Population Council | Frontiers in Reproductive Health

FRONTIERS
Research Projects in Peru

A Diagnostic Study Relevant to the Promotion of Youth’s Health Behaviors in Alternative Development Zones of Peru. In collaboration with the Ministry of Health, researchers from FRONTIERS and the Center for Information and Education on the Prevention of Drug Abuse studied various groups of young people in the coca-growing zones of Peru to recommend interventions to support healthy development and prevent unplanned pregnancy, drug use, and violence against women. The study compared youth subpopulations by gender, region, residence, and schooling, assessed the role of parents, teachers, and community leaders as prevention agents, and proposed interventions based on study results. Findings showed that the risks of pregnancy and alcohol and tobacco use increased with age, but risks of violence and drug use did not. Researchers recommended that the community-oriented values generally imparted to girls should be strengthened, as should the protective roles played by parents and teachers. The indicators used in this study can be used as baselines in subsequent studies on youth in this area.
Project duration: 11/02–12/03
Project publication:

Final Report: "Youth behavioral risks and psychosocial resources in Peru’s alternative-development zones"

Information, Education, and Communication Strategies Culturally Appropriate for Improving Adolescents’ Reproductive Health in the Inca Region of Peru (Cusco). In collaboration with the Ministry of Health, Communicación Andina coordinated this project to develop a youth reproductive health program in Cusco, Peru. Live bilingual radio programs were broadcast to 15 rural communities over the period of one year. Adolesencia y Sexualidad, 20-minute daily programs, included music and youth news features, as well as information about reproductive health, sexuality, sexually transmitted infections including HIV/AIDS, and self-esteem. They also included responses to questions submitted by listeners. Survey results show increased sexual and reproductive health knowledge among students. There was a great demand from adolescents and parents to continue and expand the radio program.
Project duration: 4/00–4/02
Project publication:

Final Report: "Culturally appropriate information, education, and communication strategies for improving adolescent reproductive health in Cusco, Peru"

Monitoring Family Planning Providers’ Compliance with the Quality of Care Norms of Peru’s Ministry of Health (MOH). FRONTIERS and the MOH collaborated in this study to assess the extent to which family planning providers complied with new guidelines from Peru’s MOH in 1999. As part of a revised service delivery strategy, the MOH set quality of care goals to assure informed choice of contraceptive methods and respect for the user's reproductive intentions and rights. The study found that providers were willing to assist clients in method choice, but spent too little time counseling. Recommendations were provided on how to improve providers’ communication of family planning information to clients. Public health and client rights can be better served if MOH shifts to a client-oriented counseling protocol.
Project duration: 9/01–6/02
Project publications:

Final Report: "Providers' compliance with quality of care norms (Peru)"
OR Summary: "Peru: Managers must monitor quality of care regularly"
OR Summary: "Peru: Tell clients how to use their chosen method"

Global Agenda: Provider and Client Impacts of an Intervention Designed to Improve the Provider–Client Interaction in Ministry of Health (MOH) Clinics in Peru. FRONTIERS collaborated with the MOH and the Graduate School of Business Administration (ESAN) to test the effect of an improved counseling model consisting of an algorithm (a series of sequenced decisions), assisted by job aids, such as cards and pamphlets on available methods, to improve the quality of family planning counseling. Reports from simulated clients showed that quality of care improved by almost 70 percent when providers used both job aids. However, about two-thirds of providers used only one job aid, and only 37 percent used both pamphlets and method cards. The intervention only benefited providers who used the counseling strategy with job aids.
Project duration: 9/01 - 6/02
Project publications:

Final Report: "One-year client impacts of quality of care improvements achieved in Peru"
OR Summary: "Peru: Targeted counseling enhances client knowledge and contraceptive use"
Program Brief: "Enhancing quality for clients: The balanced counseling strategy"

Sustainability of Postabortion Care (PAC). In collaboration with the Ministry of Health, Ipas conducted this study in 2000 to assess the sustainability of changes made during a 1997 intervention to improve PAC at a large urban hospital. Comparison of data from the 1997 study with this three-year follow-up shows that the PAC model is sustainable and benefits both the institution and the patients. PAC services were well integrated with other emergency services, and over 80 percent of women treated received family planning counseling and left with a contraceptive method. Hospital costs and patient fees decreased, although the time spent in the hospital increased marginally.
Project duration: 9/00–2/02
Project publication:

Final Report: "Sustainability of postabortion care in Peru"
OR Summary: "Peru: Leadership facilitates sustainability of postabortion care services"

Year 2000: Monitoring Family Planning Providers’ Compliance with the Quality of Care Norms of Peru’s Ministry of Health (MOH). FRONTIERS and the MOH collaborated on this study, a follow-up to an earlier project, which assessed the extent to which family planning providers complied with revised guidelines from Peru’s MOH one year later. Providers displayed sustained effort to assist clients in method choice, but focused too little on the method chosen by the client. Public health and client rights may be well served if the MOH makes its goal-setting process conform to explicit health goals of the client, rather than to the goal of reducing unmet need for contraception.
Project duration: 8/00–8/01

Copies of summaries, reports, program briefs, and research updates can be ordered free of charge by contacting frontiers@popcouncil.org. FRONTIERS publications are also available on the U.S. Agency for International Development's Development Experience Clearinghouse Web site www.dec.org.