The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57664

Catharine McKaig, DrPH, International Program, World Neighbors, 4127 NW 122nd Street, Oklahoma City, OK 73120, (405) 752-9700, cmckaig@wn.org

Of the 1.2 billion people who live in extreme poverty, 75% or 900 million, live in rural areas where the communication and service infrastructures are rudimentary at best. The challenge of providing effective reproductive health information and services to these marginalized rural communities is greater than extending physical access to facilities. In many cases, women simply do not have the freedom within social and cultural context to make decisions about their own fertility. Social institutions that generate values and attitudes relating to gender roles may serve to limit women’s access to essential reproductive health services. For these groups, innovative models of service delivery that consider the local context are urgently needed.

Over the past three years, World Neighbors has been working in six countries (Nepal, India, Kenya, Burkina Faso, Ecuador and Haiti) to develop effective models of service delivery for these groups. The model framework included dimensions of gender and integrated linkages to economic activities as well as service delivery. Evaluations demonstrated positive changes in reproductive health outcomes including:

1) Rates of family planning use rates of family planning use in program areas were as much as two times higher than would have been expected among rural populations. 2) Similar increases in rates for prenatal care, including, including increased iron-folate supplementation and tetanus toxoid immunization. 3) Increased levels of couple communication regarding family size and contraceptive use. These were positively associated with contraceptive use. 4) Changes in community attitudes regarding reproductive health services and understanding of service content and standards.

Learning Objectives:

• At the conclusion of this session the participant will be able to:
• 1. Recognize the importance of effective service delivery for rural populations and the limitations of physical access only approaches
• 2. List five lessons learned about effective reproductive health information and service delivery in those settings.
• 3. Apply a model framework that addresses reproductive health through an integrated development approach.

Keywords: Access and Services, International Reproductive Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.