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.


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

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.

PCLAC’s 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

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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

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My internship 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.

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