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Jafari H, Pourreza A, Kabiri N, Khodyari-Zarnaq R. Main actors in the new population policy with a growing trend in Iran: a stakeholder analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:57. [PMID: 36510303 PMCID: PMC9743608 DOI: 10.1186/s41043-022-00338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The total fertility rate in Iran has declined to below replacement level recently, and a new approach has been taken to tackle this issue. Thus, this study aimed to identify the involved stakeholders and their characteristics in the new population policy change in Iran. We employed a qualitative approach using the purposive sampling of key informants and the identification of relevant documents. The main stakeholders were divided into seven key groups: religious, political, governmental, professional, international sectors, media, and nongovernmental organizations. In addition, there was no centralized, clear, and comprehensive mechanism to guide the activities of stakeholders to coordinate and bring the total fertility rate to the replacement level in Iran. Despite the importance of the new population policy in Iran, in recent years, we still experience dispersion and inconsistency among various actors in this area. It is imperative to go through a consensus and coalition at macro-level authorities alongside evidenced-based population policymaking.
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Affiliation(s)
- Hasan Jafari
- Department of Health Care Management, Health Policy and Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abolghasem Pourreza
- Department of Management and Health Economics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Neda Kabiri
- Research Center for Evidence-based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Khodyari-Zarnaq
- Department of Health Policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
- Tabriz Health Service Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Namagembe I, Nakimuli A, Byamugisha J, Moffett A, Aiken A, Aiken C. Preventing death following unsafe abortion: a case series from urban Uganda. AJOG GLOBAL REPORTS 2022; 2:100039. [PMID: 35252906 PMCID: PMC8883508 DOI: 10.1016/j.xagr.2021.100039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Maternal deaths from unsafe abortion continue to occur globally, with particularly high rates in Sub-Saharan Africa where most abortions are classified as unsafe. Maternal death reviews are an effective part of cohesive strategies to prevent future deaths while abortion remains illegal. OBJECTIVE This study aimed to conduct maternal death reviews for all deaths occurring following unsafe abortion during the study period, to assess preventability, and to synthesize key learning points that may help to prevent future maternal deaths following unsafe abortions. STUDY DESIGN Full case reviews of all maternal deaths (350 cases from Jan 2016 to Dec 2018) at the study center (a national referral hospital in urban Uganda) were conducted by specially trained multidisciplinary panels of obstetricians and midwives. We extracted the reviews of women who died following unsafe abortions (13 [2.6%]) for further analysis. RESULTS Most maternal deaths owing to unsafe abortion were found to be preventable. The key recommendations that emerged from the reviews were (1) that clinicians should maintain a high index of suspicion for delayed presentation and rapid decompensation in cases where unsafe abortion has occurred, (2) that a low threshold for early intravenous antibiotic therapy should be applied, and (3) that any admission with complications following an unsafe abortion merits review by an experienced clinician as soon as possible. CONCLUSION Postabortion care is part of essential emergency medical care and should be provided with high standards, especially in areas where there is limited or no legal access to abortion care. Implementing the recommended learning points is likely to be feasible even in low-resource obstetrical settings and, given the high rates of preventability found in maternal deaths owing to unsafe abortion, is likely to be effective.
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Nalukwago J, Alaii J, van den Borne B, Bukuluki PM, Kimbowa M, Bockh E, Coutinho SM, Crutzen R. A process evaluation of the Communication for Healthy Communities adolescent health program in Uganda. HEALTH EDUCATION RESEARCH 2020; 35:15-31. [PMID: 31763679 PMCID: PMC6991622 DOI: 10.1093/her/cyz032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/17/2019] [Indexed: 06/10/2023]
Abstract
This study is a process evaluation of an adolescent-focused intervention of the USAID Communication for Healthy Communities program, in Uganda. We used mixed methods including observation, consultations and review of program documents to collect data on program coverage, reach and factors influencing implementation. Findings show that program activities were successfully implemented through collaborative partnerships with service partners and the community. Interpersonal communication complemented by mass-media messaging was effective in reaching and empowering adolescents with health information to make informed choices for behavior change. The program used theoretical frameworks to guide targeted interventions through audience segmentation and community empowerment. Targeted mass-media messaging and placement was found to be pertinent for program reach. Working through existing community structures is important for an effective reach of health promotion programs. Lessons identified for scaling-up adolescent health programs include the need to harmonize training and deployment of community champions by development partners, recruit audience-specific influential champions and link income-generating activities to health education interventions. There is thus need to collaboratively develop and institutionalize effective monitoring and evaluation strategies during program inception and design phases for appropriate accountability, ownership and a continuation of gains.
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Affiliation(s)
- Judith Nalukwago
- Department of Health Promotion, Faculty of Health, Medicine and Life Science, CAPHRI Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands
- FHI 360 (Family Health International), USAID/Communication for Healthy Communities Project, Plot 15 Kitante Close, PO Box 5768, Kampala, Uganda
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, PO Box 7062, Kampala, Uganda
| | - Jane Alaii
- Context Factor Solutions, PO Box 27598-00100, Nairobi, Kenya
| | - Bart van den Borne
- Department of Health Promotion, Faculty of Health, Medicine and Life Science, CAPHRI Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Paul Mukisa Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, PO Box 7062, Kampala, Uganda
| | - Musa Kimbowa
- FHI 360 (Family Health International), USAID/Communication for Healthy Communities Project, Plot 15 Kitante Close, PO Box 5768, Kampala, Uganda
| | - Emily Bockh
- FHI 360 (Family Health International), Durham, NC, USA
| | - Sheila Marunga Coutinho
- FHI 360 (Family Health International), USAID/Communication for Healthy Communities Project, Plot 15 Kitante Close, PO Box 5768, Kampala, Uganda
| | - Rik Crutzen
- Department of Health Promotion, Faculty of Health, Medicine and Life Science, CAPHRI Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands
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Ogbe E, Van Braeckel D, Temmerman M, Larsson EC, Keygnaert I, De Los Reyes Aragón W, Cheng F, Lazdane G, Cooper D, Shamu S, Gichangi P, Dias S, Barrett H, Nobels A, Pei K, Galle A, Esho T, Knight L, Tabana H, Degomme O. Opportunities for linking research to policy: lessons learned from implementation research in sexual and reproductive health within the ANSER network. Health Res Policy Syst 2018; 16:123. [PMID: 30558612 PMCID: PMC6297973 DOI: 10.1186/s12961-018-0397-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/22/2018] [Indexed: 11/16/2022] Open
Abstract
Background The uptake of findings from sexual and reproductive health and rights research into policy-making remains a complex and non-linear process. Different models of research utilisation and guidelines to maximise this in policy-making exist, however, challenges still remain for researchers to improve uptake of their research findings and for policy-makers to use research evidence in their work. Methods A participatory workshop with researchers was organised in November 2017 by the Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER) to address this gap. ANSER is a consortium of experienced researchers, some of whom have policy-making experience, working on sexual and reproductive health and rights issues across 16 countries and 5 continents. The experiential learning cycle was used to guide the workshop discussions based on case studies and to encourage participants to focus on key lessons learned. Workshop findings were thematically analysed using specific stages from Hanney et al.’s (Health Res Policy Syst 1:2, 2003) framework on the place of policy-making in the stages of assessment of research utilisation and outcomes. Results The workshop identified key strategies for translating research into policy, including joint agenda-setting between researchers and policy-makers, as well as building trust and partnerships with different stakeholders. These were linked to stages within Hanney et al.’s framework as opportunities for engaging with policy-makers to ensure uptake of research findings. Conclusion The engagement of stakeholders during the research development and implementation phases, especially at strategic moments, has a positive impact on uptake of research findings. The strategies and stages described in this paper can be applied to improve utilisation of research findings into policy development and implementation globally.
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Affiliation(s)
| | - Emilomo Ogbe
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium.
| | - Dirk Van Braeckel
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | | | - Elin C Larsson
- Department of Women's and Children's Health, Uppsala University/Karolinska Institutet, Uppsala, Sweden
| | - Ines Keygnaert
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | | | - Feng Cheng
- School of Medicine and Research Centre for Public Health, Tsinghua University, Beijing, China
| | - Gunta Lazdane
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia
| | - Diane Cooper
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Simukai Shamu
- Foundation for Professional Development, Pretoria, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Peter Gichangi
- University of Nairobi, Ghent University and International Centre for Reproductive Health, Nairobi, Kenya
| | - Sónia Dias
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Hazel Barrett
- Centre for Trust, Peace and Social relations, Coventry University, Coventry, United Kingdom
| | - Anne Nobels
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Kaiyan Pei
- National Research Institute for Family Planning, Beijing, China
| | - Anna Galle
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Tammary Esho
- Department of Community and Public Health, Technical University of Kenya, Nairobi, Kenya
| | - Lucia Knight
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Hanani Tabana
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Olivier Degomme
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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