Suchergebnisse

The concept of accountability is increasingly important in the family planning (FP) and reproductive health (RH) field. While much recent discussion has focused on developing global or national-level mechanisms for accountability, less emphasis has been placed on understanding the relevance of "social accountability" approaches for ensuring access to, and quality of, FP/RH services. Social accountability refers to the efforts of citizens and civil society to scrutinize and hold duty bearers (politicians, government officials, and service providers) to account for providing promised services, actions most often at the subnational or community level. In the FP/RH field, this concept builds on a rich history of community involvement and civil society participation. This working paper draws on the debates and emerging lessons of the social accountability field to better understand its potential for improving FP/RH programs. It synthesizes the literature across a variety of sectors including the health sector, and on broad review papers as well as individual studies related to FP/RH programs.

Rates of emergency contraceptive (EC) use in sub‐Saharan Africa are highest in Kenya and Nigeria, although little is known about user characteristics and use dynamics in these countries. To better meet women's emergency contraceptive needs and to contribute to the limited knowledge base regarding this method in Africa, this study examines data from a sample of EC users drawn from a large, representative household survey that included sexually experienced women in urban Kenya and Nigeria. Bivariate and multivariate analyses reveal greater knowledge of EC among these urban women than was reported in other nationally representative surveys. Recent users of EC were more likely to be in their 20s, unmarried, and more highly educated than never users or ever users of EC in both countries. Results contradict public perceptions of EC users as young adolescents and indicate the importance of strengthening EC provision in Africa, including targeting information and services to unmarried women and supporting private pharmacies in delivering quality services.

The concept of accountability is important in the family planning (FP) and reproductive health (RH) sector, building on a rich history of community involvement and civil society participation. There are three categories of FP/RH accountability initiatives: tracking donor and government financial commitments, tracking national-level program implementation, and tracking service-delivery outcomes. The third category, often referred to as "social accountability," includes the efforts of citizens and civil society to scrutinize and hold duty bearers to account for providing promised services, most often at the subnational or community levels. Social accountability is premised on the assumption that increased and targeted citizen and civil society engagement and action will force public officials to act on their commitments. The Evidence Project convened an expert consultation, "Strengthening the Evidence Base on Social Accountability for Improving Family Planning and Reproductive Health Programs" in July 2014 hosted by the International Planned Parenthood Federation, an Evidence Project partner, in London. This meeting report notes that the aim was to develop an understanding of social accountability for improving FP/RH programs and to identify gaps in the evidence base that can be addressed by the Evidence Project.

This research agenda is the result of a stakeholders' meeting held in Nairobi on June 11–12, 2008, that identified, developed, and prioritized areas for research on sexual violence in Kenya. The meeting was convened by the Population Council, Liverpool VCT, Care & Treatment, and the International Centre of Reproductive Health, Kenya. Kenya's research agenda is premised on the need to generate the evidence required to impact policy formulation and services strengthening. Knowledge gaps that form the basis of key research areas identified include the need to: 1) Understand the nature, contexts, and prevalence of sexual violence; 2) Document and evaluate prevention initiatives from national to grassroots and spanning legislation, advocacy, and community interventions to identify replicable and scalable interventions; 3) Research innovative ways to improve access to, uptake, and deliver quality sexual violence care, treatment, and rehabilitation services for men and women in Kenya; and 4) Improve knowledge on sexual violence focusing on priority populations with higher risk and vulnerability.

In 2005, the Kenya Ministry of Health, Department of Reproductive Health (DRH), began an initiative to strengthen the provision of emergency contraception (EC) in the public sector. As a first step, 700,000 units of the dedicated EC product Postinor 2 were procured by UNFPA for use in government facilities and select providers were trained on its administration. In 2006, the DRH requested assistance from ECafrique, the African Forum on Emergency Contraception, to expand access to the product. This report documents the results of a diagnostic assessment conducted at the outset of this initiative. It examines the provision and utilization of EC in the public sector to inform future program strategies. Upon request from the DRH and the United Nations Population Fund, this assessment also gathered data on two other "underutilized methods" of family planning: female condoms (FCs) and intrauterine contraceptive devices (IUDs).

Emergency contraception (EC) has been around for decades, but the first serious introduction and scale-up efforts started in the mid 1990's. This paper reviews programmatic experiences that sought to expand access to emergency contraceptive pills (ECP) in Africa, Asia and Latin America over the last decade. This multiregional review identifies the individual phases of the introductory processes as well as facilitators and barriers to successful scale-up of ECP service provision. Characteristics of successful projects included conduction of multi-sector diagnostic assessments; careful consideration of legal and policy issues; collaborative advocacy and technical assistance for inclusion in public family planning programs by national and international institutions; as well as attention to programmatic areas such as capacity-building, supply-chain and awareness-raising. Lessons learned from varied developing country experiences are discussed as is the need for increased attention to evaluating and disseminating project results.

For many women, emergency contraceptive pills (ECPs) offer an opportunity to prevent unintended pregnancy following contraceptive method failure, rape, or unprotected sex. Access to this safe, effective option remains an essential element of women's quality reproductive health care. However, ECPs remain inaccessible across much of the world, particularly in developing countries where limited commodity supplies, provider competency, public awareness, and misinformation routinely coalesce to restrict availability. While ECPs have been introduced on a pilot basis in many countries, their effective integration into both the public and private sectors has lagged. Successful interventions are guided by the principle that provision of ECPs is not exclusively the responsibility of government family planning programs, and so seek to mainstream delivery of ECPs by developing links with private sector providers and pharmacies, the HIV/AIDS sector, and sexual assault services. Successfully introducing ECPs into a country's health-care system is a complex undertaking. This handbook provides comprehensive guidance to reproductive health program managers and policymakers on introducing and mainstreaming ECPs, including needs assessments and operations research, drug registration, training and logistics, and introduction of ECP scale-up.

The Population Council seeks to understand the social, economic, political, and physical context of risks for sexual and gender-based violence and HIV. Among the top priorities of Council research are supporting and evaluating efforts to prevent violence and HIV, including creating safe spaces for adolescent girls, and working with men and boys to change gender norms within the community; and comprehensively responding to the needs of survivors (including those who are HIV-infected) by strengthening health systems and integrating services. The purpose of this guide is to provide practical guidance on the steps necessary to establish and strengthen sexual violence (SV) services within existing public health facilities, improve linkages to other sectors, and engage local communities around issues of sexual violence. It includes tips, resources, and tools that will help partners and stakeholders design, implement, and evaluate SV programs.