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Browse POLICY Project (1995-2006) Materials

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Family Planning/Reproductive Health

HP+ More recent Family Planning/Reproductive Health publications are available.

  • The POLICY Project conducted assessments of adolescent and youth reproductive health in 13 countries in the Asia and Near East (ANE) region that represent diverse population sizes and geographical, cultural, and socioeconomic settings. The countries included Egypt, Jordan, Morocco, and Yemen in the Near East; Bangladesh, India, Nepal, Pakistan, and Sri Lanka in South Asia; and Cambodia, Indonesia, the Philippines, and Vietnam in Southeast Asia. In 2000, there were 354 million young people ages 15–24 in these 13 countries combined. The purpose of the assessments was to highlight the reproductive health status of adolescents and youth in each country within the context of the lives of young males and females.
    English
    arh.cfm
  • The National Centre for Youth Development (NCYD) created the Jamaica Youth Programmatic Inventory (YPI) as a database of active youth-serving organizations. The goal of the NCYD in collecting this information is to facilitate a national process of coordination and planning across sectors in an attempt to identify where gaps may exist in the array of programmes existing to address young people’s needs. The data was collected and analysed at two distinct levels: the organizational level, and the level of programmes directed at young people. 141 organizations are included in the YPI database encompassing 451 programmes in 358 locations serving hundreds of thousands of young people in every parish on the island.
    English
    JAM_YPI.pdf
  • This paper describes the AGOA objectives and explains how HIV/AIDS may affect our ability to achieve those objectives.
    English
    AGOA_1.PDF
  • This study tests the hypothesis suggested by many smaller studies that young people prefer to use private providers to access contraceptive methods. It examines the patterns in young women’s levels of sexual activity, use of modern methods of contraception, and sources of modern contraception by age group and union status, using Demographic and Health Survey (DHS) data. In addition, while controlling for other important explanatory variables, the study seeks to answer the question of whether young women are more likely to choose private sector providers than older women. Results indicate that young women ages 15–24 have higher levels of sexual experience in Africa than in the Latin American, Caribbean, or Asian countries included in this analysis. Overall proportions of young women currently using modern contraceptive methods in Africa, however, are quite low when compared with countries included in the analysis from the Latin American, Caribbean, and Asian regions. Data examining whether young women are more likely than older women to choose private sector providers—while controlling for important explanatory variables—reveal mixed results. In Africa, data for most countries indicate that young women are significantly more likely to choose private and commercial sector providers. In two of the four countries examined in Asia, young women were significantly more likely to choose the private sector. Only in the Latin American and Caribbean (LAC) countries were young women generally less likely to choose private and commercial sector providers than older women.
    English
    contraception_sources.pdf
  • As part of the POLICY Project’s investigations into the delivery of family planning (FP) services in the context of high HIV prevalence, six focus group discussions were held in Cambodia in December 2004. The aim of these discussions was to document the views of FP users, service providers, and HIV-positive (HIV+) women on the accessibility and quality of FP services, particularly in light of the HIV/AIDS epidemic in Cambodia.
    English
    CamFP-HIV_FGDs.pdf
  • Involving men in reproductive healthcare could help Cambodia achieve some major development goals, such as a decreased maternal mortality rate and an increased contraceptive prevalence rate. Involving men could also help reduce the overall prevalence of HIV/AIDS—an outcome possible only if men are involved not just as clients of RH care but also as partners, service providers, policymakers, teachers, and project managers. Until today, male involvement in RH in Cambodia has been relatively underdeveloped. Despite the availability of a few contraceptive methods for men, maternal and child health (MCH) programs provide most RH care, strategic plans and services lack indicators for men, and most service providers are not equipped or trained to accommodate male clients. RH facilities tend to be female-oriented; as a result, men are often reluctant to avail themselves of services. Men’s reluctance to access RH care can also mean that barriers to accessing health, such as distance and cost, which affect both men and women, are even more influential in preventing men from seeking RH counseling or treatment or even seeking services as partners. To expand and strengthen male involvement in reproductive health in Cambodia, this report offers the following recommendations: • A set of guidelines to mainstream male involvement need to be developed and distributed. • Agencies interested in implementing male involvement in reproductive health must plan for a long-term commitment. • Campaigns need to be implemented that educate seemingly “low-risk” social and demographic groups. • Current education campaigns need to be reviewed in the context of male involvement and should not, for example, reinforce gender inequities or the notion that condom use is restricted only to high-risk situations. • Existing services should be made more “male-friendly,” with service providers undergoing additional training and engaging in effective outreach activities. • The private health sector should be directly involved in efforts that foster male involvement.
    English
    MaleInvolv_Cam.pdf
  • This is a compilation of significant information and data on the current situation of child survival in Nigeria. Facts have been drawn from a wide range of sources including the Nigeria Demographic and Health Survey (1999), Population Bureau, Federal Office of Statistics, National Planning Commission, UNICEF’s Children’s and Women’s Rights in Nigeria: A Wake-up Call—Situation Assessment and Analysis (2001), survey reports, academic articles, policy and programme documents, budget documents, and publications from development partners. This document is intended to serve as a concise public source of data on the major child survival issues in Nigeria and to assist policymakers to “put children first” in national priorities and in the design of public policies.
    English
    NIG_CSrevised.pdf
  • Since the 1960s, the Ministry of Health (MOH) of Turkey has enjoyed the benefits of external assistance for its family planning (FP) program especially from the U.S. Agency for International Development (USAID). The MOH has since developed an FP program that operates through a widespread network of facilities across the entire country. Today, the MOH dispenses about 70 percent of all intra-uterine devices (IUDs) and about 30 percent of all oral contraceptives (OCs) and condoms in the country. MOH’s FP service provision has traditionally been based on free and universal access. The only exception has been that some of the facilities have in recent years started to collect donations from better-off IUD clients as a result of spontaneous trend. In 1995, the Government of Turkey (GOT) and USAID signed an agreement whereby USAID’s assistance for the FP program would be phased out in five years. This meant that Turkey would have to develop a self-sustaining financing policy to bridge the resource gap created by the departure of USAID’s assistance. The MOH has since been continuing its efforts to develop and implement a new policy. According to the phaseout plan, USAID would donate 20 percentage points less condoms and OCs in each year of the phaseout period. IUD donations, however, would fully continue until the fourth year, when they would be lowered to 50 percent of the forecasted consumption of that year. In 2000, total responsibility would pass onto the GOT. However, there was a diversion from the original phaseout in the implementation stage. Although this has caused confusion, the MOH was quick to respond to the plan by initiating its first-ever contraceptive commodity procurement in 1996.
    English
    TURclidon.PDF
  • Twenty parliamentarians from Benin, Burkina Faso, Chad, Guinea, Mali, and Senegal and 15 of their close allies in the public and nongovernmental sector convened in Conakry, Guinea, June 2–6, 2003, and adopted legislative agendas and strategies to improve family planning and reproductive health (FP/RH) programs in their respective countries.
    English
    Conakry_Summary.pdf
  • The overall objective of the study is to develop a financial sustainability strategy for contraceptive self-reliance (CSR) in the Philippines using a market segmentation approach. The development of such a strategy is in keeping with the statement of the Department of Health (DOH) in its 2001 Family Planning (FP) Policy that PhilHealth shall be a key partner in the mobilization of investments in the FP program, and that the DOH will adopt the recommendations of the technical working group on the Contraceptive Independence Initiative (CII). In particular, the CII will segment the population and will ensure the availability of commodities for all segments through direct subsidy, health insurance, socialized pricing, and/or commercial procurement.
    English
    PHIL_CSR.pdf
  • The overall objective of the study is to develop a financial sustainability strategy for contraceptive self-reliance (CSR) in the Philippines using a market segmentation approach. The development of such a strategy is in keeping with the statement of the Department of Health (DOH) in its 2001 Family Planning (FP) Policy that PhilHealth shall be a key partner in the mobilization of investments in the FP program, and that the DOH will adopt the recommendations of the technical working group on the Contraceptive Independence Initiative (CII). In particular, the CII will segment the population and will ensure the availability of commodities for all segments through direct subsidy, health insurance, socialized pricing, and/or commercial procurement.
    English
    PHIL_CSR_ES.pdf
  • This report documents the significance and impact of the first three core packages implemented in Romania, Ukraine, and Nigeria. It also presents key highlights of results achieved through the packages.
    English
    Synthesis_core_packages(final).doc
  • This report examines the present situation of both the HIV/AIDS epidemic in Cambodia and the progress of its FP program. It examines the trends in funding, staff resources, impact of the epidemic on personnel, and the activities of the government, private health sector and nongovernmental organizations (NGOs) in both sectors. Finally, the report will examine the efforts being made to integrate HIV/AIDS and FP services so that they jointly address these issues that are having such a profound effect on Cambodia’s development.
    English
    CamFP-HIV_analysis.pdf
  • This study is an investigation into the status and trends of family planning (FP) and reproductive health (RH) programs within the context of Ethiopia’s heightening HIV/AIDS epidemic. By helping individuals and couples control the number and timing of pregnancies, family planning provides far-reaching benefits (Dayaratna et al., 2000). In addition, by reducing unintended and high-risk pregnancies, family planning can lower the instances of maternal and child injury, illness, and death associated with childbirth and unsafe abortions (Shane, 1997). Ethiopia has not been able to expand FP services to satisfy the increasing unmet need in the country, and its maternal mortality ratio (MMR) ranks as one of the world’s highest. At the same time, Ethiopia is among the countries that have been hardest hit by the HIV/AIDS epidemic. The findings of this study are expected to inform policy and program managers about the various dimensions of HIV/AIDS and family planning in Ethiopia.
    English
    EthiopiaFP-HIV.doc
  • This study was designed to document the extent to which Kenya has managed both its family planning/reproductive health (FP/RH) and HIV/AIDS programs in the context of the high HIV prevalence (14%) the country is experiencing. In order to gain further insights on the dynamics of the FP program (FPP) in the country, interviews were conducted with 16 key informants from relevant government ministries/departments, NGOs, collaborating agencies, and donors. Questions touched on specific issues of FP/RH and HIV/AIDS regarding funding levels, staffing/personnel issues, integration and role of nongovernmental organizations (NGOs) and the private sector in FP/RH and HIV/AIDS programs. The background information for the study was obtained from several policy documents and other related official documents such as strategic plans, relevant survey results/reports, development plans, and statistical abstracts.
    English
    Ken_FPHIV.pdf
  • This study forms part of an investigation by the POLICY Project on how countries have been managing family planning in the face of high HIV/AIDS prevalence. This report describes recent trends in family planning/reproductive health (FP/RH) and HIV/AIDS service delivery in Zambia. The study was conducted in two parts. First, the desk review of documents on FP/RH and HIV/AIDS was carried out. The second part involved in-depth interviews with selected stakeholders in FP/RH and HIV/AIDS service delivery. Respondents included representatives from the Ministry of Health/Central Board of Health (MOH/CBOH), National AIDS Council (NAC), donor agencies, nongovernmental organizations (NGOs), and cooperating partners as well as public and private service providers. Questions were asked about the FP/RH and HIV/AIDS programs with regard to the status of the programs, funding levels, staffing and personal issues, the role of NGOs and the private sector, and health sector reform.
    English
    Zam_FPHIV.pdf
  • English
    SPARHCS-Egypt.doc
  • English
    SPARHCS-Honduras.doc
  • English
    SPARHCS-Jordan.doc
  • English
    SPARHCS-Nicaragua.doc
  • English
    SPARHCS-Paraguay.doc
  • English
    SPARHCS-Peru.doc
  • English
    SPARHCS-Ukraine.doc
  • English
    SPARHCS-Bolivia.doc
  • This report reviews the progress made to date under Egypt’s family planning (FP) program and estimates the benefits that have already been realized. It documents the effects of the FP program on Egypt’s demographic transition through a review of the country’s major demographic indicators. To estimate the benefits realized, a scenario of a less successful FP program was created and compared with the cumulative public sector savings achieved as a result of Egypt’s actual FP program for the period of 1980–2005. The health benefits for children and mothers were also analyzed.
    English
    Egypt 25 yr retro Final.pdf
  • French
    WW_WillToPay_Fr.pdf
  • The HIV/AIDS epidemic is having a wide impact on Nigeria. One of the more alarming is the emerging cohort of AIDS orphans and other vulnerable children (OVCs)—children who have lost either or both of their parents to AIDS. Experiences from other countries, such as Ethiopia, Uganda, and South Africa, where the epidemic is more advanced, tell us that AIDS orphans face serious threats to their well-being, and these threats can have far-reaching and long-term effects on society, public health, and the economy. Nigeria, like many sub-Saharan African countries, has a young population. Current estimates indicate that about 44 percent of the country’s population is under age 15. Unfortunately, a sizable proportion of these children have lost either one or both their parents. This report provides an estimate of orphans (under age 15) that have lost their parents to AIDS-related and non-AIDS-related causes for the 36 states of Nigeria and the Federal Capital Territory (FCT) between 2000 and 2015. The paper also briefly describes the methodology and data used to develop the estimates.
    English
    Nig_Orp_Proj.pdf
  • English
    senfrenc.pdf
  • This study was prepared at the request of the POLICY Project to analyze the existing and potential procurement mechanisms in the Ministry of Health (MOH), Royal Medical Services (RMS), UN Relief and Works Agency (UNRWA), Jordan University Hospital (JUH), and Jordan Association for Family Planning and Protection (JAFPP), which are the main providers of contraceptives obtained through the USAID grant to the MOH in Jordan.
    English
    Jor_procurement.pdf
  • This paper presents a detailed market segmentation analysis of the family planning sector in Jordan. Section 2 provides an overview of the provider market. Section 3 analyzes the consumer market in terms of consumer characteristics, needs, method use, and sources of contraceptives. Section 4 studies profiles of the public-, NGO-, and private-sector clients. Section 5 presents a comparative analysis of the 1997 and 2002 markets. Section 6 assesses the current targeting behavior in the public sector. Section 7 segments the current market to establish a better match between current/potential users and the appropriate source of FP methods and services. Section 8 projects the potential demand across SLI quintiles and the potential market for the public, NGO, and commercial sectors; while Section 9 presents policy options for achieving contraceptive security based on market segmentation results.
    English
    JOR_MS.pdf
  • English
    fpeb.pdf
  • Over the past decade, Cambodia has made good progress in re-establishing a nationwide health system that had been devastated by decades of civil conflict. The efforts of the Ministry of Health and nongovernmental organizations to expand family planning services have had an impact on individual lives and most health indicators. Between 1995 and 2000, the contraceptive prevalence rate for married couples practicing modern family planning methods increased from 7 to 18.5 percent. The risk that women will die due to pregnancy-related causes, while still quite high, has also been greatly reduced due to lower fertility and improved access to service provision. Despite these achievements, Cambodia faces great challenges. This booklet reviews Cambodia's current reproductive health situation and focuses on the challenges ahead for family planning and safe motherhood programs. (Hard copy available in English and Khmer)
    English
    CAM_SavingLives.pdf
  • The volume presents information on the status of RCH financing in Rajasthan. It rests on the multifaceted research endeavor that encompassed: 1) a comprehensive literature review of health financing studies in India; 2) a detailed analysis of cost recovery through Medical Relief Societies; 3) an analysis of public sector health expenditure based on a review of government budget and expenditure reports at both the state and district levels; 4) an RCH expenditure and utilization survey of 1,100 households in the district of Udaipur, Rajasthan; and 5) an inventory of public and private sector health facilities for seven districts in Rajasthan; and provider interviews on time allocation at health facilities in Udaipur, Rajasthan.
    English
    IND_RAJ_FIN.pdf
  • This report describes networking among NGOs in five districts of Ghana's Eastern Region.
    English
    Ghana_NGO_Networking__rev2_.pdf
  • For the first time in the country, four states have taken initiative on their own and formulated state specific population policies. Processes followed to prepare population policies varied from one state to another and also the strategies selected for achieving population stabilization within a stipulated time period within the broad framework of reproductive and child health programme. All the four states, Andhra Pradesh, Rajasthan, Madhya Pradesh and Uttar Pradesh, tried to set realistic objectives, integrate family planning services with maternal and child health services, encourage informed choice, address gender issues and decentralize the programme implementation to a large extent. Processes followed to formulate the policies largely included preparation of background papers, consultations with a wide range of stakeholders including women, adolescent, non-government organizations and private sector, discussions within the department of health and family welfare and with other development departments and involvement of political leaders and policy makers from the beginning in policy development. Given the involvement of diverse groups in consultative processes, building consensus is a difficult, cumbersome and time-consuming process. It is to the credit of these states who selected a difficult path of consultative processes and consensus building to formulate policies than the usually employed short cut method of producing a confidential document and getting it formally approved by the Cabinet and then announcing to the world the arrival of new era. More often than not, policies formulated without openness and broad consensus failed at implementation stages although policies formulated with consultation processes do not automatically guarantee success without implementation plans and follow up with the help of strengthened and effective monitoring systems. This paper illustrates the way UP Government has converted UP Population Policy into an implementation plan.
    English
    India_Pop_Policy_Imp.pdf
  • This paper provides an overview of the rationale for integrating family planning into HIV programs, as well as lists of resources that can be used for policy development and policy implementation to integrate FP into HIV policies and programs. It is a companion document to the CD-ROM of the same name, which contains the actual resources listed. The paper is divided into seven sections: 1. International conventions (FP and HIV-related service integration) 2. National HIV policies and FP 3. VCT policies and FP 4. PMTCT policies and FP 5. ART policies and FP 6. Operational policies 7. Additional resources
    English
    ImplementingPoliciesandPrograms.pdf
  • The document describes the goal and approach of the IFPS project in improving reproductive health services.
    English
    INDinnov.pdf
  • This paper is designed to serve as a key background document for the Sustainability Strategy Conference, May 3-4, 2001. It summarized the findings of 12 individual situation analysis papers developed under four different subject areas: financial sustainability, institutional capacity, enabling environment and sustainability of demand.
    English
    EGY_SFP.pdf
  • A quarterly newsletter on population issues in Kenya, produced by the National Council for Population and Development (NCPD) and the POLICY Project. Theme: Kenya Demographic and Health Survey 2003
    English
    KEN_KenPop_1.1.pdf
  • A quarterly newsletter on population issues in Kenya, produced by the National Council for Population and Development (NCPD) and the POLICY Project. Theme: Improving the Quality of our Population: ICPD+10: Lessons Learnt
    English
    KEN_Kenpop_1.2.pdf
  • RAPID Booklet for Madhya Pradesh
    English
    INDmp.pdf
  • Brochure describing Malawi's National Reproductive Health Programme
    English
    Mala_broch.pdf
  • Reproductive Health Promotion Working Group advocacy material
    English
    CAM_MaleInvolveEng.pdf
  • Brochure on maternal mortality and women's status in Haiti.
    French
    Mor.PDF
  • English
    Kenya_Condom_Policy.pdf
  • This document is the actual National Health Policy for Bangladesh.
    English
    Health_Policy_for_Bangladesh.pdf
  • A major outcome of the International Conference on Population and Development held in Cairo in 1994 is that many countries including Nigeria shifted the focus of their population and development programmes to reproductive health. In this regard, the Reproductive Health Division of the Federal Ministry of Health, with assistance from POLICY Project, developed a 5-year RH strategic plan for the period 2002 – 2006. This strategic framework and plan is fashioned to translate the reproductive health policy into actionable plans. The goal of the strategic framework is to improve the quality of life of all Nigerians, men,, women and children through enhanced reproductive health. Thus the key objectives are to reduce the maternal mortality rate by 90% and perinatal mortality rate by 30% of the 1999 figures. Other objectives to reduce the prevalence of STIs and HIV infections, limit all forms of gender-based violence and other harmful practices, reduce the incidence of reproductive cancers and infertility, and increase contraceptive prevalence rate. In providing a comprehensive right based and gender sensitive reproductive health services, linkages between that make services comprehensive should be established such that health care staff, made polyvalent in their skills offer services in a wide range of RH care needs within each care centre. The strategic framework and plan also promotes community participation and encourages private sector support. Since health is under the concurrent list in Nigeria, the three tiers of government, shall spearhead the funding and implementation of the Plan with support from Developmental Agencies, International organizations and NGOs The following priority areas have been given focused attention: • Safe Motherhood • Family Planning • Adolescent Reproductive Health • STIs, HIV/AIDS • Harmful Practices, Reproductive rights and Gender Issues • Tumours of Reproductive Organs • Infertility and Sexual Dysfunction’ • Menopause and Andropause The contemporary issues under each of these component areas are to be addressed through five strategies of advocacy and social mobilization, promotion of healthy reproductive behaviour, equitable access to quality services, capacity building and research promotion. It is expected that this strategic framework and plan may be reviewed as necessary. With an estimated budget of N21,000,000.000 (Twenty one billion Naira), successful implementation of this strategic framework and plan should substantially contribute to achievement of the goals of the RH policy, the National Health Policy and the National Policy on Population for sustainable Development.
    English
    NIG_RHStrat.pdf
  • This paper documents the achievements of the Edo State YAARH core package, which was implemented over the period from August 2001 through March 2004. Section II presents the context, policy issues, and stakeholders affecting the successful implementation of YAARH policies and programs in Edo State. Sections III and IV focus on the interventions and results achieved under the package, and Section V discusses the legacy of the project. In summary, this paper documents a pilot effort to facilitate a participatory networking, strategic planning, capacity building and advocacy process, resulting in a strengthened role for civil society in policy processes; the development, adoption, and funding of an evidence-based state-level YAARH strategy; and an improved enabling environment for the implementation of national YAARH policies and strategies at the state level.
    English
    Nigeria_CP_final_report.pdf
  • Although contraceptive use has risen impressively in many countries over the last few decades, there have been occasional flat periods that have raised serious concerns about the effectiveness of the national family planning programs involved. Of special concern are a few instances in the Asia and Near East region, where interruptions of an established upward trend in contraceptive use have raised troubling policy and program questions for both governments and international donor agencies. Issues exist concerning the actual frequency of plateaus in contraceptive increase, why they occur, why most are so brief, and what actions should be taken when they occur. The analysis reported here uses a large set of national surveys to explore especially the first of those questions and to offer suggestions as to the other three.
    English
    wps-10.pdf
  • The role of policy in improving program outcomes in the family planning/reproductive health (FP/RH), safe motherhood, and HIV/AIDS fields has been increasingly recognized. Despite this increased recognition, “policy” is often seen as a black box. Existing frameworks or models focus on some aspects of policy—the stages of policy development, decision makers and stakeholder institutions, the intent and content of a policy, or its implementation—yet none captures all policy components. This paper provides a practical framework to analyze components of family planning, reproductive health, maternal health, and HIV/AIDS policies. The Policy Circle framework is presented and the six “Ps” of policy are described: Problem, People/Places, Process, Price Tag, Paper, and Programs/Performance. Each component of the Policy Circle can be analyzed using a variety of tools. The Policy Circle is not intended to be linear or even circular, but places the problem or issue to be solved at the center. The six policy “Ps” of the Policy Circle operate under the broader contextual forces of politics, society, and economics. The Policy Circle has wide applicability. The proposed framework can be used to analyze different policy levels, including national and local policies and sectoral and operational policies. In the case of FP/RH, the Policy Circle can be viewed through different lenses specific to three overarching concerns: youth, gender, and human rights. Each of the six “Ps” points to important aspects of policy that need to be considered to ensure comprehensive policy analysis of the issue or area of concern to which the Policy Circle is applied. Visit the Policy Circle online - click here
    English
    wps-11.pdf
  • Nigeria is in the early stages of carrying out its new national policy on sexuality and reproductive health education. Worldwide, school-based programs are an important element of efforts to improve the reproductive health of young people. This paper reviews the international experience and its implications for Nigeria.
    English
    wps-12.pdf
  • In 1994, after three decades of donor support to Turkey’s national family program, the U.S. Agency for International Development (USAID) announced its intention to phase out assistance. On the eve of donor phaseout, Turkey’s public sector program was serving nearly 60 percent of the market for modern family planning methods, including many nonpoor clients. During the transition period, the Ministry of Health was challenged not only to obtain new resources to replace donated contraceptive commodities but also to assume new technical responsibilities for the program. The story of how the ministry succeeded is often told in technical terms (e.g., number of procurements, budget trends, pilot project design, etc.). An equally important part of the story is the political and institutional context within which success was achieved. Examining how the MCH-FP Directorate overcame challenges to put in place a sustainable strategy for the public sector family planning program reveals the political dimensions of the process. Using a political economy framework, this paper examines the processes that led to implementation two central components of Turkey’s national self-reliance strategy: obtaining annual budget allocations for contraceptives and targeting free services to the poor. The framework used here to analyze the process of formulating and adopting Turkey’s contraceptive self-reliance strategy has five components: stakeholders’ characteristics, institutional characteristics, contextual conditions, process characteristics, and reform characteristics.
    English
    WPS13.pdf
  • The research reported here concerns the Maternal and Neonatal Program Effort Index (MNPI), a standardized assessment instrument applied in both 1999 and 2002. Previous reports cover the detailed methodology and the results from the 1999 study, as well as the relation of the MNPI ratings to maternal mortality ratios (Ross, Campbell, and Bulatao, 2001; Bulatao and Ross, 2002; Bulatao and Ross, 2003a). The MNPI instrument is designed to measure the strength and character of government programs to improve maternal health. It contains items for the most proximate determinants of maternal survival, including those related to emergency obstetric and abortion cases, as well as the less proximate determinants of the policies and institutional arrangements necessary to build treatment capacities. Capturing these program features can document the low effort levels that now exist and create a baseline against which to trace future improvements. The overall purpose is to measure program inputs and strength of effort for the reduction of maternal mortality and morbidity and closely related neonatal items.
    English
    WPS15.pdf
  • User fees are gaining widespread use in government health programs as a means of alleviating pressure on constrained budgets as demand for services increases. Concerns that fees reduce access to services among the poor have led to the promotion of fee exemption mechanisms in order to protect those unable to pay for services. The exemptions, however, may not effectively ensure access among the poor because (1) informal fees and other costs associated with seeking and receiving services are not alleviated by most exemption mechanisms and (2) exemption mechanisms are poorly implemented. The low proportion of formal fees to total costs to the consumer and the unpredictable nature of informal fees and other costs of access may actually work against formal fee exemption mechanisms. Even though little is known about how well fee and waiver mechanisms function for maternal health services, it is important to understand whether exemption mechanisms alone hold promise for protecting access for the poor or whether the mechanisms need to be supplemented with other strategies. This study was conducted simultaneously in five countries: Egypt, India (Uttaranchal), Kenya, Peru, and Vietnam. The objectives were to survey actual costs to consumers for antenatal and delivery care; survey current fee and waiver mechanisms; assess the degree to which these mechanisms function; assess the degree to which informal costs to consumers constitute a barrier to service; and review current policies and practices regarding the setting of fees and the collection, retention, and use of revenue.
    English
    WPS16.pdf
  • Following the Platform of Action set forth at the 1994 ICPD in Cairo, nearly all countries place at least some policy emphasis on preventing and treating reproductive health problems. However, the necessary resources, both domestic and international, continue to be scarce. Nowhere in the developing world do reproductive health programs reach all the persons who would benefit. This means that policymakers and program managers must set priorities. This policy brief describes how to set priorities, various models and techniques available to set priorities and how priority setting works in practice.
    Spanish
    PI2Spanish.pdf
  • Following the Platform of Action set forth at the 1994 ICPD in Cairo, nearly all countries place at least some policy emphasis on preventing and treating reproductive health problems. However, the necessary resources, both domestic and international, continue to be scarce. Nowhere in the developing world do reproductive health programs reach all the persons who would benefit. This means that policymakers and program managers must set priorities. This policy brief describes how to set priorities, various models and techniques available to set priorities and how priority setting works in practice.
    French
    PI2French.pdf
  • Following the Platform of Action set forth at the 1994 ICPD in Cairo, nearly all countries place at least some policy emphasis on preventing and treating reproductive health problems. However, the necessary resources, both domestic and international, continue to be scarce. Nowhere in the developing world do reproductive health programs reach all the persons who would benefit. This means that policymakers and program managers must set priorities. This policy brief describes various models and techniques available to set priorities and how priority setting works in practice.
    English
    PI2English.pdf
  • Global demand for family planning services continues to increase rapidly. By 2015, the number of women using modern contraceptives is expected to nearly double (Ross and Bulatao, 2001). This dramatic growth is due in part to an increase in the number of women of reproductive age. It also stems from the fact that national family planning programs are doing a better job of both reaching out to women in need of family planning products and removing barriers to family planning services. Demand for condoms is rising even faster as a “dual-use” product, protecting against unwanted pregnancies as well as against sexually transmitted infections (STI), including HIV. New challenges for family planning programs have arisen from their success. In many family planning programs operated by the public sector, resources are falling short of growth in demand for services. At the same time, individuals with unmet need for family planning services are increasingly concentrated among hard-to-reach groups. Moreover, as low-cost public services come to dominate the family planning market, they compete with and crowd out the private sector. This brief explores one potential solution—targeting—to meet these challenges, alleviating barriers to the expansion and use of family planning services.
    Spanish
    PF3_Sp.pdf
  • Global demand for family planning services continues to increase rapidly. By 2015, the number of women using modern contraceptives is expected to nearly double (Ross and Bulatao, 2001). This dramatic growth is due in part to an increase in the number of women of reproductive age. It also stems from the fact that national family planning programs are doing a better job of both reaching out to women in need of family planning products and removing barriers to family planning services. Demand for condoms is rising even faster as a “dual-use” product, protecting against unwanted pregnancies as well as against sexually transmitted infections (STI), including HIV. New challenges for family planning programs have arisen from their success. In many family planning programs operated by the public sector, resources are falling short of growth in demand for services. At the same time, individuals with unmet need for family planning services are increasingly concentrated among hard-to-reach groups. Moreover, as low-cost public services come to dominate the family planning market, they compete with and crowd out the private sector. This brief explores one potential solution—targeting—to meet these challenges, alleviating barriers to the expansion and use of family planning services.
    French
    PF3_Fr.pdf
  • Global demand for family planning services continues to increase rapidly. By 2015, the number of women using modern contraceptives is expected to nearly double (Ross and Bulatao, 2001). This dramatic growth is due in part to an increase in the number of women of reproductive age. It also stems from the fact that national family planning programs are doing a better job of both reaching out to women in need of family planning products and removing barriers to family planning services. Demand for condoms is rising even faster as a “dual-use” product, protecting against unwanted pregnancies as well as against sexually transmitted infections (STI), including HIV. New challenges for family planning programs have arisen from their success. In many family planning programs operated by the public sector, resources are falling short of growth in demand for services. At the same time, individuals with unmet need for family planning services are increasingly concentrated among hard-to-reach groups. Moreover, as low-cost public services come to dominate the family planning market, they compete with and crowd out the private sector. This brief explores one potential solution—targeting—to meet these challenges, alleviating barriers to the expansion and use of family planning services.
    English
    PF3_Eng.pdf
  • Private sector involvement is crucial not only in helping respond to growing market demand but also in expanding consumer choices and ensuring equity in the contraceptive market. Evidence from many countries shows that the nonpoor benefit disproportionately from free and subsidized public sector services and commodities (Winfrey et al., 2000). A recent analysis of 10 donor-dependent countries reveals that 45 percent of pills and 56 percent of condoms supplied, respectively, by the public sector and social marketing initiatives went to those who could otherwise afford to pay for them (Sine, 2002). Redirecting wealthier/middle-income clients to the private sector will free up scarce donor and public resources for those most vulnerable and in need. A recent market segmentation study in the Philippines shows that shifting middle- and high-income users of government services to the private sector would reduce the burden on the public sector by more than 40 percent (Alano et al., 2002). It is important to recognize that more than one-third of all family planning users in the developing world already obtain contraceptives from the private sector (Rosen and Conly, 1999). In countries such as Cameroon, Colombia, the Dominican Republic, Ghana, and Jordan, more than 60 percent of users obtain their contraceptives from private rather than public sources (Ross et al., 1999). Given that the private sector in many countries is already a major player in the contraceptive market, any feasible contraceptive security plan needs to take into consideration the private sector’s current and potential role. This policy brief provides an overview of processes, strategies, and tools that developing countries can adopt to foster complementary public/private sector roles that enhance the private sector’s contribution to contraceptive security. Specifically, the brief examines the roles of the public and private sectors in the provision of contraceptives and condoms; and describes strategies/mechanisms used at both the policy and operational levels to mobilize the private sector.
    English
    PF4_Eng.pdf
  • The improved nutritional status of women, particularly during their childbearing years, is an important element of reproductive health. Efforts to improve women's nutrition and health include increasing food intake at all stages of the life cycle, eliminating micronutrient deficiencies, preventing and treating parasitic infections, reducing women's workload, and reducing unwanted fertility. This paper outlines the critical role of maternal nutrition and, in particular, micronutrients to reproductive health. The micronutrient status of women in developing countries affects their health during pregnancy and lactation, the outcomes of their pregnancies, and the health of their infants. For women who are vitamin and nutrient deficient, improving micronutrient intake can be an important means of reducing maternal morbidity and mortality. Micronutrient malnutrition is primarily the result of inadequate dietary intake. Dietary surveys in developing countries have consistently shown that multiple micronutrient deficiencies, rather than single deficiencies, are common, and that low dietary intakes and poor bioavailability of micronutrients account for the high prevalence of these multiple deficiencies. Recent evidence concerning increased micronutrient supplementation suggests the following findings: • Enhancing vitamin A intake reduces maternal mortality. • Increasing calcium and magnesium intake can reduce the risk of death from eclampsia. • Ensuring adequate intake of iron, zinc, iodine, calcium, magnesium, and folic acid during pregnancy can improve pregnancy outcome. • Increasing the intake of folic acid before pregnancy can reduce birth defects. • Providing zinc, calcium, and magnesium supplements during pregnancy can improve birthweight and reduce prematurity, especially among high-risk women. • Improving the maternal intake of many nutrients directly enhances the quality of breast milk. In addition, micronutrients play an essential role in the function of the immune system, and deficiencies in them influence the rate, duration, and severity of infections. Infection rates during pregnancy or lactation, including reproductive tract infections, increase because of deficiencies in iron, vitamin A, and zinc. Also, low serum vitamin A levels in pregnant women have been associated with increased transmission of HIV to infants and with increased transition from HIV to AIDS and increased mortality from AIDS among infants. The consequences of malnutrition affect the ability of women to sustain work and care for their families. Solutions to prevent or eliminate micronutrient malnutrition include nutrient supplementation of women of childbearing age before and after pregnancy through repeated reproductive cycles. Combined supplements are usually more effective in improving micronutrient status than single supplements, since women are usually deficient in more than one micronutrient. In addition, universal or targeted food fortification, which has proved cost-effective, can be an important strategy in preventing micronutrient malnutrition.
    English
    wps-05.pdf
  • The POLICY Project conducted assessments of adolescent and youth reproductive health in 13 countries in the Asia and Near East (ANE) region that represent diverse population sizes and geographic, cultural, and socioeconomic settings. The countries include Egypt, Jordan, Morocco, and Yemen in the Near East; Bangladesh, India, Nepal, Pakistan, and Sri Lanka in South Asia; and Cambodia, Indonesia, the Philippines, and Vietnam in Southeast Asia. In 2000, the 13 countries accounted for a total of 354 million young people ages 15 to 24 years. The purpose of the assessments was to highlight the reproductive health status of adolescents and youth in each country within the context of the lives of young males and females.
    English
    op-09.pdf
  • Despite some attempts to integrate family planning with sexually transmitted infection (STI) and HIV/AIDS services, policies and programs continue to treat them as unrelated areas of intervention. Furthermore, international attention to the HIV/AIDS pandemic has overshadowed attention to family planning, particularly in Africa where the HIV/AIDS epidemic is most acute. Yet family planning is closely related to two components of HIV/AIDS services: prevention of mother-to-child transmission (PMTCT) and voluntary counseling and testing (VCT). Is there a role for family planning in the context of HIV/AIDS programs? This paper analyzes how international guidelines, national HIV/AIDS policies and PMTCT and VCT policies have addressed family planning in 16 high-HIV prevalence countries. It also describes major gaps in the various countries’ policy environment.
    English
    wps-09.pdf
  • This paper suggests ways in which policy analysis guided by human capital theory might inform national debates concerning the implementation of programs aimed at achieving the reproductive health priorities set forth in the ICPD Programme of Action. Linking reproductive health policies and programs to their likely human capital impacts shows policymakers that, in addition to helping meet individuals' basic human rights to reproductive health, investments in reproductive health services benefit the public interest by increasing the productive potential of individuals and their immediate social unit—the family or household. Moreover, increases in productive potential at the individual, family, or household level cumulate to increases in productive potential at the societal level. The economic rationale and supporting evidence provided by a human capital approach to the promotion of reproductive health may help strengthen the case for adopting policies and financing programs that will make the right to reproductive health services and information a reality. To gain a better understanding of how to design reproductive health policies and programs to promote human capital development, this paper relies on a conceptual framework built in three stages. The first stage presents an overview of how reproductive health contributes to development both directly through human capital accumulation and indirectly through the loosening of resource constraints resulting from reduced population growth. The second stage develops more fully the mechanisms through which reproductive health augments human capital. Finally, the third stage synthesizes the concepts and linkages presented in the first two stages and shows how the human capital approach might be relevant to reproductive health and program development. The paper contains a detailed list of illustrative impacts of selected reproductive health interventions on human capital formation as well as an extensive bibliography of research documenting those impacts.
    English
    op-01.pdf
  • Este documento presenta información de algunos est
    Spanish
    op-02es.pdf
  • The 1994 ICPD intensified the worldwide focus on reproductive health policies and programs. Officials in many countries have worked to adopt the recommendations in the ICPD Programme of Action and to shift their population policies and programs from an emphasis on achieving demographic targets for reduced population growth to a focus on improving the reproductive health of their population. This paper presents information from case studies carried out in Bangladesh, India, Nepal, Jordan, Ghana, Senegal, Jamaica, and Peru to assess each nation's process and progress in moving toward a reproductive health focus. The case studies show that within their unique social, cultural, and programmatic contexts, the eight countries have made significant progress in placing reproductive health on the national health agenda. All countries have adopted the ICPD definition of reproductive health either entirely or in part. Policy dialogue has occurred at the highest levels in all countries. The countries have also achieved considerable progress in broadening participation in reproductive health policymaking. Bangladesh, Senegal, and Ghana have been particularly effective in involving NGOs and civil society organizations in policy and program development. In some of the other countries, however, the level of participation and political support for reproductive health may not be sufficient to advance easily to the next crucial stage of implementation. The case studies indicate almost uniformly that countries are grappling with the issues of setting priorities, financing, and implementing reproductive health interventions. Bangladesh has made the greatest progress in these areas while India, Nepal, Ghana, Senegal, Jamaica, and Peru are beginning to take steps toward implementation of reproductive health activities. Jordan continues to focus primarily on family planning. Several challenges face these countries as they continue to implement reproductive heath programs. These challenges include improving knowledge and support of reproductive health programs among stakeholders; planning for integration and decentralized services; strengthening human resources; improving quality of care; addressing legal, regulatory, and social issues; clarifying the role of donors; and maintaining a long-term perspective regarding the implementation of the ICPD agenda. Despite many encouraging signs, limited progress has been achieved in actually implementing the Programme of Action; this finding is neither surprising nor unexpected. It took more than a generation to achieve the widespread adoption and implementation of family planning programs worldwide, and that task is far from complete. The key to continuing progress lies in setting priorities, developing budgets, phasing-in improvements, and crafting strategies for implementation of reproductive health interventions.
    English
    op-02.pdf
  • Ce document présente des informations provenant de
    French
    op-02fr.pdf
  • This brief describes a study conducted in several developing countries to estimate the impact of unwantedness and number of children on several measures of child health, with a special focus on illness, treatment, and preventive care. Research findings and conclusions (1) provide support for the notion that unwanted children suffer health consequences; (2) present evidence in favor of measures to help parents attain their family size goals; and (3) recommend that governments strengthen vaccination programs to ensure 100-percent coverage and promote medical treatment for all children in case of illness.
    English
    pm-02.pdf
  • This study estimated the impact of unwantedness and number of children on several measures of child health, specifically focusing on illness, treatment, and preventive care. The findings of this research (1) provide strong support for the notion that unwanted children suffer health consequences; (2) provide strong evidence in favor of measures to help parents attain their family size goals; and (3) recommend that governments strengthen vaccination programs to ensure 100 percent coverage and that they promote medical treatment for all children in case of illness.
    English
    pm-04.pdf
  • This brief examines the extent to which the 1994 ICPD has shaped reproductive health policies and programs in Bangladesh, Ghana, India, Jamaica, Jordan, Nepal, Peru, and Senegal. Within their unique social, cultural, and programmatic contexts, the eight countries have made significant progress in placing reproductive health on their respective national health policy agendas. The progress illustrated by the case studies is a logical beginning for defining and adopting reproductive health policies and principles, while building political and popular support. However, whereas well-established reproductive health services, such as family planning and maternal and child health, have remained high priorities, the case studies indicate that a continued effort will be required to place more sensitive issues, such as gender-based violence and reproductive rights, on the policy agenda. In addition, in some countries, a greater level of participation and political support for reproductive health may need to be cultivated before the countries are able to advance to the next crucial stage of implementation. Countries also need sufficient financial resources to implement the expanded reproductive health programs and services envisioned by the ICPD—resources that most respondents suggested were not immediately forthcoming.
    English
    pm-05.pdf
  • 1998, le Réseau de recherche en santé reproductive
    French
    op-06fr.pdf
  • The 1994 Cairo International Conference on Population and Development (ICPD) increased worldwide focus on reproductive health. Many countries have been working to revise their reproductive health policies in accordance with the ICPD Programme of Action. In 1998, the Network for Reproductive Health Research in Africa (RESAR), with support from the POLICY Project, conducted case studies in five Francophone African countries-Benin, Burkina Faso, Cameroon, Côte d'Ivoire, and Mali-to examine field experiences in formulating and implementing reproductive health policies. Findings were based on in-depth interviews with key informants active in the reproductive health field in their respective countries. Because the five countries are located in the same region, they exhibit many similarities, yet each differs slightly in the challenges it faces and the approaches it takes to confront them. In general, the five countries have made considerable progress in integrating the concept of reproductive health into policies and programs, although more needs to be done to disseminate new policies and implement effective programs. While some aspects of reproductive health generate opposition, particularly programs for youth and programs against female genital cutting, overall support for reproductive health has increased in recent years. Governments are allowing nongovernmental organizations (NGOs) to participate in policy formulation, and most countries are devoting more internal resources to reproductive health. Though these changes are encouraging, continued resistance on the part of the public sector to full partnership with NGOs, as well as the varying capabilities of many NGOs, has hindered NGO participation. Moreover, countries are still highly dependent on support from international donors for their funding. Less progress has been made in program implementation than in policy formulation. Some concrete changes are apparent, but the task of converting the concept of reproductive health into a reality in the field is sure to be a long, slow process. Poverty and underdevelopment in the region are major constraints to reproductive health programs; consequently, countries must focus their efforts on priority interventions and use their existing resources more efficiently. The case studies also highlight the need to continue efforts to create broad-based support for reproductive health programs, improve coordination among stakeholders, strengthen NGOs so that they can effectively participate in the policy process, and enhance the financial sustainability of programs.
    English
    op-06.pdf
  • This brief examines the extent to which the 1994 ICPD has shaped reproductive health policies and programs in five Francophone African countries—Benin, Burkina Faso, Cameroon, Côte d’Ivoire, and Mali. All five countries have made significant progress in developing reproductive health policies, but only limited progress in implementation. This brief discusses the policy process, program implementation, financial resources, participation and coordination, and understanding of, acceptance of, and opposition to reproductive health.
    English
    pm-06.pdf
  • Spanish
    op-7es.pdf
  • Many countries around the world have made great progress in improving reproductive health programs that now reflect the principles of the 1994 ICPD Programme of Action. Governments and donors have pursued two main routes to improving reproductive heath. First, they have enacted national policies and laws aimed at expanding services and raising the quality of available services. Second, they have implemented a wide range of service projects and demonstrations to show how services can be enhanced and client education improved. Too often, however, national policies and laws are not translated into systemwide programs and improved reproductive health services, especially for the poor. Because these doctrines are necessarily broad and encompassing, they neglect the structures and systems that serve as a bridge between national policies and local programs. Projects and demonstrations are often not replicable because they are not financially sustainable in the long run. More important, they generally do not systematically address the underlying policy constraints in the structures and systems that affect the service delivery environment. This paper focuses on the vast arena between national policies and the point of service delivery, which is the domain of operational policies. Operational policies are the rules, regulations, codes, guidelines, and administrative norms that governments use to translate national laws and policies into programs and services. While national policies provide necessary leadership and guidance, operational policies are the means for implementing those policies. In many cases, program deficiencies, such as a lack of trained service providers and other resources, can be traced to operational policies that are inadequate, inappropriate, or outdated. Poor operational policies result in wastage and inefficiency that pervades every clinic, health post, and hospital and adversely affects health personnel and every client. When drafted or modified appropriately, operational policies can help enhance the quality of reproductive health programs by making more efficient use of existing resources. The paper discusses the nature of operational policies, stresses the important role they play in the continuum from national decrees to local services, and provides a framework for operational policy reform.
    English
    op-7.pdf
  • French
    op-7fr.pdf
  • The transition to low fertility in much of the developing world is incomplete. To leave it half-finished or to slow its pace would have enormous demographic, programmatic, and foreign assistance implications. Despite considerable progress over the last 35 years, much remains to be done to complete the demographic transition. The world’s population has not stopped growing, and it is growing fastest in the poorest countries. To achieve sustainable development, strong measures by governments and donor organizations to promote fertility decline in developing countries—and to give individuals and couples the means to do so—need to continue for the foreseeable future. This paper reviews the status of the demographic transition worldwide, discusses factors associated with fertility decline, and highlights challenges associated with completing the transition in developing countries. It is intended to help policymakers both here and abroad to better understand the need for continued efforts to reduce fertility and population growth rates, even in the wake of the HIV/AIDS epidemic. A reduction in population growth to sustainable levels is not something that will just occur on its own. Completing the demographic transition requires addressing a number of challenges—and first and foremost is maintaining strong support for family planning programs from governments and donor organizations. Sustaining the demographic transition also requires focused attention on other proximate, or direct, determinants of fertility, such as increasing the age at marriage and reducing abortion. In addition, donors and governments have an important role to play in providing continued support for policies that indirectly affect fertility, such as promoting girls’ education and safe motherhood.
    English
    op-8.pdf
  • This brief summarizes findings a study on the transition from home to clinic-based services in rural Bangladesh. It documents how communities and programs are responding to policy changes in a dynamic service environment and social context; how women who previously relied on home delivery now obtain contraceptives; how clients and families are responding to NGOs’ efforts to improve quality and cost recovery; and how clients are adapting to the new program norms.
    English
    pm-08.pdf
  • Other
    UKR_PolBrief_(u).pdf
  • The workshop, Pathways to Contraceptive Security, October 31–November 1, 2002, in Konya, Turkey, was organized by the Ministry of Health General Directorate of Maternal and Child Health and Family Planning (GD MCH/FP) and the POLICY Project. Many organizations and professionals contributed not only to this workshop but also to previous policy analysis and dialogue initiatives that have guided the National Family Planning Program in Turkey to achieve contraceptive self-reliance. The workshop embodied the strategic thinking that drives the National Family Planning Program and reflected the visions of the many policy champions, planners, and service providers who share responsibility for public health in Turkey.
    English
    Tur_PCS.pdf
  • English
    jorpes.pdf
  • Draft population policy.
    Spanish
    parapoppol.pdf
  • This paper summarizes findings from over 130 studies of private services provided to improve child health.
    English
    Final_-_WHO_2.pdf
  • This volume, an updated and enlarged edition of the first edition, was conceived as a way to assist action programs by bringing together much of the comparative data that bear upon family planning and reproductive health. A matrix for 116 countries was constructed to embrace time trends for each of numerous data sets. The object was to provide both reference information through supporting tables, and basic analyses through textual presentation. The body of the text comments on the chief patterns and trends of each feature, usually by region. The topics chosen embrace a continuum from the demographic context to past and future contraceptive use, to service burdens, maternal and child health, HIV/AIDS, and, finally, to a selection of alternative action objectives. Large countries are given special attention in most sections.
    English
    Profiles116FP2ed.pdf
  • Concerns about ensuring an uninterrupted supply of contraceptives around the world has lead to a multi-agency effort called The Strategic Pathway to Reproductive Health Commodity Security (SPARHCS.) In August of 2002 the SPARHCS approach was field tested in Nigeria. A technical advisory group was established to use the FAMPLAN model to determine the country’s contraceptive commodity needs for five years (2003 – 2007). This document includes the results of the FAMPLAN application.
    English
    NIG_FAMPLAN.pdf
  • Kenya’s family planning (FP) success has been overshadowed by the HIV/AIDS epidemic, which was declared a national crisis in 1999. Data from the 2003 Demographic and Health Survey in Kenya (KDHS) provide a cautionary tale of the unintended outcomes associated with the shift in attention of programs and resources from family planning primarily to HIV/AIDS. From a steady rise in contraceptive prevalence from 27 percent in 1989 to 39 percent in 1998, contraceptive prevalence stalled and remained at 39 percent in 2003. Yet, the surveys have consistently shown that many women report wanting to delay or limit future births but are not using any FP method. In the context of the HIV/AIDS pandemic, is there still a need for family planning? As government and donor resources in Africa shift increasingly to support of AIDS programs, the answer to this question is crucial. The purpose of this study was to explore how family planning is being implemented in Kenya in the context of high HIV prevalence. A similar study was conducted in Zambia.
    English
    Ken_FGD.pdf
  • In the context of the HIV/AIDS pandemic, is there still a need for family planning? As government and donor resources in Africa shift increasingly to support AIDS programs, the answer to this question is crucial. The objective of this study was to document the status and trends in Zambia’s family planning (FP) program in the context of high prevalence of HIV/AIDS. A similar study was conducted in Kenya. This qualitative research study used focus group discussions (FGDs) to examine the views of 215 service providers, HIV-positive (HIV+) women, and FP/antenatal care (ANC) clients on the need for family planning within the context of the HIV epidemic. The study was conducted in Lusaka, Livingstone, Kitwe, and Kabwe in 2003.
    English
    Zam_FGD.pdf
  • This paper provides a background on the financing of health care and identifies and discusses reproductive health policy issues in the context of the social health insurance system in Romania.
    English
    Romania_Lazarescu_HI_paper.pdf
  • This report contains abstracts from the Russian Federation legislative and regulatory acts (laws, decrees, executive orders, and instructions) governing the area of reproductive health, and also from draft laws currently under consideration by the State Duma of the Russian Federation. Although reproductive health issues are inevitably closely related to various areas of law (ranging from work safety to environmental law), this report focuses on the area of healthcare.
    Russian
    RUS_RHLeg_Rus.pdf
  • The purpose of this study was to provide the Population Development Group with evidence that operational policy barriers result in inefficient resource use in reproductive health care in Ukraine and to recommend solutions. The analysis will serve as the foundations for recommendations that the MOH will make to the Cabinet of Ministers on ways to remove the existing operational policy barriers. The specific objectives of this study were to understand, analyze, and recommend solutions to the following problems: -Inefficiencies at the facility level in the areas of staff time use, bed capacity and use, and availability and use of supplies and equipment; -Infelxibility in allocating funds for health care from local budget and financial decision making at the facility level; -The shadow economy in health care from the client perspective (and its relationship to inefficiencies in financial resource allocation); and -Poor quality of care from the client perspective (and its relationship to inefficiencies in health care facilities).
    English
    UKR_RH_Efficiency.pdf
  • This paper synthesizes the results of nine case studies carried out in: Andhrah Pradesh, Bihar, Gujarat, Karnataka, Madhya Pradesh, Maharashtra, Orissa, Rajasthan, and Uttar Pradesh. The objectives of the case studies were to: 1) examine the transition from the original target system to the target free approach, and subsequently the community needs assessment approach; 2) Analyze the countrywide implementation of CNA and the impact of the new system on programme performance 3) Identify programmatic shortcomings that affected the transition, draw lessons from the experiences of implementation, and identify steps that could be taken to improve the management and performance of the new client-oriented system.
    English
    IND_CNA.pdf
  • Contraceptive security, defined as a condition when all women and men who need and want contraceptives can obtain them (Sine and Sharma, 2002), is a new concept in Romania. Nonetheless, in August 2000, the government approved—for the first time ever—policies that included a budget line item for contraceptives and the provision of free commodities to vulnerable population sectors. The August 2000 policies were broad, and implementation problems soon emerged. In response, the USAID-funded POLICY Project (POLICY) provided a focused package of technical assistance (TA) that lasted from March 2001 to December 2002 to help the government of Romania (GOR) to target those most in need and improve family planning equity. POLICY assistance contributed to four GOR policy decisions that occurred between 2001 and 2003: 1. Increased Ministry of Health and Family (MOHF) resources for free contraceptives in 2001 and 2002 2. Generic contraceptive formularies covered by social health insurance (2002) 3. Norms for government funding of nongovernmental organizations (NGOs) involved in public health programs, including providing free contraceptives to the poor (approved in 2003) 4. Self-certification of poverty status as documentary proof for access to free contraceptives (2003)
    English
    Romania_CP_(final).doc
  • USAID prepared pathways to achieve the strategic objective of reduced fertility and improved reproductive health in North India. Intermediate results to achieve the strategic objective have been prepared in December 1997 for the IFPS Project in Uttar Pradesh that covers 28 districts. Subsequently in January 1999, the SO2 Indicator survey was undertaken in five districts with a sample size of 5000 households to measure the progress made by the IFPS project during the calendar year 1998. In the following year, the study was undertaken in ten districts with a sample size of 10,000 households. Since the IFPS project was working in full gear in 15 priority districts and had started scaling-up its intervention in the 13 other PERFORM districts, it was desired to have separate estimates for priority and other PERFORM districts. Hence, the SO2 Indicator survey for year 1999 was undertaken with a sample size of 10,000 households covering 10 out of the 28 districts. The sample size was proportionally split between the priority and other PERFORM districts. As slightly over three-fifths of the population was in the priority districts, 6130 households from six districts were covered and the remaining 3870 households were from four other PERFORM districts. The selected priority districts were Etawah, Gorakhpur, Varanasi, Allahabad, Kanpur nagar and Meerut while the other PERFORM districts included Gonda, Azamgarh, Bareilly and Saharanpur.
    English
    India_SO2Report-2000.pdf
  • The success of family planning programs, continued growth in the number of women of reproductive age, and the growing response to curb the HIV/AIDS pandemic are increasing demand for contraceptives, including condoms, worldwide. Countries are faced with the challenge of ensuring that this demand can be sustainably met. Financing is not keeping pace, while the problem is also often one of disruptions and vulnerabilities in the systems that need to work well, and work together, to ensure that supplies are available to people. SPARHCS - The Strategic Pathway to Reproductive Health Commodity Security - is a tool to help countries develop and implement strategies to secure essential supplies for family planning and reproductive health programs. SPARHCS is meant to bring together a wide range of stakeholders to initiate at the country level concerted efforts toward the goal of reproductive health commodity security. It is not a roadmap, or a fixed process. SPARHCS can be customized to a country’s specific needs and resources. It can be used for contraceptives alone, for contraceptives and condoms for HIV/STI prevention, or for a still broader set of reproductive health supplies. (French)
    French
    SPARHCS_fre.pdf
  • The success of family planning programs, continued growth in the number of women of reproductive age, and the growing response to curb the HIV/AIDS pandemic are increasing demand for contraceptives, including condoms, worldwide. Countries are faced with the challenge of ensuring that this demand can be sustainably met. Financing is not keeping pace, while the problem is also often one of disruptions and vulnerabilities in the systems that need to work well, and work together, to ensure that supplies are available to people. SPARHCS - The Strategic Pathway to Reproductive Health Commodity Security - is a tool to help countries develop and implement strategies to secure essential supplies for family planning and reproductive health programs. SPARHCS is meant to bring together a wide range of stakeholders to initiate at the country level concerted efforts toward the goal of reproductive health commodity security. It is not a roadmap, or a fixed process. SPARHCS can be customized to a country’s specific needs and resources. It can be used for contraceptives alone, for contraceptives and condoms for HIV/STI prevention, or for a still broader set of reproductive health supplies.
    English
    SPARHCS.pdf
  • The success of family planning programs, continued growth in the number of women of reproductive age, and the growing response to curb the HIV/AIDS pandemic are increasing demand for contraceptives, including condoms, worldwide. Countries are faced with the challenge of ensuring that this demand can be sustainably met. Financing is not keeping pace, while the problem is also often one of disruptions and vulnerabilities in the systems that need to work well, and work together, to ensure that supplies are available to people. SPARHCS - The Strategic Pathway to Reproductive Health Commodity Security - is a tool to help countries develop and implement strategies to secure essential supplies for family planning and reproductive health programs. SPARHCS is meant to bring together a wide range of stakeholders to initiate at the country level concerted efforts toward the goal of reproductive health commodity security. It is not a roadmap, or a fixed process. SPARHCS can be customized to a country’s specific needs and resources. It can be used for contraceptives alone, for contraceptives and condoms for HIV/STI prevention, or for a still broader set of reproductive health supplies. (Spanish)
    Spanish
    SPARHCS_spa.pdf
  • Family planning remains one of the most cost-effective public health measures available in developing countries. Use of family planning is associated with lower rates of maternal and infant mortality and can influence economic growth. It is an essential component in the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS and in adolescent reproductive healthcare programs, and it can play a role in improving gender equity. Expanding access to and improving the quality of family planning programs around the world is central to improving and maintaining the health of individuals and societies and helping them reach their full potential. The purpose of this toolkit is to assist advocates in the family planning/reproductive health fi eld in their efforts to promote policy dialogue on the health, social, and economic benefi ts of increasing access to family planning services. By tailoring the messages included in the toolkit, advocates can present culturally relevant arguments to promote family planning and birth spacing in their particular settings.
    English
    Family Planning Toolkit final.pdf
  • The Family Planning Program Effort Index (FPE) is a composite measure of family planning program efforts using the expert judgment of people who are very knowledgeable about the family planning program in a country or a region. It tests how program efforts interact with socioeconomic settings to increase contraceptive use and lower fertility rates. This is the fifth cycle to be conducted in Ethiopia. The FPE was previously conducted in 1982, 1989, 1994 and 1999. The study is based on an extensive questionnaire containing 125 items. Respondents are requested to address each one of these items. The items are coded and combined to give 30 program elements. These 30 program elements in turn are organized into four major categories: 1. Policy and stage setting activities. 2. Service and service related activities. 3. Evaluation and record keeping. 4. Availability of fertility control methods.
    English
    ETH_FPE_2002.pdf
  • To begin to protect young men and young women from this heightened risk of HIV/AIDS, it is important that policymakers and program managers gain a better understanding of transactional sex among youth. Policymakers and program managers need answers to questions such as: Are youth at higher risk of engaging in transactional sex than other groups? What factors influence youth to engage in transactional sex? And, what subgroups of youth are particularly vulnerable to engaging in transactional sex? This study seeks to answer these questions by exploring whether adolescent boys and girls are at higher risk for engaging in transactional sex than older men and women by analyzing data from the Demographic and Health Surveys (DHS) from 12 sub-Saharan African countries including Benin, Burkina Faso, Central African Republic (CAR), Chad, Guinea, Kenya, Mali, Niger, Nigeria, Togo, Zambia, and Zimbabwe. We also examine the relationship between young men and young women’s individual socio-demographic characteristics and the probability that they will engage in the exchange of sex for money.
    English
    Trans_Sex.pdf
  • The purpose of this paper is to summarize POLICY’s assistance in Turkey featuring results and lessons learned to date. In addition to this introduction, the paper is organized in three parts representing technical components of POLICY’s work in Turkey: Contraceptive Self-reliance, National Strategies for Women’s Health and Family Planning, and Nongovernmental Organization (NGO) Strengthening and Advocacy. This paper reflects experiences through December 2001 and will be updated at the close of the project in December 2002.
    English
    TURfinal.pdf
  • The Policy Environment Score (PES) is intended to measure the degree to which the policy environment supports the reproductive health of the population, with particular focus on access to high quality family planning and reproductive health services. It is designed to reflect both the current level of support and the changes that take place over a one to three year period as a result of policy activities. The POLICY Project has developed a prototype questionnaire to offer to each interested country, with the understanding that local adaptations would often be desirable. That was the case in Egypt, and considerable thought was given to the particular items of the questionnaire. The PES instrument has now been used 5 times in Egypt (1996, 1997, 1998, 1999 and 2000).
    English
    PES_2000.pdf
  • English
    JamPESRpt_rev_.PDF
  • The Policy Environment Score (PES) has been designed to measure the overall status of the policy environment in a particular country, evaluating changes in the policy environment over time, and identifying those areas most in need of improvement with particular focus on access to high quality reproductive health services including family planning, adolescent reproductive health and HIV/AIDS, safe motherhood and post-abortion care. The PES is designed to provide a quick assessment of the policy environment at low cost. It necessarily contains a number of items that depend on the judgment of experts. It is not designed to provide a comprehensive assessment of the policy environment, but to be part of a system for measuring the impact of policy activities. The policy environment score was first undertaken in Nigeria in 2000 by the POLICY Project. Though the report was not officially published the results were used to inform the review of the National Population Policy. This 2002 assessment of the policy environment in Nigeria in the year 2002 is being carried out by the Department of Community Development and Population Activities with the technical assistance of the POLICY Project, Nigeria. The knowledge gained will be used in informing future planning for reproductive health activities in the areas of family planning (FP), STI/HIV/AIDS and Adolescent Reproductive Health (ARH). It will also reveal areas of the policy environment that will also need improvement through advocacy and planning.
    English
    NIG_PES2002.pdf
  • This report shares findings from a pilot of the POLICY Project’s Gender Equitable Male Involvement (GEMI) Assessment Tool. In October 2002, the POLICY Project used the GEMI tool to conduct an assessment of the policy environment related to gender-equitable male involvement in Jamaica, with a focus on male youth. Based on interviews with key stakeholders from a cross-section of government, civil society, and youth-serving organizations, the assessment sought to describe the current policy environment related to gender-equitable male involvement, and identify priority areas for developing or strengthening policies to support gender-equitable male involvement, and the related advocacy and policy dialogue, information, and capacity building needed to support this.
    English
    GEMI_Pilot_Jam.pdf
  • USAID and its cooperating agencies are studying procurement issues and options for countries that no longer receive USAID and/or international donor support for contraceptive commodities, including Brazil, Chile, Colombia, Costa Rica, and Mexico. This report summarizes the key findings from Costa Rica. This review of Costa Rica's contraceptive procurement practices suggests that the country program has been successful in maintaining a consistent supply of contraceptives from a variety of sectors. The Costa Rican government received its final contraceptive commodity support from international donors more than 12 years ago. In 1992—just before USAID's withdrawal from Costa Rica—contraceptive prevalence was already high at 75 percent. The latest reproductive health survey conducted (1999) showed another increase in prevalence to 80 percent—almost six years after USAID's withdrawal. This report highlights the key factors that were important in procuring sufficient contraceptive commodities to meet the needs of Costa Rican men and women.
    English
    382_1_Procurement_Options_Costa_Rica.pdf
  • USAID and its cooperating agencies are studying procurement issues and options for countries that no longer receive USAID and/or international donor support for contraceptive commodities, including Brazil, Chile, Colombia, Costa Rica, and Mexico. This report summarizes the key findings from Mexico. The review of Mexico's contraceptive procurement practices suggests that almost seven years after the phaseout of USAID support, public health institutions—particularly the Ministry of Health—are still facing some challenges in ensuring the availability of high-quality, affordable contraceptive supplies.
    English
    383_1_Procurement_Options_Mexico_FINAL.pdf
  • The National Population Commission formulated the National Population Strategy in 1996 based on the doctrines of Islam (al share a al Islamic), the Constitution of Jordan, the National Charter, and the principles of democracy and human rights. The strategy further adheres to the values of Jordanian society and culture. This is an updated version of that strategy. It was written in the context of recent developments at the national and international levels as Jordan enters the third millennium, an era characterized by globalization, information technology, and revolutionary communication systems. This document is the product of the dedicated efforts of the National Population Commission and is to be considered as a reference for planners and for policymakers and decision makers in all areas related to population.
    English
    Jordan_NPS.pdf
  • Through a targeted package of activities, POLICY assisted major stakeholders in analyzing the operational policy barriers to implementing the National Reproductive Health Program 2001-2005 (NRHP). POLICY also provided technical assistance from September 2001 to November 2003 to help the RH Policy Development Group identify and document operational policy barriers to efficient resource allocation and use in two typical Ukrainian cities (Kamianets-Podilsky and Svitlovodsk) and to help RH stakeholders in Kamianets-Podilsky set priorities and include them in an RH implementation plan. This paper documents the role of the POLICY Project in achieving policy changes and decisions regarding the NRHP.
    English
    Ukraine CP final 11.05.doc
  • This companion piece to the National RH Program, 2001-2005 document, provides information about the aggregate cost of the Program to central and local governments, as well as to non-governmental sources. It also provides more detailed information about the costs of each individual activity, thereby allowing program implementers to assess the pros and cons, as well as the feasibility of each activity.
    English
    UK_BRA.PDF
  • English
    Uknprh8.PDF
  • A fresh reason for attending to fertility dynamics has emerged—the “demographic dividend.” As fertility rates fall during the demographic transition, if countries act wisely before and during the transition, a special window opens up for faster economic growth and human development.
    English
    Demo_Div.pdf
  • Jamaican youth are key agents for social change, economic development, and technological innovation and are a major human resource for development. Youth ages 10 to 24 are also an important demographic group, comprising almost one-third of the population in the year 2000. To better understand and address the challenges youth in Jamaica face, the National Centre for Youth Development (NCYD) recently commissioned two studies, Situation Assessment Report, Youth in Jamaica, 2001 and Adolescent and Youth-Serving Organisations in Jamaica: Results from the Youth Programmatic Inventory (YPI) Survey. This document synthesizes information from the two studies to help in identifying important gaps and overlaps in the coverage of youth services, to inform the current review of the National Youth Policy, and to aid in the development of a strategic plan for implementing the national policy.
    English
    JAM_YJ.pdf