Medicine and Health Sciences Commons^™

Smarter Mothers, Healthy Children, Smaller Families: A Look At The Impact Of Women’S Education On Family Planning Decisions In The Sultanate Of Oman, Kerala Hise

Independent Study Project (ISP) Collection

Is there a single, perfect, cure-all policy that a government can enact to achieve sustained development? This is a question international organizations and individual leaders ask themselves every day. There will always be ‘less-developed’ nations, this is a reality of having ‘developed’ nations, but there is no reason that humanity should allow there to be ‘under-developed’ nations, not when we have at hand the tools and knowledge to enact immediate, sweeping changes now. However, because different people, different groups feel that their idea or proposal is of the utmost importance, that change is often never realized. Often, too much value …

An Integrated Intervention In Pregnant African Americans Reduces Postpartum Risk: A Randomized Trial, Ayman El-Mohandes, Michele Kiely, Jill G. Joseph, Siva Subramanian, Allan A. Johnson, Susn M. Blake, Marie G. Gantz, M. Nabil El-Khorazaty

Publications and Research

Objective—To evaluate the efficacy of an integrated multiple risk intervention delivered mainly during pregnancy, in reducing such risks (smoking, environmental tobacco smoke exposure, depression and intimate partner violence) postpartum.

Design—Data from this randomized controlled trial were collected prenatally and on average 10 weeks postpartum in six prenatal care sites in the District of Columbia. African Americans were screened, recruited and randomly assigned to the behavioral intervention or usual care. Clinic-based, individually tailored counseling was delivered to intervention women. The outcome measures were number of reisks reported postpartum and reduction of these risks between baseline and postpartum.

Results—The …

The Association Of Maternal Intention To Breastfeed, Early Skin-To-Skin Mother/Infant Contact, And Exclusive Breastfeeding During The Maternity Hospital Stay, Leslie Mary Bramson

Loma Linda University Electronic Theses, Dissertations & Projects

Breastfeeding is the optimal method to nourish and nurture an infant. Exclusive breastfeeding rates in the United States have reached the goal of Healthy People 2010 that 75% of mother's breastfeed in the immediate postpartum period. Yet, less than 35% of San Bernardino county mothers and 47.7% of Riverside county mothers are exclusively breastfeeding during their maternity hospital stays, with as many as 50% of the infants being weaned from the breast in the first 14 days of life.

This prospective study examined archived data collected by Perinatal Services Network (PSN) of Loma Linda University Medical Center/Children's Hospital for the …

Validation Of A Short Questionnaire To Assess Mothers’ Perception Of Workplace Breastfeeding Support, Yeon Bai, C-Y Joanne Peng, Alyce D. Fly

Department of Nutrition and Food Studies Scholarship and Creative Works

The purpose of this study was to create and establish the validity of a short questionnaire to measure mothers' perceived support for breastfeeding from the workplace. The items in the workplace breastfeeding support scale (WBSS) were derived from a literature review. The scale was self-administered in central Indiana during the fall of 2005 to a convenience sample of 66 volunteers who were primiparous, 6 to 12 months postpartum, worked outside the home and had initiated breastfeeding prior to the survey. Internal consistency (α) and split-half reliability (r) test and factor analysis were done to establish reliability and construct …

Clark County Child Death Review: 2007 Annual Report, Nevada Institute For Children’S Research And Policy

Nevada Institute for Children's Research and Policy Reports

The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …

What Are The Individual Preparations For Children With Special Health Care Needs In The Event Of An Emergency?, Karen Sue Barcelo

Master of Public Health Program Student Publications

Children with special health care needs are one of the most vulnerable groups in the event of an emergency. Natural and manmade disasters or emergency events occur on a daily basis. Government agencies, schools and day care centers have begun developing emergency disaster plans; fewer plans have been developed for children with special needs. One explanation for the lack of specific planning for children is that agencies may believe that plans for adults are not different from plans for children. There may be many reasons why parents who have children with special needs may not have an emergency plan in …

The Mercury Connection: Autism And Childhood Vaccines, Sarah Rossi

Pell Scholars and Senior Theses

A literature survey of government and private studies have found that Thimerosal not to be a cause of auism. The reliance on limited, flawed and outdated studies on the effect of ethyl-mercury suggest that more research is needed to understand the effects of ethyl-mercury and particularly Thimerosal. In the meantime efforts should be increased to remove Thimerosal from vaccines world-wide.

Type 1 Diabetes: A Non-Fiction Perspective/ Just A Kid: Emily’S Diabetes Story, Kristen Moody

Senior Honors Projects

How many people do you know with diabetes? Many Americans are living with this disease in our society today. As adults, acknowledging this prevalence seems to be an easy task. However, imagine yourself as a young elementary school child. How much do you know about diseases? What happens if a student in your classroom has a disease? What do you think of this person? For some children, these questions are an imminent reality, part of their everyday childhood life. Thinking about the answers to similar questions mentioned above, I understand the importance of a reliable, accurate, and knowledgeable source for …

Prenatal Exposure To Wood Fuel Smoke And Low Birth Weight, Amna R. Siddiqui, Ellen B. Gold, Xiaowei Yang, Kiyoung Lee, Kenneth H. Brown, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Maternal exposure to wood fuel smoke may lead to impaired fetal growth due to hypoxia and or oxidative stress from smoke constituents such as carbon monoxide and particulate matter. Objectives: We studied the risk of low birth weight (LBW) and reduced mean birth weight in relation to reported use of wood for cooking during the prenatal period, compared with natural gas (NG).
Methods: We studied a historical cohort of women who had a singleton live birth in the years 2000-2002, from a semirural area of Pakistan. Infant's birth weight was obtained from records, and prenatal records had data for …

Give Life Without Losing Life: The Casa Materna Of Matagalpa And The Struggle To Prevent Maternal Death, Lily Emiko Friedman

Independent Study Project (ISP) Collection

Maternal mortality has a face. It is the health indicator with the greatest disparity between the developed and developing worlds, disproportionately affecting poor women with low levels of education, high levels of fertility, and inadequate access to health services. It is the health inequality that most clearly shows how poor health outcomes continue to be directly linked to poverty and socioeconomic disadvantage, while the right to safe pregnancy and motherhood comes with economic privilege. As it occupies such a critical position in community health, maternal mortality has been widely studied and the target of countless health interventions aimed at its …

Childhood Obesity Predicts Adult Metabolic Syndrome: The Fels Longitudinal Study, Shumei S. Sun, Ruohong Liang, Terry T-K Huang, Stephen R. Daniels, Silva Arslanian, Kiang Liu, Gilman D. Grave, Roger M. Siervogel

Publications and Research

Objectives—To determine the age of significant divergence in body mass index (BMI) and waist circumference in adults with and without the metabolic syndrome, and to provide age- and sexspecific childhood values that predict adult metabolic syndrome.

Study design—Part 1 of this study is a retrospective cohort study of 92 men and 59 women (mean age, 51 years) who had metabolic syndrome and 154 randomly selected adults matched for age and sex who did not have the syndrome. Part 2 is a study of predictive accuracy in a validation sample of 743 participants.

Results—The first appearance of differences …

Infant Feeding Decisions Among Pregnant Black Wic Participants And The Role Of Peer Support, Astrid D. Mickens

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal …

Integrating Tuberculosis Case Finding And Treatment Into Focused Antenatal Care In Kenya, Charlotte E. Warren, Annie Mwangi

Reproductive Health

The Population Council/FRONTIERS program, in collaboration with the National Leprosy and Tuberculosis Programme, the Division of Reproductive Health, and the Provincial Health Management Team in Western Province, Kenya, received PEPFAR funding to improve screening for tuberculosis (TB) for pregnant women, including HIV-positive pregnant women. An intervention was tested to strengthen TB case detection to ensure that maternal and child health providers, in addition to providing antenatal care and PMTCT services, also screen and assess the client’s need for TB services and refer for further management. The effectiveness of this approach was demonstrated by the increased number of pregnant women who …

Assessment Of Progress Of The Postabortion Care Initiative In Francophone Africa, Thierno Dieng, Mohamed Diadhiou, Nafissatou J. Diop, Youmane Niang Faye

Reproductive Health

The goals of this study were to assess the national situation concerning postabortion care (PAC) in six countries (Burkina Faso, Guinea, Mali, Niger, Senegal and Togo), including the process of introduction, integration and decentralization of PAC; the successes and obstacles in the process of introducing PAC; and recommended key steps to strengthen the introductory process. The study used two approaches: a comprehensive review of the introduction and institutionalization of PAC in the six countries, and a situation analysis of PAC services within each country.

Obstetric Fistula: Can Community Midwives Make A Difference? Findings From Four Districts In Kenya, Charlotte E. Warren, Annie Mwangi

Reproductive Health

As part of the UNFPA Global Campaign to End Obstetric Fistula, the Population Council and UNFPA built on Kenya’s Community Midwifery Approach to develop a comprehensive community midwifery intervention strategy that aimed at increasing skilled attendants at birth and prevention of obstetric fistula. This report seeks to understand the experiences of women affected by fistula and whether community midwives can contribute to preventing obstetric fistula in rural settings in Kenya. The key recommendations emerging from this report are to: update health facility midwives in maternal and neonatal health (MNH) skills including prevention, treatment, and care of obstetric fistula; train more …

Child Psychosocial Adjustment And Parenting In Families Affected By Maternal Hiv/Aids, Tanya L. Tompkins, Gail E. Wyatt

Faculty Publications

Child adjustment and parenting were examined in 23 9-through 16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of …

Technical Assistance For Implementing Best Practices In The Asia And Near East Region, M.E. Khan, Sohini Roychowdhury, Mary Philip Sebastian, Sitanshu Sekhar Kar, Anurag Mishra, Vivek Sharma, G. Narayana, Bhawana Sharma, Nahla G. Abdel-Tawab, Ahmed Afifi

Reproductive Health

The Population Council's Frontiers in Reproductive Health (FRONTIERS) program offered technical assistance to any Asia Near East (ANE) country mission interested in funding adaptation of USAID‟s “best practices” in family planning or reproductive health. The ANE Bureau provided funding for the costs of FRONTIERS technical assistance. The overall objective of this study was to replicate and scale up "best practices" based on findings from FRONTIERS. The specific objectives were to institutionalize the Systematic Screening Instrument in the entire state of Uttarakhand, India; to strenghten emergency contraceptive pills service provision in Uttarakhand, India; and to enhance the use of Lactational Amenorrhea …

Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu

Reproductive Health

In Uganda, HIV/AIDS treatment, care and support programs are still organized around either adult or pediatric care and fail to adequately address the needs of adolescents, specifically perinatally-infected adolescents. This study, implemented jointly by the Population Council's Frontiers in Reproductive Health (FRONTIERS) program and the AIDS Support Organization (TASO), aimed to better understand the reproductive health and sexuality of this population group, and to identify anxieties or fears they have around entering social stages of adulthood. This study confirms that wide programmatic gaps exist in addressing the sexual and reproductive health needs of young people perinatally infected with HIV who …

Using Operations Research To Enhance Delivery Of Postpartum/Postabortion Family Planning Services In The Arab Region, Frontiers In Reproductive Health

Reproductive Health

The FRONTIERS program in Cairo organized a two-and-half day workshop to share programmatic experiences and lessons learned in integrating family planning with service providers from Egypt, Jordan, Sudan, and Yemen representing mid-level program managers and researchers. It was held in 2008 in tandem with a national end-of-project seminar for stakeholders in Egypt. Participants emphasized the need to capture missed opportunities in antenatal, delivery, postpartum or postabortion care by providing family planning services in all encounters between women and the health care system. They also agreed on an overarching need for operations research in assisting policy makers and program managers in …

Evaluation Of The Long-Term Impact Of The Tostan Programme On The Abandonment Of Fgm/C And Early Marriage: Results From A Qualitative Study In Senegal, Nafissatou J. Diop, Amadou Moreau, Helene Benga

Reproductive Health

In 1998–99, a village empowerment program was implemented in the Thiès/Fatick and Kolda regions of Senegal by the nongovernmental organization Tostan, to mobilize communities to hold public declarations in support of abandoning harmful traditional practices, including female genital mutilation/cutting (FGM/C) and child marriage. The information presented in this report indicates that many did end the practices following a public declaration, however, the lack of follow-up in the field and the absence of support mechanisms pose a large obstacle. Nevertheless, the program achieved significant results: knowledge of life skills resulting in positive changes and a shift in the perception of FGM/C …

Strengthening The Financial Sustainability Of Two Population Services And Training Center (Pstc) Clinics (Bangladesh), Population Services And Training Center (Pstc), Frontiers In Reproductive Health

Reproductive Health

The Population Services and Training Center of Bangladesh (PSTC) operates 15 clinics and 150 satellite posts that provide an Essential Services Package (ESP) to the poor, consisting of child health, family planning, maternal health, communicable disease treatment, and limited curative care. The objective of this study was to conduct an operations research study to determine the feasibility of improving cost recovery in two clinics by raising prices. It appears that the study design was too ambitious for PSTC, a service delivery organization with no prior research experience. Lack of experience was compounded by the resignation of all three PSTC research …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In The Dominican Republic, Gisela Quiterio, Maritza Molina, Marija Miric, Ricardo Vernon, M. Estela Rivero-Fuentes

Reproductive Health

A diagnostic study of the provision and use of contraception in postpartum, postabortion, and prevention of mother-to-child transmission (PMTCT) programs in the Dominican Republic was conducted with funding from USAID. The objectives of the study were to assess the contraceptive knowledge, attitudes, and behaviors of providers and clients; the degree to which information, counseling, and delivery are implemented in postpartum, postabortion, and PMTCT services; the quality of these services; and the readiness of postpartum, postabortion, and PMTCT services to offer contraceptive services. The report finds that family planning services are linked to antenatal, delivery, and postpartum care in most of …

Helping Egyptian Women Achieve Optimal Birth Spacing Intervals Through Fostering Linkages Between Family Planning And Maternal/Child Health Services, Nahla G. Abdel-Tawab, Sarah Loza, Amal Zaki

Reproductive Health

The Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Egyptian Ministry of Health and Population and the NGO Social Planning, Analysis and Administration Consultants, conducted an operations research study to measure the acceptability and effectiveness of two birth spacing message models in Upper Egypt. Overall, the study found that providing birth spacing messages to low-parity women during antenatal and postpartum care and also to husbands through community awareness activities was feasible and acceptable. As a result, birth spacing messages have been integrated into service delivery guidelines for antenatal and postpartum care, and IEC materials on …

Increasing The Accessibility, Acceptability And Use Of The Iud In Gujarat, India, M.E. Khan, Sitanshu Sekhar Kar, Vikas Kishor Desai, Pratibha Patel, B.P. Itare, Sandhya Barge

Reproductive Health

The USAID-funded FRONTIERS Program of the Population Council, in collaboration with the Department of Health & Family Welfare, Government of Gujarat, and the Center for Operations Research and Training, Vadodara, conducted an operations research study in India to test the hypothesis that by improving the demand for the IUD and simultaneously strengthening the technical competencies and counseling skills of the providers, use of the IUD use would increase. The findings show that demand-generation activities and provision of good-quality IUD services, together with a supportive programmatic environment, when carried out simultaneously showed increased acceptance of the IUD. The intervention could be …

Taking Critical Services To The Home: Scaling-Up Home-Based Maternal And Postnatal Care, Including Family Planning, Through Community Midwifery In Kenya, Annie Mwangi, Charlotte E. Warren

Reproductive Health

With support from USAID, the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project supported the scaling up of a community-based model in Kenya that enabled women to give birth safely at home or be referred to a hospital when attended by a self-employed skilled midwife living in the community. To strengthen the sustainability of this approach FRONTIERS engaged a microfinance NGO to develop a training curriculum on basic business skills and financial literacy, and encouraged the community midwives (CMs) to form clusters or informal associations so that they could be trained in business skills. Following these interventions, CMs proved more …

Feasibility, Acceptability, Effect, And Cost Of Integrating Counseling And Testing For Hiv Within Family Planning Services In Kenya, Wilson Liambila, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Rick Homan, Ibrahim Mohammed, Robert Ayisi, Margaret Gitau, Josephine Kibaru, Mary W. Gathitu, Judith Maua, Helton Jilo, Juma Mwangi, John Njoroge, Anthony K. Wanyoro, Peter Mohammed Njuguna, Andrew Mboche

Reproductive Health

FRONTIERS supported the Division of Reproductive Health and the National AIDS and STI Control Program of the Kenya Ministry of Health to design, implement, and compare two models of integrating counseling and testing (CT) for HIV within family planning (FP) services in terms of their feasibility, acceptability, cost, and effect on the voluntary use of CT, as well as the quality of FP services. The study demonstrated that both models were feasible and acceptable to providers and to clients as means of integrating and linking HIV prevention counseling, condom promotion, and counseling and testing with FP services, and are effective …

Strengthening Postnatal Care Services Including Postpartum Family Planning In Kenya, Annie Mwangi, Charlotte E. Warren, Nancy Koskei, Holly Blanchard

Reproductive Health

The objectives of this study were to develop and introduce a strengthened postnatal care package into one hospital and four health centers in one district in Kenya, to document the feasibility, acceptability, and quality of care of the strengthened postnatal care, and to evaluate the effectiveness of the postnatal package on women’s reproductive health behaviors. The study was implemented jointly by the Population Council’s Frontiers in Reproductive Health (FRONTIERS) project and by Jhpiego’s ACCESS-FP project, both funded by USAID. A postnatal care–family planning orientation package for providers was developed that incorporated relevant maternal and newborn healthcare services in the postnatal …

Extending Prevention Of Mother-To-Child Transmission Through Postpartum Family Planning In Lesotho, Charlotte E. Warren, Semakaleng Phafoli, Bosielo Majara, Thato Tsukuluet

Reproductive Health

Recognizing the need to improve the care and follow up of mothers and infants in the postpartum period, the Lesotho Ministry of Health and Social Welfare (MOHSW), with technical support from the Frontiers in Reproductive Health (FRONTIERS) of Population Council and funding from PEPFAR/RHAP/USAID, carried out an operations research project to strengthen the existing postpartum care services. This study had a specific focus on strengthening linkages with existing PMTCT follow-up and family planning services during the postpartum period by changing the number, timing, and content of postpartum consultations that a woman and her newborn should receive. The key findings indicated …

Developing Comprehensive And Evidence-Based Policy And Guidelines For Antenatal And Postnatal Care In Kwazulu-Natal, Prudence Ditlopo, Mantshi Menziwa, Saiqa Mullick, Saumya Ramarao, Janet Dalton, Dolly Nyasulu, Mags Beksinska, Busi Kunene

Reproductive Health

In May 2004, the Maternal Child and Women’s Health department of Kwazulu-Natal (KZN), South Africa requested technical assistance from the Population Council’s USAID-funded FRONTIERS project for developing standardized and comprehensive antenatal and postnatal (ANC/PNC) care policies and guidelines and supportive training and educational materials. The aims and objectives of this project were to: support the development of a comprehensive evidence-based antenatal and postnatal care program in KZN; consolidate lessons learned and evidence around delivery of comprehensive ANC and PNC; revise provincial guidelines to enable comprehensive ANC and PNC services that address PMTCT, partner involvement, syphilis screening, focused visits, and antiretrovirals; …

Empowering Communities To Make Pregnancy Safer: An Intervention In Rural Andhra Pradesh, Dipa Sinha

Reproductive Health

Recognizing that multiple factors are responsible for adverse pregnancy-related outcomes, a community-based intervention was implemented in Mominpet, in Andhra Pradesh, India in collaboration with the M.V. Foundation, a nongovernmental organization. The intervention focused on improving maternal health outcomes by raising awareness and building family and community support for pregnant women; involving pregnant women’s families, notably their husbands, in pregnancy-related care; and supporting pregnant women to access health services. This report describes the experience and outcomes of the intervention. In particular, it explores the extent to which the intervention was effective in increasing community support for safe motherhood on the one …