Family Planning and Reproductive Health

Family planning allows women and couples to determine whether and when to have children. The ability to make these choices is fundamental to healthy families and communities worldwide. Improvement methods can help solve the many operational challenges to delivering family planning and reproductive health services in different settings, including integrating family planning with other health services, assuring the availability of a well-balanced mix of contraceptive methods, and increasing the effectiveness of family planning counseling to increase uptake of modern contraceptive methods at both the facility and community levels.

Dando respuesta a los asuntos de género para mejorar los resultados en la atención en salud relacionada con el Zika

Este documento proporciona información sobre los problemas relacionados con el género en relación con la atención médica relacionada con el Zika.

Resalta los principales problemas:

• Roles y valores relacionados con el género
• Acceso limitado y / o control sobre educación sexual, anticonceptivos y otros servicios de salud reproductiva
• La falta de poder de las mujeres para negociar el uso de anticonceptivos (incluidos los condones)
• Estigma que lleva al abandono de la madre y el niño

Version en español

Responding to Gender Issues to Improve Outcomes in Zika-related Health Care

This document provides information on the issues surrounding gender with regards to Zika- related health care.

It highlights the main issues:

• Gender-related roles and values
• Limited access to and/or control over sexuality education, contraceptives, and other reproductive health services
• Women’s lack of power to negotiate contraceptive use (including condoms)
• Stigma leading to mother and child abandonment

English Version


USAID ASSIST Project Semi-Annual Performance Monitoring Report FY18

University Research Co., LLC (URC) and its partners have completed 5.5 years of implementation of the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project. This report is the eleventh Semi-Annual Performance Monitoring Report for ASSIST, summarizing the project’s accomplishments and results during the first two quarters (Q1-2) of Fiscal Year 2018 (FY18).  In late September 2017, the project was awarded a two-year costed extension with additional funding for Zika-related activities.  No further funding was provided for non-Zika work.  The project’s FY18 work plan thus focuses mainly on Zika-related support in eight countries and completion of previously funded work in other countries.

Overall goals
The USAID ASSIST Project fosters improvements in a range of health care processes through the application of modern improvement methods by host country providers and managers in USAID-assisted countries. The project’s central purpose is to build the capacity of host country health and social service systems to improve the effectiveness, efficiency, client-centeredness, safety, accessibility, and equity of the services they provide. In addition to supporting the implementation of improvement strategies, the project seeks to generate new knowledge to increase the effectiveness and efficiency of applying improvement methods in low- and middle-income countries.
USAID ASSIST country programs align with the goals of United States Government’s global initiatives and policies, including preventing child and maternal deaths, achieving HIV epidemic control, combating other public health threats, protecting life, and addressing gender inequalities.

Where we work
During the first half of FY18, USAID ASSIST provided technical support in 23 countries through field and core funding. USAID Mission funds supported work in nine countries: Cambodia, Côte d’Ivoire, India, Indonesia, Lesotho, Mali, Swaziland, Tanzania, and Uganda. USAID core funds from the Office of HIV/AIDS supported activities in seven countries: Kenya, Lesotho, Malawi, Mozambique, Namibia, Tanzania, and Zimbabwe.  Funds for Neglected Tropical Diseases supported improvement work to combat the Zika virus in the Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Jamaica, Nicaragua, Paraguay, and Peru.  USAID cross-bureau-funded activities, through the Office of Health Systems, supported malaria prevention activities in Malawi and global and regional initiatives that contribute to local and global learning in improvement.

FY18 Q1-2 accomplishments and results:

  • Improvement in key indicators: As discussed in this report, ASSIST-supported programs demonstrated improved care and outcomes for a range of services, including antenatal and postnatal care, essential obstetric and newborn care, screening of pregnant women and newborns for Zika-related signs and symptoms, Zika care and support, PMTCT, and HIV prevention.
  • Research and evaluation studies: At of the end of the reporting period, the project had 29 research studies in planning, underway or completed in 14 countries. Three are multi-country studies.
  • Promoting the use of improvement methods: During the reporting period, project staff published nine peer-reviewed articles; seven case studies; four technical and research reports; and 10 guides, tools, and job aids. ASSIST staff led six sessions and made eight oral presentations at six regional and international conferences. ASSIST’s work continued to be promoted through the project’s website and social media engagement, with some 27,867 visitors viewing 61,572 pages within the ASSIST Knowledge Portal during the past two quarters.

Our “Best 9” stories in 2017

Vicky Ramirez

Consultant, USAID ASSIST Project/URC

Looking back, 2017 was a great year for us at ASSIST. In 2017, we were featured in USAID’s Exposure; we collaborated with a number of partners to publish ICHC Blog Series, which was cross-posted on The Huffington Post; and we ran a blog series in honor of Health Worker Week. After our resources page, our blog was the most visited page on our website. In case you missed some of these highlights, we’ve put together our “Best 9” stories. These posts illustrate the stories behind the great work employed by our country teams, partners, and individuals. Let us know which story you loved the most!

USAID ASSIST Project Annual Performance Monitoring Report FY17

University Research Co., LLC (URC) and its partners have completed the fifth year of implementation of the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project. This report is the tenth Semi-Annual Performance Monitoring Report for the project and aims to summarize the accomplishments and results toward the program objectives of USAID ASSIST activities during quarter (Q) 1 through 4 of Fiscal Year 2017 (FY17).

Scale of USAID ASSIST work, FY17

FY17 Accomplishments and Results

  • Improvement in key indicators: As discussed in this report, ASSIST-supported programs demonstrated improved care and outcomes for a range of services, including antenatal and postnatal care, essential obstetric and newborn care, family planning, PMTCT, HIV care and treatment, HIV prevention, NACS, TB diagnosis and treatment, malaria diagnosis and case management, and services for vulnerable children and families.
  • Gender integration: Onsite gender training and technical support was provided to country teams in Burundi, Cote d’Ivoire, DRC, Lesotho, Mali, South Africa, and Uganda to integrate gender considerations into their improvement work. Ongoing gender support was provided to all field offices with improvement activities to collect and analyze sex-disaggregated indicators, identify gender-related gaps affecting outcomes, and respond to those gaps.
  • Research and evaluation studies: At of the end of the reporting period, the project had 37 studies underway or completed in 15 countries. Four are multi-country studies.
  • Promoting the use of improvement methods: In FY17, project staff published 14 peer-reviewed articles; 23 case studies; 11 technical and research reports; 42 guides and tools, six short reports; 29 annual reports, and seven multimedia products describing project-supported work and results as well as gender integration learning videos. ASSIST had an active presence at 16 international and national conferences. In all, project staff led 18 sessions and workshops and delivered 14 oral and 14 poster presentations. ASSIST’s work continued to be promoted through strategic engagement in Twitter chats, reaching close to 2,374 followers (26% increase from FY16) and an average of 26,500 unique Twitter users per month (impressions). We continued sharing resources via the ASSIST Facebook page (over 6,200 likes) as well as publishing engaging blog content (28 blogs in FY17).

SUSTAIN's Adolescent Friendly Health Services Change Package

Since 2010, the United States Agency for International Development (USAID) has been working with Uganda’s Ministry of Health (MoH) to improve HIV and AIDS service delivery at select health facilities through the Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) project.

The project supported six regional referral hospitals to implement interventions aimed at improving the provision of adolescent friendly health services (AFHS) through the application of continuous quality improvement methods and techniques. QI teams were supported to increase the proportion of adolescents: (a) attending AFHS centers, (b) newly testing for HIV, (c) assessed for their nutritional status, (d) provided with family planning services, (e) and linking those who test HIV positive to HIV care.

The purpose of this quality improvement change package is to provide a synthesis of the most robust and effective QI interventions to improve Adolescent Friendly Health Services in SUSTAIN-supported hospitals in Uganda.

This change package is part of a series of quality improvement change packages developed by the SUSTAIN project based on their work in Uganda. Other technical areas include: prevention of mother-to-child transmission of HIV, laboratory, monitoring and evaluation, voluntary medical male circumcision, nutrition, HIV care and treatment, supply chain, tuberculosis, and quality improvement.

What we learned while improving care for 180,000 babies annually in India

Nigel Livesley

Regional Director for South Asia, USAID Applying Science to Strengthen and Improve Health Systems (ASSIST) project, University Research Co., LLC (URC)

Evaluation of a quality improvement intervention for obstetric and neonatal care in selected public health facilities across six states of India

In India, in recent years, there has been a great increase in the number of women delivering in health facilities; however, the quality of obstetric and neonatal care within these facilities is often quite poor, which contributes to continuing high rates of maternal and neonatal mortality.

The USAID ASSIST Project supported health workers in 125 public health facilities across six states – delivering approximately 180,000 babies per year – to use quality improvement (QI) approaches to provide better care to women and babies before, during, and immediately after delivery.

This study analyzed the impact of this intervention on nine elements of routine delivery and newborn care and found that quality improvement had a positive, statistically significant impact on 8 out of the nine elements of care.Perinatal mortality declined from 26.7 to 22.9 deaths/1000 live births (p < 0.01) over this same period; however, it is difficult to show statistically that this was directly caused by the intervention.

This paper discusses the intervention and its evaluation in detail and presents the implications of its finding for policymakers and health professionals.

Read the full journal article on BioMed Central.