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Throughout the Reproductive Life Course: Opportunities and Challenges for Empowering Girls and Women

April 2 3, 2014, Washington, D.C.

photo credits: Pathfinder International

* This diagram was created by the USAID-funded project, Evidence to Action for Strengthened Reproductive Health Services for Women and Girls (E2A), which is led by Pathfinder International in partnership with the African Population and Health Research Center, ExpandNet, Intrahealth International, Management Sciences for Health, and PATH.

Acronym List - Lifecycle Diagram


EC FP Emergency Contraception Family Planning

HTSP Healthy Timing and Spacing of Pregnancy LAM Lactational Amenorrhea Method LARC Long-Acting Reversible Contraceptive PM RH Permanent Methods Reproductive Health PPFP Postpartum Family Planning SBCC Social and Behavior Change Communication SDM Standard Days Method
Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Welcome Message & Meeting Overview


Welcome to Throughout the Reproductive Life Course: Opportunities and Challenges for Empowering Girls and Women. The United States Agency for International Development (USAID), Office of Population and Reproductive Health, in collaboration with USAIDs flagship projects for maternal and child health and reproductive health and family planningthe Maternal and Child Health Integrated Program and the Evidence to Action for Strengthened Reproductive Health Project have partnered with the Maternal and Child Health Bureau of Health Resources and Services Administration (HRSA) to bring US domestic and international reproductive health experts together to discuss possible linkages and shared learning that address the reproductive health needs of girls and women across the entire reproductive life cycle. The end goals of this meeting are to: Disseminate knowledge and identify gaps about effective approaches for empowered decisionmaking throughout the reproductive life course; and Explore the use of these findings to strengthen programs, and stimulate new interventions and research opportunities.

USAID and HRSA are working on similar problems in reproductive health including unintended pregnancies; rapid, repeat pregnancies; preterm birth, and the need for post-abortion care. Both agencies are developing tools and models to reach vulnerable, marginalized, low-income populations, especially to help girls and women make healthy decisions over the entire reproductive life course. Both are supporting research and working to mobilize the evidence on effective models and approaches. Both seek opportunities to disseminate knowledge and share learning opportunities about what works, what doesnt work, and why. Over the course of this meeting, you will have the opportunity to interact and learn from other participants. To encourage cross-pollination, presenters on panels and plenaries will be a mix of individuals who work internationally and in the US. Each day the meeting will begin with two opening plenaries of experts followed by concurrent panel presentations in the afternoon. Presentations will involve the following themes: Youth Using Family Planning to Prevent High-Risk Pregnancies Community-Based Services Family Planning Integration with Health Services Multisectoral Family Planning Links with Non-Health Activities Integration of Empowerment or Motivational Components

At the end of the meeting, participants will divide into small groups to identify the learning that resonated with them. These key areas of learning will be written up and shared with participants in a comprehensive conference report. In closing, we would like to thank you for your contributions to this important meeting and all of the work you do for girls and womens reproductive health across the lifecycle.

Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Acknowledgments
We would like to acknowledge the generous support of the US Agency for International Development (USAID) for making this meeting possible, and the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau, for its partnership in helping to bring forward important evidence that will contribute to increasing girls and womens access to the reproductive services they need across their entire lifecycles. Finally, we would like to thank all of the researchers and programmers who submitted abstracts and shared important evidence that will no doubt further global learning in the fields of family planning, maternal and child health, and sexual and reproductive health. The following individuals from USAID, HRSA, and the USAID-funded Evidence to Action (E2A) and Maternal and Child Health Integrated (MCHIP) projects should be acknowledged for their roles in organizing this important meeting: Linda Cahaelen, Patricia MacDonald, and Maureen Norton of USAID; Johannie Escarne of HRSA; Salwa Bitar, Laurel Lundstrom, and Seda Yener of E2A; and Holly Blanchard, Sadie Healy, Sruti Ramadugu, and Elizabeth Sasser of MCHIP.

The conference and this program were made possible by the generous support of the American people through USAID, under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-0800002-00 and by USAIDs Office of Population and Reproductive Health, Bureau for Global Health Award Number AID-OAA-A-11-00024
Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, DC

Table of Contents
Agenda ..................................................................................................................................................7 Opening Session, Day 1 ....................................................................................................................8 Setting the Stage: Domestic and International Perspectives .....................................................8 Plenary Sessions, Day 1 .................................................................................................................. 10 Concurrent Sessions, Day 1 ......................................................................................................... 13 Opening Session, Day 2 ................................................................................................................. 18 Emerging Approaches to Improving Pregnancy Outcomes ................................................... 18 Plenary Sessions, Day 2 .................................................................................................................. 19 Concurrent Sessions, Day 2 ......................................................................................................... 22 Small Group Work & Closing Session ........................................................................................ 25 Presenter Biographies .................................................................................................................... 26 Moderator Biographies .................................................................................................................. 35

Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Agenda
Tuesday, April 1, 2014
All Day 10:00 am 12:00 pm Hotel Check-In and Meeting Preparation Panel Coordinators and Core Team Meeting By invitation only and via GoToMeeting E2A Office

Wednesday, April 2, 2014


7:30 8:30 am 8:00 8:30 am 8:30 9:30 am 9:30 9:40 am 9:40 11:00 am 11:00 11:30 am 11:30 1:00 am 1:00 2:00 pm 2:00 3:30 pm Breakfast Registration Technical Meeting Overview Youth Plenary Break Family Planning Integration w/ Health Plenary Lunch Concurrent Sessions A Community Panel Family Planning and High-Risk Pregnancy Panel 3:30 4:00 pm 4:00 5:30 pm Coffee Concurrent Sessions B Family Planning Integration w/ Health Panel 2 Youth Panel 2 Chinese Room Virginia Room In Session Chinese Room Chinese Room Virginia Room First Floor Chinese Room In Session In Session First Floor Chinese Room Chinese Room

Setting the Stage: Domestic and International Perspectives Chinese Room

Thursday, April 3, 2014


7:30 8:30 am 8:30 10:00 am 10:00 10:15 am 10:15 10:45 am 10:45 12:15 pm 12:15 1:15 pm 1:15 2:45 pm Breakfast Multisectoral Integration Plenary Break Empowerment Plenary Lunch Concurrent Sessions C Family Planning Integration w/ Health Panel 3 Youth Panel 3 2:45 3:15pm 3:15 4:15 pm 4:15 5:00 pm Coffee Small Group Work Presentation of Findings and Closing Remarks Chinese Room In Session Chinese Room Virginia Room First Floor Chinese Room Chinese Room

Emerging Approaches to Improving Pregnancy Outcomes Chinese Room

Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, DC

Opening Session, Day 1 Setting the Stage: Domestic and International Perspectives
April 2, 8:30 9:30, Chinese Room
Robert Clay, Deputy Assistant Administrator, Bureau of Global Health, USAID
Robert Clay will outline the following international public health goals and explain how USAID is working with global and domestic partners to achieve them: FP2020increasing access to family planning for an additional 120 million women by 2020; A Promise RenewedEnding Preventable Child and Maternal Deathsreducing child deaths to 20 or fewer per 1,000 live births by 2035; and Achieving an AIDS-Free Generationensuring that no child is born with the AIDS virus.

Mr. Clay will review key strategies that will be applied to achieve these objectives. These include: focusing activities in 24 high-priority countries, and on high-burden, vulnerable populations, while employing evidence-based, high-impact interventions. These activities are intended to accelerate reductions in under-five and maternal mortality. Mr. Clay will emphasize the link between the work of presenters attending this conference with the potential to contribute to these important objectives. About Robert Clay. A Senior Foreign Service Officer, when Robert Clay joined USAID in 1983, he was responsible for expanding the Agencys efforts to increase oral rehydration therapy worldwide. Since then, he has served the Agency in positions including: Director of the Office of HIV/AIDS, where he was responsible for leading the Agencys programs under the Presidents Emergency Plan for AIDS Relief; Director of USAIDs Population, Health and Nutrition (PHN) Office in India; from1998 to 2003, Director of the PHN Office in Zambia, where he led the development of one of the first multisectoral HIV/AIDS programs at USAID; Chief of the Health Services Division in the Bureau for Research and Development; and Deputy Director of the Office of Health and Nutrition in Washington, DC.

Katie Taylor, Deputy Assistant Administrator, Bureau for Global Health, USAID
Katie Taylor will discuss family plannings role in contributing to achieving the goals of Ending Preventable Child and Maternal Deaths, particularly how family planning helps women time and space their pregnancies to occur at the healthiest times of their liveswhen they are psychologically, emotionally, and physically ready for a pregnancy. She will explain that family planning use helps women practice four healthy behaviors:
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Avoiding adolescent pregnancy; Preventing rapid, repeat pregnancy; and Avoiding pregnancy after age 34 and after parity 4.

Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

She will conclude with an overview of the various phases of reproductive life course and the continuum of care needed to ensure that girls and women have access to the information and services they need for informed decision-making. About Katie Taylor. Previously, Katie Taylor served as the Executive Director of the Center for Interfaith Action on Global Poverty (CIFA). She also worked for General Electric for nearly 20 years in a wide variety of businesses, including its health care, transportation, and mortgage units. Before joining CIFA, she was Vice President for International Business Development at the University of Pittsburgh Medical Center. A multilingual executive, she has lived and worked in the Americas, Europe, the Middle East, North Africa, and Asia. She has a BA in political science from Yale University, a graduate Certificate of Political Studies from Institut dEtudes Politiques de Paris and an MS in international business from Georgetown University.

Michael Lu, Associate Administrator, Maternal and Child Health Bureau, HRSA
Michael Lu will present on the life course perspective and how this framework is utilized in HRSAs Maternal and Child Health Bureau (MCHB) programs. Dr. Lu will outline the components of this multidisciplinary approach including the importance of early life events on the individuals health trajectory. Protective and risk factors along the life continuum will be presented to provide the context for preconception/interconception care. There will be an emphasis on the application of the life course perspective in maternal and child health practice. Dr. Lu will review MCHB activities supporting the life course perspective and provide practical application for this framework. In conclusion, Dr. Lu will provide reflections on future directions of collaboration with HRSA and USAID. About Michael Lu. Dr. Lu joined HRSA from the University of California, Los Angeles (UCLA) Schools of Medicine and Public Health, where he was associate professor of obstetrics, gynecology and public health. Dr. Lu brings years of experience in maternal and child health research, practice, and policy to his post at HRSA. Prior to his appointment, Dr. Lu chaired the Secretarys Advisory Committee on Infant Mortality. He has served on two Institute of Medicine (IOM) Committees (Committee on Understanding Premature Birth and Assuring Healthy Outcomes, and Committee to Reexamine IOM Pregnancy Weight Guidelines), and the Centers for Disease Control and Prevention Select Panel on Preconception Care. While at UCLA, Dr. Lu was best known for his research on racialethnic disparities in birth outcomes, and his visionary leadership on life course. Dr. Lu has received numerous awards for his teaching, has attended over 1,000 births, and has been voted one of the Best Doctors in America since 2005. Following opening remarks, Salwa Bitar, Senior Advisor for Global Alliances at the Evidence to Action Project, will give a 10-minute Technical Overview of the meeting.

Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, DC

Plenary Sessions, Day 1


April 2, 9:40 11:00, Chinese Room Youth Plenary
Moderator: Koki Agarwal, MCHIP Panelists: Sithokozile Maposa, Saskatchewan School of Nursing Oby Obyerodhyambo, PATH Kenneth W. Buyinza, Plan International Uganda

Again, its Abstinence until when? Unveiling Meanings of Sexual Relationships and HIV Risk in Young Black, Sithokozile Maposa
In the context of a hidden but growing disproportionate HIV/AIDS epidemic impacting African women from HIV-endemic regions, we would be remiss if we did not explore their experiences in our response to HIV/AIDS. This interpretive phenomenological study examined meanings influencing practical understanding of HIV risk and sexual practices of 12 young black African women in a Midwestern US city. This presentation unveils the reality checks, a missing dialogue of self-understanding enhanced through relationship, and traditions that silence women in sexual relationships that were related to limited sexual agency. Such issues can potentially make young women impervious to incompatible sexual health interventions.

Innovative Approach to Reaching At-Risk Youth with High-Impact Sexual Health Services, Oby Obyerodhyambo
This presentation provides insights on sexual and reproductive health challenges facing Kenyan youth, describing gaps in awareness, financing, and access to health services. It describes an innovative approach by Partnership for an HIV Free Generation that mobilized the private sector to offer support for comprehensive services to youth by financing production and use of tele-drama series, offering cash and in-kind support for a talent show, as well as building private-public partnership for economic empowerment targeting female youth in informal settlements. The presentation shares results of these initiatives as well as lessons learnt.

Bridging the Gaps: Low-Cost Multimedia Approaches Improve Sexual Reproductive Health & Rights/Family Planning Practices Among Youth in the PostConflict Rural Communities of Northern Uganda, Kenneth W. Buyinza
Young people in Northern Uganda districts have limited access to accurate, comprehensive sexual and reproductive health (SRH) rights, information, and services. This is reflected in a low contraceptive prevalence rate; higher unmet need for family planning; and results in a high proportion of unplanned births. This situation increases the adolescent/youth SRH risks, including infection with HIV/STI and unwanted teenage pregnancies. Through a SIDA-funded two-year adolescent SRH & Rights project, Plan International Uganda demonstrated that youth SRH & Rights/Family Planning programs in rural communities succeed when integrated and locally contextualised approaches for behavior change communication are used, youth are the change agents, and local health systems are strengthened to meet resulting demand.

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

April 2, 11:30 1:00, Chinese Room Family Planning Integration with Health Services Plenary
Moderator: Fabio Castao, Management Sciences for Health Panelists: Stephen Rahaim, SHOPS Project Nancy Termini, Population Council Natalia Vartapetova, Institute for Family Health, Russia Irit Sinai, Institute for Reproductive Health, Georgetown University

Enabling Private Facility Provision of LA/PMs through an Integrated Model, Stephen Rahaim
Bangladesh has achieved a remarkable drop in total fertility rate, from 6.3 in 1975 to 2.3 in 2011. The modern contraceptive rate is 52%, but only 8% of couples use long-acting/permanent methods (LA/PMs). Although there are opportunities, private facilities provide virtually no LA/PMs. Introducing a new service in the private sector is challenging because health businesses need to consider not just health impact, but also viability and other business issues. LA/PM services were successfully integrated into 35 large private facilities through a carefully designed flexible model. In medical college hospitals, a LA/PM practicum is being introduced to medical students and interns for the first time.

The Community Midwifery Approach: Expanding Access to Comprehensive Maternal Health Services, Including Postpartum Family Planning, in Kenya, Nancy Termini
The Community Midwifery approach is an innovation that addresses a range of maternal and child health issues in Kenya, including problems of unskilled/lack of birth attendance, low use of postnatal care services, and unmet need for family planning. It is an innovation that supports skilled workers in bringing critical services right to the homes of women in their own communities. In this project, we tested the feasibility of improving the integration of maternal and child health, family planning, and HIV services offered by community midwives by expanding their breadth of services to encompass a continuum of care, from pregnancy to the postpartum period.

Trends in Reproductive Health in Russia: Role of USAID-funded Projects and Lessons Learned, Natalia Vartapetova
This presentation describes reproductive health/maternal and child health USAID-funded project approaches and results to address Russian reproductive health needs through integration of family planning across the spectrum of maternal and infant care. To measure health outcomes and actual improvements in health services, facility-based data on postpartum and post-abortion care from 10 core regions that participated in the projects from 2004 through 2010 were analyzed. Ministry of health data were used to assess abortion trends in Russia and the project regions. The data show that the project approach to family planning as an integrated, horizontal service and client-centeredness were crucial to improve quality of services and decrease abortions.

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Act Local, Think Global: Applying Systematic Screening to Health Services in Central California, Irit Sinai
Systematic screening is an international best practice addressing multiple patient needs during a single facility visit. We tested a paper version of the screening tool, adapted from those used in developing countries, and an electronic version integrated into the facilitys electronic records, in California health centers. Multiple evaluation methodologies were used at baseline/endline. Adding a new process to a complex, fast-paced system was challenging, but results were generally positive. When testing the electronic version, the mean number of services received increased significantly, suggesting that systematic screening is a promising

Concurrent Sessions, Day 1


April 2, 2:00 3:30, Chinese Room
Community-Based Services Panel Moderator: Salwa Bitar, Management Sciences for Health, Evidence to Action Project Panelists: Adrienne Allison, World Vision Jessica Izquierdo, ChildFund International Kidest Lulu, Pathfinder International Ethiopia Kim Williams, Healthy Start New Orleans

Building Advocates for Family Planning Among Male Leaders in Senegal, Adrienne Allison
Senegals 50-year-old family planning program has yielded a contraceptive prevalence rate (CPR) of 11 percent. In this traditional Islamic society, men control most decisions about fertility and contraceptive use, yet family planning programs have neglected to engage them. World Vision (WV) educated Christian and Muslim leaders on the benefits of Healthy Timing and Spacing of Pregnancies for building healthy families and communities. WV brought civic, religious and health leaders together to break down barriers and discuss their support for family planning. In 12 months, the CPR rose from 2% to 9%.

Building on Safety, Feasibility and Acceptability of Community-Based Distribution of DMPA and Implications for Youth, Jessica Izquierdo
A critical shortage of medical staff in many sub-Saharan African countries inhibits efforts to expand access to family planning services, especially in rural areas. One way to fill this gap is for community health workers to provide injectable contraceptives, an intervention for which there is growing evidence and international support. In 2009, ChildFund Zambia collaborated with FHI360 to design and implement such an intervention as part of its existing Family Planning Integrated Health Program. The intervention demonstrated the impact of community-based provision of injectables on method choice and uptake, and the costs of adding DMPA to established community-based family planning programs.

Increasing Access to LAFP at the Community Level: The Pathfinder International Ethiopia Experience, Kidest Lulu
In Ethiopia, contraceptive prevalence has increased significantly over the past decade; however, unmet need still remains high (25%). Pathfinder International Ethiopia trained Health Extensions Workers on Implanon insertion and later introduced the LAFP back-up support intervention to make all long-acting family planning (LAFP) services more widely available. From September 2011 to December 2012, data were collected from 48 health centers and 98 HPs where back-up interventions took place. During the back-up service, 48.5% received LAFP services compared to the 22% who received LAFP services at the 139 health centers over the 16-month period. Integrating back-up services increases access to and use of LAFP.

Map Your Life, Reproductive Health Planning, Kim Williams


In 2013, Healthy Start New Orleans collaborated with the Louisiana Birth Outcomes Initiative, the Birthing Project USA, the New Orleans Fatherhood Consortium, and Title X Family Planning to develop a reproductive health plan known as Map Your Life. This cultural and linguistically appropriate tool helps women and men of reproductive age explore their readiness to parent, effectiveness of
Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, DC

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contraceptive options based on CDC information, and healthy tips that are based on ACOG recommendations for preconception health, and information on local resources for family planning. To date, the Life Maps have been distributed to over 1,000 women and men of reproductive age in the greater New Orleans area and other health care organizations are using the plan.

April 2, 2:00 3:30, Virginia Room Using Family Planning to Prevent High-Risk Pregnancies Panel
Moderator: Johannie Escarne, HRSA Panelists: Saleh Ahmed, NGO Health Service Delivery Project, Bangladesh Peggy Vander Meulen, Strong Beginnings, Federal Healthy Start Candace Lew, Pathfinder International Lisa Schlar and Jessica Brubach, University of Pittsburgh Medical Center (UPMC) Family Residency Programs

Study on Adolescent Mothers Pregnancy Decisions in Bangladesh, Saleh Ahmed


Adolescent pregnancy is a key cause for maternal and child deaths in Bangladesh, and contributes to higher population growth. Lack of knowledge among adolescents on maternal health, family planning, misperceptions, social prejudice and socio-economic context about fertility is the main determinant for adolescent pregnancies, according to a study on adolescent mothers pregnancy decisions in Bangladesh. The study aimed to identify adolescents pregnancy decisions in order to improve programs that end harmful early childbearing among adolescents. Key policy implications can be advocated and implemented from this finding, i.e. strengthening program elements to reduce adolescent pregnancy.

Improved Child Spacing Among Low-Income African American Women, Peggy Vander Meulen
Rapid repeat pregnancies play a significant role in poor pregnancy outcomes. In Kent County, Michigan, 46% of African American women on Medicaid become pregnant within 18 months of delivery, yet our program has successfully reduced that rate to 7.2% among our high-risk participants by providing intensive and holistic services with teams of community health workers, nurses, and social workers during pregnancy and for two years after delivery. Outreach, case management, wrap-around services, reproductive life plans, and male engagement are some of the approaches used, along with training service providers in racial equity.

Introduction of Contraceptive Implants as an Acceptable Method of Life Course Birth Spacing and Reduction of Maternal Mortality in Afghanistan, Candace Lew
The Afghanistan Mortality Survey 2010 shows that both the fertility rate and maternal mortality rate are highest in rural women aged 15-24 years and 40-49 years. In addition, knowledge and use of modern contraception in these groups is low. Furthermore, in Afghanistan, birth spacing and birth limiting must be considered and advocated within an Islamic context. Pathfinder International, in collaboration with the Ministry of Public Health and UNFPA, conducted a program which introduced Jadelle in Afghanistan. Program demographic data and interviews with clients suggest that long-acting reversible contraceptives such as Jadelle offer an acceptable contraceptive method for these highest risk groups for maternal mortality.

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Interconception Care: An Innovative Model to Improve Maternal Health and Future Pregnancy Outcomes, Lisa Schlar and Jessica Brubach
Interconception Care (ICC) is an emerging model designed to identify and potentially modify behavioral risks to improve future pregnancy outcomes. Because mothers accompany children to the doctor, the childs visit offers a consistent, common point of contact between physicians and women between pregnancies. ICC is a brief, efficient, innovative model that works to address tobacco use, maternal depression, multivitamin use, and compliance with contraception by questioning potential mothers when they come in with their children. Addressing behavioral risks that a woman can control during the interconception period can improve maternal health and birth outcomes for subsequent pregnancies.

April 2, 4:00 5:30, Chinese Room Family Planning Integration with Health Services Panel 2
Moderator: Holly Blanchard, MCHIP Panelists: Charlotte Warren, Population Council Nisreen Bitar, Health Systems Strengthening II Project, Abt Associates Salwa Bitar, E2A Project Chelsea Cooper, MCHIP; Trinity Zan, FHI360

Family Planning Uptake During Postnatal Care in Swaziland, Charlotte Warren


This presentation explores PPFP service delivery among HIV-positive and HIV-negative women receiving an integrated package of postnatal care and also seeks to understand postpartum womens fertility desires and access to and use of family planning prior to becoming pregnant as well as after the birth.

Effect of Family Planning Counseling Provided to Postpartum Women Before Discharge from Hospital on the Adoption and Continuation of Modern Contraceptive Methods, Nisreen Bitar
Despite a 42% modern contraceptive prevalence rate, Jordan has a relatively high rate of unmet need for family planning and reliance on traditional methods. Since 98% of women deliver in hospitals, in 2011, USAIDs Health Systems Strengthening II project introduced postpartum family planning (PPFP) counseling and services to public hospital Ob/Gyn units. By the end of 2013, 23 public hospitals were providing PPFP. This prospective case control study shows the positive effect of family planning counseling for postpartum women before discharge on their uptake and use of family planning. There was a significant increase (p value <0.05) of early adoption and use of family planning among the women who received PPFP counseling compared to the group that did not. Among counseled women, 50% had begun using a modern family planning method 40 days after delivery, compared to 28% of non-counseled women. At three months postpartum, the percent difference in family planning use between the two groups was 10% and by six months postpartum the difference remained perceptible at 5%.

Scale-up of Integrated Family Planning and Emergency Obstetric and Neonatal Care in Uganda, Salwa Bitar
This session will present the process, results, and multiple challenges of family planning integration with a package of comprehensive emergency obstetric and neonatal care services in 46 low-resource hospitals in Uganda using the Improvement Collaborative approach. The Improvement Collaborative organized a number of teams to improve quality by applying approved clinical standards and indicators,
Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, DC 15

and sharing experiences and learning for a specific period of time. Results include: Partograph use increased from 33% at to 75%; essential new born care increased from 30% to 70%; family planning counseling increased from 4% to 62%; and PPFP uptake increased from zero to 6%.

Its Got Promise! Recent Advances in Family Planning and Immunization Integration, Chelsea Cooper and Trinity Zan
The vast majority of women in the extended postpartum period desire to delay or avoid future pregnancies, however many are not using a family planning method. Closely spaced pregnancies increase risk of maternal and infant morbidity and mortality. Routine immunization services offer an opportunity to reach women with family planning information and services during this critical period. Integrating family planning and routine immunization services has been recognized as a promising High Impact Practice by USAID, UNFPA and partners. This presentation will highlight the rationale for integration, describe existing evidence, and provide recommendations for programs. Content draws from FHI 360s and MCHIPs field and research experiences, as well as from learning emerging from an interagency Family Planning/Immunization Integration Working Group.

April 2, 4:00 5:30, Virginia Room Youth Panel 2


Moderator: Nandita Thatte, USAID Panelists: Hanna Klaus, NFP Center of Washington, DC, and Teen STAR Program Lina Guzman, Child Trends *Substitute Presenter: Kris Moore/Selma Caal, Child Trends Sitawa Kimuna, East Carolina University

Supporting Premarital Abstinence by Fertility Awareness, Hanna Klaus


Teen STAR, a fertility awareness-based program designed to support premarital abstinence and partner fidelity, was supported by PEPFAR in Uganda and Ethiopia from 2006-2012. The six- to seven-month program was delivered by program-trained teachers to in- and out-of-school teens and young adults, and graduated 29,733 Ethiopian and 27,238 Ugandan students. Girls generally required three cycles to discover and own their fertility, while males deepened self-knowledge. Two- to three-year post program behavioral outcomes among available groups include: 80% female, 20% male, 32% age 16, 45% age 18 years. Of 96.5% virgins at entry, 4% initiated intercourse during or after the program; last coitus >1 year by 33.3%, 7-12 months ago by 16.7% (compared with womens median age at first intercourse: Uganda 16.8 years, Ethiopia - 16.1 years, the program warrants support).

Reducing Teen Childbearing Among Hispanics: An Innovative Anti-Poverty Strategy, Lina Guzman *Substitute Presenter: Kris Moore/Selma Caal
To inform the development of a teen pregnancy prevention program for Latino teens in the US, we synthesized evidence from research studies, interventions, and national datasets, and conducted interviews and focus groups with parents, teens, and practitioners. We find that Hispanic adolescents do not want to be teen parents, highly value education, and see education as a pathway to improving life chances. Our review indicates that there are few interventions for Latinos that are culturally relevant,

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

and that ineffective and effective programs include the same components, suggesting that the critical differences may lie in implementation. We suggest several components of effective programs.

Determinants of Adolescent Premarital Sex in 18 African Countries, Sitawa Kimuna


Demographic and Health Surveys conducted between 2004 and 2008 in 18 African countries are used to examine gender differences and factors influencing adolescent premarital sex. We focus specifically on levels of premarital sex among unmarried adolescents aged 15-19 years; association between sociodemographic characteristics and premarital sex; association between socio-demographic characteristics and condom use; and compare findings across countries. Results show high prevalence of premarital sex among ever married adolescents as well as substantial variations by gender and country in reporting condom use. In each of the 18 countries, premarital sex was significantly more prevalent among evermarried than never married.

Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, DC

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Opening Session, Day 2 Emerging Approaches to Improving Pregnancy Outcomes


April 3, 10:00 10:15, Chinese Room
* Note: Opening remarks follow plenary session that begins at 8:30 a.m.

Hani Atrash, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, HRSA
Hani Atrash will present on emerging approaches to improving pregnancy outcomes in the US. Dr. Atrash will review US data on infant mortality, preterm birth, and low birth weight while also providing data on racial disparities in these perinatal outcomes. The presentation will outline three approaches to improve pregnancy outcomes: 1) Comprehensive womens health 2) Preconception/Interconception 3) Life course approach Dr. Atrash will also present key strategies to address this objective, which include circles of influence, collaborative innovation and improvement network (CoIIN), and collective impact. These strategies will be reviewed with a focus on potential or realized accomplishments. In conclusion, the Healthy Start Program will be described as a national program poised to improve pregnancy outcomes in the US with an emphasis on the programs new approaches. About Hani Atrash. Prior to joining HRSA, Dr. Atrash was at the Centers for Disease Control and Prevention (CDC), where he served as the Chief of the Pregnancy and Infant Health Branch from 1987 to 2001, Associate Director for Program Development of the National Center on Birth Defects and Developmental Disabilities from 2001 to 2008, and Director of the Division of Blood Disorders from 2008 to 2012. During his distinguished public health career, Dr. Atrash has served as faculty at the American University of Beirut, where he also received his medical training; a consultant for the World Health Organization and several other international groups; and has led CDC efforts around safe motherhood, maternal and child health epidemiology, and preterm delivery. He spearheaded the new CDC initiative on Preconception Health and Health Care. Dr. Atrash received numerous CDC and national awards and authored/ coauthored over 170 scientific publications and book chapters.

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Plenary Sessions, Day 2


April 3, 8:30 -10, Chinese Room Multisectoral Family Planning Links with Non-Health Activities Plenary
Moderator: Maureen Norton, USAID Panelists: Sarah Verbiest, and Erin McClain, UNC Chapel Hill Center for Maternal and Infant Health and Every Woman Southeast Rena Greifinger and Meredith Center, Population Services International Kathryn (Callie) Kaplan, The Institute of Women and Ethnic Studies

Engaging New Partners to Promote Reproductive Life Planning Among Young Women and Men in the Southeast US, Sarah Verbiest, Erin McClain
Every Woman Southeast (EWSE) is a coalition representing nine southern states focused on employing a collaborative, equity-focused, life course approach to improving womens wellness. From 2012-13, EWSE funded eight pilot projects focused on improving reproductive life planning among young adults. These projects reached over 10,000 young adults, collaborating with education, urban planning, the media, law enforcement, and faith institutes across the South. Each project provided essential health information and service links. There are many ways to engage young adults in reproductive life planning and a host of new, non-traditional partners that can be engaged in this work.

Expanding Access to Critical Family Planning and HIV Services to Low Literacy Youth in Liberia, Rena Greifinger and Meredith Center
Liberian youth face significant SRH challenges. Lack of education is a key determinant of family planning use and HIV protective behavior. HealthyActions is a collaboration between Population Services International Liberia and EDCs Advancing Youth Project (AYP), launched in October 2012 with support from USAID. AYP provides alternative basic education, social/leadership development, and livelihoods training for out-of-school 13-35 year-olds with no/marginal literacy and numeracy skills. HealthyActions leverages existing classes to provide a five-day program aimed at increasing contraceptive use and HIV testing and counseling. The program has reached 2,769 youth; 50% females accepted a contraceptive method (compared to 15% national contraceptive prevalence rate) and 68% tested for HIV.

GenNext: Reducing Adolescent Births in Rural Haiti through Sexual Health Education and Soccer, Kathryn (Callie) Kaplan
The Haitian Health Foundations (HHF)s GenNext program links sexual health education with an allfemale soccer league in southwestern Haiti to improve health outcomes among adolescent girls. This retrospective cohort study assessed birth rates among young women (15-19) whose village participated in the GenNext program in 2006. Bivariate analyses, and multiple logistic regression and cox regression models were analyzed to assess differences in birth rates based on program participation. Participation in the education and soccer program components was significantly more protective against deliveries. The HHFs GenNext program demonstrates the importance of positive youth development programs to promote reproductive health for adolescent women.

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April 3, 10:45 12:15, Chinese Room Integration of Empowerment or Motivational Components Plenary
Moderator: Myra Betron, Jhpiego Panelists: Victoria H. Jennings, Institute for Reproductive Health, Georgetown Sara Riese, Dimagi, Inc. Reem Mehana, Pathfinder International *Substitute Presenter: Julio Paca, Pathfinder International Suniti Neogy, CARE India

Fertility Awareness May be Critical in Increasing Family Planning Use and Improving Reproductive Health, but Evidence is Scarce, Victoria H. Jennings
A systematic literature review showed lack of sexual and reproductive health knowledge, e.g., puberty, menstruation, fertility return postpartum/post-abortion, variable fertility during the menstrual cycle, actual pregnancy risk, and knowledge of how family planning methods work and affect health. This may contribute to non-use of family planning, delayed use postpartum/post-abortion, discontinuation, and inaccurate use during fertile days, poor vaginal health, girls low school attendance, and gender-based violence. Interventions with key target groups may increase fertility awareness, including self-efficacy to make and implement sexual and reproductive health decisions.

Mobile Tools for Family Planning in Benin: Texting for Maternal Wellbeing, Sara Riese
Sara Riese has served as the technical backstop for the Benin Child Survival Project, implemented by the Center for Human Services (CHS) since 2011, and played a key role in the development of the detailed implementation plan and the operations research component of the project. In addition, she worked closely with the Benin team to create and implement the family planning mhealth pilot, with the support of Dimagi. At URC-CHS, she oversees a number of implementation research projects as a research advisor for the global implementation science project, Translating Research into Action.

Fostering Opportunities in Rural Southern Areas in Egypt: An Integrated Intervention to Empower Women and Raise Community Awareness about Family Planning/Reproductive Health/Maternal and Child Health Issues, Reem Mehana *Substitute Presenter: Julio Paca
As a part of its USAID-funded project, FORSA, Pathfinder International established a platform that integrates poverty alleviation, womens empowerment, and health improvement. Short-term community outreach workers jobs were created for young women from rural communities after building their capacities through training on interpersonal communication and counseling skills as well as family planning and reproductive health issues. They were then in charge of raising womens awareness in their communities about family planning, reproductive health, maternal and child health, childcare, and nutrition issues through household visits. Capacity building and empowerment of outreach workers were assessed quantitatively and qualitatively. Preliminary results revealed that the intervention was successful and is recommended for scale-up.

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Womens Empowerment Through Inner Spaces Outer Faces Initiatives, Suniti Neogy
CAREs Inner Spaces Outer Faces Initiative (was designed to share a simple lesson: Every person has both an internal space and an outer face. Their internal space includes their perceptions of issues such as gender, sexuality, identity, and family. Their outer face represents the way they communicate ideas with others; hence we need to work on both for long-term benefits in a sexual and reproductive health programming. While ISOFI aimed to study the impact of empowerment model on health outcomes, Join My Village aimed to scale up the learnings, addressing the challenges, innovating all the way to empower women and girls.

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Concurrent Sessions, Day 2


April 3, 1:15 2:45, Chinese Room Family Planning Integration with Health Services Panel 3
Moderator: Stembile Mugore, E2A Project Panelists: Alden Nouga, Pathfinder International Theresa Hoke, FHI 360 Kathleen Hill, Abt Associates Tauseef Ahmed, Pathfinder International Pakistan *Substitute Presenter: Julio Paca, Pathfinder International

Lifecycle Considerations in Family Planning/HIV Integration Findings from a Baseline Survey of HIV Service Clients in Uganda, Alden Nouga
Efforts to integrate family planning services into HIV services aim to increase access to contraception among HIV service clients who wish to space or limit pregnancies. The goals of Arise/Ugandaled by Pathfinder Uganda and the National Community of Women Living with HIV/AIDS, with funding and technical su.pport from Arise/PATH via a grant from the Canadian International Development Agency were reducing unintended pregnancy and increasing dual method use among HIV positive women. Facility-based surveys (baseline and endline) were conducted in 2011 and 2013. Endline results show modern contraceptive use increased from 38.4% to 54.2%, but contraceptive availability was a major challenge. Baseline results suggested the importance of a lifecycle approach to family planning/HIV integration: Only two-thirds of the women seeking HIV services had been sexually active in the past year; overall, 40% of the women seeking care were not at risk of pregnancy. Unmet need for contraception was highest among unmarried women not living with partners (29%). 61.6% of women without children expressed a desire for a pregnancy. While there is general support for family planning integration into HIV services, we cannot assume there are general family planning service needs among HIV service clients.

Providing Long-Acting, Reversible Contraception to Postpartum Women: Introducing Postpartum IUD in Rwanda, Theresa Hoke
FHI 360, Jhpiego, and the Ministry of Health of Rwanda examined the feasibility and acceptability of delivering postpartum IUD services in public sector health facilities. Implementation was documented using an intervention-tracking tool, and data on the incremental cost of the intervention were collected. Evaluative data collected six months after service introduction showed postpartum IUD service provision can be incorporated into routine services at public sector district hospitals and health centers, but delivery of this service depends on the motivation of individual providers and managers. IUD uptake is likely to increase with greater provider support and intensified client education.

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Integrating Family Planning into Postpartum Care Through Quality Improvement in Afghanistan, Kathleen Hill
To address low provision of postpartum family planning (PPFP) services in Afghanistan, the USAID Health Care Improvement project collaborated with the Afghanistan Ministry of Health to support two large public maternity hospitals and three private hospitals in Kabul to use improvement methods to integrate family planning into postpartum care. Improvement teams in the five hospitals were supported to identify and overcome barriers to provision and uptake of PPFP. Common barriers included lack of routine PPFP counseling, lack of a private counseling space, weak provider skills, and lack of essential commodities (especially long-acting reversible contraceptives). Over 10 months of implementation, the proportion of postpartum women discharged with a modern family planning method of choice increased from 12% to 91%. A follow-up telephone survey with a random sample of women receiving the intervention and a control sample demonstrated significant differences in the proportion of women who were pregnant or suspected of being pregnant at 6, 12 and 18 months.

Expanding Community Access to Quality Family Planning Services through Integration and Coordination The Kasur Model, Tauseef Ahmed *Substitute Presenter: Julio Paca
Progress of population welfare programs is constrained by low coverage, availability and access, low quality of care, weak monitoring, and minimal involvement of health sector. Pathfinders project in Kasur district, Punjab, supported functional integration at grassroots, facility, and district levels to enhance expertise of Family Welfare Centers (FWCs) and involvement of community-based Lady Health Workers (LHWs) to increase demand generation for long-acting reversible contraceptives (LARCs) and referral to FWCs for services on a Family Health Days. The FWCs have become key facilities in provision of LARCs. Within six months of implementation, IUCD use rose from 4% to 12%, an 80% increase from past averages in the same period. The results show that involvement of LHWs, enhancing capacity of FWCs, good referral mechanisms, and extensive coordination by DTC, can now be replicated.

April 3, 1:15 2:45, Virginia Room Youth Panel 3


Moderator: Rehana Gubin, MCHIP Panelists: Alice Bumanzi, Health Development and Performance Organization Jeffrey Edmeades, ICRW, Ethiopia Timothy Oboth, Plan International Uganda Ann Warner, International Center for Research on Women (ICRW)

Improving Reproductive Health of Girls through Girls Room Program (GRP) in Rwanda, Alice Bumanzi
Carrying out the GRP is not simply to get girls into school, but also to improve the overall quality of schooling and address threats to participation as well unintended pregnancies and lack of sanitary pads. Since 2008, the GRP has been implemented in primary schools by the Ministry of Education and partners. Despite the project's sustainability strategies that seem difficult, the project has contributed to reducing the dropout rate of girls from 4% to1% today, resulting from sexual education and distribution of sanitary pads to vulnerable girls.

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Reaching the Most Marginalized: Programming with Adolescent Ever-Married Girls in Amhara, Ethiopia, Jeffrey Edmeades
The TESFA project delivered sexual and reproductive health (SRH) and economic empowerment (EE) programming to approximately 5,000 ever-married girls Amhara, Ethiopia. Girls were divided into three intervention arms (SRH-only, EE-only, and a combined arm), and a control group. Girls were trained using group-based, peer-education model. Baseline and endline survey data were collected from 3,079 girls, including information on both SRH and economic activity. Program participation increased SRH knowledge, attitudes and behavior, particularly in the SRH-only arm. The EE-only arm saw greater increases in microenterprise and productive use of savings, while the combined arm saw smaller gains.

Innovations v. Sustainability: Exploring Feasible Approaches for Sustainable YouthFriendly Adolescent Sexual and Reproductive Health Services in Resource-Limited Settings, Timothy Oboth
In post-conflict areas of Northern Uganda, adolescents/youth (Y) have limited access to accurate, comprehensive sexual reproductive health & rights (SRH&R) information/services, compounded by early initiation of sexual activity, limited use contraception, teenage marriage, and high unmet need for family planning, resulting in high risk of teenage pregnancy and HIV/STI. Plan International has applied two comparative approaches of Y/SRH programming and demonstrated that specialized Y/SRH&R centers are ideal for ensuring confidentiality, but are not sustainable, create dependence, and aggravate Y/SRH social-cultural stigma within the mainstream health system; hence, there is a call for development partner projects to explore working within and strengthening established local service delivery structures for Y/SRH. Paying Girls to Delay Marriage? Evaluation Findings from a Conditional Cash Transfer Program to Delay Marriage in India, Ann Warner Apni Beti Apna Dhan was the first conditional cash transfer (CCT) program in India designed to delay girls age of marriage by offering a savings bond that could be cashed when the beneficiary turned 18, provided she was unmarried. The first cohort turned 18 in 2012-13, presenting an opportunity to study the programs impact on education, age of marriage, and value of girls. This presentation focuses on education-related findings: beneficiary girls have higher probability (coeff=0.6, p<0.000) of being in school than non-beneficiaries, even after controlling for other factors. CCTs can be an effective approach to enhancing girls education, and potentially delaying marriage.

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Small Group Work & Closing Session


April 3, 3:15 5:00, Chinese Room Small Group Work
To wrap up the two-day meeting, participants self-select to join one of the six thematic groups below to discuss what ideas and learning resonated with them from the panel presentations. The following groups will meet in the Chinese Room Youth (Moderator: Rehana Gubin) Using Family Planning to Prevent High-Risk Pregnancies (Moderator: Johannie Escarne) Community-Based Services (Moderator: Salwa Bitar) Family Planning Integration with Health Services (Moderator: Holly Blanchard)

The following groups will meet in the Virginia Room Multisectoral Family Planning Links with Non-Health Activities (Moderator: Maureen Norton) Integration of Empowerment or Motivational Components (Moderator: Myra Betron)

Moderators will lead the group work and use the following questions as a guide to facilitate discussion. 1. How do we improve programming so that women and children can access quality services throughout the life course? 2. What have we learned that we can apply to our work? 3. Where are there gaps in existing structures and how do we close them? 4. Have you identified opportunities for future research? Moderators can also ask the group for a pearl that reflects your thematic area from the presentations over the past two days. Feedback collected during this interactive session will be shared with all meeting participants during the closing session. Each group should select a representative who will present answers to two of the questions posed.

Closing Session: Presentation of Findings and Closing Remarks


Results of the small group work will be shared. Maureen Norton, Senior Technical Advisor for the Office of Population and Reproductive Health, Bureau for Global Health, at USAID in Washington, will give closing remarks.

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Presenter Biographies
Saleh Ahmed currently works at the USAID NGO Health Service Delivery Project in Bangladesh as BCC Technical Coordinator, and prior to that, worked on the USAID Modhumita HIV Prevention Program in Bangladesh. His career has focused on areas including social and behavior change communication, community mobilization, policy-level advocacy, media advocacy, and capacity building. His interest in social research has led him to pursue a Masters degree in population sciences at the University of Dhaka, Bangladesh. In his coursework, he conducted a study on adolescent mothers pregnancy decisions in Bangladesh, where he found determinants likely to be liable for adolescent pregnancy in Bangladesh. Tauseef Ahmed has been the Country Representative of the Pathfinder International Pakistan Office since 2010. Dr Ahmed is a sociologist by education and has actively worked with government and donor agencies to lower fertility, enhance the contraceptive prevalence rate, and focus on maternal health indicators. Dr. Ahmed has also been a visiting professor at the Pakistan Institute of Development Economics, where he has taught population sciences, and has been a major contributor to the two Pakistan Demographic and Health Surveys. He has managed several recent projects that have direct bearing on family planning activities in Pakistan, particularly pilot projects to test innovative ideas for reaching low-parity mothers with family planning. Dr. Ahmed has worked closely with the provincial Departments of Health and Population Welfare in Punjab and Sindh provinces to facilitate family planning policy development. Adrienne Allison joined World Vision in 2007 to direct the USAID-funded Integrated Birth Spacing Project and build the capacity of the organization to integrate family planning into maternal and child health programs. Previously, she worked on population policies with USAIDs Office of Population and Reproductive Health; while with the Bureau of Africa, she introduced a grants program that enabled INGOs in Africa to integrate HIV/AIDS strategies into ongoing program programs, and went on to become the vice president of CEDPA. She also served as director of Jhpiegos flagship Maternal and Neonatal Health Program, was appointed adjunct professor at The George Washington University School of Public Health and, later, at the Johns Hopkins Bloomberg School of Public Health. Nisreen Bitar is the Reproductive Health/Family Planning Senior Task Manager at the Health Systems Strengthening II Project, led by Abt Associates in Jordan. She has 19 years of experience working on USAID-funded reproductive health and family planning programs, encompassing project management and coordination, research, training, and performance assessment. Her main focus has been supporting Jordans reproductive health and family planning programs in the public and NGO sectors. Previously, Dr. Bitar was the Jordan Program Manager for EngenderHealth and has worked as a national and international consultant. She has conducted in-depth research on family planning in Jordan including: IUD discontinuation rates; service provider knowledge on how to manage IUD and oral contraceptive sideeffects; knowledge, attitudes and practices of service providers concerning long acting and permanent contraceptive methods; and postpartum family planning. Salwa Bitar is a medical doctor who has provided family planning/reproductive health/maternal, newborn and child health (FP/RH/MNCH) services in developing countries, and has been a trainer in contraceptive technology and best practices in family planning, safe motherhood, emergency obstetric care, and neonatal care. She has spent the last six years with Management Sciences for Health, currently working with the USAID-funded Evidence to Action (E2A) Project as Senior Advisor on Global Alliances and previously with E2As predecessor, Extending Service Delivery, under which she led the scale-up of FP/MNCH in Asia and Middle East. Dr. Bitar has 25 years experience building strong connections with
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international partners, and has been a global leader in advocacy, dissemination and scaling up of FP/RH/MNCH best practices, resulting in improved quality and scale-up of FP/RH/MNCH services in numerous African and Asian countries. Jessica Brubach graduated from Carlow University with a Bachelor of Science in biology and a minor in chemistry. At Carlow, Jessica developed a passion for event and project coordination and working for mission-driven organizations. She currently attends the University of Pittsburghs Graduate School of Public and International Affairs and is pursuing a Master of Public Administration in Public and Nonprofit Management. Jessica recently began working as the Interconception Care Project Coordinator at the University of Pittsburgh Medical Center Family Health Centers and serves as the IMPLICIT Network Coordinator, managing 20 family medicine residency programs dedicated to enhancing preconception, prenatal, postpartum, and interconception care. Alice Bumanzi currently works for the Health, Development and Performance Organization as a Sexual and Reproductive Health Expert on a multi-country project called Making Sexual and Reproductive health Services Work for the Next Generation. For the project, she is implementing the Girls Room Program for schools and the Youth Corner Program for health centers. She has worked as Adolescent Sexual Reproductive Health & Rights (ASRH&R) Specialist for UN Deliver. She has been certified as National Master Trainer in ASRH&R and has been involved in developing school health policy, youth policy, and ASRH&R policy. Kenneth Buyinza is a medical doctor and currently Country Health Advisor at Plan International Uganda, where he provides technical oversight over Plan Internationals health program in Uganda, including designing integrated health projects; program monitoring, evaluations and research; capacity building for improved quality of program implementation and integrated health service delivery; and networking and partnership coordination. Over the last seven years, Kenneth has also served as a Project Manager for HIV/AIDS and sexual reproductive health and rights projects in post-conflict and other hard-to-reach communities in Uganda. Kenneth has a strong background of application of community-driven approaches that empower communities in advocacy and social accountability for health services. Meredith Center has over eight years of experience in development and private-sector marketing, working both in Africa as well as in a supporting role at PSI, where she currently serves as a Program Manager. Meredith is responsible for the overall management and support of PSIs programs in Guinea, Liberia, Nigeria, and Senegal. Prior to PSI, she spent three years in Zambia working for agricultural HIV education NGOs. While in Zambia, she worked with the private sector to launch a voucher scheme for specialized farming equipment. Chelsea Cooper currently serves as Social & Behavior Change Communication Advisor for MCHIPs family planning team. Her areas of expertise include social and behavior change, community health, and postpartum family planning. Within her role at MCHIP, she co-facilitates the Family Planning/Immunization Integration Working Group and provides technical support for several demonstration projects/studies focused on integrated service delivery. Prior to joining MCHIP, she worked with the American Refugee Committee, where she managed the USAID-funded participatory communication program Through Our Eyes. Jeffrey Edmeades is a Senior Social Demographer at the International Center for Research on Women, with over 15 years of experience conducting research, designing monitoring and evaluation approaches, and program design. His current research focuses on the determinants of contraceptive choices, particularly within household decision-making processes; the design of effective programs
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addressing child marriage; and the evaluation of programs addressing child marriage and comprehensive sexuality education for adolescents. He has considerable experience with capacity building around monitoring and evaluation, particularly with regard to programs targeting adolescent girls. Recent projects he has played a lead role in include: the evaluation of the Towards Improved Economic and Sexual/Reproductive Health Outcomes for Adolescent Girls project in Amhara, Ethiopia; and the Womens Reproductive Histories project, focused on understanding the determinants of womens reproductive behavior in Madhya Pradesh, India. Rena Greifinger is a Technical Advisor for Sexual and Reproductive Health and Tuberculosis at PSI, where she facilitates the development of innovative marketing and communication for HIV prevention and family planning, focusing on youth and gender-based violence. Through her work with PSI and previously as the Founding Director of Next Steps One Love Project for young people living with HIV, she has developed dozens of programs, guidelines, and tools to reach young people with sexual and reproductive health services and messages. Rena has served as co-chair of the Youth, Health and Rights Coalition, and is currently the co-chair of the Effective Practices Working Group for the Coalition for Adolescent Girls. Lina Guzman is Co-Area Director of the Reproductive Health and Family Formation area at Child Trends. She also serves as Director of Child Trends Hispanic Institute, which seeks to provide timely and insightful research-based information and guidance to improve outcomes for Latino children and youth in the US. She is the co-principal investigator of the National Center for Research on Hispanic Children and Families, where she oversees cross-cutting research focused on poverty and selfsufficiency, fatherhood and healthy marriage, and early care and education, as well as communication and dissemination activities, and capacity building. Her substantive research focuses on reproductive health and union formation among minority teens and young adults, particularly contraceptive decision-making and reproductive health service delivery. Since has hired, trained, and mentored bilingual researchers focused on Latinos families. Kathleen Hill is a practicing primary care physician with extensive public health and quality improvement experience in low-, middle-, and high-income settings. As Deputy Director and MNCH/FP technical lead on the global USAID Applying Science to Strengthen Health Systems project, she provides technical leadership for the adaptation of improvement approaches to strengthen quality of care and health systems in low- and middle-resource settings, working closely with colleagues, ministry of health counterparts, and front-line providers in sub-Saharan Africa, Eastern Europe and the LAC region. Born in Nigeria and raised partly in Niger, she has spent many years living and working in Francophone West Africa. Theresa Hoke has 20 years of experience conducting applied research to maximize the effectiveness of public health interventions. At FHI 360, as Director of Health Services Research, she leads teams conducting implementation research to strengthen family planning and HIV/AIDS service delivery in resource-poor settings. She specializes in mixed-method studies to test approaches for integrating family planning services into health and non-health services and delivering an expanded range of contraceptive options. She has conducted studies in Uganda, South Africa, and Zimbabwe to strengthen contraceptive services for HIV infected women, among others. Dr. Hoke also serves as a global advisor on female condom programming. Jessica Izquierdo, with eight years of experience in public health and emergency response, currently works with ChildFund International as the Technical Specialist for Youth Programs. Ms. Izquierdo serves as the primary advisor for adolescent sexual reproductive health programs across Asia, Africa, and Latin America. She leads organization-wide gender-based violence mainstreaming efforts and promotes multi
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sector integration and critical transitions across three life stages (infants and young children, very young adolescents, and youth). Ms. Izquierdo currently supports the pilot adolescent sexual and reproductive health projects in Asia and Latin America, and is advising the scale-up of the community-based distribution of family planning in Zambia. In previous roles, she worked with Save the Children in Somalia, and with Ipas, focusing on access to safe abortion services for youth. Victoria H. Jennings is Director of the Institute for Reproductive Health and Professor in the Department of Obstetrics and Gynecology at Georgetown University. With more than 25 years of experience in global health research, focusing on family planning, including fertility-awareness methods, she is a long-standing advocate for expanding family planning method choice worldwide. Dr. Jennings serves on numerous expert and advisory committees, has published in peer reviewed journals, and is an invited speaker at many reproductive health conferences worldwide. Kathryn (Callie) Kaplan has significant experience working in the field of global adolescent sexual health. She is now the Research and Evaluation Manager at the Institute of Women and Ethnic Studies, an organization working to address health disparities among women of color and their families in New Orleans. Ms. Kaplan coaches a womens high school soccer team in New Orleans, is a trained doula, and a strong community advocate for women and youth rights. She participated in the 2011 cohort of the Maternal and Child Health Leadership Training program and was the 2012 recipient of the Ceasar Corzantes Award for Excellence in Maternal and Child Health. Previously, she worked for the Haitian Health Foundation as the program coordinator for the GenNext program, introducing gendertransformative programming. Sitawa R. Kimuna is the Associate Professor of Sociology at East Carolina University. Her research is interdisciplinary and covers substantive areas from sexual behavior and HIV in sub-Saharan Africa, gender-based violence, and immigration to social demography/population dynamics, including socioeconomic support of elderly people. Dr. Kimuna has publications in peer-reviewed international and national journals. Her current research is on sexual behavior and intimate partner violence. She has also co-edited a book on Women in African Development: The Challenge of Globalization and Liberalization in the 21st Century. Hanna Klaus is an obstetrician/gynecologist with seven years of experience in Pakistan. She was a faculty member of the OB/GYN departments of Washington and St. Louis University medical schools, and of the George Washington University Medical Center. She initiated training and research in the Billings Ovulation Method of natural family planning in St. Louis, Missouri, Wichita, Kansas, and Washington, DC. She founded the Teen STAR Program in 1980. She belongs to several professional societies and has published 70 scientific articles and presentations.

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Candace Lew is Pathfinder Internationals Senior Technical Advisor for Contraception. She has 20+ years of clinical experience as a practicing obstetrician/gynecologist and also has extensive experience in short-term medical service delivery and training programs in Latin America, Africa, and Asia. She has served on governing boards of sexual reproductive health non-profits such as Planned Parenthood Arizona and the Arizona Foundation for Women. Her responsibilities at Pathfinder include providing technical leadership in contraception, including technical assistance and training to the organizations programs; developing, implementing, and assessing evidence-based guidelines and programs; and participation in international working groups and consortia such as the Implementing Best Practices Consortium. Kidest Lulu is a medical doctor specializing in public health, and is currently Deputy Country Representative for Pathfinder International Ethiopia. She is also Deputy Technical Director for the USAID-funded Integrated Family Health Program. Starting her career as a general practitioner in rural Ethiopia, she went on to teach Epidemiology at Jimma University and served the university as the Gender Office Coordinator. For the past decade, she has worked in various technical capacities for USAID, the Millennium Villages Project, and the Family Health Program of WHO. She is very passionate about improving the lives of Ethiopian women through access to quality of sexual and reproductive health services, especially family planning. Dr. Sithokozile Maposa is an Assistant Professor at the University of Saskatchewan, College of Nursing. Her research interests in women's and adolescents' health and public policy focus on understanding factors that reduce or worsen HIV sexual risk and abuse among African women. Dr. Maposa has lobbied for self-governance in nursing in Zimbabwe. She has also worked as a nurse leader facilitating improved access to integrated family planning, adolescent reproductive/sexual health, and HIV/AIDS prevention and mental health services in primary health care and in-patient settings. In her doctoral dissertation, she examined cultural meanings influencing sexual experiences of young black African women living in the United States. Findings demonstrated that within the context of living with cultural contradictions, practicing safer sex was less a problem of knowledge than that of limited sexual agency. Erin McClain is a Research Associate with the UNC Center for Maternal and Infant Health. She has over 10 years of project management and research experience in maternal and child health, as well as training and experience in international conflict resolution and humanitarian assistance. Ms. McClain provided training and technical assistance for the Title X family planning programs throughout the southeast on topics of preconception health, preventing unplanned pregnancy, and infertility prevention. Currently, Ms. McClain provides oversight, training, and technical assistance for perinatal tobacco cessation quality improvement initiatives in North Carolina and the Every Woman Southeast reproductive life planning pilot projects.

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Suniti Neogy has been working on issues of women, environment and development, maternal and child health, family planning, and gender equity and diversity since 1992. In her 12 years with CARE, she has intensified her work on womens empowerment. Prior to CARE, she worked with Johns Hopkins Universitys Community Based New Born Care Project in Shivgarh, India, and CEDPAs Prerana Population Resource Centre on innovation in family planning services in Uttar Pradesh. Dr. Neogy actively campaigns for womens right has contributed to articles published by CNN, Harvard International Review, Gender and Development Journal, Eldis/Insights, and The Guardian. Alden Nouga has 14 years of experience providing best practices technical support in design, implementation, and monitoring to HIV/AIDS and reproductive health field projects. In her position at Pathfinder, she provides technical guidance and direction to field offices in all areas related to HIV prevention and care. In addition, she leads organizational initiatives in program integration for HIV, contraception, and maternal health service delivery. She currently provides support to a portfolio of projects in Cameroon, Ethiopia, Kenya, Niger, and Tanzania, and also works closely with the global E2A Project on HIV and integration assignments. Timothy Oboth is a Project Coordinator at Plan International Uganda, where he oversees implementation of adolescent sexual and reproductive health and rights interventions, which includes technical design of project interventions and development of tools, project monitoring, evaluations and research; capacity building for improved quality of program implementation, as well as partnership management. Over the last six years, Timothy also served as a Community Development Facilitator for a number of projects in sexual and reproductive health and rights, child and youth participation, livelihood and child protection in hard-to-reach communities in Uganda. Timothy has a strong background in applying rights-based and community-driven approaches that empower communities in advocacy and social accountability for health services. Oby Obyerodhyambo has three decades of experience in creative/expressive arts, education, and public engagement. He specializes in development and application of innovative strategic behavior change communication strategies in formal and informal settings. His experience informs his philosophy and his deliberately inclusive strategies towards public health objectives. Oby dedicates spends significant time developing and working on projects serving marginalized gender and sexual communities, people with disabilities, and PLWHIV. The extensive repertoire of learning materials he has developed as tools for implementation, monitoring and evaluation for health communications and intervention initiatives covers areas such as HIV & AIDS and related challenges, family planning and other reproductive health areas. He has undertaken equally extensive and influential work in the development of communications materials for advocacy, civic and health education targeting semi- and non-literate communities. Stephen Rahaim, Senior Associate at Abt Associates, is a private sector health and behavior change communication specialist with more than 13 years of program development and management experience in international development and the private sector. As the Asia and Middle East Regional Manager and BCC Advisor for the SHOPS Project, Stephen is leading projects focused on private sector solutions for family planning and child health in India, Bangladesh, and Jordan, and supporting family planning and BCC activities in Kenya, Namibia, Nigeria, and elsewhere; this includes the integrated family planning model that he will talk about today. Stephen received his MPH from Tulane University School of Public Health and Tropical Medicine, and has worked across South and Southeast Asia, East Africa, and the Middle East.

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Reem Mehana is currently the Project Manager of FORSA. She is a community development expert and advocate with expertise in program management, policy development, research, and capacity building. She has 13 years of experience in planning, implementing, monitoring, and evaluating social and economic development projects with focus on womens empowerment issues. She has proven skills, and hands-on experience in policy analysis, community development, training, and advocacy. Ms. Mehana is a professional passionately dedicated to empowerment and changing the lives of low-income and marginalized communities. Sara Riese has served as the technical backstop for the Benin Child Survival Project, implemented by CHS since 2011. She has played a key role in the development of the detailed implementation plan and the operations research component of the project. In addition, she worked closely with the Benin team to create and implement the family planning mhealth pilot, with the support of Dimagi. At URC-CHS, she oversees a number of implementation research projects as a research advisor for the global implementation science project, Translating Research into Action (TRAction). Sara has masters degrees in public health and international affairs, both from Columbia University. Lisa Schlar is a board-certified family physician who practices full spectrum family medicine, including maternity care. Dr. Schlar has spent nearly 20 years working with underserved populations, with a strong interest in reducing unintended pregnancies and promoting maternal and child health. She worked four years in rural Alaska caring for native Eskimos before joining the faculty at the University of Pittsburgh Medical Center, Shadyside Family Medicine Residency in 2001. Dr. Schlar is currently the Director of Women's Health, teaching and mentoring residents and medical students while maintaining an active clinical practice. For 10 years, she has been actively involved with the IMPLICIT Network, a collaborative of 20 family medicine residencies dedicated to enhancing maternal health by restructuring curriculum and practice habits in an effort to reduce preterm birth and low birth weight infants through innovative quality improvement techniques. Irit Sinai is a Senior Research Officer at the Institute for Reproductive Health, Georgetown University. She has over 18 years of experience in research design and implementation, monitoring, learning and evaluation, instrument design, data management, analysis, report and article writing, and dissemination of results. She was involved in the development and testing of the Standard Days Method and the Two-Day Method fertility awareness methods. In recent years her work focused on unmet need for family planning in developing countries, fertility awareness-based methods of family planning, monitoring and evaluation of programs and research studies, and social network analysis. She is also a vice chair of Georgetown Universitys Institute Review Board, committed for social and behavioral sciences. Nancy Termini works with the Reproductive Health Program at the Population Council, where she supports research, writing, and communications work. She is currently engaged with the Heshima Project on Promoting Dignified and Respectful Care during Childbirth in Kenya; the DFID-funded Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) project; and the Councils work on sexual and gender-based violence. Prior to joining the Council, Nancy worked as a Case Manager at the International Institute of New England (Boston), resettling refugee families from Bhutan, Iraq, Somalia, and Eritrea. She specialized in working with survivors of domestic abuse and connecting female refugees to education on womens and family health. Peggy Vander Meulen is Program Director for Strong Beginnings, a federal Healthy Start project that seeks to improve maternal and child health among African Americans. Since 2004, she has managed an interdisciplinary program providing services to underserved high-risk pregnant women and their infants. Before that, she served for eight years as the Maternal Support Services Coordinator for three urban clinics. She chairs an 85-member community coalition working to eliminate disparities in birth outcomes
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with a focus on reproductive health, racial equity, and community engagement. The previous 25 years were spent as medical contractor for the Peace Corps and as a consultant for maternal and child health programs in Central America, Bangladesh, and West Africa. She is a member of several state and national boards working to promote womens health and has been the recipient of numerous awards. Natalia Vartapetova has over a decade of experience working for USAID-funded programs in reproductive, maternal and child health and family planning. From 1999 through 2012, she led John Snow, Inc. projects in Russia. She has experience with policy and advocacy, project management, training, monitoring and evaluation, guidelines and information/education materials development. Dr. Vartapetova is a founder and director of Institute for Family Health, a Russian non-governmental public health organization. She is also a consultant for programs in Eastern Europe and Central Asia, where she collaborates closely with international partners. Sarah Verbiest is the Executive Director of the Center for Maternal & Infant Health and Research Assistant Professor in the OB/GYN Department at the School of Medicine at UNC Chapel Hill. She is the CDC Senior Advisor Consultant for the National Preconception Health and Health Care Initiative and a consultant with the HRSA Maternal and Child Health Bureau. Dr. Verbiest coordinates the NC Recurring Preterm Birth Prevention Program and a statewide smoking cessation program for pregnant and new mothers. She serves on the Governors NC Child Fatality Task Force, chairs the NC Perinatal Health Committee, serves on AMCHPs Best Practice Review Committee, and is the cofounder of the Every Woman Southeast Coalition. Prior to her present position she served as the State Program Director for the NC Chapter of the March of Dimes for seven years. Ann Warner is Senior Gender and Youth Specialist at the International Center for Research on Women (ICRW), where she leads research and advocacy projects that empower women and young people, especially adolescent girls, in the developing world. Her current research and advocacy efforts focus on adolescent transitions to adulthood, with a special focus on child marriage, sexual and reproductive health, and girls education, in India and sub-Saharan Africa. Ann is the Deputy Director of the IMPACCT study in India, which is assessing the impact of a conditional cash transfer on girls age of marriage. Prior to joining ICRW six years ago, Ann led a research project for Columbia University and the International Rescue Committee that documented the prevalence of violence against women and girls in Liberia. Ann also worked as the Director of Development at CARE. Charlotte Warren is one of the Population Councils lead social scientists, with extensive experience in research, policy, and program development in maternal and neonatal health, reproductive health, family planning, and primary health care. She is a nurse by training with expertise in pediatrics. She has worked in ten African countries building the skills of policymakers and program managers to address critical public health issues. She co-developed the community midwifery approach in Kenya as a strategy to increase skilled attendance at birth and access to long-acting reversible contraceptives in the community, and has conducted research in areas including: developing a comprehensive package of postnatal care, assessing the benefits of integrated HIV and SRH services, evaluating voucher and accreditation interventions for reproductive health, and measuring the prevalence of abuse and disrespect during facility-based childbirth. Kim Williams has served as the Program Director for Healthy Start New Orleans since 2012, overseeing daily operations. She led the Inter-pregnancy Care Project, which involved outreach to over 500 households that experienced an adverse pregnancy outcome. She has presented on the interpregnancy care work at local, state, and national conferences. She also serves as the Best Babies Zone lead for New Orleans in partnership with LSU Health Sciences Center. She has 13 years experience in maternal and child health.
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Trinity Zan, a member of FHI 360s Research Utilization team, has 12 years of experience working in international development, with the last nine focused on international family planning in sub-Saharan and Francophone Africa. Her areas of technical expertise include stakeholder engagement; partnership development; and dissemination, advocacy and scale-up of evidence-based practices to policy makers at the international, regional and national levels. Her subject matter expertise includes postpartum family planning, community-based family planning, natural family planning, long-acting reversible contraception and permanent methods, and mHealth. She has lived in Senegal, worked in eight countries, and speaks French and Wolof.

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.

Moderator Biographies
Koki Agarwal is the Director of Jhpiego. Dr. Agarwal has more than 25 years of service delivery experience in reproductive health, family planning, and maternal health, and over 16 years leading, managing, and implementing large-scale USAID-funded global health projects. Dr. Agarwal is an internationally recognized expert in safe motherhood, reproductive health, and family planning policies and programs, as well as promoting policy dialogue and advocacy for policy reform. Dr. Agarwals approach draws on her education in population studies and public health, clinical experience in pediatrics and obstetrics/gynecology, and professional background in research methods and demographic analysis. During her tenure at Jhpiego, Dr. Agarwal has led the MCHIP and ACCESS programs, greatly expanding their country activity portfolio. Previously she served as Deputy of the POLICY Project (with the Futures Group). Salwa Bitar is a medical doctor who has provided family planning/reproductive health/maternal, newborn and child health (FP/RH/MNCH) services in developing countries, and has been a trainer in contraceptive technology and best practices in family planning, safe motherhood, emergency obstetric care, and neonatal care. She has spent the last six years with Management Sciences for Health, currently working with the USAID-funded Evidence to Action (E2A) Project as Senior Advisor on Global Alliances and previously with E2As predecessor, Extending Service Delivery, under which she led the scale-up of FP/MNCH in Asia and Middle East. Dr. Bitar has 25 years experience building strong connections with international partners, and has been a global leader in advocacy, dissemination and scaling up of FP/RH/MNCH best practices, resulting in improved quality and scale-up of FP/MNCH services in numerous African and Asian countries. Holly Blanchard, a Certified Nurse Midwife and Senior Reproductive Health/Family Planning Advisor, has more than 30 years of experience in family planning, obstetrics, and gynecology. Ms. Blanchard has worked in capacity building in reproductive health practices that are culturally sensitive and evidenced based in low-resource settings in: Afghanistan, Albania, Burkina Faso, Cote dIvoire, Ghana, Haiti, Indonesia, Kenya, Liberia, Mali, Nepal, Nigeria, the Philippines, Tanzania, and Yemen. Internationally, Holly has worked for both the American College of Nurse-Midwives and Jhpiego. Domestically, she worked for Planned Parenthood, New York University Hospital, and New York Methodist Hospital. She is a returned Peace Corps volunteer from Mauritania. Myra Betron is Senior Gender Advisor at Jhpiego. Ms. Betron has been working on gender in the context of sexual and reproductive health internationally for the past twelve years. Her work has ranged from managing a World Bank gender-based violence (GBV) training project for health providers in Latin America; to designing advocacy tools and strategies; to promoting a health sector response to GBV while at the Futures Group; to giving technical assistance to integrating gender and GBV into HIV programs; and most recently, designing gender norms changing and GBV prevention interventions, including an award-winning mass media campaign while with EngenderHealth in Tanzania. Fabio Castao works with Management Sciences for Health as the Global Technical Lead for Family Planning and Reproductive Health and as Portfolio Regional Director for Southern Africa and Latin America. He leads technical assistance on family planning/reproductive health to design, implement, and supervise service delivery strategies through MSH projects in more than 30 countries. Dr. Castao has over 23 years of experience designing, implementing, and evaluating complex international family planning/reproductive health projects in Latin America, the Caribbean, Africa, and Asia. In Colombia, his home country, he worked as health advisor to the Presidents Office closely participating in the design and implementation of health sector reform and policy development.
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Johannie Escarne is an active duty US Public Health Service Commissioned Corps officer and a Senior Public Health Analyst with the Health Resources and Services Administrations Maternal and Child Health Bureau. She currently serves as the Project Officer for 12 Healthy Start communities with special interest in family planning and reproductive health. She also serves as the principal manager for the Interconception Care Steering Committee. CDR Escarne is currently pursuing a Doctorate in Public Health from the University of Illinois at Chicago. Rehana Gubin is Jhpiegos Technical Advisor for Global Health Practice and Policy Research. Rehana provides research and publications guidance to Jhpiegos technical leadership office as well as policy and advocacy guidance to MCHIPs family planning and maternal health teams. Before joining Jhpiego, Rehana practiced international business and immigration law at Cleary Gottlieb Steen & Hamilton LLP in Washington, DC and worked in medical and biotechnology communications. Stembile Mugore works with IntraHealth International under the auspices of E2A Project. With E2A, she serves as the Senior Technical Advisor for Health Sector Performance and Sustainability. She has over 20 years experience in reproductive health and family planning, and has provided technical assistance to strengthen FP/RH programs, mostly in East and Southern Africa. She works with policy makers, program managers, and health workers at all levels of the health care delivery system, as well as health worker education institutions and professional councils to strengthen capacity for delivering family planning and reproductive health services. In addition, she has provided leadership and technical guidance for health systems strengthening and human resources for health for a regional HIV and AIDS program in Southern Africa. A native of Zimbabwe, Ms. Mugore is a nurse and midwife. Maureen Norton is Senior Technical Advisor for the Office of Population and Reproductive Health, Bureau for Global Health, at USAID in Washington. Dr. Norton leads USAIDs studies and activities related to Healthy Timing and Spacing of Pregnancy. Throughout her career, she has participated in the design and evaluation of family planning, reproductive health, and maternal and child health programs in over 20 developing countries. She has managed several global family planning and reproductive health projects in Asia, Africa, and Latin America. She currently is the headquarters technical advisor to USAIDs health and family planning/reproductive health program in Pakistan, and participates actively in the Zambia, Mozambique, Burma, Yemen, and India teams. Apni Beti Apna Dhan was the first conditional cash transfer (CCT) program in India designed to delay girls age of marriage by offering a savings bond that could be cashed when the beneficiary turned 18, provided she was unmarried. The first cohort turned 18 in 2012-13, presenting an opportunity to study the programs impact on education, age of marriage, and value of girls. This presentation focuses on education-related findings: beneficiary girls have higher probability (coeff=0.6, p<0.000) of being in school than non-beneficiaries, even after controlling for other factors. CCTs can be an effective approach to enhancing girls education, and potentially delaying marriage. Nandita Thatte is a Technical Advisor in the Office of Population and Reproductive Health at USAID. Her work supports the translation and implementation of research evidence into country-level programs to improve family planning and reproductive health outcomes. She works with USAID programs in sub-Saharan Africa with a focus in Mozambique and francophone West Africa. She is currently pursuing her DrPH at the George Washington University where her research focuses on adolescent risk perceptions of HIV and unplanned pregnancy among Ghanaian youth, and sexual and reproductive health behavior outcomes. ,

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Throughout the Reproductive Lifecycle: Opportunities and Challenges for Empowering Girls & Women April 23, 2014, Washington, D.C.