Publication: Sparing Lives : Better Reproductive Health for Poor Women in South Asia, Summary for Policymakers
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2008
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2012-06-12
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In this context, the overall purpose of this review is to bring attention to the opportunities that five countries in the region - Bangladesh, India, Nepal, Pakistan and Sri Lanka - have to strengthen and expand interventions to improve the reproductive health of poor women. The specific objectives are: i) to provide an accurate picture of the current status of women's reproductive health, describe the use of reproductive health services and barriers to use, and identify the improvements required to increase their effectiveness and improve health outcomes; ii) to elucidate individual and household characteristics that affect reproductive health status and use of services so that the most important of these can be used to identify women and households with the greatest need for care to achieve better health; iii) to describe a simple and effective approach - decentralized action planning - that can be used widely in all five countries to improve reproductive health service delivery and outcomes, and point to a body of best practices in reproductive health that provides models and lessons for improvements in South Asia; and iv) to strengthen the case for investing in poor women's reproductive health by demonstrating the links between poverty, inequality, reproductive health care and expenditure.
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“Chatterjee, Meera; Levine, Ruth; Murthy, Nirmala; Rao-Seshadri, Shreelata. 2008. Sparing Lives : Better Reproductive Health for Poor Women in South Asia, Summary for Policymakers. © World Bank. http://hdl.handle.net/10986/7848 License: CC BY 3.0 IGO.”
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Publication Sparing Lives : Better Reproductive Health for Poor Women in South Asia(New Delhi: Macmillan India, Ltd., 2008)In this context, the overall purpose of this review is to bring attention to the opportunities that five countries in the region - Bangladesh, India, Nepal, Pakistan and Sri Lanka - have to strengthen and expand interventions to improve the reproductive health of poor women. The specific objectives are: i) to provide an accurate picture of the current status of women's reproductive health, describe the use of reproductive health services and barriers to use, and identify the improvements required to increase their effectiveness and improve health outcomes; ii) to elucidate individual and household characteristics that affect reproductive health status and use of services so that the most important of these can be used to identify women and households with the greatest need for care to achieve better health; iii) to describe a simple and effective approach - decentralized action planning - that can be used widely in all five countries to improve reproductive health service delivery and outcomes, and point to a body of best practices in reproductive health that provides models and lessons for improvements in South Asia; and iv) to strengthen the case for investing in poor women's reproductive health by demonstrating the links between poverty, inequality, reproductive health care and expenditure.Publication The Potential for Integrating Community-Based Nutrition and Postpartum Family Planning : Review of Evidence and Experience in Low-Income Settings(World Bank, Washington, DC, 2013-11)The objective of this review was to study where community-based family planning and nutrition programs have been integrated, how this has been accomplished, and what the results have been. Although family planning is a nontraditional intervention in community-based nutrition programs, it can have profound effects on maternal and child health and nutrition. When family planning does not occur, short intervals between pregnancies deplete mothers' reserves of nutrients needed for pregnancy and later for breastfeeding. As a result, short birth intervals are associated with higher maternal and neonatal mortality and malnutrition rates of infants. Family planning, which promotes contraceptive use and the lactational amenorrhea method, can thus improve nutrition outcomes in both mothers and babies. The authors identified a few studies on integrated services in the published literature; thus the main part of the review is built on operational research studies and unpublished smaller scale intervention studies. However, the controlled studies that were identified indicate positive correlation between breastfeeding levels and increased contraception use. Additionally, although the design of the intervention studies did not make it possible to assess the degree to which integration had an impact, the studies did highlight factors that were key to a successful integration process. These are community engagement; multiple and frequent contact points between mothers, community volunteers, and health workers; involvement of husbands; moving implementation decisions closer to the users of the program; and assuring transparency, clarity, and simplicity in the transmission of development objectives to communities.Publication Fertility Regulation Behaviors and Their Costs : Contraception and Unintended Pregnancies in Africa and Eastern Europe & Central Asia(World Bank, Washington, DC, 2007-12)The report consists of three parts: global trends in fertility, contraceptive use and unintended pregnancies; studies of two regions (Africa and Eastern Europe/Central Asia) and two countries (Nigeria and Kazakhstan) on the costs of fertility regulation behaviors and provider attitudes towards contraceptive use. Fertility levels have declined steadily over the last three decades but the pace of decline varies among regions. Countries that have achieved a high level of contraceptive use have reached a lower fertility level. A gap continues to exist between actual and desired family size, resulting in unintended pregnancies. More than one-third of the pregnancies that occur are unintended and one in five pregnancies ends in induced abortion. Almost half of all induced abortions are unsafe, and the proportion of all abortions that are unsafe have increased during the last decade. Sixty-six percent of unintended pregnancies occur among women who are not using any method of contraception. Investing in quality family planning programs is a cost-effective way to address unmet need for contraception and reduce the risks of unsafe abortion, thereby improving maternal health. If contraception were provided to the 137 million women who lack access, maternal mortality will decline by 25-35 percent.Publication Reproductive Health(Washington, DC, 2002-03)Reproductive health (RH) problems account for a significant part of the burden of disease suffered by poor people in developing countries. Poor women and men are more afflicted with RH problems and often lack access to minimal RH care even when average levels of RH in the country are good. Many RH problems are most cost-effectively managed by prevention - serious problems are costly and very difficult to solve once manifest. This article covers the types of interventions needed to sustain reproductive health including increasing girls' education, preventing and managing sexually transmitted disease, providing contraception to avoid abortion, improving pre-natal and delivery care, increasing the number of skilled providers of health care, post-abortion care, bolstering maternal health services, and reducing practices that increase reproductive health risks such as unsafe sex, female genital mutilation, and domestic violence.Publication Better Reproductive Health for Poor Women in South Asia(World Bank, 2007-05)The overall purpose of this review is to bring attention to the opportunities that five countries in the region - Bangladesh, India, Nepal Pakistan and Sri Lanka have to strengthen and expand interventions to improve the reproductive health of poor women. The report's specific objectives are: 1) to provide an accurate picture of the current status of women's reproductive health and describe the use of reproductive health services and barriers to use; 2) to identify individual and household characteristics that affect reproductive health status and use of services; 3) to develop a simple and effective approach to decentralized health planning that can be used widely in each of the five countries to improve health service delivery and outcomes locally; and 4) to strengthen the case for investing in poor women's reproductive health by demonstrating the links between poverty, inequality and reproductive health. The review puts forth the following recommendations for reforms for reproductive health: to increase the supply of reproductive health services to poor women and adolescents by specifically targeting the poorest areas and households; to enhance demand among the poor for key services using BCC and demand-side financing; to integrate reproductive health services through a client-centered approach and strengthen weak services using specific relevant approaches; and to improve the reach, quality and status of women providers by better training, deployment and support are the 'frontline' improvements required for better reproductive health among poor women in South Asia.
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