6867 research outputs found
Sort by
What are the main barriers and facilitating factors associated with intergenerational communication on sexual and reproductive health in Niger and Côte d’Ivoire?
Get PDFWhen parents communicate with their youth on sexual and reproductive health (SRH) issues, they have a greater influence on youth SRH behaviors. But parents’ lack of knowledge of SRH, low self-efficacy in engaging young people, and unfavorable social norms about communication and youth access to SRH information are barriers to open intergenerational communication. Breakthrough RESEARCH conducted a qualitative study in Niger and Côte d’Ivoire to better understand the specific barriers to intergenerational communication about SRH, and ways in which adult allies can be supported to engage young people and encourage them to lead a healthy life. This research contributes to a nascent body of literature that is specific to the context of francophone West African countries, which have among the highest rates of adolescent pregnancy in the world
A mixed-methods study of factors influencing postpartum intrauterine device uptake after family planning counseling among women in Kigali, Rwanda
No full textIntroduction: Rwanda has high unmet need for family planning (FP), especially in the postpartum period when women are advised to space pregnancies at least two years for improved maternal-child health. Despite interest in the copper intrauterine device (IUD), a highly cost-effective method, access and uptake remain low. This study aimed to determine factors associated with postpartum IUD (PPIUD) uptake after postpartum family planning (PPFP) counseling as well as provider perceptions of facilitators and barriers to clients’ PPIUD uptake. Methods: Postpartum women who received PPFP counseling and were less than 6 weeks postpartum were recruited for a case-control study in Kigali, Rwanda in 2018. We recruited n = 74 women who had accepted and n = 91 women who had declined the PPIUD. Multivariate logistic regression analyses evaluated associations between women’s socio-demographics, FP knowledge and decision-making, and the outcome of PPIUD uptake. Six focus groups (FGs) were conducted with FP providers (n = 24) and community health workers (n = 17) trained to deliver PPFP counseling to assess perceptions of PPFP counseling and facilitators and barriers to PPIUD uptake. FG discussions were recorded, translated, and analyzed for themes. Results: Factors associated (PConclusions: Knowledge of the IUD and its benefits was associated with PPIUD uptake. There is need to refine PPFP counseling messages to address remaining knowledge gaps and concerns. Additionally, male partner involvement in FP counseling and decisions with their partners could be a key strategy to increase both PPIUD and FP uptake in Rwanda
Learnings from past interventions in the digital era: Evidence-based considerations for adolescents’ programming using information and communication technologies
Get PDFThis commentary examines key lessons from evidence-based adolescents’ programs—related to intentional recruitment, the role of mentors, and multi-level intervention strategies—and how the adoption of digital technologies can create opportunities to strengthen programs, provided that evidence-based lessons remain at the core of intervention strategies
Policies and interventions to remove gender‐related barriers to girls\u27 school participation and learning in low‐ and middle‐income countries: A systematic review of the evidence
No full textBackground: Gender disparities in education continue to undermine girls\u27 opportunities, despite enormous strides in recent years to improve primary enrolment and attainment for girls in low- and middle-income countries (LMICs). At the regional, country and subnational levels gender gaps remain, with girls in many settings less likely to complete primary school, less likely to complete secondary, and often less likely to be literate than boys. The academic and policy literatures on the topic of gender-related barriers to girls\u27 education are both extensive. However, there remain gaps in knowledge regarding which interventions are most likely to work in contexts with different combinations of barriers.
Objectives: This systematic review identified and assessed the strength of the evidence of interventions and exposures addressing gender-related barriers to schooling for girls in LMICs.
Search Methods: The AEA RCT Registry, Africa Bibliography, African Education Research Database, African Journals Online, DEC USAID, Dissertation Abstracts, EconLit, ELDIS, Evidence Hub, Global Index Medicus, IDEAS-Repec, Intl Clinical Trials Registry, NBER, OpenGrey, Open Knowledge Repository, POPLINE, PsychINFO, PubMed, Research for Development Outputs, ScienceDirect, Sociological Abstracts, Web of Science, as well as relevant organization websites were searched electronically in March and April of 2019. Further searches were conducted through review of bibliographies as well as through inquiries to authors of included studies, relevant researchers and relevant organizations, and completed in March 2020.
Selection Criteria: We included randomized controlled trials as well as quasi-experimental studies that used quantitative models that attempted to control for endogeneity. Manuscripts could be either published, peer-reviewed articles or grey literature such as working papers, reports and dissertations. Studies must have been published on or after 2000, employed an intervention or exposure that attempted to address a gender-related barrier to schooling, analyzed the effects of the intervention/exposure on at least one of our primary outcomes of interest, and utilized data from LMICs to be included.
Data Collection and Analysis: A team of reviewers was grouped into pairs to independently screen articles for relevance, extract data and assess risk of bias for each included study. A third reviewer assisted in resolving any disputes. Risk of bias was assessed either through the RoB 2 tool for experimental studies or the ROBINS-I tool for quasi-experimental studies. Due to the heterogeneity of study characteristics and reported outcome measures between studies, we applied the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) approach adapted for situations where a meta-analysis is not possible to synthesize the research.
Results: Interventions rated as effective exist for three gender-related barriers: inability to afford tuition and fees, lack of adequate food, and insufficient academic support. Promising interventions exist for three gender-related barriers: inadequate school access, inability to afford school materials, and lack of water and sanitation. More research is needed for the remaining 12 gender-related barriers: lack of support for girls\u27 education, child marriage and adolescent pregnancy, lack of information on returns to education/alternative roles for women, school-related gender-based violence (SRGBV), lack of safe spaces and social connections, inadequate sports programs for girls, inadequate health and childcare services, inadequate life skills, inadequate menstrual hygiene management (MHM), poor policy/legal environment, lack of teaching materials and supplies, and gender-insensitive school environment. We find substantial gaps in the evidence. Several gender-related barriers to girls\u27 schooling are under-examined. For nine of these barriers we found fewer than 10 relevant evaluations, and for five of the barriers—child marriage and adolescent pregnancy, SRGBV, inadequate sports programs for girls, inadequate health and childcare services, and inadequate MHM—we found fewer than five relevant evaluations; thus, more research is needed to understand the most effective interventions to address many of those barriers. Also, nearly half of programs evaluated in the included studies were multi-component, and most evaluations were not designed to tease out the effects of individual components. As a result, even when interventions were effective overall, it is often difficult to identify how much, if any, of the impact is attributable to a given program component. The combination of components varies between studies, with few comparable interventions, further limiting our ability to identify packages of interventions that work well. Finally, the context-specific nature of these barriers—whether a barrier exists in a setting and how it manifests and operates—means that a program that is effective in one setting may not be effective in another.
Authors\u27 Conclusions: While some effective and promising approaches exist to address gender-related barriers to education for girls, evidence gaps exist on more than half of our hypothesized gender-related barriers to education, including lack of support for girls\u27 education, SRGBV, lack of safe spaces and social connections, inadequate life skills, and inadequate MHM, among others. In some cases, despite numerous studies examining interventions addressing a specific barrier, studies either did not disaggregate results by sex, or they were not designed to isolate the effects of each intervention component. Differences in context and in implementation, such as the number of program components, curricula content, and duration of interventions, also make it difficult to compare interventions to one another. Finally, few studies looked at pathways between interventions and education outcomes, so the reasons for differences in outcomes largely remain unclear
Multisite, mixed methods study to validate 10 maternal health system and policy indicators in Argentina, Ghana and India: A research protocol
No full textIntroduction: Most efforts to assess maternal health indicator validity focus on measures of service coverage. Fewer measures focus on the upstream enabling environment, and such measures are typically not research validated. Thus, methods for validating system and policy-level indicators are not well described. This protocol describes original multicountry research to be conducted in Argentina, Ghana and India, to validate 10 indicators from the monitoring framework for the \u27Strategies toward Ending Preventable Maternal Mortality\u27 (EPMM). The overall aim is to improve capacity to drive and track progress towards achieving the priority recommendations in the EPMM strategies. This work is expected to contribute new knowledge on validation methodology and reveal important information about the indicators under study and the phenomena they target for monitoring. Validating the indicators in three diverse settings will explore the external validity of results. Methods and Analysis: This observational study explores the validity of 10 indicators from the EPMM monitoring framework via seven discrete validation exercises that will use mixed methods: (1) cross-sectional review of policy data, (2) retrospective review of facility-level patient and administrative data and (3) collection of primary quantitative and qualitative cross-sectional data from health service providers and clients. There is a specific methodological approach and analytic plan for each indicator, directed by unique, relevant validation research questions. Ethics and Dissemination: The protocol was approved by the Office of Human Research Administration at Harvard University in November 2019. Individual study sites received approval via local institutional review boards by January 2020 except La Pampa, Argentina, approved June 2020. Our dissemination plan enables unrestricted access and reuse of all published research, including data sets. We expect to publish at least one peer-reviewed publication per validation exercise. We will disseminate results at conferences and engage local stakeholders in dissemination activities in each study country
Promises to Keep: Impact of COVID-19 on Adolescents in Kenya—Photo Exhibition
No full textThe COVID-19 pandemic has had unprecedented effects on communities around the world. In 2021, the Presidential Policy and Strategy Unit (PASU), in collaboration with the Population Council, launched a study to explore the social, economic, health, and education impact the pandemic has had on the lives of adolescents in Kenya. The resulting report covered the following topics: remote learning, economic effects, teenage pregnancy, early marriage and harmful practices, mental health, gender-based violence, and the return to school. This photo reel shares the stories of some of the study participants
Manifestations, responses, and consequences of mistreatment of sick newborns and young infants and their parents in health facilities in Kenya
No full textBackground: Despite efforts to incorporate experience of care for women and newborns in global quality standards, there are limited efforts to understand experience of care for sick newborns and young infants. This paper describes the manifestations, responses, and consequences of mistreatment of sick young infants (SYIs), drivers, and parental responses in hospital settings in Kenya. Methods: A qualitative formative study to inform the development of strategies for promoting family engagement and respectful care of SYI was conducted in five facilities in Kenya. Data were collected from in-depth interviews with providers and policy makers (n = 35) and parents (n = 25), focus group discussions with women and men (n = 12 groups), and ethnographic observations in each hospital (n = 64 observation sessions). Transcribed data were organized using Nvivo 12 software and analyzed thematically. Results: We identified 5 categories of mistreatment: 1) health system conditions and constraints, including a) failure to meet professional standards, b) delayed provision of care; and c) limited provider skills; 2) stigma and discrimination, due to provider perception of personal hygiene or medical condition, and patient feelings of abandonment; 3) physically inappropriate care, including providers taking blood samples and inserting intravenous lines and nasogastric tubes in a rough manner; or parents being pressured to forcefully feed infants or share unsterile feeding cups to avoid providers’ anger; 4) poor parental-provider rapport, expressed as ineffective communication, verbal abuse, perceived disinterest, and non-consented care; and 5) no organized form of bereavement and posthumous care in the case of infant’s death. Parental responses to mistreatment were acquiescent or non-confrontational and included feeling humiliated or accepting the situation. Assertive responses were rare but included articulating disappointment by expressing anger, and/or deciding to seek care elsewhere. Conclusion: Mistreatment for SYIs is linked to poor quality of care. To address mistreatment in SYI, interventions that focus on building better communication, responding to the developmental needs of infants and emotional needs for parents, strengthen providers competencies in newborn care, as well as a supportive, enabling environments, will lead to more respectful quality care for newborns and young infants
Translating evidence into impact: Enhancing health in Francophone West Africa and the Sahel
Get PDFFrancophone West Africa (FWA) is a diverse subregion known for its strong national identities and regional collaboration. With high maternal and child death rates and low contraceptive prevalence compared to other parts of West Africa, Francophone countries have worked together to pursue common health and development goals, such as enhancing access to family planning/reproductive health; meeting the health, education, and employment needs of a growing population of young people; and addressing challenges such as climate change and conflict. Over the past three decades, the Population Council has worked to advance subnational, national, and regional efforts to improve health and promote evidence-based policies across FWA. This brief highlights the Council’s work in FWA and the Sahel, which has included research activities, technical assistance, and collaborations across 11 countries: Benin, Burkina Faso, Cameroon, Chad, Cote d’Ivoire, Guinea, Mali, Mauritania, Niger, Senegal, and Togo
Girls on the Map: Mapping for Program Planning and Social Change
Get PDFThis guide explores ways in which maps can add depth to the learning process as practitioners design programs for girls. Mapping leads practitioners through a cycle of information collection and analysis. It supports decision-making about where, with whom, and when to work, and how programs can make a real difference in girls’ lives. Programs increasingly recognize the importance of household and community characteristics in shaping girls’ lives, yet it is relatively less common to measure or map community features as part of program planning. Mapping relevant populations of girls and the features of the communities they live in can inform not only where to work but what further investigation is needed to understand girls’ needs. This guide is meant to spark practitioners’ interest in using maps, to make maps accessible, practical, and useful, and to provide guidance on how to keep girls as the center of focus when making programmatic decisions
Role of social network on life satisfaction among older persons in Delhi, India: A structural equation modelling
No full textThe percentage of older persons in India is projected to rise to 11 percent of the total population by 2025 and to 19 percent by 2050. Available literature suggests that life satisfaction of older persons depends extensively on their social network. Young people in urban areas have a busy lifestyle and little time for older family members. The present study aims to explore the role of social networking and the support from these networks on life satisfaction of the older people in India. Primary data from 530 households were collected between November 2014 and March 2015. Descriptive statistics, chi square test and Berkman’s theoretical model were partially used. Structural equation modelling (SEM) was applied to examine the association between the social network and life satisfaction, arbitrated by different types of social support. Different types of social network act differently on the perception of life satisfaction among the older person. Findings show that networks with family, neighbours, friends and close ones were significantly associated with life satisfaction of the older people in urban area. Support derived from different social networks is important for life satisfaction at later ages. Having a strong confidant social network is significant in promoting life satisfaction among older persons. The main characteristic of this network support is trust between the support provider and old people