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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

Improving the health care response to gender-based violence - phase II : project evaluation report

BUDIHARSANA, Meiwita P
TUNG, Mai Quoc
2010

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This report describes phase II of the Population Council Vietnam project on gender-based violence (GBV). The project involves both a hospital and community based intervention to address this problem in Hanoi and to conduct research to assess its effectiveness. This report is useful to practitioners interested in gender-based violence issues in Vietnam

Sexual and gender based violence in Africa : literature review

RUMBOLD, Victoria
February 2008

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"This literature review is intended to inform partners in the Population Council-coordinated regional network that aims to develop a multi-sectoral and comprehensive response to SGBV (Sexual and Gender Based Violence) in Eastern, Central and Southern Africa. The review is structured around seven components collectively designed to meet the medical, psychological and justice needs of survivors of sexual violence. The components consist of a comprehensive review of region-specific policies, programmatic experiences and best practices relating to the appropriate medical management of sexual violence, enabling effective criminal justice responses to all SGBV cases, and the reduction of levels of violence at the community level"

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

The straight talk campaign in Uganda : impact of mass media initiatives

ADAMCHK, Susan E.
et al
September 2007

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This summary report presents the findings of an evaluation of the Straight Talk mass media communication programmes to inform youth in Africa about sexual and reproductive health, which have been implemented in Uganda since 1993. The campaign was delivered through a radio show and two newspapers - one aimed at primary school children and one at secondary school students

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

Transcending boundaries to improve the food security of HIV-affected households in rural Uganda : a case study

COON, Katharine
et al
July 2007

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This report provides a case study of a process to bring key technical sectors together with communities in a partnership for reducing food insecurity among HIV-affected households in Tororo, Uganda. Food security is the ability of individuals to consume sufficient quantity and quality of food to meet their daily needs. Food security depends on the availability of food, physical and economic access to it, and the physiological utilisation of nutrients. The case study is based on project documents and qualitative interviews and focus group discussions conducted with participants in the Partners for Food Security PAFOSE project

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

Reaching truckers in Brazil with non-stigmatizing and effective HIV/STI services

CHINAGLIA, Magda
et al
May 2007

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In 2001, the Population Council conducted an assessment in Brazilian border areas, commissioned by the Brazilian Ministry of Health, with support from USAID/Brazil, to determine which populations were most in need of HIV prevention activities. The research findings in the southern region revealed the presence of an extremely mobile, international truck driver community with little or no access to HIV prevention, testing and treatment services. In response to this need, Horizons/Population Council implemented an operations research study focused on trucker drivers (2002-2005) in the south of Brazil. In collaboration with the administration of the customs stations, municipal and state STI and AIDS programmes, and Health Ministries, the investigators sought to examine the feasibility and impact of an HIV prevention project targeted at truckers crossing the southern border of Brazil

Continuum of care for HIV-positive women accessing programs to prevent parent-to-child transmission : findings from India

MAHENDRA, Vaishali S
et al
2007

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This is the report of a diagnostic study in 2005 to provide an evidence base to strengthen the national Indian prevention of parent-to-child transmission (PPTCT) initiative. The key research questions were: What are the treatment, care, and support needs of HIV-positive women and what services do the women utilize to meet their needs? What are the different ways (clinic-based, community-based, etc) to link HIV-positive women and their families with treatment and care services? The study indicated that linkages between PPTCT and HIV care services, as well as PPTCT and reproductive health services, were limited

Community advocates training manual : the HIV/AIDS prevention project for vulnerable youth in northern Nigeria

POPULATION COUNCIL
2007

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"The Community Advocates training manual is a curriculum developed by Population Council, Nigeria under the HIV Prevention Project for Vulnerable Youth in Northern Nigeria funded by USAID/Nigeria. The curriculum was developed as a tool for training community advocates to conduct advocacy activities on the issues of early marriage, HIV/AIDS and reproductive health. The curriculum is developed on the premise that community representatives can speak out on issues concerning their lives and community, if given the necessary skills"

Expanding pediatric access to antiretroviral therapy in South Africa

MICHAELS, Desireé
et al
August 2006

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This paper presents the results of a rapid situational analysis of the antiretroviral (ARV) rollout in South Africa which found that several ARV programmes are treating children successfully. However, all the institutions surveyed identified a large number of concerns and challenges that need to be overcome in order to improve care for children living with HIV. Key actions required include early identification of HIV-infected children, effective referral, standardised training in pediatric HIV management for health professionals, and increased community awareness and support

Teachers matter : baseline findings on the HIV-related needs of Kenyan teachers

KIRAGU, K.
et al
August 2006

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This paper summarises a baseline study on assessing changes in teachers’ knowledge of HIV & AIDS, risk behaviours (e.g., multiple partners and unprotected sex), and utilisation of voluntary counselling and testing. The workplace model will also aim to assist teachers who are infected with and affected by the disease through helping them to identify and access available treatment, care, and support community resources

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

Examining adherence and sexual behavior among patients on antiretroviral therapy in India

SARNA, Avina
et al
April 2006

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This is the report of a diagnostic study among people living with HIV&AIDS receiving antiretroviral therapy (ART) at selected private and public sector health facilities in Delhi and Pune. The objectives of the study were to: assess the current levels of adherence to ART among clients; identify the factors that influence adherence to treatment; examine the sexual risk behaviours of clients; and determine the economic burden of ART on clients

Tap and reposition youth (TRY) : providing social support, savings, and microcredit opportunities for young women in areas with high HIV prevalence

ERULKAR, Annabel
et al
March 2006

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Tap and Reposition Youth (TRY) was a multiphase initiative undertaken by the Population Council and K-Rep Development Agency (KDA), the oldest and largest microfinance institution in Kenya. The overall aim of the project was to reduce adolescents' vulnerabilities to adverse social and reproductive health outcomes, including HIV infection, by improving their livelihoods options. The project was launched in low-income and slum areas of Nairobi, Kenya, where rates of HIV infection are alarming and where young women are disproportionately affected

Orphans and vulnerable youth in Bulawayo, Zimbabwe : an exploratory study of psychosocial well-being and psychosocial support programs

GILBORN, Laeila
et al
February 2006

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This is the report of a study to develop a better understanding of psychosocial well-being among vulnerable adolescents and how to measure it, and to explore the effects of participation in psychosocial support programmes on adolescents’ psychosocial well-being. The study focuses on adolescents because of the presence of psychosocial support programmes for this age group in the study area. Adolescence is a distinct stage in psychological development, and vulnerable adolescents, especially those affected by HIV & AIDS, face unique responsibilities and challenges, such as earning wages, managing households, and caring for younger children and sick adults

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