Download or read book Assessment of a Community Based Distribution CBD Model for Increasing Demand and Utilization of Family Planning Services in 49 Districts of Pakistan written by Syed Khurram Azmat and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The performance of the Marie Stopes Society's (MSS') Community Based Distribution (CBD) project that provided Family Planning (FP) and Reproductive Health (RH) information and services to the doorstep of the clients is illustrated in this analytical report. Baseline registration of Married Women of Reproductive Age (MWRA (15-49 years of age) was carried out during August 2008-Febuary 2009 in 49 project districts before the inception of the project. The Services were started in March 2009. Eighteen months into project implementation, the End-Line survey was conducted in 40 project districts (during August-September 2010). Over the course of the project approximately half a million MWRA from a catchment population of over 3 million were provided FP/RH information and services. This analysis includes baseline survey results and comparison of these with end of the project survey results; and trend changes in contraceptive use and behavior for a cohort of half a million MWRA. The project increased CPR from 38% at baseline to 51% at endline in 18 months. The results show that the contraceptive prevalence rates increased from 38% at baseline to 51% at the end of project, with modern methods accounting for 41% increase and representing a 52% increase over baseline. The annual change in CPR brought about by the CBD Project intervention at 13% in 18 months is almost 10 times higher than the annual change in national CPR between 2000 and 2007. Substantial increases were seen in all modern methods by 67% to 200% except female sterilization. While CPR rose, the rate of currently pregnant women fell from 11% to 7% - or by 36% over baseline - representing 20,000 fewer pregnancies among half a million women reached by the project. If CBD were to be implemented all over Pakistan, with a similar extrapolation of the project findings points towards a likely increase in national CPR to 45% with a reduction of 2 million (40%) pregnancies nationwide. True to its roots in the Willows Foundation Model of community based information and distribution, MSS CBD workers were the source of provision of current contraception method for nearly 2 in 5 (39%) users, followed by a friend or relative and a government facility (13%). It is interesting to note that in comparison to the PDHS 2006-7 where 52% of contraception commodities were self-procured (usually from a store or chemist directly by clients), the CBD had replaced self-procurement as the main source of family planning. The project may have implications and lessons for the government's very large Lady Health Worker program in aspects of training and outreach. Women (and to some extent their spouses) consider family planning a necessary service. This project strongly demonstrates that quality services, delivered to women directly, can significantly increase CPR and that women (and to some extent their spouses) consider family planning a necessary service. However, research is required to further elaborate the effectiveness or not, of a number of aspects of the intervention. One is the involvement of men: a small proportion amongst non-users is men-centric refusal to use family planning. Research must elaborate if this is relevant and if so how to overcome it. Further research should explore how this model can be replicated and scaled up by other NGOs or civil society groups rather than the public sector. Operations research would be required to ascertain if the model can be adopted within government health structures (such as LHWs, CMWs and fixed facilities) and if so what would be the modalities. Exploring/ascertaining the potential impact/role of incentives (demand and supply side) in reaching nonusers, provision of transport to clients to reach family planning centers and performance based incentives for the project teams is required.

Download or read book Health And Family Planning In Community based Distribution Projects written by Maria Wawer and published by Routledge. This book was released on 2019-03-07 with total page 382 pages. Available in PDF, EPUB and Kindle. Book excerpt: The authors of this book address the major issues involved in developing and evaluating community-based delivery (CBD) healthcare services administered by nonmedical workers in developing countries. Ranging from a general discussion of integrated community-based programs to the prescription of dose regimens that nonmedical personnel can use in field situations, the contributions cover such topics as nutrition intervention, antihelminthics distribution, oral rehydration therapy, and the efficacy of existing programs designed to train those who administer these services.

Download or read book Findings of an 18 Month Assessment of the Effectiveness of a Rural Based Social Franchising Programme Using Vouchers of Long Term Family Planning Services in Pakistan written by Syed Khurram Azmat and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Nearly 14,000 women die each year in Pakistan from causes related to pregnancy. This number is projected to have been 1.7 times higher without contraceptive practice. Family planning is known to be one of the most cost-effective ways to reduce maternal deaths, but currently only 29.3% use contraceptives. This paper evaluates the effectiveness of a two pronged approach using social franchising and vouchers designed to increase contraceptive utilization, especially long term birth spacing methods, among underserved women in rural areas of Pakistan where the use of contraceptives is very low in order to improve maternal health. Methods: A quasi-experimental study design with controls was used. One intervention and one control district were purposely (based on socio-demographic and reproductive health indicators) selected each from two provinces of Pakistan; and each district had a total of four providers. All providers in intervention groups were franchised, trained, and have demand generated through field workers (social franchising intervention) and vouchers (free voucher intervention); while control providers continued with their routine practices without changes. A population-based, cross-sectional survey was carried out among 4992 married women of reproductive age group (MWRA) in Feb 2009 within the catchment areas of each provider and after 18 months, an endline survey was conducted among 4003 MWRA. Multiple logistic regressions were used to estimate net effect (difference in intervention difference in control) using STATA 11.2. Results: The intervention significantly increased the awareness of modern contraception by 5% (p-value

Download or read book Policy and Programmatic Implications of Task Shifting in Pakistan A Case Study written by Ehsan Ullah and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Policy and programmatic implications of Task shifting in Pakistan: A Case StudyHaris AhmedBackground:Access to use of family planning services remains a concern in Pakistan. With 98% knowledge of family planning methods, only 34% women are using any form of contraception, and only 26% using modern contraception.1 Lady Health Workers (LHWs) are pivotal component of the FP and Primary Health Care- they are the only workforce that provides both contraceptive, and supplies including oral contraceptives and condoms, at the door step of beneficiary. 2-3 Realizing the high demand of contraceptive injectable-a small sample of LHWs working in per urban (low socio economic) area have been trained to provide at dose of contraceptive injection, at the door step. Project Introduction:Sukh works with married women of reproductive age (MWRAs) to address their myths and misconceptions on use of modern contraceptive methods through door to door mobilization activities. Working with both public and private service delivery points within project area, Sukh ensures provision of quality FP services by trained health care providers. Engaging youth to be responsible adults, Sukh includes young boys and girls (12 to 19 years) both at school and in the community to provide them with life skill based education. A 24/7 helpline (9123) provides FP and youth counselling, referral and follow-up services.Methods: An observational study design was used by reviewing the retrospective record of Lady Health service data from June 2016-May 2018. A sample of 200 LHWs working in the project intervention area were trained on screening and providing 1st dose of contraceptive injection through comprehensive 6 days training. To evaluate the intervention- research team used pre-existing record which is available in hard copies and electronic form. The analysis was done on SPSS version 25.0). Differences in groups were assessed with u03c72 tests for association among categorical variables. Results: Total 28,361 women were approached during June 2016- May 2018. 1,812 number of women received DMPA injections in just one year and 534 new injectable users added in the cohort, with an increase of 18% during June 2017-May 2018. The overall contraceptive use in the targeted area has also increased by 10.5% from baseline (41.3%- 51.87%). Community-based distribution of injectable contraceptives by lady health worker is an exceptional example of appropriate task shifting in Pakistan-, now desired services are extended to underserve population with an average increase of 54 new contraceptive users every month. Significant association was found between young women (15-25) and low parity women with 0-2 kids, reported the highest acceptability and use of injection 47.2% and 42.0% (with p-value

Download or read book Population Report written by and published by . This book was released on 1978 with total page 590 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Lessons from Community based Distribution of Family Planning in Africa written by James F. Phillips and published by . This book was released on 1999 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Disease Control Priorities Third Edition Volume 2 written by Robert Black and published by World Bank Publications. This book was released on 2016-04-11 with total page 419 pages. Available in PDF, EPUB and Kindle. Book excerpt: The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

Download or read book Population Reports written by and published by . This book was released on 1991 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Rural Extension Education and Training Abstracts written by and published by . This book was released on 1980 with total page 706 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Family Planning Operations Research written by James R. Foreit and published by Population. This book was released on 1998 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Ethiopia Health Extension Program written by Huihui Wang and published by World Bank Publications. This book was released on 2016-04-25 with total page 121 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a low-income country, Ethiopia has made impressive progress in improving health outcomes. This report examines how Ethiopia s Health Extension Program (HEP) has contributed to the country s move toward Univeral Health Coverage (UHC), and to shed light on how other countries may learn from Ethiopia s experiences of HEP when designing their own path to UHC. HEP is one of the government s UHC strategies introduced in a context of limited resources and low coverage of essential health services. The key aspects of the program include the capacity building and mobilization of more than 30, 000 Health Extension Workers (HEWs) targeting more than 12 million model families, and the mobilization of health development army ? to support the community-based health system. Using the HEP-UHC conceptual model and data from Demographic and Health Surveys, the study examines how the HEP has contributed to the country s move toward UHC. During the period that the HEP has been implemented, the country has experienced significant improvements in many dimensions: in terms of socioeconomic, psychological, behavioral, and biological dimensions of the beneficiaries; and in terms of the coverage of health care services. The study finds an accelerated rate of improvements among the rural, less-educated, and the poor population, which is leading to an overall reduction in equity gaps and improvements in the equity indicators including the concentration indices - that suggest a more equitable distribution of resources and health outcomes. The HEP in Ethiopia has demonstrated that an institutionalized community approach is effective in helping a country make progress toward UHC. The elements of success in the HEP include the emphasis on community mobilization which identifies community priorities, engages and empowers community members, and supports their ability to solve local problems. The other aspect of HEP is the emphasis on institutionalization of the activities, which addresses the sustainability of community programs through high level of political commitment, and effective coordination of national policies and leveraging of support from partners. These findings may offer useful lessons for other low income countries facing similar challenges in developing and implementing a sustainable UHC strategy.

Download or read book Livestock s Long Shadow written by Henning Steinfeld and published by Food & Agriculture Org.. This book was released on 2006 with total page 418 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The assessment builds on the work of the Livestock, Environment and Development (LEAD) Initiative"--Pref.

Download or read book The Water Footprint Assessment Manual written by Maite M. Aldaya and published by Routledge. This book was released on 2012-08-21 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: People use lots of water for drinking, cooking and washing, but significantly more for producing things such as food, paper and cotton clothes. The water footprint is an indicator of water use that looks at both direct and indirect water use of a consumer or producer. Indirect use refers to the 'virtual water' embedded in tradable goods and commodities, such as cereals, sugar or cotton. The water footprint of an individual, community or business is defined as the total volume of freshwater that is used to produce the goods and services consumed by the individual or community or produced by the business. This book offers a complete and up-to-date overview of the global standard on water footprint assessment as developed by the Water Footprint Network. More specifically it: o Provides a comprehensive set of methods for water footprint assessment o Shows how water footprints can be calculated for individual processes and products, as well as for consumers, nations and businesses o Contains detailed worked examples of how to calculate green, blue and grey water footprints o Describes how to assess the sustainability of the aggregated water footprint within a river basin or the water footprint of a specific product o Includes an extensive library of possible measures that can contribute to water footprint reduction

Download or read book Urban Planning for City Leaders written by Pablo Vaggione and published by . This book was released on 2012 with total page 190 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Guidelines for Protected Areas Legislation written by Barbara J. Lausche and published by IUCN. This book was released on 2011 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: The central aim of this publication is to consider the key elements of a modern, comprehensive, and effective legal framework for successful management of protected areas. They provide practical guidance for all those involved in developing, improving, or reviewing national legislation on protected areas, be they legal drafters and practitioners, protected area managers, interested NGOs, or scholars. These guidelines include fifteen case studies, eight dealing with the protected area legislation of individual countries and six cases dealing with specific sites providing fundamental solutions that stand the test of time.

Download or read book Disease Control Priorities in Developing Countries written by Dean T. Jamison and published by World Bank Publications. This book was released on 2006-04-02 with total page 1449 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.

Download or read book The Indus Basin of Pakistan written by Winston H. Yu and published by World Bank Publications. This book was released on 2013 with total page 188 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study, Indus basin of Pakistan: the impacts of climate risks on water and agriculture was undertaken at a pivotal time in the region. The weak summer monsoon in 2009 created drought conditions throughout the country. This followed an already tenuous situation for many rural households faced with high fuel and fertilizer costs and the impacts of rising global food prices. Then catastrophic monsoon flooding in 2010 affected over 20 million people, devastating their housing, infrastructure, and crops. Damages from this single flood event were estimated at US dollar 10 billion, half of which were losses in the agriculture sector. Notwithstanding the debate as to whether these observed extremes are evidence of climate change, an investigation is needed regarding the extent to which the country is resilient to these shocks. It is thus timely, if not critical, to focus on climate risks for water, agriculture, and food security in the Indus basin of Pakistan.