scholarly journals Mapping and assessing sexual and reproductive health policy changes over time in Colombia: measuring their impact on pregnancy terminations

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
José Ignacio Nazif-Munoz ◽  
Rose Chabot
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Data Set ◽  
The Government ◽  
Changes Over Time ◽  
The Impact ◽  
Over Time

AbstractSexual and reproductive health and rights policies (SRHRPs) and their association with reproductive and non-reproductive behavior require precise theoretical and methodological frames. By studying the case of Colombia, we move forward with a comprehensive framework that considers simultaneously multiple SRHRP conceptualizations and their impacts over time on induced pregnancy terminations (IPT). With a mixed-method approach, we first map the evolution of SRHRPs and then analyze their direct and indirect effects on IPTs, using the provision of contraceptive methods by the government, female use of contraceptive methods, and conversations with health professionals in a mediation approach. We build a unique data set from more than 2100 policy documents, and then use data on 81,760 women (20–40 years) from four waves (2000–2015) of Colombia’s Demographic and Health Surveys. We find that SRHRPs are directly associated with an 18% reduction in reported IPTs. Associations between these variables are explained by the increased use of modern contraceptive methods (6%), and the government’s provision of those contraceptive methods (13%). Studies interested in the impact of SRHRPs need to consider not only the direct effects of legal changes on abortion outcomes but also show changes over time may operate through different sub-programs embedded in these policies, such as access to contraceptive methods and family planning. This will add further nuances to how SRHRPs are both multilayered and implemented.

scholarly journals Zika outbreak, resilient health systems, and women’s sexual and reproductive health: a qualitative study in Colombia

2019 ◽  
Author(s):  
Juan Carlos Rivillas-García ◽  
Luz Janeth Forero-Martinez ◽  
Mariana Calderon-Jaramillo ◽  
Victoria Vargas-Pinzón ◽  
Rocío Murad-Rivera ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Technical Equipment ◽  
Care Providers ◽  
Data Set ◽  
National Response ◽  
The Government ◽  
The Impact

Abstract Background There is substantial evidence of the profound consequences of Zika on women's Sexual and Reproductive Health. Health system resilience begins by measuring critical capacities ahead of a crisis such as zika outbreak. Even though zika as vector-borne disease is well documented, there is dearth of studies linking Zika with women's Sexual and Reproductive Health. The main objective of this study was to analyze the national response to the Zika epidemic and its relation to women’s sexual and reproductive health matters through key implementation mechanisms in order to promote resilience of the health system in five cities in Colombia.Methods This study used a qualitative design to enable an in-depth exploration of the national response to the Zika epidemic and sexual and reproductive health matters through key implementation mechanisms (based on facilitators and gaps) within the health system. The overall data set was comprised of 31 semi-structured individual interviews (23 women and 8 men), 25 interviews with key informants responsible for the implementation of the Zika Virus Response Plan; six interviews with pregnant women diagnosed with Zika; and five focus groups discussions with communities (n=122 participants) in five cities in Colombia: Barranquilla, Cucuta, Los Patios, San Andres and Soledad.Results The findings revealed the three major facilitators that promoted the implementation of actions to address the Zika epidemic: i) the role of health care providers; ii) the development of technical equipment capabilities; and iii) inter-institutional coordination. The study also identified implementation gaps: i) absence of a human rights and sexual and reproductive health approach; ii) focus on territorial actions centered on mosquito management; and iii) limited attitudes, behaviors and knowledge at the community level.Conclusion This study provided a comprehensive insight of critical facilitating processes and gaps in the implementation of the government response during the Zika epidemic in Colombia. This study reveals that the lack of understanding of the intersection between gender, the Zika epidemic and Sexual and Reproductive Health limited the adoption, development and implementation of a more comprehensive responses to address the impact on women’s sexual and reproductive health.

Zika outbreak, resilient health systems, and women’s sexual and reproductive health: a qualitative study in Colombia

2020 ◽  
Author(s):  
Juan Carlos Rivillas-García ◽  
Luz Janeth Forero-Martinez ◽  
Mariana Calderon-Jaramillo ◽  
Victoria Vargas-Pinzón ◽  
Rocío Murad-Rivera ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Technical Equipment ◽  
Care Providers ◽  
Data Set ◽  
National Response ◽  
The Government ◽  
The Impact

Abstract Background There is substantial evidence of the profound consequences of Zika on women's Sexual and Reproductive Health. Health system resilience begins by measuring critical capacities ahead of a crisis such as Zika outbreak. Even though Zika as vector-borne disease is well documented, there is dearth of studies linking Zika with women's Sexual and Reproductive Health. The main objective of this study was to analyze the national response to the Zika epidemic and its relation to women’s sexual and reproductive health matters through key implementation mechanisms in order to promote resilience of the health system in five cities in Colombia.Methods This study used a qualitative design to enable an in-depth exploration of the national response to the Zika epidemic and sexual and reproductive health matters through key implementation mechanisms (based on facilitators and gaps) within the health system. The overall data set was comprised of 31 semi-structured individual interviews (23 women and 8 men), 25 interviews with key informants responsible for the implementation of the Zika Virus Response Plan; six interviews with pregnant women diagnosed with Zika; and five focus groups discussions with communities (n=122 participants) in five cities in Colombia: Barranquilla, Cucuta, Los Patios, San Andres and Soledad. Results The findings revealed the three major facilitators that promoted the implementation of actions to address the Zika epidemic: i) the role of health care providers; ii) the development of technical equipment capabilities; and iii) inter-institutional coordination. The study also identified implementation gaps: i) absence of a human rights and sexual and reproductive health approach; ii) focus on territorial actions centered on mosquito management; and iii) limited attitudes, behaviors and knowledge at the community level.Conclusion This study provided a comprehensive insight of critical facilitating processes and gaps in the implementation of the government response during the Zika epidemic in Colombia. This study reveals that the lack of understanding of the intersection between gender, the Zika epidemic and Sexual and Reproductive Health limited the adoption, development and implementation of a more comprehensive responses to address the impact on women’s sexual and reproductive health.

scholarly journals The impact of the COVID-19 crisis on meeting needs for family planning: a global scenario by contraceptive methods used

2020 ◽  
Vol 4 ◽  
pp. 102
Author(s):  
Aisha Dasgupta ◽  
Vladimíra Kantorová ◽  
Philipp Ueffing
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Reproductive Health Services ◽  
Contraceptive Methods ◽  
Essential Services ◽  
Potential Impact ◽  
The Impact

The COVID-19 crisis could leave significant numbers of women and couples without access to essential sexual and reproductive health care. This research note analyses differences in contraceptive method mix across Sustainable Development Goal regions and applies assumed method-specific declines in use (from 0 per cent to 20 per cent) to produce an illustrative scenario of the potential impact of COVID-19 on contraceptive use and on the proportion of the need for family planning satisfied by modern methods. Globally, it had been estimated that 77 per cent of women of reproductive age (15-49 years) would have their need for family planning satisfied with modern contraceptive methods in 2020. However, taking into account the potential impact of COVID-19 on method-specific use, this could fall to 71 per cent, resulting in around 60 million fewer users of modern contraception worldwide in 2020. Overall declines in contraceptive use will depend on the methods used by women and their partners and on the types of disruptions experienced. The analysis concludes with the recommendation that countries should include family planning and reproductive health services in the package of essential services and develop strategies to ensure that women and couples are able to exercise their reproductive rights during the COVID-19 crisis.

scholarly journals Reaching rural communities through ‘Healthy Entrepreneurs’: a cross-sectional exploration of community health entrepreneurship’s role in sexual and reproductive health

2019 ◽  
Vol 34 (9) ◽  
pp. 676-683
Author(s):  
Robert A J Borst ◽  
Trynke Hoekstra ◽  
Denis Muhangi ◽  
Isis Jonker ◽  
Maarten Olivier Kok
Keyword(s):  
Rural Communities ◽  
Reproductive Health ◽  
Community Health ◽  
Sexually Transmitted Infections ◽  
Sexual And Reproductive Health ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Logistic Regression Models

Abstract The purpose of the current study was to explore the association between community health entrepreneurship and the sexual and reproductive health status of rural households in West-Uganda. We collected data using digital surveys in a cluster-randomized cross-sectional cohort study. The sample entailed 1211 household members from 25 randomly selected villages within two subcounties, of a rural West-Ugandan district. The association between five validated sexual and reproductive health outcome indicators and exposure to community health entrepreneurship was assessed using wealth-adjusted mixed-effects logistic regression models. We observed that households living in an area where community health entrepreneurs were active reported more often to use at least one modern contraceptive method [odds ratios (OR): 2.01, 95% CI: 1.30–3.10] had more knowledge of modern contraceptive methods (OR: 7.75, 95% CI: 2.81–21.34), knew more sexually transmitted infections (OR: 1.86, 95% CI: 1.14–3.05), and mentioned more symptoms of sexually transmitted infections (OR: 1.83, 95% CI: 1.18–2.85). The association between exposure to community health entrepreneurship and communities’ comprehensive knowledge of HIV/AIDS was more ambiguous (OR: 1.27, 95% CI: 0.97–1.67). To conclude, households living in areas where community health entrepreneurs were active had higher odds on using modern contraceptives and had more knowledge of modern contraceptive methods, sexually transmitted infections and symptoms of sexually transmitted infections. This study provides the first evidence supporting the role of community health entrepreneurship in providing rural communities with sexual and reproductive health care.

scholarly journals The impact of the COVID-19 crisis on meeting needs for family planning: a global scenario by contraceptive methods used

2020 ◽  
Vol 4 ◽  
pp. 102
Author(s):  
Aisha Dasgupta ◽  
Vladimíra Kantorová ◽  
Philipp Ueffing
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Reproductive Health Services ◽  
Contraceptive Methods ◽  
Essential Services ◽  
Potential Impact ◽  
The Impact

The COVID-19 crisis could leave significant numbers of women and couples without access to essential sexual and reproductive health care. This research note analyses differences in contraceptive method mix across Sustainable Development Goal regions and applies assumed method-specific declines in use to produce an illustrative scenario of the potential impact of COVID-19 on contraceptive use and on the proportion of the need for family planning satisfied by modern methods. Globally, it had been estimated that 77 per cent of women of reproductive age (15-49 years) would have their need for family planning satisfied with modern contraceptive methods in 2020. However, taking into account the potential impact of COVID-19 on method-specific use, this could fall to 71 per cent, resulting in around 60 million fewer users of modern contraception worldwide in 2020. Overall declines in contraceptive use will depend on the methods used by women and their partners and on the types of disruptions experienced. The analysis concludes with the recommendation that countries should include family planning and reproductive health services in the package of essential services and develop strategies to ensure that women and couples are able to exercise their reproductive rights during the COVID-19 crisis.

scholarly journals Immediate postnatal care following childbirth in Ugandan health facilities: an analysis of Demographic and Health Surveys between 2001 and 2016

2021 ◽  
Vol 6 (4) ◽  
pp. e004230
Author(s):  
Teesta Dey ◽  
Sam Ononge ◽  
Andrew Weeks ◽  
Lenka Benova
Keyword(s):  
Postnatal Care ◽  
Health Surveys ◽  
Post Partum ◽  
Quality Care ◽  
Critical Time ◽  
Healthcare Facility ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Changes Over Time ◽  
Over Time

IntroductionProgress in reducing maternal and neonatal mortality, particularly in sub-Saharan Africa, is insufficient to achieve the Sustainable Developmental Goals by 2030. The first 24 hours following childbirth (immediate postnatal period), where the majority of morbidity and mortality occurs, is critical for mothers and babies. In Uganda,<50% of women reported receiving such care. This paper describes the coverage, changes over time and determinants of immediate postnatal care in Uganda after facility births between 2001 and 2016.MethodsWe analysed the 2006, 2011 and 2016 Ugandan Demographic and Health Surveys, including women 15–49 years with most recent live birth in a healthcare facility during the survey 5-year recall period. Immediate postnatal care coverage and changes over time were presented descriptively. Multivariable logistic regression was used to examine determinants of immediate postnatal care.ResultsData from 12 872 mothers were analysed. Between 2006 and 2016, births in healthcare facilities increased from 44.6% (95% CI: 41.9% to 47.3%) to 75.2% (95% CI: 73.4% to 77.0%) and coverage of immediate maternal postnatal care from 35.7% (95% CI 33.4% to 38.1%) to 65.0% (95% CI: 63.2% to 66.7%). The majority of first checks occurred between 1 and 4 hours post partum; the median time reduced from 4 hours to 1 hour. The most important factor associated with receipt of immediate postnatal care was women having a caesarean section birth adjusted OR (aOR) 2.93 (95% CI: 2.28 to 3.75). Other significant factors included exposure to mass media aOR 1.38 (95% CI: 1.15 to 1.65), baby being weighed at birth aOR 1.84 (95% CI: 1.58 to 2.14) and receipt of antenatal care with 4+Antenatal visits aOR 2.34 (95% CI: 1.50 to 3.64).ConclusionIn Uganda, a large gap in coverage remains and universal immediate postnatal care has not materialised through increasing facility-based births or longer length of stay. To ensure universal coverage of high-quality care during this critical time, we recommend that maternal and newborn services should be integrated and actively involve mothers and their partners.

scholarly journals Non-Price Criteria for the Evaluation of the Tender Offers in Public Procurement of Ukraine

2020 ◽  
Vol 8 (3) ◽  
pp. 44
Author(s):  
Alexander Baranovsky ◽  
Nataliia Tkachenko ◽  
Vladimer Glonti ◽  
Valentyna Levchenko ◽  
Kateryna Bogatyrova ◽  
...  
Keyword(s):  
Public Procurement ◽  
Well Being ◽  
Gdp Per Capita ◽  
Tender Offers ◽  
Product Categories ◽  
Per Capita ◽  
The Government ◽  
The Impact ◽  
Over Time ◽  
The Eu

Traditionally, public procurement has been associated with the measurement of achieving savings. However, recent research shows that the economic impact of public procurement is not limited only to savings, but by measuring the impact of four capitals—natural, human, social, and economic—on sustainable well-being over time. Ukraine is a country with a very low gross domestic product (GDP) per capita, which exacerbates the problem of the impact of public procurement results on the population’s welfare. Ukrainian public procurement legislation allows customers to apply non-price criteria (the share of non-price criteria cannot be more than 70%), which, together, are taken into account in the formula of the quoted price. The studies show that the effect of the use of non-price criteria depends on the relevance of the method of the evaluation of non-price criteria. The most important non-price criteria for Ukrainian customers by product categories and the methods of their evaluation are analyzed according to the Bi.prozorro.org analytics module. Therefore, it is concluded that the quoted price method, which is used in Ukrainian practice, is not relevant in comparison with the method used in the EU. A survey of the government buyers on the practice of applying non-price criteria was conducted, and the areas of their use were identified.

scholarly journals Free contraception and behavioural nudges in the postpartum period: evidence from a randomised control trial in Nairobi, Kenya

2018 ◽  
Vol 3 (5) ◽  
pp. e000888 ◽  
Author(s):  
Margaret McConnell ◽  
Claire Watt Rothschild ◽  
Allison Ettenger ◽  
Faith Muigai ◽  
Jessica Cohen
Keyword(s):  
Postpartum Period ◽  
Randomised Control Trial ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Birth Intervals ◽  
Financial Barriers ◽  
Maternity Hospitals ◽  
Sms Reminder ◽  
The Impact

BackgroundShort birth intervals are a major risk factor for poor maternal and newborn outcomes. Utilisation of modern contraceptive methods during the postpartum period can reduce risky birth intervals but contraceptive coverage during this critical period remains low.MethodsWe conducted a randomised controlled experiment to test whether vouchers for free contraception, provided with and without behavioural ‘nudges’, could increase modern contraceptive use in the postpartum period. 686 pregnant women attending antenatal care in two private maternity hospitals in Nairobi, Kenya, were enrolled in the study. The primary outcomes were the use of modern contraceptive methods at nearly 3 months and 6 months after expected delivery date (EDD). We tested the impact of a standard voucher that could be redeemed for free modern contraception, a deadline voucher that expired 2 months after delivery and both types of vouchers with and without a short message service (SMS) reminder, relative to a control group that received no voucher and no SMS reminder.ResultsBy nearly 6 months after EDD, we find that the combination of the standard voucher with an SMS reminder increased the probability of reporting utilisation of a modern contraceptive method by 25 percentage points (pp) (95% CI 6 pp to 44 pp) compared with the control group. Estimated impacts in other treatment arms were not statistically significantly different from the control group.ConclusionsReducing financial barriers to postpartum contraception alone may not be enough to encourage take-up. Programmes targeting the postpartum period should consider addressing behavioural barriers to take-up.

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