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Everybody Matters: Good practices for inclusion of people with disabilities in sexual and reproductive health and rights programmes

Van SLOBBE, Caroline
November 2017

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This publication provides introductory chapters from two activists who work to create better opportunities for people with disabilities in Nigeria and India. Subsequently, the challenges that organisations worldwide have encountered whilst improving the access to and knowledge of sexual and reproductive health and rights for people with disabilities are presented. Ways in which they managed to find solutions and the results achieved are reviewed. Some cases show the importance of a more personal approach whilst others emphasise the advantage of changing systems and policies. Different regions, types of disabilities and various SRHR-topics are reflected in these stories. All cases provide lessons learnt that contribute to a set of recommendations for improved responses. The closing chapter highlights the challenges, solutions, and ambitions that are presented and lead up to a concise overview of recommendations.  

Good practice examples include:

A shift in SRH programming (Nepal)

Breaking Barriers with performance art (Kenya)

Her Body, Her Rights (Ethiopia)

People with disabilities leading the way (Israel Family Planning Association)

Best Wishes for safe motherhood (Nepal)

It’s my body! (Bangladesh)

Calling a spade a spade (Netherlands)

Four joining forces (Colombia)

Change agents with a disability (Zimbabwe)

Tito’s privacy and rights (Argentina)

Sign language for service providers (Kenya)

The potential impact of community-based distribution programmes on contraceptive uptake in resource-poor settings : evidence from Ethiopia

TAWYE, Yenehun
et al
December 2005

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This article assesses the impact of community-based reproductive health services (CBRHS) and programmes on contraceptive use in Ethiopia. The 1993 National Population Policy provided a strong political backing to community-based contraceptive programmes, which grew in number and outreach to the community. The article shows that 'women living in areas covered by the CBRHS programme were three times more likely to use contraception than the average Ethiopian woman'. The study concludes that scaling up the programme nationwide would have the effect of doubling the national contraceptive prevalence rate

CBD research in Muheza district : final report for Tanzanian German Programme to Support Health (TGPSH)/GTZ

SIMBA, Daudi O
November 2005

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This study was done to determine the extent to which Community Based Distribution (CBD) reaches the poor compared with health facilities. It found that contraceptive prevalence rate in the CBD area was 32 per cent, more than double the national figures for rural areas. People from all wealth categories had equal access to contraceptive services from CBD agents. It is therefore likely that the presence of CBD agents increases the access of the poor to family planning services. Interestingly, adolescents, men, and Catholics were more likely to use CBD services to access contraceptives, than older women and people from other religions

Who do the CBD reach? A study for the Tanzanian German Programme to Support Health (TGPSH)

KIBUGA, Kate Forrester
July 2005

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The GTZ-supported CBD (Community Based Distribution) agents are volunteers at village level in Tanga region of Tanzania, who provide information on sexual and reproductive health topics, and distribute contraceptives in their neighbourhoods, thus increasing access to family planning services and reproductive health information. This study examined whether CBD reached poorer people and whether poverty influences the choice made in sourcing contraceptives. A participatory methodology was used - CBD agents drew maps of their neighbourhood, marking every house, determining the wealth status of each household, and indicating each house using their services. Poorer people are effectively reached by CBD, but the average wealth group makes greater use of it. However, poorer people are more likely to use CBD than to go to the health facilities. CBD agents found the maps a useful tool for monitoring their work, but there were doubts as to their accuracy for this study. CBD agents may have inflated the number of clients, or omitted houses with no clients

A client-centered approach to reproductive health : a trainer's manual

POPULATION COUNCIL
February 2005

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'The Population Council has developed a novel framework for training providers to deliver client-centered reproductive health services. The essence of the approach is to bring about behaviour change in providers by making them more receptive and responsive to client needs. Further, providers are taught to treat clients with respect and dignity, to assess their reproductive health needs holistically within the context of their household circumstances, and to negotiate solutions that clients are able to implement. Known by the acronym SAHR, this approach involves four interconnected steps: Salutation, Assessment, Help, and Reassurance. Through operations research, SAHR was successfully tested in Pakistan in 2000-02. The training manual describes the SAHR approach and is meant to facilitate training of reproductive health providers in how to offer client-centered services. The manual is written in fairly generic terms and can be used, with slight modifications, in any setting or country. The manual has three sections. Section One, the introduction, is an overview of the contents. Section Two, the trainer's guide, comprises the training modules. Each module describes the individual components of client-provider interaction and includes learning objectives, key learning points, a schedule, and a list of materials required. Trainer notes and step-by-step instructions for each activity are included within each module. Section Three contains support materials to help trainers prepare for the sessions.'

Impact of sex and HIV education programs on sexual behaviors of youth in developing and developed countries

KIRBY, Douglas
LARIS, B A
ROLLERI, Lori
2005

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This paper discusses findings from a review of 83 evaluations of sex and HIV education programmes. The analysis found substantial positive impact on sexual behaviours in more than two-thirds of the evaluations and identified 17 characteristics of the most effective curricula used in the programmes evaluated. More information on this review is available, including links to data sheets on each of the 83 evaluations. [Publisher's abstract, amended]

Follow up reproductive health needs assessment in the process of evaluating a CBD programme in Lushoto Division, Lushoto District

KRAUT, Angela
et al
April 2004

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The study is the follow up to a baseline study (2000) on Deutsche Gesellschaft fuer Technische Zusammenarbeit (GTZ) GmbH supported Community Based Distribution (CBD) activities in Lushoto Division in Tanzania. The study found that contraceptive prevalence was 43.2%, almost double previous figures, and that women's knowledge of contraceptive methods had increased from 77.1% to 84.4%. CBD agents provide an important 'social link' between communities and the professional health sector. The knowledge of long term methods is high and it seems, in the comparison with non-CBD villages, that CBD agents intensify the demand for these services. The number of unplanned pregnancies has decreased from 58.3% to 26.8%, while a higher proportion of deliveries was attended by health personnel (22% to 37.5%). In the context of this study, it was however not possible to measure the CBD contribution to these changes over time, other contributing factors being difficult to measure

Follow up reproductive health needs assessment in the process of evaluating a CBD programme in Lushoto Division, Lushoto District

KRAUT, Angela
et al
April 2004

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This study is a follow up to a baseline study (2000) on GTZ supported Community Based Distribution (CBD) activities in Lushoto Division in Tanzania. The study found that contraceptive prevalence was 43.2 per cent, almost double previous figures, and that women's knowledge of contraceptive methods had increased to 84.4 per cent from 77.1 per cent. CBD agents provide an important 'social link' between communities and the professional health sector. The knowledge of long term methods is high and it seems, in the comparison with non-CBD villages, that CBD agents intensify the demand for these services. The number of unplanned pregnancies has decreased to 26.8 per cent from 58.3 per cent , while a higher proportion of deliveries was attended by health personnel (37.5 per cent from 22 per cent). In the context of this study, it was however not possible to measure the CBD contribution to these changes over time, other contributing factors being difficult to measure

Reproductive health outlook

PROGRAM FOR APPROPRIATE TECHNOLOGY IN HEALTH (PATH)
2004

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Provides summaries of research findings, programme experience and clinical guidelines related to key reproductive health topics, as well as analyses of policy and programme implications. Reproductive Health Outlook is designed for reproductive health programme managers and decision makers working in developing countries and low-resource settings

Reproductive health strategy

WORLD HEALTH ORGANIZATION (WHO)
2004

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The strategy presented in this document is the World Health Organization's first global strategy on reproductive health. It was adopted by the 57th World Health Assembly (WHA) in May 2004. Three of the eight Millennium Development Goals (MDGs) are directly related to reproductive and sexual health, namely, improving maternal health, reducing child mortality and combating HIV/AIDS, malaria and other diseases. This strategy addresses five priority aspects of reproductive and sexual health: improving antenatal, delivery, postpartum and newborn care; providing high-quality services for family planning, including infertility services; eliminating unsafe abortion; combating sexually transmitted infections, including HIV, reproductive tract infections, cervical cancer and other gynaecological morbidities; and promoting sexual health. This document is intended for policy-makers within governments, international agencies, professional associations, nongovernmental organisations and other institutions

Community views on CBD activities in Muheza and Lushoto in Tanga region : final report

SANGALE, Loserian
November 2003

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This is an evaluation of the Community Based Distribution (CBD) of family planning (FP) methods, implemented in Tanga region of Tanzania, which aimed to increase the use of contraceptives through better geographical and social access. In collecting views from community members it was found that CBD activities are felt to improve child and maternal health, and to free women to participate in economic and community work. Clients felt that the FP accessed through CBD gave them improved capacity to care for their smaller families and to work more productively. Community members also felt that CBD introduced sensitive topics such as HIV/AIDS in a culturally acceptable way. In short, the community clearly expressed how CBD activities contribute to reaching the Millennium Development Goals. Much of the programme has been successfully absorbed into the district work plan, but initial training of CBD is still financially dependent on GTZ, putting into question the programme's sustainability

Best practices compendium for family planning and reproductive health

ADVANCE AFRICA. Best Practices Unit
October 2003

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This is a seachable database designed to present information on previously implemented programmes in an accessible format. It focuses on public health interventions and programme models rather than medical practices. It is continually updated, and each submission is reviewed by a technical advisory review board

Popline

CENTER FOR COMMUNICATION PROGRAMS, JOHNS HOPKINS UNIVERSITY BLOOMBERG SCHOOL OF PUBLIC HEALTH
June 2003

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This bibliographic database on reproductive health provides more than 300,000 citations with abstracts of scientific articles, reports, books, and unpublished reports in the fields of population, family planning, and related health issues. It has numerous special features including links to free, full-text documents; the ability to limit your search to peer-reviewed journal articles; and many abstracts in French and Spanish

Reproductive health

USAID AFRICA BUREAU. Office for Sustainable Development
2003

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A collection of briefings from USAID's Africa Bureau on their activities in various areas of reproductive health

Reproductive health indicators for global monitoring : report of the second interagency technical meeting

WORLD HEALTH ORGANIZATION (WHO)
2001

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This document is a report of the second interagency technical meeting on indicators. The meeting reviewed country experiences in strengthening health information systems for monitoring reproductive health and discussed a guideline for district level health managers describing a process of identifying reproductive health indicators according to specific criteria. The meeting also discussed a draft set of indicators for global monitoring

Training manual : an introduction to promoting sexual health for men who have sex with men and gay men

NAZ FOUNDATION (INDIA) TRUST
2001

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Manual providing training modules on issues related to the sexuality and sexual health of men who have sex with men and gay men. It is intended for NGOs and CBOs in South Asia. The objective of the training is to give participants a clear understanding of a wide range of issues including those related to sexual health. It can also be used to train other NGOs and CBOs to develop services for MSM and gay men to incorporate their issues into existing services

Reproductive health in refugee situations : an inter-agency field manual

UNITED NATIONS HIGH COMMISSIONER FOR REFUGEES (UNHCR)
et al
1999

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A guide for field staff involved in introducing and strengthening reproductive health (RH) interventions in refugee situations. May be useful in decision-making around planning, implementing, monitoring and evaluating RH activities. Advocates for a multi-sectoral approach to meeting the reproductive health needs of refugees and fosters co-ordination among all partners

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