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ORGANIZATION: Mexican Institute of Social Security (IMSS)
LOCATION: Cuernavaca, Morelos, México
STUDENT: Jaimie Morse
YEAR: Summer 2005 |
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I completed my internship at the Mexican Institute of Social Security (IMSS) in the Epidemiology and Health Services Research Unit (EHSRU) in Cuernavaca , Morelos , Mexico . IMSS is the health services and health policy research arm of the federal Department of Social Services. IMSS is also the main social security institution in Mexico , providing health insurance coverage to approximately 50-60% of the population. All people who are, or have been, employed in the formal sector of the economy (as well as their spouses and dependants) are eligible for IMSS services. Reproductive health and family planning services are provided free-of-charge to all individuals insured by IMSS. My supervisor was Dr. Yvonne Flores, a Principal Investigator in the EHSRU. I also worked closely with the Director of the EHSRU, Dr. Jorge Salmerón.
Cervical cancer is a leading cause of death among women in Mexico. IMSS initiated a large-scale, 5-year human papillomavirus (HPV) and cervical cancer cohort study to examine risk factors associated with persistent HPV infection and development of cervical cancer among attendees of cervical cancer screening services at the 23 IMSS clinics in the state of Morelos. Women were asked about their choice of contraceptives and use of barrier methods, such as condoms. I participated in analysis of the results of this cohort study to assess risk factors for persistent HPV infection and developing cervical cancer, with particular attention to risks associated with choice of contraceptive and use of barrier methods, such as condoms. The results were intended to inform cervical cancer screening protocols based in part on HPV testing at IMSS in the state of Morelos, as well as to revise IMSS family planning guidelines to include information about the association between choice of contraceptive and risk of infection with HPV.
To ground my research in health services delivery, I conducted clinic visits and met with key individuals involved in designing adolescent reproductive health care services to determine what types of services and patient education were being offered by IMSS. When observing clinics and meeting with IMSS staff, I applied my knowledge of cervical cancer disease etiology and barriers to seeking family planning services and treatment for sexually transmitted infections such as HPV, to assess the strengths and weaknesses of current service delivery strategies. I went to several clinics in and around Cuernavaca to assess adolescent reproductive healthcare services. I noted the presence (or absence) of patient education messages visible in the waiting areas, the physical space allocated to treatment of reproductive health needs (such as pap smears, etc.), the presence (or absence) of confidential family planning counseling areas (with attention to auditory and visual confidentiality), and the overall attitude toward adolescents seeking reproductive health and family planning services. I observed first hand the challenges of incorporating recommendations based on policy-oriented research into health service design and delivery.
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ORGANIZATION: Centro Las Libres de Información en Salud Sexual
LOCATION: Guanajuato, México
STUDENT: Lissette Flores
YEAR: Summer 2004 |
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For 10 weeks during the summer of 2004, I worked with Centro Las Libres de
Información en Salud Sexual in Guanajuato, México. Centro Las Libres
is a non-governmental organization (NGO) dedicated to promoting and defending
women's sexual and reproductive rights through advocacy efforts, youth health
promoter trainings, and ongoing educational activities for providers in the medical,
legal, and public health sectors. Centro Las Libres is a member of Milenio Feminista,
a national network of over 80 NGOs working at the grassroots level to advance
the sexual and reproductive rights of women. During my internship I worked
on Centro Las Libres' Legal Abortion Project. In the year 2000, the Guanajuato
state Legislature passed a bill that made it a crime for rape survivors to terminate
a pregnancy resulting from the assault. Centro Las Libres and other women's groups
organized a statewide protest against the bill; the governor ultimately vetoed
the bill. Despite this victory, the state continues to provide inadequate medical
and legal services to rape survivors. Government institutions lack official procedures
for assuring timely and quality services to survivors of rape seeking a legal
abortion. Consequently, the rights of girls and women are consistently violated.
When Guanajuato's governor vetoed the bill, national polls indicated that the
majority of Mexican citizens were in support of the initiative. In collaboration
with Ipas, Centro Las Libres was in the process of conducting interviews with
public and private institutions in several states to learn about what services
were available to survivors of sexual violence. This project was part of a larger
effort to monitor and analyze the procedures by which government and private agencies
specializing in sexual crimes handle rape cases. I was responsible for interviewing
social workers, psychologists, doctors and persons in charge of setting policy
within private and public hospitals and other government entities. The interview
contained questions about the services each of the institutions offered, the protocols
set in place to deal with rape survivors, the person's role within the institution
as well as the person's views about Emergency Contraception (EC) and abortion.
Once completed, information from States across Mexico would be compiled in order
to identify key issues on which NGOs should focus their attention. Centro Las
Libres is also working on building a statewide network of youth health promoters.
Young people received trainings focused on topics such as family planning, violence,
sexual and reproductive rights and advocacy skills. I was involved in this project
as a facilitator. Once a solid group of youth health promoters had been trained,
they would be responsible for monitoring the quality of reproductive and sexual
health services in their local community health centers and advocate for quality
medical care. |

ORGANIZATION:
Population Council's Regional Office for Latin America and the Caribbean (PCLAC)
LOCATION: Mexico STUDENT: Ingrid Dies-Draffner YEAR:
Summer 2004 | Factsheets
Main
Theme Factsheet Rural
Factsheet
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Between July and December 2005, I worked as an intern for the Population Council's
Regional Office for Latin America and the Caribbean (PCLAC). The Population Council
("The Council") is a U.S.-based research organization that has project
offices throughout the world and one main office in each region that serves as
regional headquarters. Research is based in reproductive health issues, and programs
vary widely from biomedical research and product development to community-based
program design and implementation. I worked for
PCLAC's Reproductive Health Program, which conducts applied research on contraception,
abortion, maternal and child health and sexually transmitted disease prevention.
PCLAC has projects in Barbados, Bolivia, Brazil, Guatemala, Jamaica, Mexico, Peru
and along the U.S.-Mexico border. My principal preceptor was Reproductive Health
Program Director Dr. Sandra Garcia, but I also assisted in various projects headed
by other PCLAC staff. PCLACs work
is primarily focused on meeting the reproductive health goals established at the
1994 International Conference on Population and Development (ICPD). Conference
goals included promoting development by increasing access to reproductive health
services and information world wide. PCLAC needs assessments have shown that while
many Latin American and Caribbean countries have made great strides to improve
reproductive hhealth outcomes over the last 20 years, there remains a great deal
of work to be done to reach the ICPD goals. While
at PCLAC, I worked on a number of different projects, the primary of which are
listed below. - Reviewed and
synthesized literature on public opinion on abortion in Latin America and the
Caribbean
- Designed factsheets addressing
Mexican youth's need for sexuality information and communication skills
- Analyzed
data and developed survey instruments for research on contraceptive use at the
U.S.-Mexico border.
All of my
work was conducted through secondary research sources in the Mexico City office
or via Internet databases and search engines. However, some of the analysis I
conducted for the U.S.-Mexico border survey was based on data collected from the
field. My experience with PCLAC provided
me an opportunity to develop essential core research skills that I know I will
carry with me throughout my career. Through my work at the Council, I was able
to further define my own career goals and gain insight into the steps that will
be necessary to achieve these goals. I could not have done any of this without
the support of the Bixby and Drabkin programs. My sincerest appreciation for your
generosity and encouragement. | |

ORGANIZATION:
Mexfam LOCATION: Mexico STUDENT: Graciella Funes-Coté
YEAR: Summer 2002 | click
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During the months of July and August of 2002 I was part of a research team
carrying out a study at Mexfam clinics in the Republic of Mexico. Mexfam is the
Mexican Family Planning Association, a non-profit organization, governed by volunteers.
Elizabeth Butrick, a Michigan International Development Associate, was the study
supervisor. Nicole Monastersky and I, both of us graduate students in the department
of Community Health Sciences in the School of Public Health at UCLA, were the
two other members of the evaluation team. The goal of the study was to understand
the role of family planning services in Mexfam's clinics. Mexfam's clinics
provide both specialized and family medicine services. The clinics are responsible
for supplying a sustainability base for a variety of social programs. These programs
are central to Mexfam's mission of providing services to the most vulnerable Mexican
population sectors. Family Planning is one of these programs. Because the provision
of family planning services is an important part of Mexfam's mission, it is essential
for the organization to understand to what extent clinics are promoting and providing
these services. Mexfam has 20 clinics throughout Mexico. A convenience sample
of 11 clinics was selected to participate in the study. The study was conducted
using a multi-method approach for gathering information. The study instruments
consisted of: a short survey for clients; a questionnaire for family planning
users who obtained their method at Mexfam; a questionnaire for family planning
users who obtained their method elsewhere; and a service provider questionnaire.
The information gathered from this study was useful in identifying strengths and
weaknesses of the family planning program at Mexfam and it will serve to develop
strategies to enhance the program in the future. |
ORGANIZATION: Mexfam LOCATION: Mexico STUDENT: Nicole
Monastersky YEAR: Summer 2002 | click
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with Mexfam, Mexico's Foundation for Family Planning (part of the IPPF) was focused
most specifically as an evaluation of the family planning services provided by
the Mexfam clinics. Together with my supervisor and another student volunteer,
we visited 11 of the clinics in various parts of the country. I spent the majority
of my time working in the small, agricultural community (population 50,000) of
San Luis de la Paz, Guanajuato. There, I conducted the evaluation (surveyed and
interviewed female clinic users of family planning use and interviewed doctors
regarding provision of family planning methods) in order to evaluate the differences
between users of family planning methods from Mexfam and users of family planning
methods obtained at other locations (e.g. other hospitals, pharmacies). In addition
to San Luis de la Paz, I also went to San Luis Potosi, Xola, and Guadalajara to
conduct the family planning evaluation in their respective Mexfam clinics. While
the bulk of my time in San Luis de la Paz was spent on the family planning evaluation,
I was also involved with two other projects in this particular clinic. The first
involved recruiting community promotoras from the local municipalities to participate
in a new series of community talks/ lectures on a health topic of their collective
choosing. The second involved designing a funding proposal for a Òletter projectÓ
whereby migrant workers from San Luis de la Paz living in the US would be contacted
and informed about the risks of STDs and HIV/AIDS, as well as family planning
and contraceptive methods available. My summer internship experience was greatly
enhanced by my living environment. I had the good fortune of staying with family
members of my bosses in San Luis de la Paz. As an American graduate student (and
the only guera around), I was initially quite the anomaly, in the home as well
as in the community. Once the cultural differences faded and became interesting
topics of conversation, I was quickly welcomed into their family as the newest
member. I joined the kids and the adults in nightly card games. I came home from
work daily to have the main comida together with the rest of the family. With
more than 25 cousins and at least that many aunts and uncles, I was rarely without
playmates. Though it may not be as soon as Christmas vacation (as was the request
of the littlest children) I am looking forward to the next chance I may have to
go back to visit my adopted Mexican family. back
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