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Panorama e impacto de las feministas jóvenes organizadas en México: Revisión rápida de evidencias
No full textEn México, mujeres feministas jóvenes están abriendo camino y poniendo en práctica enfoques radicales para abordar injusticias sociales como la violencia de género, la falta de atención en salud sexual y reproductiva y la discriminación por razones de Aunque las feministas jóvenes organizadas (OFJ) en México están mostrando una creciente capacidad para abogar por y lograr el cambio, hay poca evidencia sistematizada sobre las estrategias y el impacto de éstas. El objetivo general de esta Evaluación Rápida de Evidencias (REA, en inglés) es proporcionar una visión general del panorama, las estrategias y el impacto de las organizaciones de jóvenes feministas en las políticas y el cambio social en México de 2010 a 2023. Definimos a las feministas jóvenes como aquellas personas menores de treinta años. Esta REA forma parte de un proyecto de Investigación Acción Participativa feminista para evaluar el impacto de las organizaciones de jóvenes feministas en México y Kenia
Optimizing integration of community-based management of possible serious bacterial infection (PSBI) in young infants into primary healthcare systems in Ethiopia and Kenya: Successes and challenges
No full textBackground: Ethiopia and Kenya have adopted the community-based integrated community case management (iCCM) of common childhood illnesses and newborn care strategy to improve access to treatment of infections in newborns and young infants since 2012 and 2018, respectively. However, the iCCM strategy implementation has not been fully integrated into the health system in both countries. This paper describes the extent of integration of iCCM program at the district/county health system level, related barriers to optimal integration and implementation of strategies. Methods: From November 2020 to August 2021, Ethiopia and Kenya implemented the community-based treatment of possible serious bacterial infection (PSBI) when referral to a higher facility is not possible using embedded implementation research (eIR) to mitigate the impact of COVID-19 on the delivery of this life-saving intervention. Both projects conducted mixed methods research from April-May 2021 to identify barriers and facilitators and inform strategies and summative evaluations from June-July 2022 to monitor the effectiveness of implementation outcomes including integration of strategies. Results: Strategies identified as needed for successful implementation and sustainability of the management of PSBI integrated at the primary care level included continued coaching and support systems for frontline health workers, technical oversight from the district/county health system, and ensuring adequate supply of commodities. As a result, support and technical oversight capacity and collaborative learning were strengthened between primary care facilities and community health workers, resulting in improved bidirectional linkages. Improvement of PSBI treatment was seen with over 85% and 81% of estimated sick young infants identified and treated in Ethiopia and Kenya, respectively. However, perceived low quality of service, lack of community trust, and shortage of supplies remained barriers impeding optimal PSBI services access and delivery. Conclusion: Pragmatic eIR identified shared and unique contextual challenges between and across the two countries which informed the design and implementation of strategies to optimize the integration of PSBI management into the health system during the COVID-19 pandemic. The eIR participatory design also strengthened ownership to operationalize the implementation of identified strategies needed to improve the health system’s capacity for PSBI treatment
Biobehavioral survey using time location sampling among female sex workers living in Ghana in 2020
No full textBackground: The HIV epidemic in Ghana is characterized as a mix of a low-level generalized epidemic with significant contributions from transmission among female sex workers (FSW) and their clients. This study seeks to identify and describe key characteristics and sexual behaviors of FSW and estimate the prevalence of HIV, syphilis, gonorrhea, chlamydia, and hepatitis B virus (HBV) among FSW in Ghana. Method: A total of 7,000 FSW were recruited for the study using Time Location Sampling (TLS) approach with 5,990 (85.6%) participants completing both biological and the behavioral aspects of the study. A structured questionnaire was administered to respondents to assess several factors, such as background characteristics, sexual risk behaviors, condom usage, HIV/AIDS knowledge, opinions, and attitudes. Trained staff conducted face-to-face interviews using mobile data collection software (REDCap) after provision of specimens for HIV and STI testing. Descriptive statistics such as medians, ranges, charts, and percentages are performed and presented. Also included, are bivariate analyses to establish relationships between FSW type and other relevant characteristics of the study. Results: Among the 7,000 (100%) FSW sampled from all regions, 6,773 took part in the behavioral and 6,217 the biological. There were 783 (11.2%) respondents who took part only in the behavioral and 227 (3.2%) only in the biological. Most were young, with a median age of 26 years, majority had never been married or were widowed/divorced and a quarter had no education or had only primary education. Majority (74.8%) of FSW first sold sex at age 25 years or less with a median age of 20 years. Most (84.8%) of the FSW indicated that they entered sex work for money, either for self or family and had an average of eleven (11) sexual partners per week. More than half (55.2%) of the FSW were new entrants who had been in sex work for less than 5 years before the study. Consistent condom use with paying clients was generally unsatisfactory (71%), and was however, very low (24%) with their intimate partners or boyfriends. Only about half (54.6%) of FSW have been exposed to HIV prevention services in the last three months preceding the survey, and this varies across regions. Overall, comprehensive knowledge about HIV and AIDS was low. Only 35% of FSW had comprehensive knowledge. HIV prevalence was 4.6% and was higher among seaters (brothel-based) and older FSW who had been sex work for a longer period. The HIV prevalence from the previous bio-behavioral survey (BBS) in 2015 and 2011 were estimated to be 6.9 and 11.1%, respectively. Conclusion: Compared to the results from the previous studies, the findings give an indication that Ghana is making significant progress in reducing the burden of HIV among FSW in the country. However, risky behaviors such as low consistent condom use, low coverage of HIV services across the regions, and low comprehensive knowledge could reverse the gains made so far. Immediate actions should be taken to expand coverage of HIV services to all locations. Efforts must be made to reach out to the new entrants while also addressing strongly held myths and misconceptions about HIV
Women’s involvement in decision-making and association with reproductive health behaviors: Findings from a cross-sectional survey in Niger
No full textBackground: Though women in Niger are largely responsible for the familial health and caretaking, prior research shows limited female autonomy in healthcare decisions. This study extends current understanding of women’s participation in decision-making and its influence on reproductive health behaviors. Methods: Cross-sectional survey with married women (15–49 years, N = 2,672) in Maradi and Zinder Niger assessed women’s participation in household decision-making in health and non-health issues. Analyses examined [1] if participation in household decision-making was associated with modern contraceptive use, antenatal care (ANC) attendance, and skilled birth attendance at last delivery and [2] what individual, interpersonal, and community-level factors were associated with women’s participation in decision-making. Results: Only 16% of the respondents were involved—either autonomously or jointly with their spouse—in all three types of household decisions: (1) large purchase, (2) visiting family/parents, and (3) decisions about own healthcare. Involvement in decision making was significantly associated with increased odds of current modern contraceptive use [aOR:1.36 (95% CI: 1.06–1.75)] and four or more ANC visits during their recent pregnancy [aOR:1.34 (95% CI: 1.00-1.79)], when adjusting for socio-demographic characteristics. There was no significant association between involvement in decision-making and skilled birth attendance at recent delivery. Odds of involvement in decision-making was significantly associated with increasing age and household wealth status, listening to radio, and involvement in decision-making about their own marriage. Conclusion: Women’s engagement in decision-making positively influences their reproductive health. Social and behavior change strategies to shift social norms and increase opportunities for women’s involvement in household decision making are needed. For example, radio programs can be used to inform specific target groups on how women’s decision-making can positively influence reproductive health while also providing specific actions to achieve change. Opportunities exist to enhance women’s voice either before women enter marital partnerships or after (for instance, using health and social programming)
Revive IPTp: Implementing Innovative Community-Based Approaches to Address Malaria in Pregnancy
No full textPregnant women are vulnerable to malaria infection, with an increased risk of anemia, miscarriage, stillbirth, and the birth of premature and low-weight babies. Sulfadoxine-pyrimethamine (SP), commonly known as Fansidar, is a safe clinically proven preventive treatment for malaria in pregnancy, yet its uptake remains low in malaria-endemic regions in Kenya.
Population Council–Kenya, in collaboration with the Kisumu Medical and Education Trust (KMET) and county governments of Kisumu and Migori, through the Revive IPTp project is working with communities and health workers to improve health outcomes for mothers and their babies. This video describes the approaches being used to empower pregnant women through self-care and work with community members to increase the uptake of SP
Measuring social norms related to child marriage among married women and men in Niger
No full textBackground: Child marriage remains prevalent in the Sahel region. Pervasive norms regarding child marriage, and sexual behavior persist. We explored norms from multiple perspectives to strengthen interventions aimed at delaying age at marriage. Methods: This study analyzed a cross-sectional household survey conducted in Niger in 2022 with women aged 15–49 (n = 2,726) and a subset of their male household members aged 15–59 (n = 1,136). Separate logistic regression models assessed factors associated with three descriptive (e.g., perception of what others do) and injunctive (e.g., perception of a group’s approval or disapproval) normative outcomes related to practices that support marriage as soon as a girl reaches puberty and beliefs related to premarital sex. Results: Our study found a greater proportion of men described early marriage as protective from the fear of socially induced ruined marital prospects for women (70% vs. 64%), while women expressed its protection from being harassed (62% compared to 42%). The injunctive norm outcome that “my neighbors think that one should marry off one’s daughter as soon as she reaches puberty” was significantly associated with the belief that child marriage was protective for females among women (OR = 4.49; 95% CI 3.13. 5.50) and men (OR = 8.21; 95% CI 5.88, 11.45). Conclusions: Programs addressing child marriage should consider both male and female perspectives to address differences and foster an environment where communities and families shift norms to delay early marriage
Power, Practice and Potential: Social Protection and Adolescent Girls—Slide deck
Get PDFSlide deck for event on the sidelines of CSW68, held on 12 March 2024
Cementing key partnerships to foster the use of evidence in humanitarian settings: Baobab Case Study Three
Get PDFThe Population Council leads the Baobab Research Programme Consortium (RPC) in partnership with Population Council–Kenya and the African Population and Health Research Center. Situated in the East and Horn of Africa (EHA), this Africa-based and African-led consortium focuses on filling critical evidence gaps to reduce inequities in sexual and reproductive health and rights (SHRH) among vulnerable populations in humanitarian settings. Baobab produces policy and program-relevant evidence to address critical SHRH concerns among vulnerable refugee populations in the EHA region. Baobab’s approach to developing partnerships includes a commitment to connection and complementarity; building trust and listening to partners; maintaining respect, patience, and perseverance in relationship building; being embedded in the target context, which fosters deep contextual understanding; flexibility and adaptability to changes within partners and the context; and dedication to utilizing evidence to inform and affect change. This report presents Baobab Case Study Three: “Number of New Partnerships and Networks Forged That Foster the Utilisation of Evidence.
An evaluation of a multi-partner approach to increase routine immunization coverage in six northern Nigerian States
No full textBackground: Global health partnerships are increasingly being used to improve coordination, strengthen health systems, and incentivize government commitment for public health programs. From 2012 to 2022, the Bill & Melinda Gates Foundation (BMGF) and Aliko Dangote Foundation (ADF) forged Memorandum of Understanding (MoU) partnership agreements with six northern state governments to strengthen routine immunization (RI) systems and sustainably increase immunization coverage. This mixed methods evaluation describes the RI MoUs contribution to improving program performance, strengthening capacity and government financial commitment as well as towards increasing immunization coverage. Methods: Drawing from stakeholder interviews and a desk review, we describe the MoU inputs and processes and adherence to design. We assess the extent to which the program achieved its objectives as well as the benefits and challenges by drawing from a health facility assessment, client exit interview and qualitative interviews with service providers, community leaders and program participants. Finally, we assess the overall impact of the MoU by evaluating trends in immunization coverage rates. Results: We found the RI MoUs across the six states to be mostly successful in strengthening health systems, improving accountability and coordination, and increasing the utilization of services and financing for RI. Across all six states, pentavalent 3 vaccine coverage increased from 2011 to 2021 and in some states, the gains were substantial. For example, in Yobe, vaccination coverage increased from 10% in 2011 to nearly 60% in 2021. However, in Sokoto, the change was minimal increasing from only 4% in 2011 to nearly 8% in 2021. However, evaluation findings indicate that issues pertaining to human resources for health, insecurity that inhibits supportive supervision and vaccine logistics as well as harmful socio-cultural norms remain a persistent challenge in the states. There is also a need for a rigorous monitoring and evaluation plan with well-defined measures collected prior to and throughout implementation. Conclusion: Introducing a multi-partner approach grounded in a MoU agreement provides a promising approach to addressing health system challenges that confront RI programs