal Periodic Review Working Group recommendations, and recommendations by Special Rapporteurs, commissions, and courtsCountries A-L.

The World Health Organization (WHO) has developed a new strategy on people-centered health care that places a strong focus on the re-orienting the health system as a whole, including the importance of engaging community and patient groups. ASSIST principles of people-centeredness are complementary to the WHO strategy, particularly with respect to coordination and continuity of care, information, and the micro-level interactions between a client and the health care service delivery team that promote or hinder people-centeredness.

Making the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana. [from abstract]

Decentralization of family planning is a critical concern for policymakers as international family planning commitments and the expansion of decentralization reforms become more common. Building on the latest research, this paper presents a family planning and decentralization analytical framework that was developed by the USAID-funded Health Policy Project to help key stakeholders better understand family planning decentralization processes, identify potential challenges and opportunities, and guide decentralization reforms. [from abstract]

Evidence-based behavior change interventions addressing health systems must be identified and disseminated to improve child health outcomes. Studies of the efficacy of such interventions were identified from systematic searches of the published literature. Two hundred twenty-nine of the initially identified references were judged to be relevant and were further reviewed for the quality and strength of the evidence.

n family planning programs, logistics refers to the selection, financing, delivery, and distribution of contraceptives and related supplies. Successful logistics management means delivering the right product, in the right quantity, in the right condition, to the right place, at the right time, for the right cost.

In this article, we open the debate on whether or not South Africa’s Youth-friendly Services (YFS) programmes should be linked to community health worker (CHW) programmes. Both are important in South Africa’s efforts to re-engineer primary healthcare in the country. This article presents the pros and cons of linking the two programmes by incorporating YFS into the current list of CHW competencies. Also, we explore the alternative of training specialist CHWs to deliver YFS. [from abstract]

Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth.

Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance. [from abstract]

mHealth has attracted considerable attention as a means of supporting maternal, newborn and child health in developing countries and research to assess the impacts of mHealth interventions is increasing. While a number of expert reviews have attempted to summarise this literature, there remains a need for a fully systematic review employing gold standard methods of evidence capture, critical appraisal and meta–analysis, in order to comprehensively map, quality assess and synthesise this body of knowledge. [from abstract]

This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. [from abstract]

Burkina Faso faces a daunting family planning (FP) challenge. While the use of any modern contraceptive method
more than tripled between 1993 and 2006, the unmet need for FP remains high, at 31.1% among married women. Long-acting methods (IUDs and implants)and permanent methods (female sterilization and vasectomy) are the most effective
of all FP methods. However, use of long-acting and permanent methods of contraception (LA/PMs) in Burkina Faso remains
low, at 13% of the overall method mix. [adapted from source]

One challenge that community health workers face when they provide hormonal contraceptives to new clients is ruling out pregnancy. A randomized controlled trial in Madagascar found that offering the health workers pregnancy tests to distribute for free increases their number of new contraceptive clients. [from introduction]

In 2012, Pathfinder conducted a study to explore whether CHWs who are intended to promote family planning as part of an integrated package of services do communicate with beneficiaries about family planning, and what actions women take based on these messages. The study also explored whether CHWs are reaching the poor, marginalized and vulnerable, and examined the costs of implementing the CHW component of the SCIP project. [from executive summary]

This training manual prepares health workers to counsel women who come to a facility for treatment of an incomplete or septic abortion and to assess and manage the complications of incomplete and septic abortions. It includes information on preparation of MVA equipment, infection prevention procedures, processing MVA equipment for reuse, pain control, the MVA procedure, management of complications of the MVA procedure, and the introduction of comprehensive PAC services in a clinical setting.

Training health care providers and medical college faculty about the supportive nature of Islam toward
family planning principles addressed their misconceptions and enhanced their level of comfort in providing
family planning services and teaching the subject. [from synopsis]

Health care is labor intensive and managers strive to identify a mix of staff that can safely deliver a range of services using available resources. In many developing countries,primary-level workers, auxiliary staff, and community health workers (CHWs) are being trained to assume roles and perform functions traditionally reserved for mid- or high-level cadres of health workers as a means of optimizing the number and capacity of available providers.

This report documents the efforts and contributions made by USAID through the Innovations in Family Planning Services (IFPS) Project towards capacity building and strengthening of public and private institutions in the health sector
in India. The report highlights the support rendered at the national level and in three Indian states: Uttar
Pradesh, Uttarakhand, and Jharkhand. [from introduction]

Local health planners are in a prime position to devise feasible context-specific activities to overcome
constraints and increase met need for family planning to accelerate progress towards MDG 5. [from abstract]

From 1990 to 2011, contraceptive use in Ethiopia increased nine fold and the total fertility rate fell from 7.0 to 4.8. What are the main elements of this success? We posit that the four most significant factors are: political will, generous donor support, non-governmental and public–private partnerships, and the government’s establishment of a network of health extension workers. In this study, we look at these factors and how their interaction increased the proportion of women having both the desire to use and ability to access contraceptives. [adapted from abstract]

The Ugandan Government has an ambitious goal to reduce unmet need for family planning (FP) from its current 34% to 10% over the next 10 years. This brief shares experiences and lessons from capacity building for Family Planning at the national and district levels in Uganda.[adapted from introduction]

Family planning (FP) services have been available in Nepal for over 50 years, most extensively from the public sector health system, with nongovernmental agencies involved from the very beginning. These services are largely delivered by
facility-based service providers, except for the distribution of condoms and pills and, occasionally,
injectables. Community workers such as VHWs and MCHWs could potentially fill the gap if they were given the necessary knowledge and skills. [adapted from resource]