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Pakistan: increasing access to SRH services in fragile contexts for rural women in hard-to-reach areas.
London, United Kingdom, IPPF, 2015 Sep. 2 p.In some areas of Pakistan, girls and women are vulnerable to harmful traditional practices, like swara (now illegal, a form of reconciliation where a girl or woman is given in marriage to settle a dispute) and early marriage, and many of them face tremendous obstacles to basic services, including sexual and reproductive health (SRH) services.
New York, Evaluation Office, United Nations Population Fund [UNFPA], 2016 Apr. 105 p.The purpose of the evaluation was to assess the performance of UNFPA in the field of family planning during the period covered by the Strategic Plan 2008-2013 and to provide learning to inform the implementation of the current UNFPA Family Planning Strategy Choices not chance (2012-2020). The evaluation provided an overall independent assessment of UNFPA interventions in the area of family planning and identified key lessons learned for the current and future strategies. The particular emphasis of this evaluation was on learning with a view to informing the implementation of the UNFPA family planning strategy Choices not chance 2012-2020, as well as other related interventions and programmes, such as the Global Programme to Enhance Reproductive Health Commodity Security (GPRHCS- 2013-2020). The evaluation constituted an important contribution to the mid-term review of UNFPA strategic plan 2014-2017. The evaluation features five country case study reports: Bolivia, Burkina Faso, Cambodia, Ethiopia, and Zimbabwe.
Guttmacher Policy Review. 2015 Spring; 18(2):27-33.The U.S. overseas program for family planning and reproductive health has been under attack from policymakers who are antiabortion and increasingly anti-family planning. The two most notorious of these attacks are the blocking of U.S. funding for the United Nations Population Fund and the enforcement of the global gag rule, which prohibits aid to foreign nongovernmental organizations that engage in abortion services or advocacy with non-U.S. funds. In an ongoing counterproductive cycle, these restrictions have come in and out of effect depending on the political party in power -- a struggle that is expected to heat up again with a socially conservative Congress.
Entre Nous. 2009; (68):24-25.Romania is a very special case when it comes to reproductive health in the modern world. After 30 years of a prohibitive society that denied couples and women the right to family planning, as a result of the political changes in December 1989 women in Romania have regained the fundamental right to freely decide the number of desired children, as well as the timing and spacing of births. Decree Law No. 1/ 1989, which promoted total abortion liberalization was the first resolution passed after the political changes in 1989 and it can be considered the symbolic foundation of family planning (FP) in Romania.
New York, New York, UNFPA, 2010. 2 p.This brief argues that despite increases in contraceptive use since 1994, high unmet need for family planning persists. Among the most significant underserved group is a new generation of adolescents. They enter adulthood with inadequate information on sexuality and reproductive health and few skills to protect their health and rights.
From advocacy to access: Uganda. The power of networks: How do you mobilize funds for reproductive health supplies? Fact chart.
London, England, IPPF, 2009 Nov.  p.In Uganda the IPPF Member Association, Reproductive Health Uganda (RHU) coordinated civil society and mobilized advocates and champions to increase the availability of RH supplies and family planning. Results to date include: The Government of Uganda increased funding for RH supplies in the 2010 budget; The Government of Uganda disburses funds directly to the National Medical Stores on an annual basis enabling the bulk purchase of contraceptives; 30 out of 80 districts have committed to increasing their resource allocation for family planning and RH supplies.
Brussels, Belgium, DSW, 2009. 62 p.In September, DSW and the European Parliamentary Forum (EPF) produced the 2009 edition of our Euromapping report, an annual publication that provides an overview of the comparative ODA and SRH funding contributions and commitments of an individual donor country over time. This year's publication has been produced with the support of the European Commission, which has allowed us to release the publication along with a coordinated advocacy and media campaign in 7 European countries. In addition to being a quick reference guide on European funding levels for family planning and reproductive health, Euromapping is intended as an advocacy tool for NGOs and decision makers to monitor the level and composition of ODA as a means of verifying whether governments are living up to their political and policy commitments.
Cambridge, Massachusetts, Belknap Press, 2008. xiv, 521 p.Rather than a conspiracy theory, this book presents a cautionary tale. It is a story about the future, and not just the past. It therefore takes the form of a narrative unfolding over time, including very recent times. It describes the rise of a movement that sought to remake humanity, the reaction of those who fought to preserve patriarchy, and the victory won for the reproductive rights of both women and men -- a victory, alas, Pyrrhic and incomplete, after so many compromises, and too many sacrifices. (Excerpt)
Sexual and reproductive health of women living with HIV / AIDS. Guidelines on care, treatment and support for women living with HIV / AIDS and their children in resource-constrained settings.
Geneva, Switzerland, WHO, 2006.  p.The sexual and reproductive health of women living with HIV/AIDS is fundamental to their well-being and that of their partners and children. This publication addresses the specific sexual and reproductive health needs of women living with HIV/AIDS and contains recommendations for counselling, antiretroviral therapy, care and other interventions. Improving women's sexual and reproductive health, treating HIV infections and preventing new ones are important factors in reducing poverty and promoting the social and economic development of communities and countries. Sexual and reproductive health services are uniquely positioned to address each of these factors. (excerpt)
Geneva, Switzerland, WHO, 2007. 8 p. (WHO/RHR/07.7)Faced with the challenge of putting into practice the ideals of the Millennium Development Goals, the International Conference on Population and Development (ICPD), and other global summits of the last decade, decision-makers and programme managers responsible for sexual and reproductive health ask how they can: improve access to and the quality of family planning and other sexual and reproductive health services; increase skilled attendance at birth and strengthen referral systems; reduce the recourse to abortion and improve the quality of existing abortion services; provide information and services that respond to young people's needs; and integrate the prevention and treatment of reproductive tract infections, including HIV/AIDS, with other sexual and reproductive health services. (excerpt)
Program scan matrix on child marriage: A web-based search of interventions addressing child marriage.
[Washington, D.C.], International Center for Research on Women [ICRW], . 25 p.The international community and U.S. government are increasingly concerned about the prevalence of child marriage and its toll on girls in developing countries. One in seven girls in the developing world marries before 15. Nearly half of the 331 million girls in developing countries are expected to marry by their 20th birthday. At this rate, 100 million more girls-or 25,000 more girls every day-will become child brides in the next decade. Current literature on child marriage has primarily examined the prevalence, consequences and reported reasons for early marriage. Much less has been analyzed about the risk and protective factors that may be associated with child marriage. Also, little is known about the range of existing programs addressing child marriage, and what does and does not work in preventing early marriage. The work presented here investigates two key questions: What factors are associated with risk of or protection against child marriage, and ultimately could be the focus of prevention efforts? What are the current programmatic approaches to prevent child marriage in developing countries, and are these programs effective? (excerpt)
Improving access to quality care in family planning: WHO's four cornerstones of evidence-based guidance.
Journal of Reproduction and Contraception. 2007 Jun; 18(2):63-71.The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policy-makers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines- Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grass-root providers. (author's)
Targeting access to reproductive health: Giving contraception more prominence and using indicators to monitor progress.
Reproductive Health Matters. 2007 May; 15(29):186-191.Unmet need for contraception represents a major failure in the provision of reproductive health services and reflects the extent of access to services for spacing and limiting births, which are also affected by personal, partner, community and health system factors. In the context of the Millennium Development Goals, family planning has been given insufficient attention compared to maternal health and the control of sexually transmitted infections. As this omission is being redressed, efforts should be directed towards ensuring that an indicator of unmet need is used as a measure of access to services. The availability of data on unmet need must also be increased to enable national comparisons and facilitate resource mobilisation. Unmet need is a vital component in monitoring the proportion of women able to space and limit births. Unmet need for contraception is a measure conditioned by people's preferences and choices and therefore firmly introduces a rights perspective into development discourseand serves as an important instrument to improve the sensitivity of policy dialogue. The new reproductive health target and the opportunity it offers to give appropriate attention to unmet need for contraception will allow the entry of other considerations vital to ensuring universal access to reproductive health. (author's)
Evaluation of the World Health Organization's family planning decision-making tool: Improving health communication in Nicaragua.
Patient Education and Counseling. 2007 May; 66(2):235-242.The World Health Organization has led the development of a Decision-Making Tool for Family Planning Clients and Providers (DMT) to improve the quality of family planning counseling. This study investigates the DMT's impact on health communication in Nicaragua. Fifty nine service providers in Nicaragua were videotaped with 426 family planning clients 3 months before and 4 months after attending a training workshop on the DMT. The videotapes were coded for both provider and client communication. After the intervention providers increased their efforts to identify and respond to client needs, involve clients in the decision-making process, and screen for and educate new clients about the chosen method. While the DMT had a smaller impact on clients than providers, in general clients did become more forthcoming about their situation and their wishes. The DMT had a greater impact on sessions in which clients chose a new contraceptive method, as compared with visits by returning clients for a check-up or resupply. The DMT proved effective both as a job aid for providers and a decision-making aid for clients, regardless of the client's level of education. Job and decision-making aids have the potential to improve health communication, even or especially when clients have limited education and providers have limited training and supervision. (author's)
Notes from the Field. 2001 Mar; (1): p..IPPF/WHR Evaluation Officer Rebecca was in Nicaragua February 11 - 17, 2001 to provide technical assistance for the UNFPA/UNFIP project, Sexual and Reproductive Health for Adolescents -- A Three Country Approach: Haiti, Nicaragua and Ecuador. "The great thing about this project is that it integrates the concept of adolescent SRH into the municipal governments' role in their communities and really institutionalizes an adolescent perspective. Working with local partners and the local municipal governments -- giving them a stake, a sense of ownership -- greatly increases the chance of this project carrying on after the initial funding ends. "This trip was interesting because we got to see a lot of the country in our visits to two of the participating municipalities. Jalapa is about six hours north of Managua. We had to leave our hotel at five o'clock in the morning. The country is still recovering from [Hurricane] Mitch [which struck Nicaragua in 1998]. The roads are really bumpy. While many towns that we passed through are made up of small adobe huts with a water pump in the center of town where people line up to get their water, we also passed towns with small concrete houses built with funds from international relief efforts after the hurricane. One village had a series of concrete UNICEF latrines." (excerpt)
Reproductive Health Matters. 2005; 13(25):106-108.The year 2005 is a pivotal year for ensuring that sexual and reproductive health are fully addressed in the implementation and monitoring of the Millennium Development Goals (MDGs). When the MDGs were developed following the Millennium Summit in 2000, no goal was included on sexual and reproductive health, for reasons that are now history. Matters that have an impact on, or are components of, sexual and reproductive health were included – maternal and child health, HIV/AIDS, gender equality and education – but sexual and reproductive health were left out. This year, however, there are real opportunities to redress the imbalance and to ensure that sexual and reproductive health are there for the rest of the time earmarked for the implementation of the MDGs, i.e. in the ten years to 2015. Targets and indicators were set shortly after the MDGs were agreed. As far as maternal health was concerned the target set was the reduction of maternal mortality by two-thirds and for HIV/AIDS of halting and beginning to reverse the spread of HIV/AIDS, both by 2015. Whole other areas are not included, however, especially access to contraceptive services. There is an increasing trend among donor governments to tie development aid to the MDGs, and to use monitoring of implementation of the MDGs for this purpose. Hence, implementation of the Programme of Action of the International Conference on Population and Development 1994 would be more easily achieved if targets for achieving sexual and reproductive health were fully integrated into the MDG process. (excerpt)
The USAID population program in Ecuador: a graduation report. [El Programa de USAID para la población de Ecuador aprueba su examen final. Informe]
Washington, D.C., LTG Associates, Population Technical Assistance Project [POPTECH], 2001 Oct.  p. (POPTECH Publication No. 2001–031–006; USAID Contract No. HRN–C–00–00–00007–00)For nearly 30 years, the United States Agency for International Development (USAID) provided assistance for population, family planning, and reproductive health programs in Ecuador. Throughout the early years, USAID worked with both private and public sector institutions to establish a broad base for national awareness of and support for family planning and for the introduction of contraceptive services. USAID led all other donors in this sector in terms of financial, technical, and contraceptive commodity assistance. Upon reflection of the accomplishments of the USAID population program during these years and considering its most recent Strategic Objective of “increased use of sustainable family planning and maternal child health services,” it is apparent that the Agency was successful in this endeavor and has adequately provided for the graduation of its local partners, particularly those in the private sector, where USAID had directed the major focus of its assistance over the past decade. During the last and final phase of assistance, 1992–2001, the USAID strategy focused primarily on assuring the financial and institutional sustainability of the two largest local nongovernmental organizations (NGOs) that provide family planning services. USAID/Ecuador worked in partnership with the Asociación Pro-bienestar de la Familia Ecuatoriana (APROFE), which is the Ecuadorian affiliate of the International Planned Parenthood Federation (IPPF), and the Centro Médico de Orientación y Planificación Familiar (CEMOPLAF)—institutions that provide contraceptive and other reproductive health services. At the same time, in order to assure that the necessary tools were in place for future program monitoring, planning, and evaluation, USAID assistance was provided to the Centro de Estudios de Población y Desarrollo Social (CEPAR). (excerpt)
Washington, D.C., Deloitte Touche Tohmatsu, Commercial Market Strategies, 2004 May. , 25 p. (Working Paper; USAID Contract No. HRN-C-00-98-00039-00)Although health-related CSR programs are fairly common, reproductive health (RH) and family planning (FP) initiatives are underrepresented in the global portfolio of CSR programs. These programs might include maternal and child health, STI/HIV/AIDS prevention and education, and provision of contraceptives. To help facilitate the inclusion of RH initiatives in CSR programs, this paper addresses the following questions: What are the motivations behind CSR programs, and what are current CSR trends? What characterizes different CSR models, and how does each model lend itself to the inclusion of family planning and reproductive health services? What opportunities exist for partnerships focused on reproductive health? To answer these questions, CMS conducted in-depth interviews with more than 50 business leaders whose companies are noted for their CSR programs. CMS’s research was designed to unearth the depth and detail of CSR processes from the corporate perspective, seeking to understand why corporations become involved in CSR, as well as how they do it, so that this knowledge could be applied to potential RH initiatives. CMS’s research clearly shows that corporate culture and values drive CSR initiatives. There are usually both internal and external motivations for these programs. Most companies do not view their social and financial responsibilities as mutually exclusive; instead, they link CSR to their core business strategies. CMS also found that a company’s stakeholders play an influential role in selecting and designing its CSR program. Companies are increasingly interested in forming partnerships with the public sector or NGOs, in order to bring technical expertise or other resources to CSR programs. (excerpt)
In: Women, international development, and politics: the bureaucratic mire. Updated and expanded edition, edited by Kathleen Staudt. Philadelphia, Pennsylvania, Temple University Press, 1997. 167-182.Using a feminist lens to inspect current PVO (private voluntary organization) family planning programs, we first define the feminist perspective as it applies to such programs and then compare that feminist vision with the reality found in the field. This paper examines the political dynamics of working for a feminist agenda within the community of population PVOs. The following case study illustrates these dynamics and leads to a discussion of both the obstacles to the realization of a feminist vision and the political strategies and attitudes that help implement this vision. Together, we draw on seventeen years of work with a variety of PVOs involved in family planning and reproductive health. (excerpt)
Capacity building in reproductive health programmes focusing on male involvement: a South-to-South framework.
In: Programming for male involvement in reproductive health. Report of the meeting of WHO Regional Advisers in Reproductive Health, WHO / PAHO, Washington DC, USA, 5-7 September 2001. Geneva, Switzerland, World Health Organization [WHO], 2002. 115-129. (WHO/FCH/RHR/02.3)The issue of male involvement in reproductive health is enigmatic. It has traditionally been held that men's role and voice are decisive in the family building process and reproductive health outcomes of both males and females. At the same time, against the backdrop of recent and ongoing experience, men also have been characterized as the neglected half in the pertinent programmes, playing a tangential role relative to women. Within this general area, the present paper explores the opportunities for capacity building in reproductive health programmes, keeping in view some critical areas where male involvement appears to be especially relevant. The exercise is undertaken in light of lessons learned in the South-to- South framework of inter-country sharing and exchange of experience in the field. Possible institutional strengthening towards increased and effective male involvement is considered in order to address capacity-building needs at the level of policy makers, programme managers, service providers and clients. (author's)
Population and Development Review. 2002 Dec; 28(4):707-733.We begin by briefly describing the shift in population policies. We then set out two theoretical frameworks expected to account for national reactions to the new policy: first, the spontaneous spread of new cultural items and the coalescence of a normative consensus about their value, and second, the directed diffusion of cultural items by powerful Western donors. We then describe our data and evaluate its quality. Subsequently, we analyze the responses of national elites in our five study countries to the Cairo agenda in terms of discourse and implementation. In our conclusion, we evaluate these responses in terms of the validity of the two theoretical frameworks. (excerpt)
New York, New York, Ford Foundation, 2003.  p.The connections between globalization and women’s reproductive health and rights are not straightforward, and as yet, there is little systematic evidence exploring these linkages. The following paper will examine more closely what is meant by globalization and attempt to analyze its broad implications for women’s health and well-being, albeit largely from first principles. (excerpt)
POPLINE. 2003 May-Jun; 25:3, 4.The president of the Population Institute contends that it would be "not only unacceptable but also morally reprehensible for the United States to back away" from commitments toward universal access to family planning and reproductive health. In testimony submitted to the foreign operations subcommittee of the House of Representatives Appropriations Committee, Werner Fornos, president of the Population Institute, was referring to apparent efforts by the Bush administration to reverse United States support of the Cairo Program of Action from the 1994 International Conference on Population and Development. (excerpt)
Population assistance and family planning programs: issues for Congress. Updated February 13, 2003. Programas de asistencia a la población y de planificación familiar: temas para el Congreso. Actualización al 13 de febrero de 2003.
Washington, D.C., Library of Congress, Congressional Research Service, 2003 Feb 13.  p. (Issue Brief for Congress)Since 1965, United States policy has supported international population planning based on principles of voluntarism and informed choice that gives participants access to information on all methods of birth control. This policy, however, has generated contentious debate for over two decades, resulting in frequent clarification and modification of U.S. international family planning programs. In the mid-1980s, U.S. population aid policy became especially controversial when the Reagan Administration introduced restrictions. Critics viewed this policy as a major and unwise departure from U.S. population efforts of the previous 20 years. The “Mexico City policy” further denied U.S. funds to foreign non-governmental organizations (NGOs) that perform or promote abortion as a method of family planning, regardless of whether the source of money was the U.S. government Presidents Reagan and Bush also banned grants to the U.N. Population Fund (UNFPA) because of its program in China, where coercion has been used. During the Bush Administration, a slight majority in Congress favored funding UNFPA and overturning the Mexico City policy but failed to alter policy because of presidential vetoes or the threat of a veto. President Clinton repealed Mexico City policy restrictions and resumed UNFPA funding, but these decisions were frequently challenged by some Members of Congress. On January 22, 2001, President Bush revoked the Clinton Administration population policy position and restored in full the terms of the Mexico City restrictions that were in effect on January 19, 1993. Foreign NGOs and international organizations, as a condition for receipt of U.S. funds, now must agree not to perform or actively promote abortions as a method of family planning in other countries. Subsequently, in January 2002, the White House placed a hold on the transfer of $34 million appropriated by Congress for UNFPA and launched a review of the organization’s program in China. Following the visit by a State Department assessment team in May, Secretary of State Powell announced on July 22 that UNFPA was in violation of the “Kemp-Kasten” amendment that bans U.S. assistance to organizations that support or participate in the management of coercive family planning programs. For FY2003, the President proposes no UNFPA funding, although there is a “reserve” of $25 million that could be used if the White House determines that UNFPA is eligible for U.S. support in FY2003. The Administration further requests $425 million for bilateral family planning programs, a reduction from the $446.5 million provided in FY2002. H.J.Res. 2, as passed by the Senate on January 23, 2003, includes the FY2003 Foreign Operations Appropriations. It provides $435 million for bilateral family planning aid and $35 million for UNFPA. Last year, the Senate Appropriations Committee (S. 2779) had recommended $450 million for bilateral activities and $50 million for UNFPA. The Senate bill further would have modified the Kemp-Kasten amendment and partially reversed the President’s Mexico City policy for some organizations. The House bill (H.R. 5410) last year provided $425 million for family planning and $25 million for UNFPA, but made no modifications to Kemp-Kasten or to the Mexico City policy. (excerpt)
A qualitative evaluation of the impact of the Stepping Stones sexual health programme on domestic violence and relationship power in rural Gambia.
[Unpublished] 2002. Presented at the 6th Global Forum for Health Research, Arusha, Tanzania, November, 2002.  p.The work presented here came from a preliminary evaluation and was followed up by several applications for funding to carry out a prospective community randomised trial. So far none have been accepted. This may be partly due to the fact that such an evaluation runs against current funding culture. Because of it's holistic approach and focus on core skills in couple communication, the Stepping Stones programme is neither just an HIV prevention or just a domestic violence prevention programme, but has something to contribute to both (and would see the two problems as inter-related). Funding on the other hand is often organised 'vertically' by problem, and evaluation criteria may differ from one problem to another. For example donors who fund evaluation of HIV prevention activities usually require a biological outcome, and hence concentrate on geographical areas with high HIV incidence where the epidemic is seen as most severe. Where sociological outcomes are used this tends to be either the use of quantitative tools to assist in risk factor analysis, or qualitative tools which can assist in replication of the intervention. As such they are usually considered secondary to the primary (biological) outcomes. The hope here is that these interventions may provide a 'blueprint' which can subsequently be applied in low prevalence areas. However by concentrating on proximal rather than distal determinants of infection these blueprints may only capture 'half the story', leading to locally inappropriate assumptions about which groups or behaviours HIV prevention programmes should target. An example would be the demand by some donors that interventions should have an exclusive focus on adolescents, when in a polygamous society adolescent's risk is often mediated by the older generation. On the other hand community interventions against domestic violence are forced to rely on self reported behaviour (perhaps backed up by participant observation) as an outcome. If the intervention is also a reflexive process then qualitative studies become essential to describe a process of change which contains empowerment, group dynamic and normative dimensions. The locally appropriate nature of such interventions is used to justify participatory interventions as being more effective than didactic approaches, but at the same time in the epidemiological-evaluation paradigm it can be seen as problematic, because (I would argue incorrectly) a participatory process is assumed to generate a wide spectrum of outcomes (low replicability), which mitigates against quantitative evaluation. (excerpt)