AIDS research in Mongolia (2)
-----------------------------
The note about behavioural research in Mongolia interested me. I com-
mend the author for initiating behavioural and attitudinal survey tech-
nology (from population-based, family planning, reproductive health,
and public health) to STD/HIV/AIDS related work in Mongolia.
In addition to population based research, I have found it quite useful
to look at the operation of services with what we at the Population
Council have called "Situation Analysis" studies - studies of the
readiness of agencies to provide services, and the actual quality of
care delivered to clients in the clinic. Our view is that a more com-
plete picture of "demand and supply" comes from looking together at
both the population and the service environment.
The latter data generally provides many insights about what managers
can do themselves to strengthen related services, in addition to
strengthening education programs directed at the population.
If you may be interested but not familiar with this additional approach
I am mentioning, I would be happy to supply you with two recent publi-
cations:
Miller, R. et al. 1997. The Situation Analysis Approach to Assessing
Family Planning and Reproductive Health Services: A Handbook. The Popu-
lation Council, New York; and
Miller, K. et al. 1998. Clinic-Base Family Planning and Reproductive
Health Services in Africa: Findings from Situation Analysis Studies.
The Population Council, New York.
This latter publication synthesises the findings from 12 such national
studies in Sub-Sahara Africa, concluding that two of the most serious
service problems with the quality of MOH services are:
1) in the information exchange between providers and clients, important
background information from the clients (such as her reproductive
goals, breastfeeding status, and the nature of her relationship(s))
is left off, thus interfering with assistance in selecting an appro-
priate contraceptive, and the providers frequently leave out impor-
tant information for clients that will be helpful for their contin-
ued use (e.g. provides provide information on how to use methods,
and their advantages, but often do not discuss possible side-
effects, or how to manage those side effects if they occur; and
2) interestingly, despite the fact that the epicenter of the AIDS pan-
demic can be said to be in Eastern and Southern Africa, when family
planning services are provided, there is almost no attention to edu-
cation for preventing STIs/HIV/AIDS. To illustrate this latter
point, providers who discuss condoms with clients, usually discuss
them in the context of family planning alone, rather than in the
context of dual protection from both pregnancy and STI/HIV/AIDS, and
they virtually never mention the fact that other methods offer no
protection from STI/HIV/AIDS.
Robert Miller
Population Council
1 Dag Hammarskjold Plaza
New York, N.Y. 10017, USA
Tel: +1-212-339-0645
Fax: +1-212-755-6052
mailto:rmiller@popcouncil.org
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