Evaluation of family planning and reproductive health programmes

Taking advantage of the recent surge of surgical repairs in recent years to investigate the lives of women post fistula reconstructive surgery in Uganda, our study involving 16 women who had gone through fistula operation in Hoima National referral Hospital (Western Region), Uganda in May 2012 during a fistula operation camp organized by Engender Health.Clinical records were used to find contacts of the women with a fistula historyfound out that no program exists for women after the operation to reintegrate into the society which they once belonged to. Family support was found to be instrumental during and after the fistula operation while community support and perceptions was found to largely negatively affect the quality of life of women during the period of fistula.We recommend that Post operation programs for women be planned to assist them successfully reintegrate into the community.

The research clearly indicates the huge amount of currently married women with different socioeconomic strata having unmet need in India and importantly give a strong message for achievement of replacement of fertility by satisfying the unmet need. There are large variations in unmet need for family planning among Indian states. The trends show that unmet need is gradually declining still there is huge amount unmet need visible in the country The study have applied Westoff and Bankole model to know the potential demographic significance of unmet need. After calculating the unmet need for family planning of India, we calculated three different models like “Maximum”, “Minimum”, “Realistic unmet need satisfied” with assumptions and then with Bongaarts Proximate Determinants Model, we have estimated figures of implied fertility rate. Study suggests, in all states the elimination of unmet need to space theoretically reduces the Total Fertility Rate (TFR) to the replacement level of fertility. Results indicate that by satisfying the unmet need for spacing we are able to control fertility to significant level. Finally Research concludes, Unmet need for spacing clearly challenges the entire family planning program personnel to quickly address the root causes and take necessary action to speed up implementation strategy.

Maternal mortality has become a grave concern worldwide. Ghana is one of the sub-Saharan African countries with a maternal mortality ratio (MMR) of 350/100,000 live births. This ratio is high when compared with other countries such as Namibia (MMR of 180/100,000 live births). Improved coverage and quality of skilled attendance at birth is one of the strategies recommended by The WHO and UNFPA to address maternal mortality. In 2000 the Ghana Health Service (GHS) began training a subset of middle level health care providers known as Community Health Officers (CHOs) to provide skilled delivery care to women in rural areas through the Community-Based Health Planning and Services (CHPS) program. This study examines factors which influence women’s decision to have skilled attendants at birth in rural areas of northern Ghana. Generally, results show that 40% of women sought skilled delivery care from the CHO-midwives in the CHPS zones. Ethnicity and husband’s education play a role in women’s choice of place of delivery. We interpret these results in light of the need for the GHS to target men especially the illiterate and the Nankam ethnic group to enable them understand the importance of women receiving skilled care at birth.

The changes in the concept of unmet need for family planning over time have led to inconsistent results across surveys. In a recent attempt, the MEASURE DHS program revised the definition of unmet need. Applying the revised and original definitions, this study measures the unmet needs for family planning in a representative sample of 700 married women, interviewed in the 2012 Mahabad Fertility Survey in Iran. Based on the revised definition, 10.8 percent of women faced an unmet need for family planning, including 7.7 percent for birth spacing and 3.1 percent for birth stopping proposes. The corresponding estimates for the original definition were respectively 9.6, 6.0 and 3.6 percent. Also, about 10 percent of women who used traditional contraceptive methods, largely withdrawal, wished to use modern methods. Taking into account this unmet need for modern methods, we estimate an overall 20.8 percent of unmet needs for family planning in the city of Mahabad based on the revised definition that is 1.3 percent more than the estimate based on the original definition. The observed gap in the original and revised estimates is consistent with the gaps found in the surveys of 70 countries in the literature.

Objective of the paper was to assess OPE incurred by beneficiaries in accessing maternal health services and the extent to which Janani Suraksha Yojana (JSY) incentives could share the burden of total cost incurred. A community based study was conducted in an Indian State on 424 women, who delivered in last one year. Data was also collected from state government’s record on yearly expenditure under JSY. Study was funded by UNFPA, Bangkok.

The OPE per delivery was USD 28.8 if conducted at home; USD 72.5 at public facility and USD 155.4 at private facility. OPE varied by type of delivery, delivery with or without complications and place of ANC. The cost was USD 44.0 and 149.7 for normal and complicated delivery, respectively.

Direct and indirect expenditure incurred by government per delivery was USD 34.5 and 11.5 respectively. After deducting government expenditure from OPE, new OPE per delivery came out to be USD 9.5 for normal delivery (without complication) and USD 115.2 for complicated delivery. The government shared 55% of the total cost (OPE) per delivery. In case of the normal delivery the share increased to 83% whereas in case of complicated delivery it reduced to 29%.

Extensive efforts to improve reproductive health generally, and to increase awareness of HIV and AIDS specifically, have taken place across Central Asia over the past two decades. Such programs have coincided with significant increases in HIV/AIDS awareness. However, among women comprehensive HIV/AIDS knowledge remains modest across the region, and misconceptions concerning HIV transmission remain. Differentials by age, education, and rural/urban residence in awareness and knowledge regarding HIV and AIDs persist among women in the countries of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan. Using Demographic and Health Surveys and Multi-Cluster Indicator Surveys from 1999 through 2011 and reports, records, and interviews from health programs in the region, I examine increases in HIV and AIDS knowledge, tracing patterns of improvement across demographic, social and cultural sub groups within each country. Findings indicate a concerning trend in poor knowledge relating to needle transmission (the major transmission route for HIV in the region) and a persistent gulf in reported knowledge (at all levels) by marital status, age, education and urban residence. These results raise questions concerning the relevance of programmatic content (emphasizing ABCs and sexual transmission) in the region and program access and reception.

This paper is based on the results of a study was implemented in 2009 by the IPSS–National Economics University of Vietnam, funded by Save Children US, The objective of the paper is to determine student teachers’ knowledge, attitude and practice relating to reproductive health (RH) and HIV/AIDS prevention. The study was conducted at Ministry of Education and Training and at four pedagogical institutions of Vietnam. The target population group includes national education officials, university officials and student teachers. The study utilized a combination of a desk review, qualitative and qualitative survey. Data analysed revealed that most student teachers had good basic knowledge but lacked key information and held mixed attitudes about RH and HIV/AIDS prevention. Student teachers are still keeping traditional point of view, were hesitant to share information on RH and HIV/AIDS prevention with other people. College’s or university’s courses and health care facilities were not frequently mentioned as information sources. Some recommendations were suggested on advocating for RH and HIV/AIDS prevention education in all pedagogical colleges and universities, on providing student teachers about in-depth information and skills on RH and HIV/AIDS prevention and on eliminating attitudes of stigma toward people living with HIV.

Well established theory by Wilkinson said that income is closely related to health care. This study tried to reveal whether maternal health care varies by wealth quintiles in selected states. DLHS data from 2002- 2008 were utilized for the purpose. Orissa showed the pro-poor distribution among social-group as well as by wealth quintiles. Percentage of women had ANC visit in first trimester and full ANC of their pregnancy was higher in Orissa and Chhattisgarh compared to other states. Natal care showed different pattern. MP improved its level in safe births substantially from a 20 percent to 44 percent during survey interval. It was higher in state of Madhya Pradesh (MP), Rajasthan and Orissa and even a sharp increase was seen for institutional births at public institutions these states. Proportion of women had ANC visit in first trimester increases from poorest to richest quintiles. Concentration index shows the inequality has reduced in all states except Chhattisgarh. Low prevalence has been observed among poorer group in all EAG states while richer section is dissimilar in different indicators of maternal care. Inequality is higher for full ANC than other two indicators; safe and institutional births. Greater within caste economic inequality was observed in states with low levels opposite to state with better performance.

Using linked data from the 2009 COMPASS health facility and household surveys, this paper examines the association of the quality of maternal health services with their use in the past five years in five states of Nigeria. The results of multilevel logistic regression models revealed a strong positive association between the availability of essential delivery care equipment and supplies and the odds of initiating antenatal care in the first trimester of pregnancy. The odds of institutional delivery were significantly higher in Local Government Areas (LGAs) that scored higher on management practices that were supportive of quality maternal health services than in LGAs that scored lower, after controlling for other factors. More comprehensive provider training on maternal health had a significant negative association with skilled attendance at birth and institutional delivery. The findings suggest that efforts to increase the utilization of maternal health services should improve health facility management practices, ensure the availability of essential equipment and supplies, and conduct further research to better understand how provider training may influence service use.

The 1994 ICPD recommended that comprehensive reproductive health information is made accessible, affordable and acceptable to all users. In response, various educational programmes are being implemented in Ghana to encourage people adopt healthy reproductive lifestyles and attitudes. Currently, sexual and reproductive health education issues form an integral part of the curriculum in all levels of education in Ghana however; a sizeable proportion of the population are currently out-of-school. This study explored how information on sexual and reproductive health is delivered and discussed at dressmaking shops and hairdressing salons. Both quantitative and qualitative data were collected from 119 and 34 respondents respectively. Economic factors were identified as a major contributor regarding respondent’s access to and utlisation of sexual and reproductive health information. The study also revealed that some shops and salons did not have access to mass media although the respondents spend most of their time at these places. It was identified that some respondents paid little or no attention to reproductive health issues nor do they make deliberate effort to listen or view such programmes to avoid being tagged as spoilt girls. It was recommended that sex education programmes should be specifically designed for informal sector.