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The balanced counseling strategy plus : a toolkit for family planning service providers working in high HIV/STI prevalence settings

POPULATION COUNCIL
2011

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"This "is an interactive, client-friendly approach for improving counseling on family planning and prevention, detection, and treatment of sexually transmitted infections (STIs) including HIV. The BCS+ was adapted from the Balanced Counseling Strategy, an evidence-based and well-researched tool for improving counseling on contraceptive methods. The BCS+ toolkit, developed and tested in Kenya and South Africa, provides the information and materials needed for health care facility providers to provide complete and high-quality family planning counseling to clients who live in areas with high rates of HIV and STIs.The BCS+ tools are generic and can be revised according to national and/or regional guidelines and different contexts
This second edition toolkit includes the following: * BCS+ Trainer’s Guide: Supervisors and others can use this to train health care facility directors and service providers on how to use the BCS+ for counseling family planning clients. * BCS+ User’s Guide: This guide focuses on how to implement the Balanced Counseling Strategy Plus. It can be distributed during training or used on its own with the BCS+ job aids. * BCS+ job aids comprising: - BCS+ algorithm that summarizes the 19 steps needed to implement the BCS+ during a family planning counseling session. These steps are organized into four stages: pre-choice, method choice, post-choice, and STI/HIV counseling. - BCS+ counseling cards that the provider uses during a counseling session. There are 26 counseling cards, the first of which contains six questions that the service provider asks to rule out the possibility a client is pregnant. Each of the next 16 cards contains information about a different family planning method. The next 3 cards provide advice on pregnancy and the postpartum period. The last 6 cards provide essential information for counseling on preventing, detecting, and treating STIs and HIV. - BCS+ method brochures on each of the 16 methods represented by the counseling cards. The brochures provide counseling to clients on the method they have chosen and then are given to clients for later reference. This means clients do not have to rely on their recollection of what was discussed with the provider. - WHO Medical Eligibility Criteria Wheel (offsite link) guides providers through medical conditions and medications that may be contraindications to use of particular contraceptive methods. The BCS+ tools are generic and can be revised according to national and/or regional guidelines and different contexts"
A video describing use of the BCS+ toolkit in South Africa also is available. To obtain Microsoft Word versions of BCS+ files to modify or revise according to your local setting, please contact the publisher

Keeping motherhood safe

May 2010

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This edition of Momentum contains articles on spacing births to reduce pregnancy-related complications, skilled birth attendants, medication to prevent eclampsia, supporting women's reproductive options, and vouchers for reproductive and maternity services

Repositioning postnatal care in a high HIV environment : Swaziland

WARREN, Charlotte
et al
2008

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This report arose from recognition of the need to provide better care and follow up of mothers and infants in the postnatal period in order to improve maternal and neonatal outcomes in Swaziland. The objectives of the study were to determine if changes to the guidelines on postnatal care would result in improvements to provision of of maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum (PP) women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirmed that the introduction of an improved postnatal package with revised timing and content provided key components of maternal, newborn, and HIV care, and increased the utilization of services among postpartum women and their infants. An assessment of the quality of care during client-provider interactions for all postpartum women demonstrated a fourfold increase in the proportion that included all aspects of care: maternal and newborn health, counseling for HIV, family planning, and improved provider-client relationships

Community based approaches to prevention of mother-to-child transmission of HIV : findings from a low income community in Kenya

KAAI, Susan-Baek
et al
August 2007

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This is the report of an intervention study in Kibera, an urban slum in Nairobi, to determine what effect three different community-based activities had on the utilisation of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants and peer counsellors as PMTCT promoters

Key findings from an evaluation of the mothers2mothers program in KwaZulu-Natal, South Africa

BAEK, Carolyn
et al
June 2007

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Mothers2mothers (m2m) is a peer support programme that aims to provide education and psycho-social support to HIV-positive pregnant women and new mothers' help women access existing health care services to prevent mother-to-child transmission of HIV (PMTCT); and follow up with mothers and babies to ensure they receive appropriate medical care after delivery. While there has been much interest in innovative psycho-social support programmes that complement PMTCT clinical services, only a few such programmes exist, and there are very little data about their effectiveness. Although m2m is a well known programme with anecdotal accounts of successfully supporting HIV-positive women, it had yet to undergo an external evaluation. The Horizons Program of Population Council, in collaboration with Health Systems Trust, completed the first evaluation of m2m as part of its introduction in KwaZulu-Natal Province, South Africa

Pregnancy-related school dropout and prior school performance in South Africa

GRANT, Monica
HALLMAN, Kelly
June 2006

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Although considerable attention has been paid to the prevalence of adolescent childbearing in the less-developed world, few studies have focused on the educational consequences of schoolgirl pregnancy. Using data collected in 2001 in KwaZulu-Natal, South Africa, this paper examines the factors associated with schoolgirl pregnancy, as well as the likelihood of school dropout and subsequent re-enrollment among pregnant schoolgirls. This analysis triangulates data collected from birth histories, education histories, and data concerning pregnancy to strengthen the identification of young women who became pregnant while enrolled in school and to define discrete periods of school interruption prior to first pregnancy. We find that prior school performance - defined as instances of grade repetition or non-pregnancy-related temporary withdrawals from school - is strongly associated with a young woman's likelihood of becoming pregnant while enrolled in school, dropping out of school if she becomes pregnant, and not returning to school following a pregnancy-related dropout. Young women who are the primary caregivers to their children are also significantly more likely to have left school than are women who shared or relinquished childcare responsibilities. Furthermore, young women who lived with an adult female were significantly more likely to return to school following a pregnancy-related dropout. Given the increasing levels of female school participation in sub-Saharan Africa, our findings suggest that future studies will benefit from exploring the causal relationships between prior school experiences, adolescent reproductive behavior, and subsequent school attendance

Involving men in maternity care in India

VARKEY, Leila Caleb
FRONTIERS IN REPRODUCTIVE HEALTH PROGRAM
et al
2004

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"The Men in Maternity (MiM) study investigated the feasibility, acceptability and cost of a new, more comprehensive, model of maternity care that encouraged husbands' participation in their wives' antenatal and postpartum care. The study specifically assessed the impact of the intervention on family planning in the postpartum period and STI preventitive practices among men and women. The study was conducted in collaboration with the Employees' State Insurance Corporation (ESIC), Delhi Directorate at their primary health facilities called dispensaries"

Empowering communities to respond to HIV/AIDS|Ndola demonstration project on maternal and child health : operations research final report

HORIZONS
August 2003

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This is the report of an evaluation study into the feasibility, acceptability and implications of improving infant feeding counselling and introducing voluntary counselling and testing into a low-resource ante-natal care/mother and child health clinic setting, where women did not at the time have access to short-course antiretrovirals to reduce vertical transmission

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