APHRC Q3 NEWSLETTER JULY – SEPTEMBER 2013

An estimated 465,000 abortions took place in Kenya in 2012, virtually all of them clandestine and unsafe procedures, and most resulting from unintended pregnancies. According to a report launched in August by APHRC through the Population Dynamics and Reproductive Health program and the Ministry of Health, 70 percent of women seeking health care as a result of unsafe abortion procedures reported they had not used any form of contraception prior to becoming pregnant, illustrating a serious lack of family planning access and education services. […]

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Rural Community-Based Family Planning Project of Western Kenya: Demonstration Phase, 2009-2012

Strong evidence base is required to effectively develop and deliver targeted reproductive health programs to underserved populations. The Packard Western Kenya (PWK) Project is a rural community-based family planning intervention funded by the David and Lucile Packard Foundation to reverse the fertility stall in Western Kenya, increase access and utilization of voluntary family planning services, and reduce unsafe abortions, infant and maternal mortality. The PWK project is a two-year demonstration imitative implemented in four rural districts of Western Kenya, namely Siaya, Bondo, Teso and Busia by a consortium led by APHRC. The consortium conducted a baseline survey in May 2010 among women age 15-49 to provide reference information for use in the measurement of the impact of the project and to inform a three-year scale-up phase planned to begin in 2012. […]

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Consortium for Advanced Research Training in Africa (CARTA) Report: Year 3

This report presents learning from the African Institution initiative’s experiences to date, with a particular focus on the third year of activity. Its audience is both the consortia funded under the initiative and the Wellcome Trust. The report is an annual (interim deliverable) of the evaluation and learning project, and is in this context a ‘living document’. As such, the report aims to provide an evaluation resource that can enable each consortium to reflect on individual progress and priorities going forward. […]

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DATA DOCUMENTATION – ORAL HIV SELF TESTING PROJECT

HIV/AIDS remains a leading cause of morbidity and mortality in sub-Saharan Africa. HIV disproportionately affects women and youth aged 15-24 years. The majority of those living with HIV/AIDS (69%) as well as the largest proportion of new infections (72%) are in sub-Saharan Africa. The percentage of the general population who are aware of their HIV status is less than 20%, a factor that may explain the large numbers in new infections each year relative to other regions of the world. In response to preliminary findings indicating relatively high approval and potential acceptance of oral HIV self-testing, this study aimed to assess and quantify perceived social harms and abuses that may arise from widespread availability of oral HIV testing kits and to describe possible actions to prevent these harms and abuses. Using both qualitative and quantitative approaches, the study explored potential social harms and abuses that could emanate from self-testing and assessed potential strategies to mitigate these harms and abuses. Information on approaches to mitigate these harms and abuses was also collected. The results of this study are expected to inform the design, development and implementation of HIV prevention and control strategies aimed at promoting the safe use of oral HIV self-testing kits as an alternative to conventional avenues of HIV testing.

To request the project data sets please email us at: datarequests@aphrc.org […]

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TRANSITIONS TO ADULTHOOD IN A HIGH FERTILITY CONTEXT: THE CASE OF SUB-SAHARAN AFRICA

Sub-Saharan Africa (SSA) is projected to experience the highest population growth rate of any subregion in the next three decades (United Nations, 2013). Rapid population growth in this region is a major challenge due largely to the inability of the economies of many countries to absorb the large number of adults in productive ages. The large population of children and young people in the region means that drastic measures are urgently needed to ensure that the educational, employment, and social needs of the youthful population are met. Failure to address these needs means that many young people’s ability to contribute meaningfully to the economy will be severely curtailed with adverse consequences to regional development. […]

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REPRODUCTIVE HEALTH AND FAMILY PLANNING FINANCING IN KENYA. A MAPPING OF THE RESOURCE FLOWS

Reproductive Health and Family planning related policy making, budgeting and planning by governments and other stakeholders at country level would benefit tremendously if quality periodic reports that compare the health sector funding needs with the allocation of resources (domestic and external), actual expenditure and distribution of resources as well as projected availability of resources (domestic and external) are made available on regular basis. […]

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REPRODUCTIVE HEALTH FINANCING IN KENYA: AN ANALYSIS OF NATIONAL COMMITMENTS, DONOR ASSISTANCE, AND THE RESOURCES TRACKING PROCESS

Understanding the flow of resources at the country level to reproductive health is essential for effective financing of this key component of health. This paper gives a comprehensive picture of the allocation of resources for reproductive health in Kenya and the challenges faced in the resource-tracking process. Data are drawn from Kenyan budget estimates, reproductive health accounts, and the Resource Flows Project database and compare budgets and spending in 2005–06 with 2009–10. Despite policies and programmes in place since 1994, services for family planning, maternity care and infant and child health face serious challenges. […]

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UNINTENDED PREGNANCY: MAGNITUDE AND CORRELATES IN SIX URBAN SITES IN SENEGAL

Abstract

Background:

In Senegal, unintended pregnancy has become a growing concern in public health circles. It has often been described through the press as a sensational subject with emphasis on the multiple infanticide cases as
a main consequence, especially among young unmarried girls. Less scientific evidence is known on this topic, as fertility issues are rarely discussed within couples. In a context where urbanization is strong, economic insecurity is
persistent and the population is globalizing, it is important to assess the magnitude of unintended pregnancy among urban women and to identify its main determinants.

Methods:

Data were collected in 2011 from a representative sample of 9614 women aged 15–49 years in six urban sites in Senegal. For this analysis, we include 5769 women who have ever been pregnant or were pregnant at the time of the survey. These women were asked if their last pregnancy in the last two years was ‘wanted ’then’ , ‘wanted later’ or ‘not wanted’. Pregnancy was considered as unintended if the woman responded ‘wanted later’ or ‘not wanted’. Descriptive analyses were performed to measure the magnitude of unintended pregnancies, while multinomial logistic regression models were used to identify factors associated with the occurrence of unintended pregnancy. The analyses were performed using Stata version 12. All results were weighted.

Results:

The results show that 14.3% of ever pregnant women reported having a recent unintended pregnancy. The study demonstrates important distinctions between women whose last pregnancy was intended and those whose last pregnancy was unintended. Indeed, this last group is more likely to be poor, from a young age (< 25 years) and multiparous. In addition, it appears that low participation of married women in decision-making within the couple (management of financial resources) and the lack of discussion on family planning issues are associated with greater experience of unintended pregnancy.

Conclusion:

This study suggests a need to implement more targeted programs that guarantee access to family planning for all women in need. In urban areas that are characterized by economic insecurity, as in Senegal, it is important to consider strategies for promoting communication within couples on fertility issues. […]

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