This issue of INFO Reports discusses three aspects of entertainment-education to improve family planning/reproductive health and prevent HIV infection: 1) How E-E works and its potential effects on knowledge, attitudes, and behavior; 2) The best uses of the various E-E formats; and 3) The important steps for managing E-E projects, within the framework of the general process for developing communication programming.

Many health and development programs use behavior change communication (BCC) to improve people's health and wellbeing, including family planning and reproductive health, maternal and child health, and prevention of infectious diseases. BCC is a process that motivates people to adopt and sustain healthy behaviors and lifestyles. Sustaining healthy behavior usually requires a continuing investment in BCC as part of an overall health program. The tools in this issue of INFO Reports are meant to help with planning and developing a BCC component in family planning programs.

Family planning providers can use the checklists and tables in this report to: 1) Counsel clients about vasectomy and ensure that they make an informed choice; 2) Identify men with conditions that require a delay or special consideration before they can have a vasectomy; 3) Explain the vasectomy procedure; 4) Try to make sure that the client's decision for vasectomy is well-considered and his own; and 5) Explain to a man what he should do before and after the vasectomy.  

For most people, the most important reason given for choosing a particular contraceptive method is how well it protects against pregnancy. Many contraceptive users, however, do not achieve the protection from pregnancy that they want. To achieve the best possible contraceptive protection against unintended pregnancy, family planning clients must make an informed decision to choose, from among available methods suitable to their individual circumstances, the one that combines the greatest inherent effectiveness with their own ability to use it correctly and consistently.

This issue of Focus On... is intended to help health care practitioners better understand the current state of knowledge on breastfeeding and HIV transmission. It examines the most recent studies and expert guidance on the topic and provides the key points from recent research trials, literature reviews, and program evaluation studies.

This edition of Focus on... briefly reviews studies on hormonal method continuation, focusing on oral contraceptives (OCs) and injectable contraceptives and the issues most relevant to service delivery. It emphasizes program strategies that either have proved successful in improving hormonal method continuation or appear promising based on initial evidence. While most of the studies reported are recent, a few key studies date back more than a decade, reflecting that hormonal method continuation is an established research topic.

Women consider effectiveness the most important factor when they choose a contraceptive method, but also consider side effects and safety. Counseling helps a woman decide if a method suits her needs, preferences, and current situation.

Meeting the unmet health care needs of young people poses a continuing challenge for health systems worldwide, yet it is critical to containing the AIDS epidemic and reducing unintended pregnancies. An integrated approach to the delivery of reproductive health care expands youth access to health care by making multiple services available at the same facility, during the same hours, and often from the same provider.

This tool offers program managers a quick reference to measure how well a continuing-client strategy is succeeding. It includes 24 key indicators organized into three areas: program readiness, quality of care, and reproductive health outcomes. By measuring these indicators, managers can track changes in program performance and fine-tune operations as needed to achieve the objectives of a continuing-client strategy.  

This tool offers family planning and HIV care providers a quick reference to answer common questions about HIV that women and their partners have. Specifically, it provides information on some basic facts of HIV acquisition, on family planning use for women with HIV, on the health of pregnant women with HIV and their infants, and on mother-to-child transmission of HIV. Information is presented in a simple question and answer format.

This guide offers health care providers a quick reference and easy-to-understand answers to some of the most common breastfeeding questions that pregnant women and mothers, their families, and community members have. The answers in the guide are based on the latest evidence and international recommendations. Topics covered are: Practicing Breastfeeding, Breastmilk Value, Maintaining Breast Health, Family Planning, and Illness or Infection.  

This first issue of Focus on... presents information about the benefits and challenges of linking HIV/AIDS services and family planning and related reproductive health care. To highlight the major issues of integration (also called linkages), Focus on... summarizes key points from selected resources--most from the past 3 years--that reflect field successes, lessons learned, and further avenues for research. There are strong arguments for family planning and HIV/AIDS integration on both sides.

More than twice as many women are using injectable contraceptives today as a decade ago, and the numbers keep growing. Women choose injectables because they are highly effective, long-acting, reversible, and private. At the same time many women do not choose injectables or stop using them because of side effects--particularly irregular bleeding, no monthly bleeding, and weight gain--or because they have trouble returning for injections. Family planning programs are meeting increasing demand while helping providers to maintain good quality of care.

This tool offers health care providers, educators, and communicators a quick reference to answer common questions about menstruation and the menstrual cycle that girls, women, male family members, and other community members have. It also answers questions about how some contraceptive methods affect the menstrual cycle. Information is presented in a simple way and accompanied by illustrations that can be used with clients.  

Microbicides are substances that are designed, when applied vaginally, to reduce transmission of HIV or other sexually transmitted infections (STIs). This report concerns the protective potential of microbicides, some of which are under development to also function as spermicides to provide contraceptive protection.  

Microbicides are substances that are designed, when applied vaginally, to reduce transmission of HIV or other sexually transmitted infections (STIs). This report concerns the protective potential of microbicides, some of which are under development to also function as spermicides to provide contraceptive protection.  

The World Health Organization (WHO) issued new guidance in 2004 on how to use certain contraceptives safely and effectively, including the following: A woman who misses combined oral contraceptive pills should take a hormonal pill as soon as possible and then continue taking one pill each day. This basic guidance applies no matter how many hormonal pills a woman misses. Only if a woman misses three or more hormonal pills in a row will she need to take additional steps (see p.3). The new guidance simplifies the missed-pill rules issued by WHO in 2002.

Obstetric fistula--a devastating medical condition consisting of an abnormal opening between the vagina and the bladder or rectum--results from unrelieved obstructed labor: Unless the fetus is delivered surgically, prolonged obstructed labor often ends only when the fetus dies, decomposes, and is finally passed from the mother. In many cases the mother's injured pelvic tissue breaks down, leaving a hole, or fistula, between adjacent organs. Fistulas also can have nonobstetric causes, such as laceration or sexual trauma.

The World Health Organization (WHO) has issued new family planning guidance, including the following: Most women with HIV infection generally can use IUDs. Women generally can take hormonal contraceptives while on antiretroviral (ARV) therapy for HIV infection, although there are interactions between contraceptive hormones and certain ARV drugs. Women with clinical depression usually can take hormonal contraceptives. More than 35 experts met at WHO headquarters in Geneva, Switzerland, in October 2003 and developed this and other new guidance.