Medicine and Health Sciences Commons^™

Formative Research On Factors Influencing Access To Fistula Care And Treatment In Uganda, Pooja Sripad, Charlotte E. Warren

Reproductive Health

This formative research builds upon the results of a systematic review by the Population Council for better understanding of the barriers and enabling factors for fistula repair care and access in Uganda. The study focuses on Fistula Care Plus project-supported treatment facilities where fistula camps are routinely held. Results reveal the nuances of women’s experiences, along with the additional perspectives of their spouses, family members, community stakeholders, and fistula camp care providers including nurses/counselors, surgeons, and facility and district managers. Barriers and enablers to fistula repair care are clustered around the following factors: psychosocial, cultural, social, financial, transportation, facility shortages, …

Measuring Quality Of Care: A Review Of Previously Used Methodologies And Indicators, Katherine Tumlinson

Reproductive Health

Despite successful efforts to increase financial and geographic access to family planning services in many parts of the developing world, large numbers of women with a desire to delay or limit future pregnancies are not using contraceptive methods. Several multi-country, large-scale facility surveys incorporate indicators for measuring the quality of family planning service delivery. These facility surveys use data collection tools such as facility audits, provider and client questionnaires, and third party observation guides. A limited body of research indicates that the validity of these tools is low, however, while large variations in analytical approaches inhibit use of existing literature …

Addressing Supply Side Factors To Improve Family Planning And Reproductive Health Services In The Indian National Health Insurance Scheme In Uttar Pradesh, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

The Indian National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), was launched by the Ministry of Labour and Employment, Government of India in 2008 to promote equitable access to health services through the private and public sectors. Almost eight years into the program, it was an opportune time to examine usage levels and barriers and facilitators to the program’s effectiveness. The Evidence Project conducted a study among the urban poor in Uttar Pradesh to look at awareness and use of the RSBY program and family planning/reproductive health (FP/RH) services, examine concerns of those administering the program and providing services, …

Adolescents In Bangladesh: Programmatic Approaches To Sexual And Reproductive Health Education And Services, Sigma Ainul, Ashish Bajracharya, Laura Reichenbach

Reproductive Health

There is a gap in knowledge and understanding of effective adolescent sexual and reproductive health (ASRH) programming in Bangladesh, especially programming at scale. Initiatives to address ASRH have been implemented at different times by both the Government of Bangladesh and NGOs, but these activities have often been fragmented and are not well documented or evaluated, making it difficult to know what worked well and what did not. This policy brief presents selected findings from a comprehensive review and analysis of ASRH programming in Bangladesh, carried out by the Population Council’s Evidence Project, with financial support from USAID/Bangladesh, as part of …

Scaling Up Family Planning In Zambia—Part 1: Assessment And Feasibility Of Maintaining An Innovative Program, Benjamin Bellows, Mary Nambao, Luigi Jaramillo, Roz Fanaiayan, Mardieh Dennis, Karen Hardee

Reproductive Health

To support the Government of Zambia in addressing its reproductive health challenges and in meeting its goals for 2020, the United Kingdom Department for International Development funded a four-year effort to support public sector contraceptive expansion under the Scaling Up Family Planning (SUFP) Project, led by Abt Associates. Launched in 2012, and with a focus on hard-to-reach areas and youth and expanding access to long-acting reversible contraceptives, SUFP was a technical assistance program designed to strengthen the ability of the public sector to provide services to meet the country’s FP2020 goals. SUFP focused on capacity building, infrastructure strengthening, behavior change …

Strengthening Factory Health Systems Under Levi Strauss & Co.'S Worker Well-Being Initiative In Egypt, Population Council, The Evidence Project

Reproductive Health

The pilot intervention described in this brief took place at an apparel manufacturing company, Lotus, located in Port Said, Egypt as part of the Worker Well-being Initiative. Worker Well-being is an initiative of Levi Strauss & Co. and the Levi Strauss Foundation that seeks to move beyond a “do no harm” compliance model of labor rights in its global supply chain. The interventions in Egypt have contributed to the overall development of a health system–strengthening approach to private workplaces, which is a new concept for management. The work in Egypt contributed to a collaboration between the Evidence Project/RAISE Health and …

The Private Sector As A Provider Of Family Planning Services In Egypt: Challenges And Opportunities [Arabic], Nahla G. Abdel-Tawab, Doaa Oraby, Benjamin Bellows

Reproductive Health

[In Arabic] The recent increase in Egypt’s fertility rate, following decades of progress in lowering fertility levels, highlights the need for renewed attention to the country’s family planning program. The Ministry of Health is currently the largest provider of family planning in Egypt, serving a diverse population of women, many of whom may not need the free public service. Expanding the role of the private sector in the provision of family planning services and supplies holds great potential to more effectively meet the current and future family planning needs of millions of Egyptian women. This brief examines the role of …

Understanding Demand For Family Planning And Reproductive Health Services Through The Indian National Health Insurance Scheme In Uttar Pradesh, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

The Indian National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), was launched by the Ministry of Labour and Employment in 2008 to promote equitable access to health services through the private and public sectors. This scheme is intended to offer economically disadvantaged families living below the poverty line in urban and rural areas access to a pre-specified package of health services including: general surgery, general medical care, pediatric care, gynecological care, family planning (FP) and other reproductive health (RH) services, dental, ophthalmology, urology, neurosurgery, and oncology. Almost eight years into the program, this is an opportune time to examine …

Building A National Pro-Choice Alliance In Mexico: Evaluation Of The Alliance Media Campaign To Promote Access To Safe, Free, And Legal Abortion Services, Population Council

Reproductive Health

The Population Council and Alliance partners designed a legal abortion media campaign aimed at informing women in Mexico City of their legal right to a safe, free elective abortion during the first 12 weeks of pregnancy. The impetus for the campaign was the apparent lack of knowledge regarding the legality of abortion in Mexico City among low-income, marginalized women of reproductive age combined with the inadequate number of Mexico City Ministry of Health facilities equipped to provide services to women living in an expansive metropolitan area such as Mexico City. This brief presents results of an evaluation that show that …

Evaluating The Impact Of Integrated Microfinance And Reproductive (Mf/Rh) Services On Household Wellbeing And Reproductive Health Behaviors Of Women In Nigeria, Population Council

Reproductive Health

A growing body of studies attempts to show that microfinance institutions are capable of contributing to improvements in women’s reproductive health (RH) status by integrating information that leads to behavioral change. In Nigeria, there is little evidence documenting the impact and health outcomes among beneficiaries of integrated microfinance and reproductive health (MF/RH) service. The integrated MF/RH program, funded by The David & Lucile Packard Foundation and implemented by Partners for Development, provided an opportunity to test the impact of integrating RH messaging and support for service provision into a microcredit scheme. The objective of this integrated approach was to improve …

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Hyderabad, Population Council

Reproductive Health

This district profile of Hyderabad is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of family planning, including other socioeconomic indicators, and consumers’ perspectives on barriers to use of family planning. While it notes the lack of information among men; it also finds limited access to public health facilities compounded by poverty—a hurdle for the urban poor. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Multan, Population Council

Reproductive Health

This district profile of Multan is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Districts Haripur And Nowshera, Khyber Pakhtunkhwa, Population Council

Reproductive Health

Through its Reproductive Maternal and Neonatal Child Health project, GIZ Pakistan is assisting the Government of Pakistan in strengthening its health system’s capacities for ensuring effective, efficient, client-oriented, and affordable reproductive, maternal, newborn, and adolescent health care. GIZ engaged with senior national and provincial government officials who indicated their interest in applying the innovative Made-In/Made-For (Maternal Death, from Informants/Maternal Death, Follow On Review) methodology, a cost-effective alternative for generating reliable estimates of maternal mortality through community-based informant networks. This Population Council study in two pilot districts identified specific areas that need strong policy and programmatic interventions to improve maternal health …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

Using The Community Informant-Based (Made-In And Made-For) Methodology To Estimate The Neonatal Mortality Rate (Nmr) In Nowshera, Khyber Pakhtunkhwa: A Feasibility Study, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, Rehan M. Niazi

Reproductive Health

Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant …

Concerns And Structural Barriers Associated With Wic Participation Among Wic-Eligible Women, Cindy H. Liu, Heidi H. Liu

All Faculty Scholarship

Objectives: To examine sociodemographic, psychosocial concerns, and structural barriers associated with women's participation in the USDA's Women, Infants, and Children (WIC) program among those eligible for the program.

Design and Sample: 1,634 White, African American, Hispanic, and Asian/Pacific Islander (A/Pl) women from the New York City area completed the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2004-2007, a population-based survey.

Measurements: Data on WIC eligibility and participation, sociodemographic details, unintended pregnancy, social support, and structural barriers were evaluated.

Results: Hispanics and Blacks were 4.1 and 2.4 times more likely to participate, respectively, in the WIC program relative to Whites. Mothers …

Black Health Matters: Disparities, Community Health, And Interest Convergence, Mary Crossley

Articles

Health disparities represent a significant strand in the fabric of racial injustice in the United States, one that has proven exceptionally durable. Many millions of dollars have been invested in addressing racial disparities over the past three decades. Researchers have identified disparities, unpacked their causes, and tracked their trajectories, with only limited progress in narrowing the health gap between whites and racial and ethnic minorities. The implementation of the Affordable Care Act (ACA) and the movement toward value-based payment methods for health care may supply a new avenue for addressing disparities. This Article argues that the ACA’s requirement that tax-exempt …

A Qualitative Pilot Study Of Aging Women’S Physical Activity Experiences In One University Fitness And Wellness Center, Alexis Hobbs

Online Theses and Dissertations

Physical inactivity is one of the driving risk factors for developing health problems such as obesity, diabetes, and cardiovascular diseases (World Health Organization, 2003). The prevalence of these diseases increases with the aging process, which renders participation in physical activity crucial among the aging population. There is strong evidence that physical activity reduces the risk of these health disparities and disabilities (Young & Dinan, 2005), however despite these well-documented benefits, aging women still remain sedentary. This study examined the phenomenon of women 55 years of age or older and their lived experiences of participating in physical activity within a university …

Potentially Traumatic Experiences And Sexual Health Among Orphaned And Separated Adolescents In Five Low- And Middle-Income Countries, Christine L. Gray, Kathryn Whetten, Lynne C. Messer, Rachel A. Whetten, Jan Ostermann, Karen O'Donnell, Nathan M. Thielman, Brian W. Pence

Community Health Faculty Publications and Presentations

Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in sub-Saharan Africa and Asia. Over 153 million children worldwide have lost one or both parents, including 17 million orphaned by AIDS, and millions more have been separated from their parents. As younger orphans enter adolescence, their sexual health and HIV-related risk behaviors become key considerations for their overall health. Importantly, their high prevalence of exposure to potentially traumatic events (PTEs) may put OSC at additional risk for adverse sexual health outcomes. The Positive Outcomes for Orphans study followed OSC randomly sampled from institution-based care and …

Relationship Among Motivation, Emotion Regulation, And Psychological Well-Being Of Sophomore And Senior Level Baccalaureate Nursing Students, Aryene C. Delgado, Douglas Garner, Nicole Langhals

Williams Honors College, Honors Research Projects

Nursing education and professional work involve stressful circumstances that may indirectly lead to attrition, which can further contribute to the projected nursing shortage. This study examines the relationships between motivation, emotional regulation, psychological well-being and academic performance in baccalaureate sophomore and senior level nursing students at a Midwest urban university in the United States. The non-experimental, correlational study is guided by the self-determination theory (Deci & Ryan, 2000) and uses online survey data collection and convenience sampling. Motivation, emotional regulation, psychological well-being (burnout; inauthenticity), and academic performance (GPA) are measured respectively with Deci and Ryan’s scale, the Emotion Regulation Questionnaire, …

The Experience Of Role Balance Among Australian Working Women With Multigenerational Caring Responsibilities, Kiah Lee Evans

Theses: Doctorates and Masters

Approximately 10% of women in developed countries are working sandwich generation women, who combine paid employment with ongoing multigenerational caring responsibilities for at least one child under 18 years and one parent or parent-in-law. This role combination is expected to become more common due to the increased workforce participation of women, childbirth at an older age, reduced fertility rates, an ageing population and a trend towards community based care. Although there are numerous benefits related to membership in the working sandwich generation, there are also a range of costs related to role participation and quality of life. In particular, these …

Speaking Through The Silence: Narratives, Interaction, And The Social Construction Of Sexual Selves, David Wayne Wahl

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research is to study the construction of sexual selves. The research entails understanding how sexual selves emerge, develop, alter, sustain, transform or deconstruct. In all cases of sexuality, sex is something we, as active agents, do. It is for this reason that I adhere, in this work and otherwise, to the tenets of symbolic interactionism as this activity involves; (1) active agents who are composed of many different categorizations of selves including sexual selves, (2) the reflexive nature between the individual and the social realm wherein sexuality, in causal terms, takes the position of a dependent …

Bullying In Senior Living Facilities: A Qualitative Study, Felicia Jo Vandenest

All Graduate Theses, Dissertations, and Other Capstone Projects

Resident-to resident bullying has attracted some attention in the popular press and is well-known to many who work with seniors in long-term care facilities. However, this is very little empirical literature that has address the topic of "senior bullying". The aim of the proposed qualitative study is to better understand the phenomenon of resident-to-resident bullying from the perspective of staff who work in long-term care facilities. Staff members (n=45) responded to a combination of open- and close-ended interview questions regarding their observations of senior-to-senior bullying. Results indicate that the majority of staff members (98%) have observed resident-to-resident bullying within senior …

Perceptions Of Female Sexual Pathology: The Role Of Racial Biases In Clinical Decision Making, Jerusha Sanjeevi

All Graduate Theses, Dissertations, and Other Capstone Projects

Diversity issues such as multicultural competence and sexual health competence have received increased but separate academic attention in recent years. Although empirical support has been found for the presence of racial biases in the diagnoses of mental health disorders, there is no evidence to date regarding the role of racial biases in the diagnoses of female sexual pathology. In the present study, 101 pre-doctoral psychology interns across the United States assessed the symptom severity of a fictional client via online vignettes in which client race was experimentally manipulated. Participants did not report significantly different symptom severity ratings between the vignettes …

The Relationship Between Emotion Regulation, Social Support, And Alcohol-Related Problems Among Racially Diverse Adolescents., Briana A. Woods-Jaeger, Richard H. Nobles, Linnea Warren, Mary E. Larimer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Motives For Participation In Triathlons Among Midlife To Older Black Women: A Mixed Method Study, Candace Brown

Theses and Dissertations

BACKGROUND: Research has established the positive link between physical activity and its impact on health among adults. Generally, as people get older, they are less likely to be active. Black women comprise 13% of the women in the US but constitute 52% of women who are inactive. Existing articles on exercise motivation among Black women have generally assessed sedentary individuals. Little research has examined the motivations to exercise among physically active Black women. METHODS: Guided by the regulators of the Self Determination Theory, the 56 item Motivations of Marathoners Scales for Triathletes (MOMS-T) was used to assess the motives of …

Experiences Of Victimization And Health Care Access Among Non-Metropolitan Lgbtq+ Individuals, Ashley-Ann Marcotte

Theses and Dissertations (Comprehensive)

Lesbian, gay, bisexual, trans, and queer (LGBTQ+) individuals report substantial rates of violence, discrimination, and negative life events due to homophobia and transphobia and these experiences impact access to health care services and programs (Bauer et al, 2009; Grant, Mottet, Tanis, Harrison, & Keisling, 2010) These experiences result in LGBTQ+ communities needing services, programs, and social supports to provide safer spaces. Although it is well recognized that health care services are not a major determinant of health outcomes and yet use more than 60% of health spending (Canadian Institute for Health Information, 2014; Muzyka, Hodgson, & Prada, 2012). As such, …

Best Practices To Increase Efficacy Of Graduate School Admissions Communications At Clark University, Diana Curran, Nikki Feinberg, Mitchell Kelley, Ruiqi Li, Anning Zhou

School of Professional Studies

Within the period of time that a graduate student deposits and subsequently arrives at their academic institution, receiving timely information is important for their preparation. This process has been deemed by the Deans of the Enterprise Schools at Clark University as one that needs further investigation. As such, this Capstone looks at the array of communication that goes out to each graduate student during this four-month period. The purpose of examining this communication is to analyze its effectiveness in engaging students. To analyze the effectiveness of this communication, surveys were distributed to current students in these schools to gather data …

Electronic Medical Records (Emr): An Empirical Testing Of Factors Contributing To Healthcare Professionals’ Resistance To Use Emr Systems, Emmanuel Patrick Bazile

CCE Theses and Dissertations

The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to resistance on the part of physicians, nurses, and clinical administrators. In 2010, only 25% of office-based physicians have basic EMR systems and only 10% have fully functional systems. One of the hindrances believed to be responsible for the slow implementation rates of EMR systems is resistance from healthcare professionals not truly convinced …