IT Manager Paul is in charge of all IT and web-based systems at the Center including the intranet and has worked towards the improvement of APHRC's web systems and implemented open source solutions. He has over 7 years experience in Web Systems Development and holds a Bachelor of Scien
Population Dynamics and Reproductive Health
Overview
Progress towards goals 4 (reducing child mortality) and 5 (improving maternal health) of the millennium development goals (MDGs) has been generally slow in sub-Saharan Africa. The 2011 MDG report indicates that between 1990 and 2009, the region recorded a decline of 28% and 26% in under-five and maternal mortality rates respectively, against the targets of 67% and 75% by 2015. About 4 infants and children continue to die annually from preventable causes such as diarrhea, malnutrition, malaria, measles and pneumonia. Unintended pregnancy which often leads to unsafe abortion remains a major contributor to poor maternal health outcomes in a region where contraceptive prevalence remains perennially low and unmet need for family planning perennially high. Equally critical is the emerging evidence that even in countries with relatively good health outcomes, disparity in key family planning and sexual reproductive health indicators may be widening between the poor and non-poor.
The population of sub-Saharan Africa is expected to more than double over the next forty years, from around 856 million in 2010 to more than 1.9 billion in 2050. Even in countries where some demographic transition has begun, questions remain regarding whether these countries will experience the “demographic dividend” that has been identified in other developing regions. The investigation of how population and reproductive health may contribute to poverty reduction is gaining momentum. The issue of climate change is also deservedly receiving greater attention from the international development community, as rapid population growth, combined with poverty and lack of access to resources, tends to exacerbate problems of environmental depletion and civil conflict.
Program Objectives and Strategic Priorities
The mission of the PDRH program is to provide scientific evidence and articulate policy and program priorities for sustainable population growth and improved sexual and reproductive health in the region. Its current projects are organized around five strategic priority areas which include:
1) Family planning, fertility and population growth, particularly focusing on:
i. Fertility patterns, preferences and transitions
ii. Contraceptive use and unmet need for family planning
iii. Population growth and socio-economic development
2) Sexual and reproductive health and rights, particularly focusing on:
i. Access to reproductive health technologies and services
ii. Unintended pregnancy
iii. Adolescents’ sexual and reproductive health
iv. Male roles and couples’ involvement in sexual and reproductive health
3) Maternal, newborn and child health, particularly focusing on:
i. Barriers to service uptake for maternal and newborn health services
ii. Infant and child health and survival
4) Linkages between population and reproductive health and poverty
5) Linkages between population growth and environmental change
Current Projects
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Project Title Reversing the Stall in Fertility Decline in Western Kenya Description This was an initial three-year demonstration project, which has been extended for another three years.The first three-year phase of the study was implemented in 2010/2012 in four rural districts in Nyanza and Western provinces in Kenya. The demonstration phase of the project sought to increase routine use of modern contraceptives among Kenyan women through a community-based initiative. The current phase of the project scales up the community-based family planning (FP) initiative in the two large counties of Kenya - Siaya and Busia. The long-term goal of the project is to improve the general health status of the target communities through reducing unwanted and mistimed pregnancies, unsafe/illegal abortion, maternal morbidity and mortality, and fertility rate. The medium-term goals are to:
Project Objectives These goals will be achieved through four interrelated objectives:
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Funder David and Lucile Packard Foundation Project Period
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Project Title Financial Resource Flows for Population Activities Description The objective of the Resource Flows project is to monitor progress achieved by donors and developing countries on the fulfillment of the 1) ICPD programme of action (1994), 2) United Nations General Assembly Special Session Declaration of Commitment on HIV/AIDS (2001) and 3) relevant Millennium Development Goals (2000). This is done by collecting data and reporting on donor assistance and domestic expenditures for population activities in developing countries. The project also aims to strengthen the role of research institutes based in developing countries. Within the context of the resource flows project, The Netherlands Interdisciplinary Demographic Institute (NIDI) has entrusted specific domestic data collection and processing-related activities to APHRC. NIDI’s principal mandate is to study population issues, with a special emphasis on population-related social developments that are relevant to policy-making at both national and international levels. The project 'Financial Resource Flows for Population Activities' is part of NIDI’s research focus on 'projections, migration and health'. Collaborators
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Project Title STEP UP – (Strengthening Evidence for Programming on Unintended Pregnancy) Description It is estimated that about 40 percent of all pregnancies in developing countries are unintended, that is, not wanted at all, or occurring at a time different than desired. Of these, almost one half results in an abortion, of which about 55 percent (or 21 million per year) are unsafe abortions, leading to an estimated 47,000 deaths per year. To reduce the burden of unintended pregnancy, especially for poor and marginalized women, DFID is supporting the scaling up of access to family planning (FP) and safe abortions (SA) services. The Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Program Consortium (RPC) was created to respond to DFID's Terms of Reference for a programme of research on "Meeting the Unmet Need for Family Planning and Improve Access to Safe Abortion. The goal of the RPC in the STEP-UP project is to produce high-quality evidence that improves the health of the poorest individuals, particularly women, in developing countries and accelerate progress towards poverty reduction and achievement of Millennium Development Goals (MDGs) 4 and 5. The objective of the project is to generate policy-relevant research that promotes the use of an evidence-based approach for improving access to family planning (FP) and safe abortion in Kenya, Ghana and Senegal. As a result of this research, reproductive health programs will be strengthened and expanded so that they function more effectively and efficiently, increasing quality service coverage while they address women’s and men’s reproductive health rights and foster increased political commitment to maternal health. By the end of the project, the research will have developed and evaluated innovative service delivery and financing models to increase the range of options available to policymakers and programme managers. Collaborators
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Project Title African Strategies for Health Project Description The African Strategies for Health (ASH) Project is a five-year project funded by the United States Government through the United States Agency for International Development (USAID) Africa Bureau (AFR/B). It is being implemented by Management Sciences for Health (MSH) in partnership with African Population and Health Research Center (APHRC), Khulisa Management Services, and Institut pour la Santé et le Développement (ISED), of Dakar University, Senegal. ASH’s mandate is to assist AFR/B to work with African institutions, other development partners and partners within the USG to provide a strategic vision for guiding investments to further the health of Africans. The project conducts reviews, assessments and dialogues with partners working in the field to improve the understanding of constraints impeding the realization of the vision and the reaching of the Millennium Development Goals (MDGs) and the goals of the Global Health Initiative (GHI). Collaborators
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Project Title Evidence to Action for Strengthened FP and RH Services for Women and Girls (E2A) Description The Evidence to Action (E2A) project seeks to increase global support for the use of evidence-based best practices (BPs) to improve family planning and reproductive health (FP/RH) service access and quality while integrating FP/RH with other health and non-health services, mitigating gender barriers, and enhancing informed decision-making for women and girls. The project will help foster an environment in which women and girls can fulfill their reproductive intentions and aspirations. By strengthening FP/RH service delivery, E2A will reduce unmet need at each stage of the reproductive life cycle—a major contribution to reducing unintended pregnancies. Significant investment has been made by USAID and others to identify BPs that strengthen FP/RH service delivery, but questions still remain about how to adapt them to country contexts and align them with country priorities, how to get BPs adopted at country, facility and community levels and how to sustainably scale them up. New BPs that may improve service delivery continue to be developed and work is needed to identify and generate evidence about them. To address the challenges facing the adoption and scale-up of BPs, it is critical to explore why knowledge is not acted upon and to produce local evidence on BPs to cultivate country ownership. The E2A team will seek to answer these questions, contributing to the overall global evidence base, and ultimately strengthening FP/RH service delivery in the GHI-Plus/BEST countries, as well as others. Project Objectives
Collaborators Pathfinder Funder USAID Project Period September 2011 – August 2016 Project Leader |
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Project Title The Magnitude and Incidence of Unsafe Abortion Description Around the world, 46 million abortions take place every year. Of these, it is estimated that nearly 22 million are unsafe. In the past decade, more than 500,000 women died from complications of unsafe abortion. Each year, an estimated 47,000 women across the globe continue to die from unsafe abortions. Countless others suffer serious and life-threatening injuries. Approximately 13 per cent of maternal deaths globally are attributed to unsafe abortion. Ninety-five per cent of deaths and other complications related to unsafe abortions occur in developing countries. This study seeks to determine the magnitude of unsafe abortion, incidence of induced abortion, as well as women’s experiences of seeking and obtaining abortion, It also seeks to contribute evidence for legal and policy reform in Kenya. In specific terms, the proposed study will:
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Project Title Measurement, Learning & Evaluation (MLE) for the Urban RH Initiative Description Family planning is essential to achieving the millennium development goals. While family planning programs had considerable impact on increasing voluntary family planning use and reducing fertility in many parts of the world in the 1970s-1990s, they have received less attention in the global level in recent years even as contraceptive use remains low in much of sub-Saharan Africa (SSA) and parts of South Asia despite high levels of unmet need. The Bill and Melinda Gates Foundation (BMGF) Reproductive Health Strategy aims to reduce maternal and infant mortality and unintended pregnancy in the developing world by increasing access to high-quality, voluntary family planning services. In particular, a significant part of urban slum dwellers in Africa and have limited access to health services that address maternal and infant morbidity and mortality, including family planning. It is against this background that the BMGF initiated the Urban Reproductive Health Initiative (URHI) to increase modern contraceptive use in selected urban areas of India, Kenya, Nigeria and Senegal. Key elements of the Initiative include 1) integrating of FP services with maternal and newborn health and HIV/AIDS services; 2) improving the quality of FP services; 3) increasing FP access through public-private partnerships; and 4) creating sustained demand for FP services among the urban poor. The Measurement, Learning & Evaluation (MLE) Project is the evaluation component of the URHI, and aims at promoting evidence-based decision-making in the design of integrated family planning and reproductive health (FP/RH) interventions for the Initiative in the targeted countries. The MLE project uses state-of-the-art methods to evaluate the impact of the initiative on modern contraceptive use and examine related questions such as whether family planning (FP) is increasing in the poorer subgroups in the population and what pathways lead to the increase. The overall goal is to use innovative methods to ensure that there is a robust evidence and knowledge base for design, implementation, and impact evaluation of the initiative in diverse urban environments. The evidence of MLE will strengthen current and future RH programs globally. Project Objectives As noted earlier, the MLE project’s goal is to use state-of-the-art methods to evaluate the impact of the URHI on modern contraceptive use in Kenya, Nigeria and Senegal, and examine other related questions. The specific objectives of the MLE are to:
Core Collaborators
Country Level Partners Kenya Reproductive Health Initiative (Tupange)
Nigeria Reproductive Health Initiative
Senegal Reproductive Health Initiative (Initiative Sénégalaise de Santé Urbaine – ISSU)
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