Social and Behavioral Sciences Commons^™

Discovering A Gold Mine Of U.S. Government Information: Exploring The Hathitrust Catalog And Its Rich Veins, Bert Chapman

Libraries Faculty and Staff Presentations

The Hathitrust Catalog provides researchers at member institutions with exponentially expanded access to historical U.S. Government information resources. This presentation describes how researchers can use this resource to conduct substantive research using government information resources on public policy issues such as Internal Revenue Service program problems, infectious diseases such as Ebola, and U.S. foreign relations with the former Soviet Union/Russian Federation.

Is The United States Prepared For Ebola?, Lawrence O. Gostin, James G. Hodge Jr., Scott Burris

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic is a humanitarian crisis and a threat to international security. It is not surprising that isolated cases have emerged in Europe and North America, but a large outbreak in the United States, with its advanced health system, is unlikely. Yet the handling of the first domestically diagnosed Ebola case in Dallas, Texas, raised concerns about national public health preparedness. What were the critical health system vulnerabilities revealed in Dallas, and how can the country respond more effectively to novel diseases in a globalized world?

Ebola: A Crisis In Global Health Leadership, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

At the core of the present Ebola crisis in West Africa is a lack of global health leadership. WHO should be the global health leader, following its constitutional charge, yet it is significantly under-resourced, having a direct effect on its rapid response capacity. The Organization's response to this crisis has been constantly behind, from low funding appeals to its delay in declaring this outbreak to be a Public Health Emergency of International Concern under the binding International Health Regulations (2005) (IHR). The IHR themselves have proven insufficient, as countries have failed to cooperate in building the public health capacities that …

Public Health In The Age Of Ebola In West Africa, Michael T. Osterholm, Kristine A. Moore, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The Ebola epidemic, with its fast-growing toll and real potential for spreading into much of Africa, including major cities, has the makings of a “Black Swan” event. Such events, using the term coined by Nassim Nicholas Taleb, are: 1) unpredictable, outside the realm of regular expectations; 2) have a major impact, and; 3) are rationalized after the fact as being explainable and predictable.

We have learned from this outbreak the potential for an infectious disease to be politically, economically, and socially destabilizing, and that what kills us may be very different from what frightens us or substantially affects our social …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara Leech, Elizabeth A. Adams, Marci Littlefield

Department of Public Health Scholarship and Creative Works

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serve as a …

Agency Of The South Sudanese: Compensating For Health Care In Mungula Refugee Settlement, Lauren Schmidt

Independent Study Project (ISP) Collection

In reaction to the endemic violence, which has forced many South Sudanese to flee their homes and seek refuge within Uganda’s borders, the researcher spent the practicum interning with the Uganda Red Cross Society (URCS) in Mungula refugee settlement, under academic advisor Steven Mawa. As the organization is the leading health provider in the settlement, the researcher gained insight into the provision of social services to the population, which allowed an extensive study on the ability of the South Sudanese to compensate for shortages in care and various complications associated with doing so.

The researcher sought to entertain these inquiries …

Breaking Barriers: The Influence Of Socioeconomic Status On Obesity Among Women In Salvador, Bahia, Brazil, Christina Camoriano

Independent Study Project (ISP) Collection

Obesity in Brazil has grown rapidly within the past decade, however research is conflicting in terms of who carries the burden of this disease- the economic elite or the poor. Despite the lack of clarity towards the current distribution of obesity, many studies have come to the conclusion that in developing countries, obesity is growing more rapidly among those of lower socioeconomic status.¹¹ Therefore, the purpose of my research study is to examine how socioeconomic status influences the dietary and exercise habits of lower and lower-middle income women who are obese. This study is relevant because it seeks to …

Structural Factors That Increase Hiv/Sti Vulnerability Among Indigenous People In The Peruvian Amazon, E. Roberto Orellana, Isaac E. Alva, Cesar P. Cárcamo, Patricia J. García

School of Social Work Faculty Publications and Presentations

We examined structural factors—social, political, economic, and environmental—that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex—including transactional sex between passengers and boat crew and commercial sex work—often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource …

The Ebola Epidemic: A Public Health Emergency Of International Concern, Lawrence O. Gostin, Daniel Lucey, Alexandra Phelan

Georgetown Law Faculty Publications and Other Works

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR).

The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response.

Beyond the public health and …

Virus Sharing, Genetic Sequencing, And Global Health Security, Lawrence O. Gostin, Alexandra Phelan, Michael A. Stoto, John D. Kraemer, K. Srinath Reddy

Georgetown Law Faculty Publications and Other Works

The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement designed to promote the international sharing of biological samples to develop vaccines, while that ensuring poorer countries would have access to those vaccines. Since the PIP Framework was negotiated, scientists have developed the capacity to use genetic sequencing data (GSD) to develop synthetic viruses rapidly for product development of life-saving technologies in a time-sensitive global emergency—threatening to unravel the Framework. Access to GSD may also have major implications for biosecurity, biosafety, and intellectual property (IP).

By rendering the physical transfer of viruses antiquated, GSD may also undermine the …

Ebola: Towards An International Health Systems Fund, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The current outbreak of Ebola virus disease (EVD) in West Africa is spiraling out of control, but it never had to happen. What can the international community do now to bring the epidemic under control, and how can we prevent the next one?

The counties most affected by Ebola (Guinea, Liberia, and Sierra Leone), rank among the lowest in global development, lacking essential public health infrastructure. If the affected countries had adequate public health systems, they probably would have contained Ebola within rural settings, avoiding the first outbreak in major urban areas.

More than 130 health workers have died from …

Understanding Health Issues Among Adolescent Females In A Northeast Province Of Afghanistan, Amina Davlatshoeva

Doctoral Dissertations

The purpose of this study is to develop a deeper understanding of the health issues facing adolescent females (ages 18-21) in rural, northeastern Afghanistan. Incorporating participant observations, in-depth interviews, and narrative inquiries, this study seeks to illustrate adolescent females’ perspectives on health issues. To achieve this goal, ten adolescent females were interviewed in rural, northeastern Afghanistan during 2010. The participants were between 18- and 21-years old. The one-on-one interviews were conducted in a multiple-response format and were structured around three research questions:

• How does a young female’s understanding of health issues shape her identity in northeastern Afghanistan?
• In what ways …

El Mal De Chagas Y Su Potencial De Eliminación, Eileen Stillwaggon

Economics Faculty Publications

La Asamblea Mundial de la Salud ha elegido algunas enfermedades como blancos para la eliminación. Hay mucha esperanza y una alta probabilidad de que varias enfermedades, recientemente llamadas desatendidas, sean eliminadas en las próximas décadas. Vamos a presenciar el fin de la transmisión de la dracunculiasis, la filariosis linfática, la poliomielitis, y en las Américas por lo menos, la oncocercosis. Ya se ven éxitos significativos como la cuasi erradicación de la dracunculiasis y paso importantes en contra de otras aflicciones. [Original Spanish version]

The World Health Assembly has chosen some diseases as targets for elimination. There is much …

Global Burden Of Disease Study 2010: Interpretation And Implications For The Neglected Tropical Diseases, Peter J. Hotez, Miriam Alvarado, Maria Gloria Basanez, Ian Bolliger, Et Al.

Faculty Publications

No abstract provided.

Developing A Measure Of Scientific Literacy For Middle School Students, Helenrose Fives, Mark Nicolich, Amanda Birnbaum, Wendy Huber

Department of Public Health Scholarship and Creative Works

Scientific literacy reflects “a broad and functional understanding of science for general education purposes” (DeBoer, 2000, p. 594). Herein, we present the ongoing development of the Scientific Literacy Assessment (SLA), a work‐in‐progress measure to assess middle school students' (ages 11–14) scientific literacy. The SLA includes a selected response measure of students’ demonstrated scientific literacy (SLA‐D) and a motivation and beliefs scale based on existing measures of self‐efficacy, subjective task value, and personal epistemology for science (SLA‐MB). Our theoretical conceptualization of scientific literacy guided the development of our measure. We provide details from three studies: Pilot Study 1 (n = …

Global Rules For Global Health: Why We Need An Independent, Impartial Who, Devi Sridhar, Julio Frenk, Lawrence O. Gostin, Suerie Moon

Georgetown Law Faculty Publications and Other Works

Over the past few years the World Health Organization (WHO) has been undergoing a significant reform process. The immediate trigger was a budget crisis in 2010 that spurred massive lay-offs at the global agency. But at a more fundamental level, deeper systematic changes in global health governance have made reform imperative. While WHO reform draws relatively little attention outside diplomatic circles in Geneva, at stake are critical issues that will impact public health everywhere. This article’s key messages are:

• Recent outbreaks of MERS highlight the need for a global response to infectious disease
• The WHO has had a crucial role …

An Ecological Approach To Experiential Learning In An Inner-City Context, Pauline Garcia-Reid, Robert Reid, Bradley Forenza

Department of Family Science and Human Development Scholarship and Creative Works

In‐depth, qualitative interviewing was employed to describe processes and competencies experienced by family science interns, who practiced in a high‐risk ecological context. Twenty interns from a 3‐year period were recruited. All had interned on the same federally funded, HIV/substance abuse prevention grant in the same focal city. Within this sample, it was determined that experiential learning—vis‐à‐vis the internship—facilitated both intrapersonal processes and ecological competencies for family science interns, who may otherwise have lacked this knowledge when assuming professional roles. Implications for policy and practice are discussed.

Human Disease - Unintended Globalization, Christopher J. Dellana

Celebration

Before man was exchanging goods and ideas, he was exchanging germs. As such, the spread of infectious disease constitutes the first truly global phenomenon and, therefore, marks the beginnings—primitive though they may have been—of what today we have finally termed ‘globalization.’ The global spread of disease, then, proves that globalization is not new and that its origins were the result of a different narrative than the ones we read from globalization theorists; it further demonstrates that the modern conception of the phenomenon is only now so well recognized because the accelerated and efficient processes that inform its daily activities have …

Diversity In Times Of Austerity: Documenting Resistance In The Academy, Tamara Leech, David Moscowitz, Terri Jett, Terri Carney, Ann Savage

Department of Public Health Scholarship and Creative Works

What happens to feminism in the university is parallel to what happens to feminism in other venues under economic restructuring: while the impoverished nation is forced to cut social services and thereby send women back to the hierarchy of the family, the academy likewise reduces its footprint in interdisciplinary structures and contains academic feminists back to the hierarchy of departments and disciplines. When the family and the department become powerful arbiters of cultural values, women and feminist academics by and large suffer: they either accept a diminished role or are pushed to compete in a system they recognize as antithetical …

Global Health And The Law, Lawrence O. Gostin, Devi Sridhar

Georgetown Law Faculty Publications and Other Works

The last two decades have brought revolutionary changes in global health, driven by popular concern over AIDS, novel influenzas, and maternal mortality. Given the rapid globalization that is a defining feature of today’s world, the need for a robust system of global health law has never been greater. Global health law has been defined as the legal norms, processes, and institutions designed primarily to attain the highest possible standard of physical and mental health for the world’s population. Global health law is not an organized legal system, with a unified treaty monitoring body, such as the World Trade Organization. There …

Sexuality Information Needs Of Latino And African American Ninth Graders: A Content Analysis Of Anonymous Questions, Francisca Angulo-Olaiz, Eva Goldfarb, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

This study used qualitative content analysis to examine anonymous questions about sex and sexuality submitted by Latino and African American adolescents in Los Angeles, California, classrooms. The majority of questions asked about sexuality and sexual behavior, or anatomy and physiology, with fewer questions about pregnancy and pregnancy prevention, sexually transmitted infections, and condoms. Overall, a notable mix was found of questions implying exposure to or awareness of a wide range of sexual activities, together with questions demonstrating fundamental misunderstandings or confusion about some of the most basic aspects of sex and sexuality. Gender differences emerged across topics, subtopics, and question …

Unintended Pregnancy By The Numbers: A Look At Kenya, Carol Mukiira, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara

Reproductive Health

This fact sheet summarizes data collated during the development of the STEP UP Country Profile Report on Unintended Pregnancies for Kenya, which presents a range of key evidence aimed at informing readers about the trends, magnitude, determinants, and consequences of unintended pregnancy in Kenya. The data shown in this fact sheet are drawn mainly from the 1993, 1998, 2003 and 2008/09 Kenya Demographic and Health Surveys (KDHS) as well as other secondary sources.

Adolescence And Sexuality, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew

Reproductive Health

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; …

Postpartum Family Planning In Burkina Faso, Marina Daniele

Reproductive Health

This is a formative study aiming to identify the main barriers to the provision and uptake of quality postpartum family planning (PPFP) services at the supply, access, demand, and policy levels in Burkina Faso. This study reveals that there are substantial shortfalls in the availability of quality PPFP at all these levels. Most of the difficulties observed in the provision of PPFP services are due to the failure to translate largely sound policies and guidelines into practice. This study contributes to identifying priority areas and makes recommendations for improvement in order to respond to unmet need for family planning in …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Participant's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. Workshop objectives outlined in the Participant’s Guide: Outline current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to respectful maternity care and …

Barriers To Obstetric Fistula Treatment In Low-Income Countries: A Systematic Review, Benjamin Bellows, Rachel Bach, Zoe Baker, Charlotte E. Warren

Reproductive Health

Obstetric fistula is a maternal morbidity condition that occurs in some low-income countries and is caused by prolonged obstructed labor that results in a hole between the vagina and the bladder or rectum through which urine or feces leak. Unrepaired fistula can lead to lifelong ostracism, stigma, and shame. Obstetric fistula is preventable and treatable, but women in these countries experience delays in seeking repair due to a number of factors including awareness of their condition as well as the potential for treatment, resources necessary for seeking care, lack of skilled fistula surgeons, and long hospital waiting times. UNFPA estimates …

Assessing The Potential Market For A Progesterone Contraceptive Vaginal Ring (Pcvr) As A New Contraceptive Option In Sub-Saharan Africa Using Needs-Based Market Segmentation, Francis Obare, Deepa Rajamani, Saumya Ramarao

Reproductive Health

Developing countries, especially in sub-Saharan Africa, have disproportionately high unmet contraceptive needs compared to other regions, and especially high levels of unmet need for spacing pregnancies. To address some of sub-Saharan Africa’s barriers to effective contraception, there is renewed focus on new methods that offer greater ease of use. New methods under investigation would not require daily action, their use would be controlled by women themselves, and they would require no medical providers or significant health-system infrastructure for service delivery. Contraceptive vaginal rings hold great potential by offering not only ease of use but a safe and effective FP solution. …

Validating Indicators Of The Quality Of Maternal Health Care: Final Report, Kenya, Charlotte E. Warren, James Kelly Kimani, Jackline Kivunaga, Brian Mdawida, Charity Ndwiga, Katharine Mccarthy, Ann K. Blanc

Reproductive Health

Despite widespread use, the majority of indicators proposed as measures of the quality of maternal health services have not been sufficiently validated. To accurately track progress toward national and global maternal health goals, the present study sought to validate and identify a set of maternal health indicators that can be practically applied in facility and population-based surveys. To evaluate indicators, the study employed a facility-based design. The study was conducted in public/government hospital facilities in Kenya and Mexico. Participants included women aged 15–49 who underwent labor and delivery at participating study facilities and the providers who attended them. Women’s self-report …

Research Gaps In Scale Up Of Family Planning And Reproductive Health Programming, The Evidence Project, E2a, Hpp, Measure Evaluation

Reproductive Health

The Evidence Project, in collaboration with the Evidence to Action Project, the Health Policy Project, and MEASURE Evaluation convened a meeting to discuss research gaps related to scale-up. The meeting was held at the request of USAID’s Office of Population and Reproductive Health (OPRH) to help guide their research strategy. The meeting had four objectives: discuss scale-up experiences and the role of research and monitoring for strengthening program performance at scale; identify research gaps related to scale-up; prioritize the scale-up research gaps for OPRH; identify next steps for addressing these priority research gaps. This meeting generated a rich discussion about …