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Quality of care in abortion in the era of technological and medical advancements and self-care
No full textBackground: Discussions around quality of abortion care have been focused mainly on service-delivery aspects inside healthcare facilities. More recently, with availability of medical abortion (MA), increase in its self-use, and emergence of other delivery platforms such as telemedicine, the responsibility of quality care has broadened to actors outside of facilities. Body of text: This commentary discusses the meaning of quality of abortion care with the paradigm shift brought by medical and technological advancement in abortions, and raises questions on the role of the state in ensuring quality in abortion management—especially in settings where abortion is decriminalized, but also in countries where abortion is permitted under certain circumstances. It consolidates the experience gained thus far in the provision of safe abortion services and also serves as a forward-thinking tool to keep pace with the uptake of newer health technologies (e.g., availability of medical abortion drugs), service delivery platforms (e.g., telemedicine, online pharmacies), and abortion care providers (e.g., community based pharmacists). Conclusions: This commentary provides context and rationale, and identifies areas for action that different stakeholders, including health advocates, policymakers, program managers, and women themselves, can adopt to fit into an alternative regime of abortion care
Breakthrough RESEARCH—Social and Behavior Change Costing Community of Practice Series Brief #5: Are integrated social and behavior change interventions cost-effective? A methodological approach
Get PDFThe Research and Learning Agenda for Advancing Integrated Social and Behavior Change (SBC) Programming, developed by Breakthrough RESEARCH through a consensus-driven process, identified the need for costing and evaluating the cost-effectiveness of integrated SBC as one of four key questions that needs addressing. This brief, developed by Avenir Health, provides an overview of the steps for examining the cost-effectiveness of integrated SBC programs that can be used for future cost-effectiveness analyses. This is the fifth in a series of programmatic research briefs intended to complement the Guidelines for Costing of Social and Behavior Change Health Interventions and support a Community of Practice around SBC costing by highlighting important issues and practices for SBC costing
S’attaquer aux tabous de la communication pour le changement social et de comportement à Niamey et Abidjan: Évaluation de la campagne médiatique Merci Mon Héros
Get PDFMerci Mon Héros (MMH) est une campagne médiatique qui catalyse les jeunes en tant que co-leaders pour améliorer la communication intergénérationnelle et les résultats des jeunes en matière de planification familiale et de santé reproductive. Le projet Breakthrough RESEARCH a été chargé d\u27évaluer la campagne MMH. Cette note met en évidence d\u27importantes conclusions d\u27évaluation et des recommandations pour le renforcement de la communication intergénérationnelle dans deux lieux prioritaires : Niamey, au Niger et Abidjan, en Côte d\u27Ivoire.
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Merci Mon Héros (MMH) is a mixed media campaign that catalyzes young people as co-leaders to improve intergenerational communication and young people’s family planning and reproductive health outcomes. The Breakthrough RESEARCH project―USAID’s flagship investment in social and behavior change research and evaluation―was tasked with evaluating the MMH campaign. This brief highlights important evaluation findings and recommendations for strengthening intergenerational communication in two priority locations—Niamey, Niger and Abidjan, Côte d’Ivoire
Capacity building of national rural livelihood mission personnel on evaluations and data utilization for evidence-based decision making
No full textSBC Costing Tool
No full textThe SBC Costing Tool was funded by the U.S. Agency for International Development and developed by Breakthrough RESEARCH. The costing tool is based on analyses of 157 social and behavior change (SBC) unit cost observations from studies in the peer reviewed and grey literature. SBC donors, implementers, and researchers can use this tool to assist with planning and budgeting. The estimates generated in this tool are best estimates based on the literature; however, actual unit costs may vary depending on external factors. See the Guide tab for further information on how to use the tool
What to expect when girls are expecting: Psychosocial support challenges and opportunities in the context and aftermath of teenage pregnancy in Kenya
No full textBackground: An understanding of the psychosocial support challenges and opportunities in the context of teenage pregnancy is important for developing appropriate interventions for pregnant and parenting girls. This qualitative study was conducted in Homa Bay County, Kenya, to examine the experience of teenage pregnancy and the resultant psychosocial support needs from the perspectives of both pregnant/parenting girls and their own parents, who are typically expected to provide various forms of support. Methods: The study used a descriptive case study design, drawing on counseling case notes documented by psychologists who held counseling sessions with 20 pregnant or parenting girls and 6 of their parents as part of a psychosocial support intervention. The counseling case notes formed a qualitative data set, which was analyzed thematically. Results: Emerging master themes were related to pregnant and parenting girls’ experience of sexual violence and adverse childbirth outcomes; psychological trauma confronted by girls and their parents alike; parental need for support in communicating with pregnant/parenting girls about sex and sexuality; and the availability of family support as a resource for teenage mothers. Conclusion: Pregnant and parenting teenage girls require a range of psychosocial support responses that recognize the realities of sexual violence and other challenges in the lives of the girls themselves, as well as in the lives of their parents and caregivers. While parents and other caregivers can serve as an important resource for supporting affected girls, they often need assistance as well, in order to support pregnant/parenting girls effectively. These realities need to be taken into account to maximize the effectiveness of health and development programs for pregnant and parenting girls. Furthermore, emerging themes from actual counseling sessions with affected girls and parents can provide important insights into the potential psychosocial support needs of the broader population of pregnant and parenting girls
“Just Another GBV Training Session”: Reflections on Psychosocial Response in the Context of Research
Get PDFNestorone nanosuspension-loaded dissolving microneedles array patch: A promising novel approach for “on-demand” hormonal female-controlled peritcoital contraception
No full textOn demand hormonal female-controlled pericoital contraception is one strategy which could be used to minimize the impact of unintended pregnancy. Nestorone (NES) is a potent contraceptive, with relatively few side effects in comparison with other contraceptives. NES presents an attractive option for on demand pericoital contraceptive. Unfortunately, the drug is inactive if taken orally, but it has high progestational activity and antiovulatory potency if administered parenterally. Current drug delivery systems, such as a transdermal hydrogel are not so satisfactory. Dissolving microneedles array (DMNs) are an attractive alternative, minimally-invasive, delivery system. In this study, we report, for the first time, development of tip-loaded NES-nanosuspension (NES-NS)-loaded bilayer DMNs to deliver NES intradermally for subsequent release. NES-NS was prepared and optimised, freeze-dried and then used to fabricate DMNs using a blend of two biocompatible polymers, namely poly(vinyl alcohol) and poly(vinyl pyrrolidone). Both NES-NS and the NES-NS-loaded DMNs were fully characterised and the performance of the DMNs was evaluated in vivo using Sprague Dawley rats. Results showed that the finalised NES-NS had particle size and PDI values of 666.06 ± 1.86 nm and 0.183 ± 0.01, respectively. The NES-NS-DMNs had relatively high tips-localised drug loading (approximately 2.26 ± 1.98 mg/array) and exhibited satisfactory mechanical and insertion properties. In Sprague Dawley rats, DMNs delivered NES into the skin, with the drug then appearing in blood and rapidly reaching its maximum concentration (Cmax of 32.68 ± 14.06 ng/mL) within 1 h post-DMNs application. Plasma levels above 3.4 ng/mL were maintained for 2 days. This suggests that DMNs are a promising drug delivery system that could be used to deliver NES as an “On demand” hormonal female-controlled pericoital contraceptive
Removing the societal and legal impediments to the HIV response: An evidence-based framework for 2025 and beyond
No full textSocietal and legal impediments inhibit quality HIV prevention, care, treatment and support services and need to be removed. The political declaration adopted by UN member countries at the high-level meeting on HIV and AIDS in June 2021, included new societal enabler global targets for achievement by 2025 that will address this gap. Our paper describes how and why UNAIDS arrived at the societal enabler targets adopted. We conducted a scoping review and led a participatory process between January 2019 and June 2020 to develop an evidence-based framework for action, propose global societal enabler targets, and identify indicators for monitoring progress. A re-envisioned framework called the ‘3 S’s of the HIV response: Society, Systems and Services’ was defined. In the framework, societal enablers enhance the effectiveness of HIV programmes by removing impediments to service availability, access and uptake at the societal level, while service and system enablers improve efficiencies in and expand the reach of HIV services and systems. Investments in societal enabling approaches that remove legal barriers, shift harmful social and gender norms, reduce inequalities and improve institutional and community structures are needed to progressively realize four overarching societal enablers, the first three of which fall within the purview of the HIV sector: (i) societies with supportive legal environments and access to justice, (ii) gender equal societies, (iii) societies free from stigma and discrimination, and (iv) co-action across development sectors to reduce exclusion and poverty. Three top-line and 15 detailed targets were recommended for monitoring progress towards their achievement. The clear articulation of societal enablers in the re-envisioned framework should have a substantial impact on improving the effectiveness of core HIV programmes if implemented. Together with the new global targets, the framework will also galvanize advocacy to scale up societal enabling approaches with proven impact on HIV outcomes
Keeping girls in schools to reduce child marriage in rural Bangladesh: Endline assessment
Get PDFThis report describes findings of changes over time attributable to the “Keeping Girls in Schools” study in Bangladesh that implemented skill-building activities for a two-year period in the districts of Chapainawabganj, Kushtia, and Sherpur. The project sought to bring about change in child marriage norms prevalent in the area by offering young girls a safe place to meet after school hours with mentors and teachers and to offer girls tutoring support and life-skills. The project was implemented by the Population Council with the cooperation of secondary schools in the community and was supported by UNICEF under the aegis of the UNICEF-UNFPA Global Programme to End Child Marriage. The intervention targeted marginalized adolescent girls who had dropped out of school and girls who were underperforming at school which put them at higher risk of child marriage. The intervention provided tutoring support in math and English, skill-building, and life-skills awareness sessions. The project engaged female mentors from the community who led girls’ groups at the sessions, and liaised with teachers, school management committees, and the community at large