Women's Health and Safe Motherhood

JSI has been at the forefront of women's health since its inception in 1978. Through the MotherCare and other projects, JSI staff have conducted research and documented trends in maternal health and safe motherhood. Today, JSI programs in the U.S. and around the world are improving health outcomes for women. The following publications present some of the documentation from key JSI projects.

Please note the following are listed in chronological order starting with the most recent publication.

General | Family Planning | Reproductive Health for Refugees |
Safe Motherhood | Sexually Transmitted Infections

General

Community Mental Health Treatment, Protection and Promotion for Women and Children in Aceh: Findings from an Evaluation of Programs Supported by the Health Services Program (HSP)

This report presents results from the successful Indonesia Health Services Program (HSP) Mental Health and Psychosocial initiative that took place following the devastating earthquake and tsunami in December 2004. In response to this disaster HSP began work in Aceh to address the psychosocial and protection needs of women and children.

Key findings include the development of a household-to hospital continuum of mental health care and a mental health system that has assisted with the restoration of health, human rights and human dignity. Survey findings concerning the new mental health program concluded that 90% of patients and caretakers reported improvements in mental health or social functioning. Developed by JSI Research & Training Institute, Inc. in conjunction with Columbia University Mailman School of Public Health and support from the USAID funded HSP Project. Neil Boothby and Maggie Veatch, Mailman School of Public Health, Columbia University, 2007.

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Russia Maternal & Child Health Initiative Final Report

This final technical report presents the results and lessons learned from JSI's successful Russia Maternal and Child Health Initiative (MCHI), funded by USAID. Over the three-year life of the project, MCHI introduced evidence-based principles and interventions into 16 regions across the Russian Federation, including the Russian Far East. Through training, capacity building, and policy development, MCHI revolutionized the provider/client dynamic and garnered widespread support for its activities and accomplishments—including improved service quality and integration, increased awareness of women and mothers of MCH services and issues, and increased use of modern contraceptives. The effective MCHI model will be sustained through JSI's affiliate, the Institute for Family Health, a Russian organization that will carry on the "legacy" of the MCHI approach. Laurel A. Cappa and Natalia Vartapetova. JSI/MCHI, March 2007.

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Prevention of Mother-to-Child Transmission of HIV and Family Planning Practices in HIV-Infected Women Facility Survey

This report presents the findings from a facility study of prevention of mother-to-child transmission of HIV (PMTCT) and family planning services provided to HIV-positive women. Conducted by JSI's Russian Maternal and Child Health Initiative staff, the aim of the study was to provide a socio-demographic profile of HIV-positive women coming to facilities for abortion or delivery, to provide quantitative information on current practices and knowledge that will allow the appropriate authorities to strengthen training programs, improve clinical services, and to provide a firm basis for policy discussions. JSI/MCHI, by Natalia V. Vartapetova and Anna V. Karpushkina, 2006.

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Russia MCHI Leveraging Study

The Maternal and Child Health Initiative (MCHI) has been extremely successful in strengthening maternal and child health services in the Russian Federation through the adoption of internationally recognized standards. One of the factors that helped to achieve such results in a relatively short time period was MCHI's ability to leverage resources for program implementation. This study was conducted in 2006 to document MCHI's leveraging processes and achievements. The study found that MCHI was extremely successful in leveraging a range of resources to support program implementation, expansion, and future sustainability. Hare, L., Makarova, T., JSI/MCHI, September 2006.

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Russia: Improving Women's Health Care

This 8-page publication describes JSI's Women and Infant Health (WIN) Project in Russia and how the Project effectively used monitoring and evaluation data to demonstrate the success of WIN's evidence-based, client-friendly model for women's health services.

This is the first in a series of evidence-based papers called Evaluation Matters, written at the end of JSI's international projects.

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Healthy Mother/Healthy Child Project - Completion Report

This final report presents the results from the successful Egypt Healthy Mother/Healthy Child (HM/HC) project. In conjunction with the Egypt Ministry of Health, over the life of twelve-year project, HM/HC helped reduce maternal mortality by 52% and infant mortality declined by almost 20%. Through both upgraded and new maternal and child healthcare facilities, more than 22 million people have improved access to essential services. Both a summary and detailed analysis of the key project achievements can be found in the HM/HC Completion Report.

Completion Report (without Annexes)

Healthy Mother/Healthy Child Project - Completion Report
(PDF, 1.7 MB)

Related Annexes

Annex 01 - Vital Statistics (PDF, 64 KB)
Annex 02 - Maps (PDF, 101 KB)
Annex 03 - USAID's Results Framework SO 20 (PDF, 24 KB)
Annex 04 - USAID's Results Framework SO 5 (PDF, 20 KB)
Annex 05 - Districts and Facilities (PDF, 34 KB)
Annex 06 - USAID Partners (PDF, 11 KB)
Annex 07 - Staff (PDF, 17 KB)
Annex 08 - Contract Performance Milestones (PDF, 26 KB)
Annex 09 - MCH Basics Benefits Package (PDF, 16 KB)
Annex 10 - Base Period - BEOC and CEOC (PDF, 24 KB)
Annex 11 - Option Period - BEOC and CEOC (PDF, 27 KB)
Annex 12 - Publications (PDF, 207 KB)
Annex 13 - Facilities Renovated by USAID (PDF, 61 KB)
Annex 15 - Operation Research Matrix (PDF, 72 KB)
Annex 18 - NGO's List (PDF, 50 KB)
Annex 19 - Checklists (PDF, 175 KB)
Annex 20 - Contract Indicators Report (PDF, 23 KB)

Perspectives and recommendations for USAID/Tanzania on community-based distribution (CBD) programs

(Harris, Nancy P., 2004)

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Improving health care delivery systems in Eritrea—technical assistance & support (TASC)

Final report of the JSI/TASC Eritrea project technical assistance & support (TASC), which was focused on maternal health, child health, and nutrition. The report also contains summary sheets of key cross-cutting topics including human resources development, logistics systems and behavior change communications, among others. JSI/Eritrea TASC, 2004.

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Final Report: NGO Networks Project, Pro Redes Salud Project

Final report of the Guatemala NGO Networks Project (Pro Redes Salud) which expanded basic care to people in the Mayan highland regions, unified the civil society and improved the MOH NGO granting program. From 2000 to 2004, the project extended high-quality services to 317,000 rural residents, and surveys showed significant improvements in health care coverage. NGOs were unified into networks, a national NGO federation had been formed, and innovations had been adopted by the MOH for improvements in the national MOH NGO program. JSI/Pro Redes Salud, 2004.

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Russia Women and Infant's Health Project Final Report

The Russia WIN Project, funded by USAID, was a comprehensive reproductive health project designed to improve maternal and newborn health care in two pilot regions of the country. The final report presents the accomplishments of the four-year project, including improved service quality, increased number of women exclusively breastfeeding, increased family planning use and a decline in abortion rates in project areas.

The WIN Project activities have been expanded and are now being implemented in 14 oblasts across Russia. JSI/WIN Project, 2003.

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Evaluation of the Russia WIN Project

From 1999 to 2003, the Women and Infant Health (WIN) Project worked in close collaboration with the Ministry of Health of the Russian Federation to improve the quality of maternal and newborn services and to increase access to and demand for high quality reproductive health services in three Russian cities. This report compiles the findings from the project's varied baseline and endline facility and household surveys and routine facility monitoring system in a data-based description of project results.
JSI/WIN Project, August 2003.

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Russia WIN Project: A Guide to Implementing Effective Health Care for Women and Infants

The recommendations of this Guide are based on the three-year experience of the Women and Infants' Health Project (WIN) in 20 medical facilities in Russia.

This Guide presents the WIN Project's methodology for developing a quality improvement process as well as detailed overviews of WIN training courses and communications approaches.

This Guide also will be useful for medical providers who want to improve the quality of services in their facilities in the region as well as for individual health care institutions—wherever health professionals are introducing state-of-the-art recommendations into their own systems and procedures.
JSI/WIN Project, 2003.

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National Maternal Mortality Study - Egypt

The National Maternal Mortality Study: Egypt 2000 documents the impact of JSI's Healthy Mother/Health Child Project on the reduction in maternal mortality in Egypt. It also examines avoidable factors that contribute to maternal deaths so as to improve maternal health programs in the country. Produced by the Doctorate of Maternal and Child Health Care Ministry of Health and Population, Egypt. June 2001.

Download Summary Report (PDF, 7.7 MB)

Download Final Report (PDF, 2.05 MB)

Safe Motherhood Strategies: A Review of the Evidence

This book, CD-Rom and website result from collaboration between DFID, the European Commission, the Institute of Tropical Medicine, Antwerp University and John Snow International-UK. In order to further its commitment to the reduction of maternal mortality, and to ensure that its strategy and policies are based on the available evidence, the EC commissioned 19 scientific background papers which reviewed the published and gray literature on particular topics. Those papers are contained within this website. 2001.

Family Planning

Romania: Reaching the Poor—Scaling Up Integrated Family Planning Services

This case study, developed as part of JSI's Best Practices in Scaling Up series, maps out how the Romanian Family Health Initiative (RFHI) has expanded family planning coverage nationwide to over 2000 rural communities. This case study highlights the process JSI's project used to integrate family planning into existing primary health services, including creating a favorable policy environment, training health care professionals, and implementing an effective logistics management system. Also included are highlights of what JSI staff learned along the way as scale-up processes were implemented. Also included in the series is an Introduction to scale up as well as case studies from Guatemala, Nepal, Turkey, Uganda, Zambia, and the DELIVER project. Merce Gasco, Diane Hedgecock and Christopher Wright, John Snow, Inc., 2007.

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Turkey: Scaling Up Nationwide Access to Integrated Family Planning through the Turkish Social Insurance Organization (SSK)

This case study, developed as part of JSI's Best Practices in Scaling Up series, reviews the successful introduction and expansion of family planning services through the Turkish government's social services agency, SSK. The paper maps out the results and sustainability of the program as well as the process used to introduce and scale up services, including contraceptive security, collaboration and quality assurance. Also included are highlights of what JSI staff learned along the way as scale up processes were implemented. Also included in the series is an Introduction to scale up as well as case studies from Guatemala, Nepal, Romania, Uganda, Zambia, and the DELIVER project. Nancy Pendarvis Harris, Nilgun Kircalioglu, Diane Hedgecock, John Snow, Inc., 2007.

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Using Management Information to Promote Performance Improvements

At the start of the Bangladesh Urban Family Health Partnership project, JSI recognized that a health program's sustainability depends on many factors. Built upon existing, manual data intake procedures at the field sites and employing simple Excel-based spreadsheet software, the UFHP management information system provided each NGO with a quarterly report showing the performance of the NGO as a whole and of its individual service delivery points-against selected indicators and across the UFHP's network of NGOs. This case study provides a description and tools for others interested in using this approach to performance improvement.

Azim T., Freidrich S., Cullem A., JSI/UFHP project, June 2003.

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Asking the Hard Questions: A Reproductive Health Providers Guide to Client-Centered HIV Risk Assessment

This guide is an interactive, self-instructional workbook created for reproductive health care providers who perform client-centered HIV, sexual behavior, and substance abuse risk assessments. JSI Research & Training Institute, Inc., 2002.

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Supporting Quality HIV Risk Assessment: A Guide for Reproductive Health Clinic Managers and Supervisors

A companion guide to Asking the Hard Questions, the goal of this material is to help clinic managers or supervisors assure that their staff are equipped with the knowledge and skills to provide quality care while performing HIV risk assessments. JSI Research & Training Institute, Inc. 2002.

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Integrating HIV Prevention and Family Planning Services: An Organizational Self-Assessment Manual

This manual was produced for Title X agencies in the U.S. that are looking how to develop and/or improve their HIV services. The topics range from Risk Assessment to Referrals to Cultural Competency. JSI Research & Training Institute, Inc., 2004.

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Reproductive Health for Refugees

Gender-Based Violence in Populations Affected by Armed Conflict: A Field Guide for Displaced Settings

This booklet defines gender-based violence, describes different forms that it takes, and outlines ways that humanitarian aid programs can help to address gender-based violence in populations affected by armed conflict. This material was produced by the Gender-Based Violence Global Technical Support Project of the Reproductive Health Response in Conflict (RHRC) Consortium. JSI/RHRC, 2004.

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Gender-Based Violence in Populations Affected by Armed Conflict: Checklist for Action

This small booklet is an addendum to the Field Guide for Displaced Settings. It reviews methods for humanitarian aid programs, involved in preventing gender-based violence. This material was adapted from a checklist developed by UNHCR, Geneva in 2003. JSI/RHRC, 2004.

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Synopsis: Sexual and Gender-Based Violence Against Refugees, Returnees, and Internally Displaced Persons: Guidelines for Prevention and Response.

This booklet is an addendum to the Field Guide for Displaced Settings. The 2003 updated UNHCR Guidelines offer advice on how to design strategies and carry out activities aimed at preventing and responding to gender-based violence. JSI/RHRC, 2004.

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Small Grants, Large Gains

Included in this report are an extensive overview of the RHRC program and in-depth summaries of RHRC projects. This material was produced by JSI Research & Training Institute, Inc., on behalf of the Reproductive Health for Refugees Consortium.
JSI/RHRC, 2002.

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Gender-Based Violence: Emerging Issues in Programs Serving Displaced Populations

This book delineates the Gender-Based Violence program, including the program model and history, program development and training, and reports on GBV programs in the different countries. This material was produced by the GBV Global Technical Support Project and JSI Research & Training Institute on behalf of the Reproductive Health for Refugees Consortium. This material is also available in French and Portuguese.
JSI/RHRC, 2002.

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Safe Motherhood

Community-Based Maternal and Neonatal Care: Summative Report

The Community-Based Maternal and Neonatal Care (CB-MNC) program of the Nepal Family Health Project (NFHP) was designed to address key health needs of mothers and newborns in Nepal who live in rural locations and have limited or no contact with facility-based health services. This document presents the summary details of a comprehensive monitoring and evaluation effort conducted with assistance from Johns Hopkins University through the NFHP. The studies found a significant increase in skilled birth attendance and dramatic declines in maternal and neonatal mortality. Nepal Family Health Program/JHU, December 2007.

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MotherCare Matters Vol. 9 No. 3: Behavioral Dimensions of Maternal Health & Survival

This issue describes and assesses MotherCare's methods for improving the health and survival of mothers and newborns. September 2000.

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MotherCare Matters. Vol. 9 No. 2: Improving Provider Performance—An Exploration of the Literature

This issue gives an overview of a wide range of interventions that have been implemented in developed countries and resource-poor settings, with a major emphasis on maternal health and family planning. August 2000.

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MotherCare Matters. Vol. 9 No. 1: Safe Motherhood Costing

A discussion on how governments can estimate the cost and plan for the necessary funding to provide quality maternal and newborn services for the majority of populations in developing countries. July 2000.

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MotherCare Matters Vol. 8, No. 3-4: MotherCare's Community Assessments: Understanding family and Community Behaviours and Practices

A comparative assessment of the findings in six countries provides an overview of family and community behaviors in key areas of safe motherhood. January 2000.

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MotherCare Matters Vol 8, No. 2: Scaling-Up MotherCare

MotherCare combined several scaling-up to increase its effect on maternal and neo-natal health over ten years of working in Guatemala and Bolivia. This issue defines and describes these efforts and their results. August 1999.

Download document in English (PDF, 271 KB)

Download document in Spanish (PDF, 286 KB)

MotherCare Matters Vol 8, No. 1: Safe Motherhood Indicators—Lessons Learned in Measuring Progress

Measuring maternal mortality is extremely difficult. This issue examines the methods that MotherCare utilized to overcome the many challenges. May 1999.

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Policy Brief 2: Safe Motherhood Indicators—Measuring Progress

Marge Koblinsky. Safe Motherhood Indicators—Measuring Progress. MotherCare Policy Brief #2. Arlington, VA: John Snow, Inc., 1999. (M751)

This helpful handout provides definitions and talking points for programs and persons advocating for maternal health.

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Policy Brief 1: Essential Obstetric Care and Subsets—Basic and Emergency Obstetric Care: What's the Difference?

Marge Koblinsky. Essential Obstetric Care and Subsets—Basic and Emergency Obstetric Care: What's the Difference. MotherCare Policy Brief #1. Arlington, VA: John Snow, Inc., 1999. (M750)

This policy brief discusses of maternal mortality indicators and complexities therein.

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MotherCare Matters Vol 7, No. 2: Family-Centered Maternity Care: MotherCare's Approach in Ukraine, Moldova and Russia

This briefing explains FCMC and its application in the Newly Independent States region in the years following the break-up of the Soviet Union. August 1998

MotherCare Matters Vol. 7, No. 1: Assessing Safe Motherhood Programs—India and Bangladesh

Large-scale safe motherhood programs in Bangladesh and India provide a rich resource for policy makers, program implementers and evaluators involved in such programs. This issue reports on the challenges and ways to overcome them. April 1998.

Africa Initiatives: Addressing Obstetric and Neonatal Complications in Africa from Community and Facility Perspectives. Descriptive reports from Ghana, Malawi, and Uganda

This final report documents the efforts and outcomes of MotherCare's work in three sub-Saharan African countries.

JSI MotherCare Arlington, VA: 1998. (M115)

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Assessing Safe Motherhood in the Community: A Guide to Formative Research

This manual is a guide to assessing community aspects of Safe Motherhood. It is intended for investigators who have the responsibility for designing community research on Safe Motherhood, and for program managers who will work with them to ensure that the research is oriented toward program needs.

Nachbar, Nancy, Carol Baume, and Anjou Parekh. Arlington, VA: John Snow, Inc., 1998. (M266)

Impact of Community Organization of Women on Perinatal Outcomes in Rural Bolivia

O'Rourke, Kathleen, Lisa Howard-Grabman, and Guillermo Seoane. Pan American Journal of Public Health Vol. 3, No. 1 (1998). (M113)

Requests for this publication should be sent to: Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037.

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MotherCare Matters Vol. 6, No. 4—Special Edition: Learning and Action in the First Decade—The MotherCare Experience

This special issue of MotherCare Matters highlights three demonstration projects and two applied research projects to illustrate how MotherCare's approach works in practice. JSI/MotherCare Project, 1997.

MotherCare Matters Vol. 6, No. 2: A Tribute to José Luis Bobadilla

This issue of MotherCare Matters is dedicated to José Luis Bobadilla, whose premature death was a profound loss for the public health and development communities. Learn about this incredible man through four abstracted publications which are representative of Dr. Bobadilla's work in maternal and perinatal health. March/April 1997.

Report on the Use of the Community Diagnosis to Explore Safe Motherhood: A Two-Country Comparison and Methodological Critique

Nachbar, Nancy. Technical Working Paper #6. Arlington, VA: John Snow, Inc., September 1997. (M063)

MotherCare Matters Vol. 6, No.1: Micronutrients for the Health of Women and Newborns

In this issue of MotherCare Matters, three questions important to program managers of iron supplementation efforts are reviewed: How best to design, implement and evaluate programs aimed at addressing three micronutrient deficiencies? November/December 1996.

MotherCare Matters Vol. 5, No. 4: Improving Obstetrical and Neonatal Management: Lessons from Guatemala

The Quetzaltenango Maternal and Neonatal Health Project was developed by INCAP with MotherCare to improve obstetrical and neonatal services. This issue of MotherCare Matters provides an in-depth review of the interventions and results from the Quetzaltenango Maternal and Neonatal Health Project. August 1996.

Reduction of Maternal and Perinatal Mortality in Rural and Peri-Urban Settings: What Works?

Kwast, Barbara E. European Journal of Obstetrics & Gynecology and Reproductive Biology. 69:47-53 (1996). (M060)

Requests for this publication should be sent to: Elsevier Science Regional Sales Office, Box 945, New York, NY 10159-0945, Fax: 212-633-3680.)

Reproductive Health: The MotherCare Experience

Turman, Tomris, Carla AbouZahr and Marjorie A. Koblinsky, eds# International Journal of Gynecology and Obstetrics Vol. 48 (suppl) (1995). (M003)

Analysis of the Vital Events Reporting System of the Maternal and Neonatal Health Project, Quetzaltenango, Guatemala

Bailey, Patricia E., Jose A. Szaszdi, Barbara Schieber MotherCare Technical Working Paper #3. Arlington, VA: John Snow, Inc., 1995. (M259)

An Antenatal Risk Scoring System—East Java Safe Motherhood Study, Probolinggo District, East Java, Indonesia

Rochjati, Poedji, Prajitno Prabowo, Agus Abahdi, Benny Soegianto, Kresnayana Yahya with Barbara E. Kwast. MotherCare Technical Working Paper #2. Arlington, VA: John Snow, Inc., 1995. (M258)

Delegation of Obstetric Care in Indonesia

Thouw, J. International Journal of Gynecology & Obstetrics.

Requests for this publication should be sent to: International Journal of Gynecology & Obstetrics, Elsevier Science, Regional Sales Office, Box 945, New York, NY 10150, Fax: 212-633-3680.

Delivering Women-Centered Maternity Care with Limited Resources: Grenada

Laukaran, Virginia H., Adity Bhattacharyya and Beverly Winikoff. Reproductive Health Matters, No. 4 (1994). (M059)

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Indicators for Obstructed & Prolonged Labor, Puerperal Sepsis & Postpartum Hemorrhage. Profile of Admissions, Hospital Management, Coverage and Referral

Kwast, Barbara E. For The Safe Pregnancy Evaluation Project, The Carolina Population Center, in collaboration with Tulane University and the Futures Group MotherCare Working Paper #21. Arlington, VA: John Snow, Inc., 1994. (M257)

MOTHERCARE: Lessons Learned 1989 - 1993: Summary Final Report

Gordis, Deborah, ed. with contributions by Marjorie A. Koblinsky, Colleen Conroy, Barbara Kwast and Kim Winnard. Arlington, VA: MotherCare/John Snow, Inc., 1994. (M056)

Safe Motherhood—The First Decade

Kwast, Barbara E. Midwifery. 9:105-123 (1993). (M053)

Requests for this publication should be sent to: Churchill Livingstone, Robert Stevenson House, 1-3 Baxter's Place, Leithwalk, Edinburgh, EH1 3AF, United Kingdom, Fax: 44-0-131-459-1177.)

Making Motherhood Safe

Tinker, Anne and Marjorie A. Koblinsky et al. Washington, D.C.: The World Bank, 1993. (M061)

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Epidemiological Study of Vesicovaginal Fistulas in Ethiopia

Kelly, John and Barbara E. Kwast. International Urogynecological Journal 4:278-281 (1993). (M254)

Obstetric Vesicovaginal Fistulas: Evaluation of Failed Repairs

Kelly, John and Barbara E. Kwast. International Urogynecological Journal 4:271-273 (1993). (M255)

Programming for Safe Motherhood: A Guide to Action

Koblinsky, Marjorie A., Anne Tinker and Patricia Daly. Health Policy and Planning. 9(3): 252-266 (1993). (M304)

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An Intervention to Reduce Maternal and Neonatal Mortality

Schieber, Barbara and Hernan Delgado. Quetzaltenango, Guatemala: MotherCare and INCAP, 1993. (M306)

Notes on an Appropriate Approach to Safe Motherhood

United States Agency for International Development/Jakarta, Indonesia. MotherCare Working Paper #8. Arlington, VA: John Snow, Inc., 1991. (M058)

Achieving Safe Motherhood with Limited Resources: A Case Study of Maternal Care in Grenada

Hight-Laukaran, Virginia. MotherCare Working Paper #6. Arlington, VA: John Snow, Inc., 1991. (M252)

Safe Motherhood: A Challenge to Midwifery Practice

Kwast, Barbara E. World Health Forum. 12:1-6 (1991). (M052)

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Interventions to Improve Maternal and Neonatal Health and Nutrition

George, Nicolette. MotherCare Working Paper #4. Arlington, VA: John Snow, Inc., 1990. (M301)

Sexually Transmitted Infections (STIs)

Sexually transmitted infections (STIs) are an increasing global health concern. JSI understands that the best defense against STIs are education and empowerment. JSI implements programs that inform international and domestic communities about STIs and to provide these groups with the resources to protect themselves.

Bacterial Vaginosis and Pre maturity in Indonesia: Association in Early and Late Pregnancy

Joesof, M. R., S. L. Hilier, B. Utomo, G. Wiknojosastro, M. Linnan, and N. Kandun. American Journal of Obstetrics and Gynecology 169(1):175-178 (1993). (M658)

(Please send requests for this publication to: American Journal of Obstetrics and Gynecology, Mosby - Year Book Reprints, 11830 Westline Industrial Dr., St. Louis, MO 63146-3318.)

Douching and sexually transmitted diseases in pregnant women in Surabaya, Indonesia

Joesof, M. R., H. Sumampouw, M. Linnan, A. Idajadi, N.E. St. Louis and S. Schmid. American Journal of Obstetrics and Gynecology 174(1):115-119 (1996). (M660)

Controlling STD's/HIV Within Dynamic Refugee Settings

Nersesian, Paula and Bill Brady. Refugee Participation Network Issue 20 (1995). (M655)