Health Policy Commons^™

Protecting Science At Federal Agencies: How Congress Can Help, Jacobs Institute Of Women’S Health, The George Washington University, Climate Science Legal Defense Fund, Democracy Forward, Environmental Integrity Project, Environmental Protection Network, Government Accountability Project, Greenpeace, National Federation Of Federal Employees, National Partnership For Women & Families, Power To Decide, Project On Government Oversight, Union Of Concerned Scientists

Jacobs Institute of Women's Health

No abstract provided.

Eating Frequency And The Role Of Snacking On Body Weight Of Wic Preschool Children, Andrea Charvet

FIU Electronic Theses and Dissertations

The objective of this study was to understand the influence of eating episodes and snack quality on body weight of children ages 3-4.9 years participating in the Broward County Special Supplementation Nutrition Program for Women, Infants, and Children (WIC).Additional objectives were to evaluate obesity risk factors and to examine the effect of childcare arrangements on body weight. Data was collected from 7 Broward County Health Department WIC clinics over 4 months via a researcher-administered questionnaire. Additional data was extracted from the WIC data system. BMI-for-age percentiles were used to categorize children by weight according to Centers for Disease Control (CDC) …

The Importance Of Medicaid For Children With Disabilities And Special Health Care Needs, 2017-2018 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees.

Policy Analysis

Changes to Medicaid financing structure should be carefully considered because any change could have a potentially negative impact on children with disabilities and special health care needs (hereafter referred to as children with disabilities) and limit their access to critically needed health care services and community supports. Currently, Medicaid funding operates through a state and federal partnership, with the federal government providing 60% of funding on average. A cornerstone of Medicaid is the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) child health benefit. This program offers vital support services to children with disabilities, including early and periodic screenings, comprehensive …

Ensuring Adequate Financing Of Family Planning Commodities And Services, Moazzam Ali, Benjamin Bellows

Reproductive Health

Increasing efficient and effective investment in family planning (FP) through the public and private sectors is key to meeting the FP2020 goal of helping 120 million additional women become modern contraceptive users. This policy brief identifies several policy and program considerations to ensure adequate financing of family planning commodities and services: sustained fundraising, pooling, and strategic purchasing; reaching new users and improving continuation rates among current users; and conducting further research on family planning quality performance metrics to test their correlation with higher continuation rates. Future efforts to reduce unmet need for FP must consider consumers’ out-of-pocket costs, programmatic cost-effectiveness, …

Reducing The Rate Of Cesarean Delivery On Maternal Request Through Institutional And Policy Interventions In Wenzhou, China, Yushan Yu, Xiangyang Zhang, Caixia Sun, Huijie Zhou, Qi Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The objective of this study was to evaluate the effect of institutional and policy interventions on reducing the rate of cesarean delivery on maternal request (CDMR) in Wenzhou, China. Institutional interventions included health education, painless delivery introduction, and doula care. Additionally, a series of health policies were developed by the Chinese central and local governments to control cesarean section rates, mostly through controlling CDMR rates. We conducted a pre-/post-intervention study using 131,312 deliveries between 2006 and 2014 in three tertiary-level public hospitals in Wenzhou, China. Chi-square tests and predictive models were used to examine changes in the CDMR rate before …

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

The Disappearance Of Nyoman And Ketut, Laura Michelle Garvie

Independent Study Project (ISP) Collection

No abstract provided.

Medicaid And Children With Special Health Care Needs, 2016-2017 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees

Policy Analysis

Medicaid funds vital services for children and youth with special health care needs and disabilities (CYSHCN). Proposed changes to the structure of Medicaid would significantly reduce federal funding for this important program. The most concerning are the proposed structural changes including per capita caps and block grants, as well as threats to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and Medicaid Waiver services. Restructuring would have devastating effects on benefits for low-income children and individuals with disabilities, and their families, putting this very vulnerable population at additional risk.

Bridging The Divide White Paper: Pregnant Women And Substance Use: Overview Of Research & Policy In The United States, Darla Bishop, Liz Borkowski, Megan Couillard, Amy Allina, Susanna Baruch, Susan Wood

Jacobs Institute of Women's Health

This paper examines the current literature and policy implications of substance use and substance use disorders among pregnant and parenting women. While this is not meant to serve as an exhaustive literature review on this topic, it seeks to describe: current research on health effects of substance use and substance use disorders on pregnant women1 and their children; policies and programs that help ensure that pregnant women who use substances have access to the highest quality healthcare, including prenatal care; the current barriers to accessing treatment for substance use disorders for pregnant women, including those who are incarcerated; and the …

The 1939 Dickinson-Belskie Birth Series Sculptures: The Rise Of Modern Visions Of Pregnancy, The Roots Of Modern Pro-Life Imagery, And Dr. Dickinson’S Religious Case For Abortion, Rose Holz

Women's and Gender Studies Program: Faculty Publications

This multidisciplinary essay examines the hugely influential—yet surprisingly overlooked—Birth Series sculptures. Created in 1939 by Dr. Robert L. Dickinson (obstetrician-gynecologist and leader of the Planned Parenthood Federation of America) and sculptor Abram Belskie, they illustrate the process of human development from fertilization through delivery. First displayed at the 1939–1940 World’s Fair in New York City, they were reproduced in a variety of forms and sent out across the United States and overseas. Hardly a brief fad, their popularity persisted into the 1980s. This essay has four purposes. First, it tells the stories of Dickinson and Belskie to appreciate their contributions …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh [Hindi], Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh, Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Syrian Refugee Women In Jordan: Family Planning Preferences And Barriers In A Host Community, Hilary Smith

Independent Study Project (ISP) Collection

The aims of this pilot study were to research and analyze the availability of birth control and family planning resources among Syrian refugee women at a reproductive age. This study took place in the host community of Karak, Jordan. Syrian women are a vulnerable population based solely on their gender. But being refugee women makes them more vulnerable and sometimes, their needs do not get met. This study is important because it will look into reproductive health aspects for this vulnerable population to ensure that there is satisfaction among women about their own health. This cross-sectional study sought to answer …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

The Road Into The Future Of Health Care: The Importance Of Addressing Access To Health Facilities In Transportation Infrastructure Investment Decisions, Nicola (Nikki) Van Den Heever

Independent Study Project (ISP) Collection

Background: One school of thought argues that transportation infrastructure is not an ultimate end goal of development and therefore shouldn’t be addressed within development funding decisions while the other argues that transportation infrastructure is the crucial foundation from which all development efforts are based and therefore needs to be addressed within development funding decisions. Within this framework, there is a lack of academic and other research addressing how physical access to health care for pregnant women can better be addressed when making decisions regarding funding of transportation infrastructure projects.

Purpose: To demonstrate the importance of considering access to health care …

“Always A Double-Edged Sword”: How Women And Health Care Providers Navigate Issues Of Contraception In Differing Senegalese Communities, Angelina Strohbach

Independent Study Project (ISP) Collection

This paper examines how women and health care providers in two distinct Senegalese settings—Dakar and Mouit, a village located within the Gandiol region-- navigate contraception as both a social and medical good. Contraception is an invaluable tool in terms of advancing women’s right to reproductive health, but major discrepancies in its usage exist across a variety of social lines in Senegal, including level of education, marital status, occupation, age, and living in a rural versus urban setting. What socially constructed thought processes and lived experiences contribute to these discrepancies? In a cultural context heavily based upon tradition and Islamic faith, …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

Multi-Sector Analysis Of The Progress And Challenges Of Soil-Transmitted Helminth Eradication In Rural Udaipur, Jessica Ellis

Independent Study Project (ISP) Collection

India is home to 240 million children currently at risk of Soil-Transmitted Helminthiasis, which is spread via unclean water, soil, and food, and causes acute pain and malnutrition. While acknowledging the research debates over WASH and mass drug administration, this study seeks to identify the systemic multidisciplinary issues affecting STH elimination efforts in rural Udaipur. Twenty-three interviews were conducted in villages, government departments, NGOs, and medical sectors to identify the challenges within each approach to deworming, and their experiences with multi-sectoral collaboration. The most recurring issues across disciplines were need for invested local leadership, increase in health literacy of adults, …

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

Detroit Health Department: Lead Report 2016, Abdul El-Sayed, Alex B. Hill, Haifa Haroon

Urban Studies and Planning Faculty Research Publications

The Epidemiology team at the Detroit Health Department rigorously stress- tested Detroit’s lead numbers. The findings suggest a true decline in EBLL levels rather than a decrease in lead testing or a change in the characteristics of the children who are being tested.

The Changing Roles And Reputations Of Dais In Rural Uttarakhand: An Investigation Into The Maternal Health Services Of Villages In Okhalkanda Block In Nainital, Jenna Davis

Independent Study Project (ISP) Collection

The dai, once a prominent figure in Indian maternal health, now faces marginalization as the government of India adopts the goal of universal institutional delivery. Under pressure from international discourse that Skilled Birth Attendants (SBAs) were more effective at lowering Maternal Mortality Rate (MMR) than Traditional Birth Attendants (TBAs) like dais (World Health Organization), dai training was discontinued and left in the hands of NGOs, while concurrently women and ASHAs were monetarily incentivized for every institutional birth (Park, 419). Yet in rural, isolated, or hilly areas like Okhalakanda block in Uttarakhand, institutional delivery is a long way from universal—only …

A Precarious Paradigm: Seeking Alternatives To Public-Private Partnerships In Health, A Case For The Code, Lena Mininberg

Independent Study Project (ISP) Collection

Background: Breastfeeding is an unparalleled source of nutrition for infants and young children and is recommended as the best practice universally by the World Health Organization (WHO). The benefits in human health and development that result from exclusive and sustained breastfeeding have enormous economic development potential. Because of the non-legally binding nature of the International Code of Marketing of Breastmilk Substitutes (the Code), and shifting socio-cultural norms, breastfeeding rates are at an alarming low. In order to progress towards the Sustainable Development Goals, breastfeeding practices must be protected, promoted, and supported worldwide.

Objective: This research paper explores implementing strong measures …

Routine Screening For Intimate Partner Violence: A Guide For Trainers, Odongo Odiyo, Chi-Chi Undie, Margaret Mak'anyengo

Reproductive Health

This the first regional document devoted to building the capacity of providers to respond to intimate partner violence (IPV). The training guide is a follow-on initiative to the 6th Best Practices Forum in Health of the East, Central and Southern Africa (ECSA) Health Community, held in August 2012. This Forum brought to the fore research findings from the region centering on the acceptability and feasibility of IPV screening, and culminated in the passage of a resolution by Health Ministers that prescribes the integration of gender-based violence screening into healthcare settings in the ECSA region. This training guide responds to this …

Bridging The Divide White Paper: Long-Acting Reversible Contraception (Larc) In The United States, Julia Strasser, Liz Borkowski, Megan Couillard, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Long-acting reversible contraceptive (LARC) methods – specifically, intrauterine devices (IUDs) and subcutaneous hormone-releasing implants – demonstrate great potential in reducing unintended pregnancy. Although LARC methods have had a rocky history in the US and use rates have remained low here in comparison to other countries where the methods are available, there has been a significant increase in uptake of newer LARC products in recent years. Researchers have identified this change as a likely contributor to the declines seen in unintended pregnancy, abortion, and teen pregnancy rates.

Decades of research have shown that current LARC methods are highly safe and effective, …

The Consumer Perspective: A Consultation With Senior Health Officials From Developing Countries On Standards Of Evidence For Reproductive And Maternal Health Care, The Evidence Project, Step Up Research Programme Consortium

Reproductive Health

The Population Council (through the STEP UP consortium and the Evidence Project) and the High Impact Practices (HIP) Collaboration, together with other partners, held a series of three consultative meetings around the topic of standards of evidence in reproductive and maternal health. This report details the third and final meeting held in Bellagio, Italy in February 2016. The meeting brought together developing-country decisionmakers to vet, from the research “consumer” perspective, the recommendations that emerged from the second consultation and to elicit further recommendations on how to better generate and package evidence to meet the needs of decisionmakers. Also in attendance …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Technical Brief, Population Council

Reproductive Health

Leader dans le domaine de la Planification Familiale (PF) en Afrique de l’Ouest francophone, le Sénégal a entrepris diverses initiatives pour atteindre ses objectifs, dont l’élaboration du Plan d’Action National de Planification Familiale (PANPF) 2012–15, basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où il arrivait à terme, et que l’élaboration d’un nouveau plan était envisagée, il était nécessaire de documenter l’approche, sa mise en œuvre, et ses réalisations. Le Population Council a mené cette étude en collaboration avec la Direction de la Santé de la Reproduction et de la Survie de l’Enfant du Ministère de la Santé et …

Bridging The Divide White Paper On Medication Abortion: Overview Of Research & Policy In The United States, Liz Borkowski, Julia Strasser, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Medication abortion (also called medical abortion) is a safe method of abortion available for the past 15 years in the US. The Bridging the Divide white paper summarizes the scientific evidence related to the current medication abortion process and potential changes to the process that could make it even safer and more accessible for patients, as well as policy considerations and directions for future research.

In the fall of 2000, the US Food & Drug Administration (FDA) approved the drug Mifeprex© (generic: mifepristone) for use in medication abortions. That approval included requirements that affect both patients and providers and that …

Socioeconomic Differences In Antenatal Care Between The United States And Scandinavia, Joshua B. Kiehl

Student Publications

Despite their analogous status as economically developed nations, the United States and Scandinavian countries have marked differences in their healthcare systems. In particular both areas discernibly differ in the antenatal treatment provided for expecting women and their babies. Sweden and Denmark’s healthcare systems are universal, run primarily on taxpayer dollars, and provide equal antenatal care regardless of socioeconomic status. The United States’ healthcare system is run on a combination of private and government run insurance, in which socioeconomic status often determines insurance coverage. This variability in insurance coverage often results in differing levels of antenatal care. An overarching question remains …