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What does adolescent girls\u27 empowerment mean?
No full textAfrica stands at a crossroads, with its future prosperity hinging on the policy and investment decisions it makes today. The continent has an opportunity to shape the trajectories of generations to come by investing in the success of a pivotal population: its adolescent girls. With over 145 million adolescent girls calling Africa home, the potential for transformative change is immense. Yet challenges persist: from high rates of child marriage to limited educational opportunities. Over half of African girls ages 15 to 19 are out of school or married or have children. How can African countries overcome these challenges to ensure that adolescent girls enter adulthood empowered to thrive? Pathways to Prosperity for Adolescent Girls in Africa, published by the World Bank, offers a groundbreaking road map for change
Assessing geographical and contextual vulnerability of reproductive, maternal, child and adolescent health in North East India
No full textCommunities in North East India are prone to various social and geographical vulnerabilities leading to poor health outcomes. This paper assesses various geographical vulnerabilities and their association, particularly with reproductive, maternal, newborn and child health outcomes. Multivariate logistic regression and univariate and bivariate Local Indicators of Spatial Association methodologies were used to study the effects of various vulnerabilities faced by women, using National Family Health Survey-5 data (2019–21). The findings can be utilised in developing regionally tailored and targeted interventions to address localised needs and improve the overall health status
Cost of care for Alzheimer’s disease and related dementias in the United States: 2016 to 2060
No full textMedical and long-term care for Alzheimer’s disease and related dementias (ADRDs) can impose a large economic burden on individuals and societies. We estimated the per capita cost of ADRDs care in the in the United States in 2016 and projected future aggregate care costs during 2020–2060. Based on a previously published methodology, we used U.S. Health and Retirement Survey (2010–2016) longitudinal data to estimate formal and informal care costs. In 2016, the estimated per patient cost of formal care was 25,893–36,667 (39,473) and 12,980–196 billion (95% uncertainty range [UR]: 213 billion), 424–305 billion (333 billion), respectively, in 2020. These were projected to increase to 837 billion–3.3 trillion (5.1 trillion), and 1.3–$3.5 trillion), respectively, in 2060
Validating the implementation of an indicator reporting policies and laws on free public maternal health-related services in the era of universal health coverage: A multi-country cross-sectional study
No full textBackground: The concept of universal health coverage (UHC) encompasses both access to essential health services and freedom from financial harm. The World Health Organization’s Maternal Newborn Child and Adolescent Health (MNCAH) Policy Survey collects data on policies that have the potential to reduce maternal morbidity and mortality. The indicator, “Are the following health services provided free of charge at point-of-use in the public sector for women of reproductive age?”, captures the free provision of 13 key categories of maternal health-related services, to measure the success of UHC implementation with respect to maternal health. However, it is unknown whether it provides a valid measure of the provision of free care. Therefore, this study compared free maternal healthcare laws and policies against actual practice in three countries. Methods and findings: We conducted a cross-sectional study in four districts/provinces in Argentina, Ghana, and India. We performed desk reviews to identify free care laws and policies at the country level and compared those with reports at the global level. We conducted exit interviews with women aged 15–49 years who used a component service or their accompanying persons, as well as with facility chief financial officers or billing administrators, to determine if women had out-of-pocket expenditures associated with accessing services. For designated free services, prevalence of expenditures at the service level for women and reports by financial officers of women ever having expenditures associated with services designated as free were computed. These three sources of data (desk review, surveys of women and administrators) were triangulated, and chi-square analysis was conducted to determine if charges were levied differentially by standard equity stratifiers. Designation of services as free matched what was reported in the MNCAH Policy Survey for Argentina and Ghana. In India, insecticide-treated bed nets and testing and treatment for syphilis were only designated as free for selected populations, differing from the WHO MNCAH Policy Survey. Among 1046, 923, and 1102 women and accompanying persons who were interviewed in Argentina, Ghana, and India, respectively, the highest prevalence of associated expenditures among women who received a component service in each setting was for cesarean section in Argentina (26%, 24/92); family planning in Ghana (78.4%, 69/88); and postnatal maternal care in India (94.4%, 85/90). The highest prevalence of women ever having out of pocket expenditures associated with accessing any free service reported by financial officers was 9.1% (2/22) in Argentina, 64.1% (93/145) in Ghana, and 29.7% (47/158) in India. Across the three countries, self-reports of out of pocket expenditures were significantly associated with district/province and educational status of women. Additionally, wealth quintile in Argentina and age in India were significantly associated with women reporting out of pocket expenditures. Conclusions: Free care laws were largely accurately reported in the global MNCAH policy database. Notably, we found that women absorbed both direct and indirect costs and made both formal and informal payments for services designated as free. Therefore, the policy indicator does not provide a valid reflection of UHC in the three settings
The effects of COVID-19 pandemic on women’s access to maternal health and family planning services in Egypt: An exploratory study in two governorates
No full textBackground: The COVID-19 pandemic has been noted to decrease access to maternal health and family planning services globally. However, evidence from the Middle East and North Africa region is very scarce and limited. We qualitatively explored women’s experiences in accessing maternal health and family planning services during the COVID-19 lockdown months in the two Egyptian governorates of Port Said and Souhag. Methods: Using a case study design, semi-structured phone interviews were conducted with a total of 40 women aged 18–35 years from Port Said and Souhag governorates in Egypt. Interviews explored women’s experiences in accessing maternal health and family planning services during COVID-19 lockdown months, their coping strategies, and impact of challenges and/or coping strategies on participants and their families. The collected data was analyzed manually using qualitative thematic analysis. Results: Many participants were unable to access maternal health and family planning services during COVID-19 lockdown due to fear of contracting the virus, closure of health facilities, changing service hours, family planning method or drug stock-outs, and/or financial constraints. The above challenges in accessing services along with coping strategies that some women and their families used exposed women to additional health risks, including unintended pregnancies, and posed several social, emotional, and financial burdens to many. Conclusions: The COVID-19 pandemic and associated lockdown measures undermined women’s access to maternal and family planning services and interfered with their ability to achieve their reproductive goals. The paper concludes with a number of recommendations to ensure access to maternal and family planning services at times of crisis. Those recommendations include: (1) adapting reliable guidelines from humanitarian settings, (2) providing adequate guidance to healthcare providers and the public to tackle fears and misinformation, (3) making self-care products available such as oral contraceptive pills, vaginal rings and self- administered injectables, (4) involving other health professionals in the provision of maternal and family planning services through task-sharing/shifting, (5) expanding the use of telemedicine and/or digital health services especially to those living in remote areas and (6) raising policymakers’ awareness of the centrality of reproductive rights and the importance of protecting them at all times
Experiences of young mothers with the uptake of Sulfadoxine-Pyrimethamine for intermittent preventive treatment of malaria in pregnancy: A cross-sectional study in the Lake endemic region, Kenya
No full textBackground: A substantial proportion of the world population is affected by malaria with 241 million malaria cases reported globally. Intermittent Preventive Treatment in pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP) is an effective chemotherapy but its utilisation has not been optimised. Few studies focus on young mothers and their experiences regarding the optimal uptake of IPTp-SP. Methods: The study design was cross-sectional with data derived from six focus group discussions with mothers aged 15–24 years who had a pregnancy and gave birth to a live baby within the last two years in Kisumu and Migori counties, Kenya. Inductive analysis was used to identify themes and patterns. Results: Young mothers were motivated to take IPTp-SP during pregnancy if they had prior knowledge about SP and its associated benefits and if they were knowledgeable about the consequences of malaria infection during pregnancy. Perceived side effects of SP, lack of awareness of SP as a malaria prevention therapy, lack of knowledge on the benefits of SP, dosage and frequency of uptake, poor communication by health providers towards young mothers, and inconsistent supply of SP at health facilities inhibited young mothers from attaining the recommended 3+ doses of IPTp-SP. Conclusions: There is a need for health literacy programmes that focus on increasing knowledge of IPTp-SP dosage, timing and benefits for both the young pregnant mother and her foetus. Community engagement through dialogue with mentor mothers and male partners will be an important complementary approach in establishing a support system for young women for positive health outcomes including attaining the recommended 3+ doses of IPTp-SP
The encouraging early successes of a dynamic choice HIV prevention model for both women and men in East Africa
No full textPower, practice, and potential: Social protection and adolescent girls
Get PDFOn March 12, 2024, the Population Council’s GIRL Center in collaboration with UNICEF and the Cash Transfer and IPV Research Collaborative, cohosted an event on the sidelines of the 68th Session of the Commission for the Status of Women (CSW68). The event brought together practitioners, researchers, adolescent girls, and representatives of governments and bilateral and multilateral organizations. Evidence on the impact of social protection and cash plus programs was highlighted. A panel of experts shared perspectives on evidence and critical actions needed to empower adolescent girls through cash plus social protection programs. This short report provides a summary of the event\u27s proceedings and key insights and recommendations
Engaging community health workers to enhance modern contraceptive uptake among young first-time parents in five cities of Uttar Pradesh
No full textIn spite of patriarchy: Pathways from school to wage work and careers among adolescent girls in Bihar
No full textBackground: In the context of rural Bihar where few women work outside the home, what scope do adolescent girls and young women have to transition into wage work and careers? While the mobility of girls is still widely restricted to secure their marriageability, the spread of higher schooling and the internet has inflated aspirations and levelled them out across boys, girls and social classes. Methods: The present study drew on 45 focus group discussions and 73 in-depth interviews among adolescent girls and young women and related stakeholders to develop 32 cases of transitioning girls across four districts of rural Bihar in India. The qualitative data were collected in 2022 and analysed using a combination of thematic and comparative narrative analyses. Results: The analysis identified some common features of transitioning girls and their pathways. Many girls had been forced by circumstance—household shocks or chronic poverty—to earn money, thereby building their skills and self-efficacy. Others were from families where progressive values ensured their mobility and exposure. Yet others transitioned “by stealth.” But all girls had the backing of at least one parent and all had to learn to navigate public space while safeguarding their reputations. By researching actual pathways (rather than distant dreams), the study identifies a variety of transition outcomes, including “good” jobs as teachers, nurses, and police officers, “low entry” jobs in factories and new services, and full-time businesses built from scratch. Conclusion: The paper suggests that interventions be designed separately for these distinct outcomes and that efforts are best directed towards girls already “self-transitioning” and demonstrating the requisite resolve and self-efficacy