Operations research (OR) is any clear and systematic data collection process either quantitative ... more Operations research (OR) is any clear and systematic data collection process either quantitative or qualitative designed to assess program functioning and lead to program improvements. Broadly defined family planning OR can encompass the diagnosis and correction of operational problems; pilot projects to demonstrate new approaches to service delivery; and experimental efforts to test different activities or to select the most cost-effective approach. Diagnostic and evaluation projects demonstration or pilot projects comparison tests and quasi-experimental designs are common study designs which have been employed in OR projects throughout the world. OR has adapted data collection methods from demography anthropology sociology and other disciplines as well as from market research. The authors review the similarities and differences between natural family planning (NFP) and other methods of family planning and improving NFP programs through OR. They conclude that while OR has many stre...
This discussion examines in detail the processes through which Tanzanias Maasai Health Services P... more This discussion examines in detail the processes through which Tanzanias Maasai Health Services Project a promary health care (PHC) undertaking is promoted. These include: holding several unhurried meetings with community members and leaders during which they define and prioritize their health problems and identify possible solutions; cultivating leadership and management from within the community while providing facilitation skills and technical assistance from the outside; working with community health workers (CHWs) who are selected by their communities; conducting the training of CHWs training. The project has been modified in both approach and content as activities have progressed. Lessons learned include: project staff must resist the role of expert and maintain that of facilitator; the role of the CHW must be a compromise between satisfying the felt need for curative services and the underlying need for preventive services; the pace of the project must be in step with the com...
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivatingleadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant site; and 5) integrating community organization skills and activities into CHW training. Some of the lessons learned are that 1) project staff must resist the role of expert and maintain that of facilitator; 2) the pace of the project must be in step with the communities' understanding and readiness to accept it ; 3) the role of the CHW must respond to the urgently felt need for curative services; the real need for preventive services, such as family planning; and the long-range need for social change; and 4) the project must respect the traditional social structure of the Maasai and Waarusha groups served and must also recognize and adapt to the differences between them.
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivatingleadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant site; and 5) integrating community organization skills and activities into CHW training. Some of the lessons learned are that 1) project staff must resist the role of expert and maintain that of facilitator; 2) the pace of the project must be in step with the communities' understanding and readiness to accept it ; 3) the role of the CHW must respond to the urgently felt need for curative services; the real need for preventive services, such as family planning; and the long-range need for social change; and 4) the project must respect the traditional social structure of the Maasai and Waarusha groups served and must also recognize and adapt to the differences between them.
This paper presents a brief description of the Massai Health Services (MHS) Project in northern T... more This paper presents a brief description of the Massai Health Services (MHS) Project in northern Tanzania. MHS is a community based training and service project in whiich individuals are selected by their communities to become Community Health Workers (CHWs). These CHWs are then trained to provide preventive and curative care emphasizing family planning and to act as facilitators for change. Project findings indicate that community organization requires communication and education skills familiarity with the communites acceptance by their members and patience. Remuneration for the CHWs has not yet been resolved. Training is an important component of the Massai Health Services Project. Training dispensary workers as trainers of CHWs has served to broaden the base of trainers and to link the tasks of training and supervision. Findings regarding implementation processes and results have national applicability. The project has served as a field test for selected aspects of the regional p...
International Quarterly of Community Health Education, 1986
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivating leadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant si...
International Quarterly of Community Health Education, 1986
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivating leadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant si...
Since the 1990s, the Inter-agency field manual on reproductive health in humanitarian settings (I... more Since the 1990s, the Inter-agency field manual on reproductive health in humanitarian settings (IAFM) has provided authoritative guidance on reproductive health service provision during different phases of complex humanitarian emergencies. In 2018, the Inter-Agency Working Group on Reproductive Health in Crises will release a new edition of this global resource. In this article, we describe the collaborative and inter-sectoral revision process and highlight major changes in the 2018 IAFM. Key revisions to the manual include repositioning unintended pregnancy prevention within and explicitly incorporating safe abortion care into the Minimum Initial Service Package (MISP) chapter, which outlines a set of priority activities to be implemented at the outset of a humanitarian crisis; stronger guidance on the transition from the MISP to comprehensive sexual and reproductive health services; and the addition of a logistics chapter. In addition, the IAFM now places greater and more consiste...
Although sexual and reproductive health services have become more available in humanitarian setti... more Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'. However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99Â % of the world's pop...
International Quarterly of Community Health Education, 1986
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivating leadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant site; and 5) integrating community organization skills and activities into CHW training. Some of the lessons learned are that 1) project staff must resist the role of expert and maintain that of facilitator; 2) the pace of the project must be in step with the communities' understanding and readiness to accept it; 3) the role of the CHW must respond to the urgently felt need for curative services; the real need for preventive services, such as family planning; and the long-range need for social change; and 4) the project must respect the traditional social structure of the Maasai and Waarusha groups served and must also recognize and adapt to the differences between them.
This is a practical framework to assist managers and policy-makers to make rational program decis... more This is a practical framework to assist managers and policy-makers to make rational program decisions when faced with multiple reproductive health needs and limited resources.
The RHRC Monitoring and Evaluation ToolKit (M&E ToolKit) presents a decision-oriented model for p... more The RHRC Monitoring and Evaluation ToolKit (M&E ToolKit) presents a decision-oriented model for program monitoring and evaluation. With tools from the M&E ToolKit, managers will find it easier to learn how their program is progressing, and what to do to make it work better. Use of the M&E ToolKit will help managers integrate useful evaluation activity into the everyday management of their programs to improve the quality of reproductive health services in refugee situations. The M&E ToolKit is tailored specifically to the information and decision-making needs of managers of reproductive health programs serving refugees and other war-affected persons. Materials in the M&E ToolKit might also be used by field staff in other sectors, country directors or headquarters personnel -anyone who uses data to make decisions for improving programs. Intro: How is the toolkit organized? The M&E ToolKit is a practical guide to monitoring and evaluation of reproductive health programs. Protocols for ...
Operations research (OR) is any clear and systematic data collection process either quantitative ... more Operations research (OR) is any clear and systematic data collection process either quantitative or qualitative designed to assess program functioning and lead to program improvements. Broadly defined family planning OR can encompass the diagnosis and correction of operational problems; pilot projects to demonstrate new approaches to service delivery; and experimental efforts to test different activities or to select the most cost-effective approach. Diagnostic and evaluation projects demonstration or pilot projects comparison tests and quasi-experimental designs are common study designs which have been employed in OR projects throughout the world. OR has adapted data collection methods from demography anthropology sociology and other disciplines as well as from market research. The authors review the similarities and differences between natural family planning (NFP) and other methods of family planning and improving NFP programs through OR. They conclude that while OR has many stre...
This discussion examines in detail the processes through which Tanzanias Maasai Health Services P... more This discussion examines in detail the processes through which Tanzanias Maasai Health Services Project a promary health care (PHC) undertaking is promoted. These include: holding several unhurried meetings with community members and leaders during which they define and prioritize their health problems and identify possible solutions; cultivating leadership and management from within the community while providing facilitation skills and technical assistance from the outside; working with community health workers (CHWs) who are selected by their communities; conducting the training of CHWs training. The project has been modified in both approach and content as activities have progressed. Lessons learned include: project staff must resist the role of expert and maintain that of facilitator; the role of the CHW must be a compromise between satisfying the felt need for curative services and the underlying need for preventive services; the pace of the project must be in step with the com...
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivatingleadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant site; and 5) integrating community organization skills and activities into CHW training. Some of the lessons learned are that 1) project staff must resist the role of expert and maintain that of facilitator; 2) the pace of the project must be in step with the communities' understanding and readiness to accept it ; 3) the role of the CHW must respond to the urgently felt need for curative services; the real need for preventive services, such as family planning; and the long-range need for social change; and 4) the project must respect the traditional social structure of the Maasai and Waarusha groups served and must also recognize and adapt to the differences between them.
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivatingleadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant site; and 5) integrating community organization skills and activities into CHW training. Some of the lessons learned are that 1) project staff must resist the role of expert and maintain that of facilitator; 2) the pace of the project must be in step with the communities' understanding and readiness to accept it ; 3) the role of the CHW must respond to the urgently felt need for curative services; the real need for preventive services, such as family planning; and the long-range need for social change; and 4) the project must respect the traditional social structure of the Maasai and Waarusha groups served and must also recognize and adapt to the differences between them.
This paper presents a brief description of the Massai Health Services (MHS) Project in northern T... more This paper presents a brief description of the Massai Health Services (MHS) Project in northern Tanzania. MHS is a community based training and service project in whiich individuals are selected by their communities to become Community Health Workers (CHWs). These CHWs are then trained to provide preventive and curative care emphasizing family planning and to act as facilitators for change. Project findings indicate that community organization requires communication and education skills familiarity with the communites acceptance by their members and patience. Remuneration for the CHWs has not yet been resolved. Training is an important component of the Massai Health Services Project. Training dispensary workers as trainers of CHWs has served to broaden the base of trainers and to link the tasks of training and supervision. Findings regarding implementation processes and results have national applicability. The project has served as a field test for selected aspects of the regional p...
International Quarterly of Community Health Education, 1986
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivating leadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant si...
International Quarterly of Community Health Education, 1986
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivating leadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant si...
Since the 1990s, the Inter-agency field manual on reproductive health in humanitarian settings (I... more Since the 1990s, the Inter-agency field manual on reproductive health in humanitarian settings (IAFM) has provided authoritative guidance on reproductive health service provision during different phases of complex humanitarian emergencies. In 2018, the Inter-Agency Working Group on Reproductive Health in Crises will release a new edition of this global resource. In this article, we describe the collaborative and inter-sectoral revision process and highlight major changes in the 2018 IAFM. Key revisions to the manual include repositioning unintended pregnancy prevention within and explicitly incorporating safe abortion care into the Minimum Initial Service Package (MISP) chapter, which outlines a set of priority activities to be implemented at the outset of a humanitarian crisis; stronger guidance on the transition from the MISP to comprehensive sexual and reproductive health services; and the addition of a logistics chapter. In addition, the IAFM now places greater and more consiste...
Although sexual and reproductive health services have become more available in humanitarian setti... more Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'. However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99Â % of the world's pop...
International Quarterly of Community Health Education, 1986
The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in w... more The Maasai Health Services Project in northern Tanzania is a primary health care undertaking in which individuals chosen by their communities are trained as providers of selected preventive and curative services, including family planning, and as facilitators of change in their areas. The communities, through the selection, support, and supervision of these community health workers (CHWs), are actively involved in every stage of project activities. This article examines in detail the process through which community management of the project is promoted. Important elements within this process include: 1) holding several unhurried meetings with community members and leaders to discuss health problems and solutions fully; 2) cultivating leadership and management from within the community while providing technical assistance from the outside; 3) working with CHWs who are selected by their communities; 4) conducting the training of CHWs in their own communities instead of at a distant site; and 5) integrating community organization skills and activities into CHW training. Some of the lessons learned are that 1) project staff must resist the role of expert and maintain that of facilitator; 2) the pace of the project must be in step with the communities' understanding and readiness to accept it; 3) the role of the CHW must respond to the urgently felt need for curative services; the real need for preventive services, such as family planning; and the long-range need for social change; and 4) the project must respect the traditional social structure of the Maasai and Waarusha groups served and must also recognize and adapt to the differences between them.
This is a practical framework to assist managers and policy-makers to make rational program decis... more This is a practical framework to assist managers and policy-makers to make rational program decisions when faced with multiple reproductive health needs and limited resources.
The RHRC Monitoring and Evaluation ToolKit (M&E ToolKit) presents a decision-oriented model for p... more The RHRC Monitoring and Evaluation ToolKit (M&E ToolKit) presents a decision-oriented model for program monitoring and evaluation. With tools from the M&E ToolKit, managers will find it easier to learn how their program is progressing, and what to do to make it work better. Use of the M&E ToolKit will help managers integrate useful evaluation activity into the everyday management of their programs to improve the quality of reproductive health services in refugee situations. The M&E ToolKit is tailored specifically to the information and decision-making needs of managers of reproductive health programs serving refugees and other war-affected persons. Materials in the M&E ToolKit might also be used by field staff in other sectors, country directors or headquarters personnel -anyone who uses data to make decisions for improving programs. Intro: How is the toolkit organized? The M&E ToolKit is a practical guide to monitoring and evaluation of reproductive health programs. Protocols for ...
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