Evidence demonstrates how rights-based family planning (FP) brings transformational benefits to w... more Evidence demonstrates how rights-based family planning (FP) brings transformational benefits to women, families, communities and countries. Investing in FP is not only a human rights issue, but also a key catalytic factor for countries to achieve the Sustainable Development Goals (SDGs). Sustainable and equitable access to FP has a tremendous socioeconomic impact and boosts synergistic efforts to reduce poverty, achieve food security and improved nutrition, save lives and improve health and well-being, improve women’s and girls’ education, advance gender equality and empowerment, mitigate the effects of access to water and sanitation, reduce the impact on health of climate change, and contribute to economic growth and social inclusion. Nevertheless, while the benefits are realized across many other sectors, the burden of financing for FP is born predominantly by the health sector. Although there have been several attempts to integrate FP into other sectors’ initiatives, the results ...
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2014
To assess the effect of a multifaceted intervention among skilled birth attendants on the use of ... more To assess the effect of a multifaceted intervention among skilled birth attendants on the use of oxytocin during the third stage of labor, the active management of the third stage of labor (AMTSL), and the rate of routine episiotomy during vaginal births in two health districts in Nicaragua. An uncontrolled before-and-after study design was used. The rates of oxytocin use in the third stage of labor, AMTSL, and episiotomy were measured for vaginal births occurring in eight hospitals and health centers during 2011-2012, before and after implementation of a multifaceted facility-based intervention. The intervention involved the use of opinion leaders, interactive workshops to develop and implement evidence-based guidelines, academic detailing, the use of reminders, and feedback on the rates of oxytocin use and episiotomy. Oxytocin use during the third stage of labor increased significantly from 95.3% to 97.4% (P=0.003). The episiotomy rate dropped significantly from 31.2% to 21.2% ove...
Revista panamericana de salud pública = Pan American journal of public health, 2011
To assess private-sector stakeholders' and donors' perceptions of a total market approach... more To assess private-sector stakeholders' and donors' perceptions of a total market approach (TMA) to family planning in Nicaragua in the context of decreased funding; to build evidence for potential strategies and mechanisms for TMA implementation (including public-private partnerships (PPPs)); and to identify information gaps and future priorities for related research and advocacy. A descriptive exploratory study was conducted in various locations in Nicaragua from March to April 2010. A total of 24 key private-sector stakeholders and donors were interviewed and their responses analyzed using two questionnaires and a stakeholder analysis tool (PolicyMakerTM software). All survey participants supported a TMA, and public-private collaboration, in family planning in Nicaragua. Based on the survey responses, opportunities for further developing PPPs for family planning include building on and expanding existing governmental frameworks, such as Nicaragua's current coordination...
International Journal of Gynecology & Obstetrics, 2014
To assess the effect of a multifaceted intervention among skilled birth attendants on the use of ... more To assess the effect of a multifaceted intervention among skilled birth attendants on the use of oxytocin during the third stage of labor, the active management of the third stage of labor (AMTSL), and the rate of routine episiotomy during vaginal births in two health districts in Nicaragua. An uncontrolled before-and-after study design was used. The rates of oxytocin use in the third stage of labor, AMTSL, and episiotomy were measured for vaginal births occurring in eight hospitals and health centers during 2011-2012, before and after implementation of a multifaceted facility-based intervention. The intervention involved the use of opinion leaders, interactive workshops to develop and implement evidence-based guidelines, academic detailing, the use of reminders, and feedback on the rates of oxytocin use and episiotomy. Oxytocin use during the third stage of labor increased significantly from 95.3% to 97.4% (P=0.003). The episiotomy rate dropped significantly from 31.2% to 21.2% overall, and from 59.6% to 40.5% in primiparous women (P<0.001 for both comparisons). The multifaceted intervention improved the targeted care practices during childbirth. However, a further decrease in the routine use of episiotomy would be desirable.
Evidence demonstrates how rights-based family planning (FP) brings transformational benefits to w... more Evidence demonstrates how rights-based family planning (FP) brings transformational benefits to women, families, communities and countries. Investing in FP is not only a human rights issue, but also a key catalytic factor for countries to achieve the Sustainable Development Goals (SDGs). Sustainable and equitable access to FP has a tremendous socioeconomic impact and boosts synergistic efforts to reduce poverty, achieve food security and improved nutrition, save lives and improve health and well-being, improve women’s and girls’ education, advance gender equality and empowerment, mitigate the effects of access to water and sanitation, reduce the impact on health of climate change, and contribute to economic growth and social inclusion. Nevertheless, while the benefits are realized across many other sectors, the burden of financing for FP is born predominantly by the health sector. Although there have been several attempts to integrate FP into other sectors’ initiatives, the results ...
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2014
To assess the effect of a multifaceted intervention among skilled birth attendants on the use of ... more To assess the effect of a multifaceted intervention among skilled birth attendants on the use of oxytocin during the third stage of labor, the active management of the third stage of labor (AMTSL), and the rate of routine episiotomy during vaginal births in two health districts in Nicaragua. An uncontrolled before-and-after study design was used. The rates of oxytocin use in the third stage of labor, AMTSL, and episiotomy were measured for vaginal births occurring in eight hospitals and health centers during 2011-2012, before and after implementation of a multifaceted facility-based intervention. The intervention involved the use of opinion leaders, interactive workshops to develop and implement evidence-based guidelines, academic detailing, the use of reminders, and feedback on the rates of oxytocin use and episiotomy. Oxytocin use during the third stage of labor increased significantly from 95.3% to 97.4% (P=0.003). The episiotomy rate dropped significantly from 31.2% to 21.2% ove...
Revista panamericana de salud pública = Pan American journal of public health, 2011
To assess private-sector stakeholders' and donors' perceptions of a total market approach... more To assess private-sector stakeholders' and donors' perceptions of a total market approach (TMA) to family planning in Nicaragua in the context of decreased funding; to build evidence for potential strategies and mechanisms for TMA implementation (including public-private partnerships (PPPs)); and to identify information gaps and future priorities for related research and advocacy. A descriptive exploratory study was conducted in various locations in Nicaragua from March to April 2010. A total of 24 key private-sector stakeholders and donors were interviewed and their responses analyzed using two questionnaires and a stakeholder analysis tool (PolicyMakerTM software). All survey participants supported a TMA, and public-private collaboration, in family planning in Nicaragua. Based on the survey responses, opportunities for further developing PPPs for family planning include building on and expanding existing governmental frameworks, such as Nicaragua's current coordination...
International Journal of Gynecology & Obstetrics, 2014
To assess the effect of a multifaceted intervention among skilled birth attendants on the use of ... more To assess the effect of a multifaceted intervention among skilled birth attendants on the use of oxytocin during the third stage of labor, the active management of the third stage of labor (AMTSL), and the rate of routine episiotomy during vaginal births in two health districts in Nicaragua. An uncontrolled before-and-after study design was used. The rates of oxytocin use in the third stage of labor, AMTSL, and episiotomy were measured for vaginal births occurring in eight hospitals and health centers during 2011-2012, before and after implementation of a multifaceted facility-based intervention. The intervention involved the use of opinion leaders, interactive workshops to develop and implement evidence-based guidelines, academic detailing, the use of reminders, and feedback on the rates of oxytocin use and episiotomy. Oxytocin use during the third stage of labor increased significantly from 95.3% to 97.4% (P=0.003). The episiotomy rate dropped significantly from 31.2% to 21.2% overall, and from 59.6% to 40.5% in primiparous women (P<0.001 for both comparisons). The multifaceted intervention improved the targeted care practices during childbirth. However, a further decrease in the routine use of episiotomy would be desirable.
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