Population Dynamics & Reproductive Health

Population, Reproductive Health and Poverty

The Center has developed a robust and multifaceted evidence base about sexual and reproductive health (SRH) issues, with special attention to young people. Our research has also provided understanding of what works to
increase uptake of modern contraceptives within high-fertility communities, and has informed debate around unintended pregnancies and unsafe abortion.

The Center has also generated evidence on drivers of sexual violence and contributed to innovations in how to address sexual violence among refugee populations. Our work is exploring how poor men express their masculinity as breadwinners with few options for employment, and how they might become champions in the global struggle for gender equality.

A deeper understanding of contexts, drivers, experiences and preferences for family planning remains. Understanding SRHR throughout the life course is critical to many health and development pathways, as is improved understanding of population dynamics and their implications for sustainable development: specifically, the realization of the demographic dividend.

There are four areas of inquiry in this Unit, aiming to promote sustainable population growth and improved sexual and reproductive health and rights across the life course:

The signature issue for the Unit will be young people’s sexual and reproductive health and rights (SRHR). We will focus in particular on early adolescents (10-14 years) and those from marginalized communities, and the magnitude and impact of adverse SRH events on adolescent health and wellbeing. We will aim to clarify the contexts for comprehensive sexuality education, including SRHR/ FP counseling for adolescents. This program will also generate
evidence about what works to reach youth with safe, respectful and comprehensive SRHR information and services.

The second signature issue for this Unit will be unsafe abortion. We will aim to understand the contexts and dynamics of unsafe abortion, family planning, and contraceptive behaviors; deepen our understanding of the mortality and morbidity associated with unsafe abortion; and assess the impact of unsafe abortion prevention programs and barriers to quality post abortion care. We will contribute to knowledge on drivers, experiences and preferences among populations for the array of options for family planning, and illuminate pathways for optimizing the provision and sustainability of services, including financing and delivery options.

The third program of work will address gender and sexuality-related vulnerabilities. Assessing the magnitude and perceptions of gender-based violence will drive this programmatic area, including identification of where
men and boys might engage in promoting women’s SRHR. The program will also seek to clarify the origins and implications of gender ideologies and practices, including masculinity.

The Unit will spearhead efforts to contribute to the discourse around the Demographic Dividend. We will seek to understand population dynamics, including regional and intra-regional fertility, mortality and migration trends,
and their implications for sustainable development and how to position Africa to achieve the demographic dividend.

Featured Project

Impact evaluation of PEPFAR’s DREAMS Initiative in Nairobi

Program: Population Dynamics & Reproductive Health

In many countries with a generalized HIV epidemic, most of the new infections are happening among adolescent girls and young women (AGYW) aged 15-24. The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women) Initiative,  a multi-component package of HIV prevention interventions targeting the multiple sources of risk among AGYW, was launched in 10 high burden countries in sub-Saharan Africa including Kenya to help reduce new HIV infections. Adolescent girls and young women living in slums are known to be particularly vulnerable and as such have been targeted by the DREAMS interventions in Kenya.

The DREAMS Impact Evaluation project aims to evaluate the impact of the DREAMS Initiative in Korogocho and Viwandani slums where the Center has been running the Nairobi Urban and Health Demographic Surveillance System (NUHDSS) since 2002 in order to:

  1. Ascertain whether the DREAMS initiative has been effective in changing HIV-related outcomes in the community
  2. Investigate the pathways of protection by which DREAMS interventions influence the lives of young women and ultimately their risk for HIV and
  3. Assess the extent to which the DREAMS interventions have been delivered as intended.

The project uses both quantitative and qualitative surveys at three points in time (yearly) among the general population aged 15 to 49 and a closed cohort of AGYW aged between 10-22 years while assessment of the delivery of the interventions is continuous process evaluation primarily using qualitative methods of data collection and observations. The results of this evaluation will help inform the planning and implementation of similar interventions targeting vulnerable populations at individual and community level.

Principal Investigators from the following institutions are participating in the impact evaluation consortium:

  • London School of Hygiene and Tropical Medicine(LSHTM),
  • Africa Health Research Institute (AHRI) in South Africa,
  • Centre for Sexual Health and HIV and AIDS Research (CeSHHAR) in Zimbabwe
  • Kenya Medical Research Institute (KEMRI), in Gem Kisumu.

 PROJECT PERIOD: 2016 to 2019

Project Funders

  • www.gatesfoundation.org ...


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