Global knowledge/local bodies: Family planning service providers’ interpretations of contraceptive knowledge(s)

Richey, Lisa Ann

doi:10.4054/demres.2008.18.17

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…These “street-level bureaucrats” (Lipsky 1980) make decisions about how to allocate limited resources and how to translate official recommendations into locally comprehensible advice—decisions that are shaped by their social position and cultural outlook as well as their personal agendas and individual capabilities (Shelton 2001). Previous research has demonstrated the importance of these factors for understanding the provision of family planning services (Kaler and Watkins 2001; Richey 2008), the implementation of health-care reform (Walker and Gilson 2004), and the introduction of HIV testing and treatment services (Buskens and Jaffe 2008; Angotti 2010). Building on this research, we examine how staff at maternal and child health (MCH) clinics understand and navigate the logistical and sociocultural challenges in family planning service provision during the rollout of VCT and PMTCT services.…”

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confidence: 99%

Providers' Views Concerning Family Planning Service Delivery to HIV‐positive Women in Mozambique

Hayford

Agadjanian

2010

Studies in Family Planning

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This study explores challenges and obstacles in providing effective family planning services to HIV-positive women as described by staff of maternal and child health (MCH) clinics. It draws upon data from a survey of service providers carried out from late 2008 to early 2009 in 52 MCH clinics in southern Mozambique, some with and some without HIV services. In all clinics, surveyed providers reported that practical, financial, and social barriers made it difficult for HIVpositive clients to follow protocols to prevent mother-to-child transmission of the virus. Likewise, staff were skeptical of their seropositive clients' ability to adhere to recommendations to cease childbearing and to use condoms consistently. Providers' recommendations to HIV-positive clients and their assessment of barriers to adherence did not depend on availability of HIV services. Although integration of HIV and reproductive health services is advancing in Mozambique, service providers do not feel that they can influence the behaviors of HIV-positive women effectively.The large-scale rollout of antiretroviral therapies is transforming HIV/AIDS from an untreatable and lethal disease to a chronic condition. As a result, increasing effort has been directed toward improving the quality of life of people living with HIV, and in particular toward managing their reproductive health and parenthood. In sub-Saharan Africa, HIV testing and treatment services have grown rapidly in the first decade of the twenty-first century. Voluntary counseling and testing (VCT) programs have become more widely available, allowing an increasing number of women to learn their HIV status. Recently developed regimens for the prevention of mother-to-child transmission (PMTCT) lower the likelihood of vertical transmission, and highly active antiretroviral therapy (HAART) can stall the progression of HIV infection to AIDS.In theory, these technologies make pregnancy and childbirth for seropositive women possible with minimal risk of mother-to-child transmission, but in practice considerable logistical, financial, and cultural barriers inhibit their full implementation. The recent introduction of rapid and readily available HIV testing, regimens for the prevention of vertical transmission, and official policies for the treatment of seropositive women have created new requirements for specialized care. Prevention and treatment protocols are developed at the national and even international level, but are implemented by local clinic staff. These "street-level bureaucrats" (Lipsky 1980) make decisions about how to allocate limited resources and how to translate official recommendations into locally comprehensible advice-decisions that are shaped by their social position and cultural outlook as well as sarah.hayford@asu.edu.

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confidence: 99%

Providers' Views Concerning Family Planning Service Delivery to HIV‐positive Women in Mozambique

Hayford

Agadjanian

2010

Studies in Family Planning

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“…Moreover, the use of contraceptives is influenced by women's knowledge of the methods available, their religious affiliation, [15][16][17], their wealth [18], and their ability to make decisions about contraceptive use [19]. Other factors include male involvement in decision-making regarding contraceptive use [20,21], fear of side effects, and educational levels [22,23,24].…”

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confidence: 99%