scholarly journals Accounting for complexity – Intervention design in the context of studying social accountability for reproductive health

2021 ◽  
Vol 5 ◽  
pp. 107
Author(s):  
Heather McMullen ◽  
Victoria Boydell ◽  
Joanna Paula Cordero ◽  
Petrus S. Steyn ◽  
James Kiarie ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Interrupted Time Series ◽  
Social Accountability ◽  
Local Context ◽  
Control Group ◽  
Intervention Design ◽  
Main Body ◽  
Design Features ◽  
Methodological Considerations ◽  
Contraceptive Uptake

Background: Social accountability interventions aim to propel change by raising community voices and holding duty bearers accountable for delivering on rights and entitlements. Evidence on the role of such interventions for improving community health outcomes is steadily emerging, including for sexual and reproductive health and rights (SRHR). However, these interventions are complex social processes with numerous actors, multiple components, and a highly influential local context. Unsurprisingly, determining the mechanisms of change and what outcomes may be transferable to other similar settings can be a challenge. We report our methodological considerations to account for complexity in a social accountability intervention exploring contraceptive uptake and use in Ghana and Tanzania. Main Body: The Community and Provider driven Social Accountability Intervention (CaPSAI) study explores the relationship between a health facility-focused social accountability intervention and contraceptive service provision in two countries. This 24-month mixed-method quasi-experimental study, using an interrupted time series with a parallel control group, is being undertaken in 16 sites across Ghana and Tanzania in collaboration with local research and implementation partners. The primary outcomes include changes in contraceptive uptake and use. We also measure outcomes related to current social accountability theories of change and undertake a process evaluation. We present three design features: co-design, ‘conceptual’ fidelity, and how we aim to track the intervention as ‘intended vs. implemented’ to explore how the intervention could be responsive to the embedded routines, local contextual realities, and the processual nature of the social accountability intervention. Conclusions: Through a discussion of these design features and their rationale, we conclude by suggesting approaches to intervention design that may go some way in responding to recent challenges in accounting for social accountability interventions, bearing relevance for evaluating health system interventions.

scholarly journals Rationale and design of a complex intervention measuring the impact and processes of social accountability applied to contraceptive programming: CaPSAI Project

2020 ◽  
Vol 4 ◽  
pp. 26 ◽  
Author(s):  
Petrus S Steyn ◽  
Victoria Boydell ◽  
Joanna Paula Cordero ◽  
Heather McMullen ◽  
Ndema Habib ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Contextual Factors ◽  
Social Accountability ◽  
Control Group ◽  
Service Users ◽  
Care Providers ◽  
The Impact

Background: There are numerous barriers leading to a high unmet need for family planning and contraceptives (FP/C).  These include limited knowledge and information, poor access to quality services, structural inefficiencies in service provision and inadequately trained and supervised health professionals. Recently, social accountability programs have shown promising results in addressing barriers to accessing sexual and reproductive health services. As a highly complex participatory process with multiple and interrelated components, steps and actors, studying social accountability poses methodological challenges. The Community and Provider driven Social Accountability Intervention (CaPSAI) Project study protocol was developed to measure the impact of a social accountability process on contraceptive uptake and use and to understand the mechanisms and contextual factors that influence and generate these effects (with emphasis on health services actors and community members). Methods: CaPSAI Project is implementing a social accountability intervention where service users and providers assess the quality of local FP/C services and jointly identify ways to improve the delivery and quality of such services. In the project, a quasi-experimental study utilizing an interrupted time series design with a control group is conducted in eight intervention and eight control facilities in each study country, which are Ghana and Tanzania. A cross-sectional survey of service users and health care providers is used to measure social accountability outcomes, and a cohort of women who are new users of FP/C is followed up after the completion of the intervention to measure contraceptive use and continuation. The process evaluation utilizes a range of methods and data sources to enable a fuller description of how the findings were produced. Conclusion: This complex study design could provide researchers and implementers with the means to better measure and understand the mechanisms and contextual factors that influence social accountability processes in reproductive health, adding important findings to the evidence base.

scholarly journals Rationale and design of a complex intervention measuring the impact and processes of social accountability applied to contraceptive programming: CaPSAI Project

2020 ◽  
Vol 4 ◽  
pp. 26
Author(s):  
Petrus S Steyn ◽  
Victoria Boydell ◽  
Joanna Paula Cordero ◽  
Heather McMullen ◽  
Ndema Habib ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Contextual Factors ◽  
Social Accountability ◽  
Control Group ◽  
Service Users ◽  
Care Providers ◽  
The Impact

Background: There are numerous barriers leading to a high unmet need for family planning and contraceptives (FP/C).  These include limited knowledge and information, poor access to quality services, structural inefficiencies in service provision and inadequately trained and supervised health professionals. Recently, social accountability programs have shown promising results in addressing barriers to accessing sexual and reproductive health services. As a highly complex participatory process with multiple and interrelated components, steps and actors, studying social accountability poses methodological challenges. The Community and Provider driven Social Accountability Intervention (CaPSAI) Project study protocol was developed to measure the impact of a social accountability intervention on contraceptive uptake and use and to understand the mechanisms and contextual factors that influence and generate these effects (with emphasis on health services actors and community members). Methods: CaPSAI Project is implementing a social accountability intervention where service users and providers assess the quality of local FP/C services and jointly identify ways to improve the delivery and quality of such services. In the project, a quasi-experimental study utilizing an interrupted time series design with a control group is conducted in eight intervention and eight control facilities in each study country, which are Ghana and Tanzania. A cross-sectional survey of service users and health care providers is used to measure social accountability outcomes, and a cohort of women who are new users of FP/C is followed up after the completion of the intervention to measure contraceptive use and continuation. The process evaluation utilizes a range of methods and data sources to enable a fuller description of how the findings were produced. Conclusion: This complex study design could provide researchers and implementers with the means to better measure and understand the mechanisms and contextual factors that influence social accountability processes in reproductive health, adding important findings to the evidence base.

scholarly journals SARS-CoV-2 and the reproductive system: known and the unknown..!!

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Indu Sharma ◽  
Priti Kumari ◽  
Anuradha Sharma ◽  
Subhas Chandra Saha
Keyword(s):  
Reproductive Health ◽  
Vertical Transmission ◽  
Reproductive System ◽  
Ovarian Function ◽  
Sperm Count ◽  
Sperm Concentration ◽  
Reproductive Potential ◽  
Oocyte Quality ◽  
Main Body ◽  
Close Monitoring

Abstract Background COVID-19 is the most recent zoonotic outbreak of coronaviruses. Mostly, it invades the cells of the respiratory system by binding to the receptor angiotensin-converting enzyme 2 (ACE2) which is also present in other organs like the kidney, testis, ovaries, breast, heart, and intestine, rendering them prone to be infected. The reproductive potential is a must for the sustenance of any species and it is our prime duty to safeguard the reproductive system of the present generation from such a deadly virus. The previously reported coronaviruses like severe acute respiratory syndrome coronavirus (SARS-CoV) had a detrimental impact on reproductive organs. There is a dearth of sufficient research to provide substantial evidence for the harmful effects of this novel virus on the reproductive system. Hence, our review compiles the knowledge available until now to boost research in this regard and to take the necessary steps in time. Main body of abstract Here we tried to compile all the data available on the effect of SARS-CoV-2 on the reproductive system as well as vertical transmission of the virus. All related articles published from February to August 2020 were reviewed and thoroughly analyzed. SARS-CoV-2 has been found to affect the sperm concentration and motility, thus degrading the fertility of males. In females, it is suspected that this virus affects the oocyte quality and ovarian function, resulting in infertility or miscarriage. Traces of SARS-CoV-2 virus have also been found in the breast milk of the infected mothers and the semen of infected males. Vertical transmission of SARS-CoV-2 has also been reported in some cases. Conclusion Based on the literature review, SARS-CoV-2 seems to have the potential of affecting both male and female reproductive tracts. This review brings together the findings and observations made in the area of reproductive health during the current pandemic. The reproductive system of the young population is preordained for subsequent disorders, infertility, reduced sperm count, and motility. Therefore, the research and medical practices should focus on possible vulnerability being posed by SARS-CoV-2 to the gametes and future generations. We, hereby, recommend close monitoring of young and pregnant COVID-19 patients concerning reproductive health with utmost priority.

scholarly journals The effect of nutrition and reproductive health education of pregnant women in Indonesia using quasi experimental study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tria Astika Endah Permatasari ◽  
Fauza Rizqiya ◽  
Walliyana Kusumaningati ◽  
Inne Indraaryani Suryaalamsah ◽  
Zahrofa Hermiwahyoeni
Keyword(s):  
Health Education ◽  
Reproductive Health ◽  
Pregnant Women ◽  
Intervention Group ◽  
Control Group ◽  
Attitudes And Practices ◽  
Significant Difference ◽  
Reproductive Health Education ◽  
Post Test ◽  
Knowledge Attitudes And Practices

Abstract Background Almost one-third of children under 5 years old in Indonesia suffer from stunting. Stunting can be prevented optimally during pregnancy as the initial phase of the first 1000 days of life. This study aims to determine the effect of nutrition and reproductive health education of pregnant women in Bogor Regency, Indonesia. Methods A quasi-experimental study was conducted among 194 pregnant women from August to November 2019. The pregnant women were randomly selected from four different villages in Bogor Regency. The intervention group (n = 97) received 2 h of nutrition and reproductive health education in small groups (four or five mothers per group) every 2 weeks for 3 consecutive months. This interactive education was given by facilitators using techniques such as lectures, role-playing, simulation, and games. The control group (n = 97) received regular health care services. A structured questionnaire was applied to collect data consisting of maternal characteristics, nutritional and reproductive health knowledge, attitudes, and practices in the intervention and control groups. Data were analysed using t-test and chi-square analysis. Results Pregnant women in the intervention group indicated a significant increase in knowledge, attitudes, and practices regarding nutrition and reproductive health after receiving education. The pre-test and post-test mean scores in the intervention group were 55.1 and 83.1 for overall knowledge, 40.2 and 49.0 for attitudes, and 36.2 and 40.2 for practices, respectively. In the control group, there was no significant difference between the pre-test and post-test mean scores for these three variables. There was a significant difference (P < 0.001) in the post-test mean between the intervention group and the control group, but the difference was not significant (P > 0.05) in the pre-test. Conclusion Providing nutrition and reproductive health education through small groups with interactive methods improves the knowledge, attitudes, and practices of pregnant women. This intervention has the potential to be replicated and developed for large-scale implementation by optimising collaboration between government, non-governmental organizations, and maternal and child health service providers.

EFFECTIVE OF INTERVENTION SOLUTIONS TO IMPROVE SITUATION OF REPRODUCTIVE HEALTH CARE AMONG ADOLESCENT GIRLS IN A LUOI DISTRICT, THUA THIEN HUE PROVINCE

2020 ◽  
pp. 32-44
Author(s):  
Trang Dao Nguyen Dieu ◽  
Huy Nguyen Vu Quoc ◽  
Thanh Cao Ngoc ◽  
Ngoc Phan Thi Bich
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Adolescent Girls ◽  
Study Design ◽  
Good Practice ◽  
Education Level ◽  
Control Group ◽  
Health Staff ◽  
Reproductive Health Care ◽  
Adolescent Reproductive Health

Objectives: To describe the knowledge, attitudes, practices of reproductive health care among adolescent girls in A Luoi district, Thua Thien Hue province and to identify the related factors to reproductive health care in adolescent girls. To assess the results of intervention solutions of reproductive health care in adolescent girls. Methods: A cross-sectional study design. A study design for community intervention comparision with control group. Results: The percentage of adolescents with not good knowledge, attitudes and practices on reproductive health care has accounted for fairly high as respectively: 85.9%, 73.9%, 72.9%. There is an a relationship between education level, adolescent stage with general knowledge on adolescent reproductive health care (p < 0.05). There is a relationship between ethnicity, education level, adolescent stage with the general attitude on adolescent reproductive health care (p < 0.05). There is a relationship between knowledge, attitude, education level, adolescent stage, economic condition, the condition of the family living at the percentage of general practice on adolescent reproductive health care (p < 0.05). The effective of intervention: Good knowlegde increase from 10% to 24.1%. Good attitude increase from 16.7% to 61.4%. Good practice increase from 27.1% to 42.9%. The effective of intervention: change knowlegde: 21.6%, change attitude: 54.2%, change practice: 34.6%. Conclusion: There is need to enhance the communication and education reproductive health for aldolescent girls and to enhance communication knowlegde and skills for reproductive health staff. Keywords: adolescents, get married early, reproductive health.

scholarly journals EFFECTIVENESS OF FEEDING DRY BREWERS GRAINS TO REPAIR HEIFERS OF THE JERSEY BREED

2019 ◽  
Vol 57 ◽  
pp. 16-21
Author(s):  
A. A. Veres ◽  
M. M. Kryvyi ◽  
V. P. Slavov ◽  
Yu. P. Polupan ◽  
V. G. Кеbkо ◽  
...  
Keyword(s):  
Research Group ◽  
Total Protein ◽  
High Protein ◽  
Economic Research ◽  
Control Group ◽  
Main Body ◽  
Joint Stock Company ◽  
Body Measurements ◽  
Research Groups ◽  
Chest Girth

Introduction. An important reserve for increasing the profitability and competitiveness of livestock production would be solving the problem of feed protein deficiency in animal feeding. Significant contribution to the solution of this problem can be made by using high-protein waste of oil extraction (meal, cake), alcohol (bard), brewing (brewers grains) industries for feeding purposes. Since the liquid brewers grains is poorly preserved and easily spoiled, especially during the summer, and its transportation over long distances requires large costs, in this regard, there is a current problem of drying the liquid brewers grains and its usage as a high-protein fodder for feeding animals in dry form as part of animal mixed fodder. The purpose of our research is to study the effectiveness of feeding dry brewers grains to repair heifers of the Jersey breed. Research materials and methods. Research on the feeding dry brewers grains effectiveness was carried out on repair heifers of the Jersey breed at the age from 2 to 12 months on the basis of the farm SE “Dan-milk” in Cherniakhiv district of Zhytomyr region. Dry brewers grains produced by private joint-stock company (PJSC) “Obolon” were used for the research. Research result. The content of crude protein in 1 kg of dry brewers grains, which was used in scientific and economic research, was 24.46%, or 244.6 g per 1 kg of dry brewers grains. In order to study the effectiveness of feeding dry brewers grains, three groups of repair heifers of the Jersey breed were formed for the research, 8 heads each, according to the following scheme: one control group of repair heifers, and the other two were research groups. According to the research scheme, the control group of repair heifers received a standard grain mixture without dry brewers grains. The difference in the feeding of repair heifers of research groups consisted in different levels of feeding dry brewers grains, which was included in the grain mix of the II research group in the amount of 15%, and the III research group - in the amount of 20%. As a result of the research, there was an increase in the average daily gains of the II research group heifers, which ration included 15% of dry brewers grains in the mixture composition: for the period from 2 until 6 months – up to 0.811 kg against 0.786 kg, for a period from 6 until 12 months – up to 0.671 kg against 0.657 kg, for a period from 2 until 12 months – up to 0.727 kg against 0.709 kg in the control group. At the age from 9 and 12 months of cultivation of repair heifers of the II research group, which grain mixture included 15% of dry brewers grains, there was a tendency of the main body measurements increase: height at the withers, chest girth and oblique torso length, compared with the repair heifers of the control group. In heifers of the III research group, which ration included 20% of dry brewers grains of the grain mixture, the main body measurements were lower than in heifers of the control and II research groups. While studding main hematological indicators of the repair heifers of the control and research groups at the age of 6 and 12 months of cultivation, it was found that the inclusion of 15% of dry brewers grains in the grain mixture of the ration of the repair heifers of the II research group improved their passage of biosynthetic processes and the use of nitrogen, which indicates a tendency to increase in their blood total protein content compared to the control group primarily due to globulins, which indicates an improvement of immune-protective properties in the heifers of this group. The increase in the content of total protein and globulins against the control group in the heifers of the III research group, grain mixture for which included 20% of dry brewers grains, was manifested to a lesser degree. Summary. The inclusion of dry brewers grains in the grain mixture of the rations of repair heifers of the Jersey breed of the II research group in the amount of 15% of the total weight of the grain mixture, provided an increase in their average daily gains compared to the repair heifers of the control group and amounted to for the period from 2 until 6 months – 3.2%, for the period from 6 until 12 months – 2.1%, for the period from 2 until 12 months –2.6% with a tendency to increase the main measurements at the age of 9 months: height at the withers up to 104.0 cm against 103.5 cm, chest girth – 142.8 cm against 141.4 cm, oblique torso length – 131.8 cm against 131.4 cm in the control group.

scholarly journals Impact of Microfinance on Income and Employment in Pakistan: A Primary Data Analysis

2017 ◽  
Vol 3 (1) ◽  
pp. 69-82
Author(s):  
Shahina Imran ◽  
Rana M. Imran Arshad
Keyword(s):  
Household Income ◽  
Positive Impact ◽  
Small Enterprise ◽  
Local Context ◽  
Primary Data ◽  
Control Group ◽  
Primary Data Analysis ◽  
Gender Education ◽  
Household Assets ◽  
The Impact

Purpose: This paper investigates impact of microfinance on household income and employment. It is a primary data research conducted in the Bahawalpur division, Pakistan. The study employed the tool developed by Assessing the Impact of Microenterprise Services (AIMS) and Small Enterprise, Education and Promotion (SEEP). The tool has been modified in local context. The sample consists of 1524 respondents, out of which 773 are established clients (treatment group) and 751 are incoming ones (control group), belonging to different microfinance providers of Pakistan.  Independent Sample T-Test and Multiple regressions have been used for analysis. The regression analysis shows that participation to microfinance program has strong positive impact on household income while very minute positive impact on employment. Other independent variables such as prior access to any other loan, micro saving, household assets, age of respondent, gender, education and household size have positive impact on household income but a mixed impact on income generating activities.

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