Demography, Population, and Ecology Commons^™

Decomposing Trends In Child Obesity, Ashley Wendell Kranjac, Robert L. Wagmiller

Sociology Faculty Articles and Research

We unravel the absolute level and relative prominence of two demographic processes that are relevant for childhood obesity, and that will ultimately determine the long-term course and pace of change in child obesity rates. We leverage data from the National Health and Nutrition Examination Survey to decompose change in child obesity from 1971 to 2012. We partition change into that attributable to (1) healthier, more nutritionally and economically advantaged cohorts in the population being replaced by cohorts of children who are less advantaged (between-cohort change), and (2) the health habits, nutrition, and social and economic circumstances of all cohorts of …

Prevalence And Correlates Of Diagnosed And Undiagnosed Hypertension In The Indigenous Kuna Population Of Panamá, Daniel R. Hanna, Rebekah J. Walker, Brittany L. Smalls, Jennifer A. Campbell, Aprill Z. Dawson, Leonard E. Egede

Center for Health Services Research Faculty Publications

Background: To determine the prevalence of hypertension and investigate sociodemographic correlates in an indigenous Kuna community living on the San Blas islands of Panama.

Methods: Data was collected from adults using a paper-based survey using a cross sectional study design. Blood pressure was measured, and hypertension defined at two cut-points: 130/80 mmHg and 140/90 mmHg. Individuals with undiagnosed hypertension had a blood pressure measurement that indicated hypertension, however, the individual had not been told by a doctor they had hypertension. Whereas individuals with diagnosed hypertension had been told by a healthcare provider that they had hypertension. Univariate tests compared diagnosed …

There Are Multiple And Geographically Distinct Opioid Crises In The U.S., Shannon M. Monnat

Population Health Research Brief Series

Rates of fatal drug overdose increased 250% in the U.S. between 1999 and 2017, due in large part to a massive surge in overdoses involving opioids. However, there is substantial geographic variation in fatal opioid overdoses, and prescription opioids, heroin, and fentanyl are differentially responsible for high overdose rates across different parts of the U.S. This research brief summarizes the findings from a study just published in the American Journal of Public Health. The study shows that there are at least four geographically distinct opioid overdose crises in the U.S.

Food Insecurity Among South Asian Immigrant Communities In The Inland Empire Of Southern California, Farhan Danish

Electronic Theses, Projects, and Dissertations

Background: Food insecurity amongst South Asian Americans is a major public health issue. The South Asian American (SAA) community is the third largest Asian community in the United States. Despite this fact, very few specific studies have been conducted to investigate the food needs and barriers that exist within the SAA community so as to successfully help them improve dietary habits.

Methods: This study utilized a mixed methods convergent parallel design, where both qualitative and quantitative methods were conducted and analyzed separately and compared and contrasted at the end.

Results: The results of this study demonstrate that ethnic grocery stores …

Child Poverty, Physical & Mental Health In Maine, Katelyn Malloy

Thinking Matters Symposium Archive

Children who live below the national poverty line account for nearly one fifth of Maine’s overall population. Child poverty is a determinant of health that can lead to negative health outcomes that affect childhood development, educational achievement, as well as physical and mental health. The purpose of this study was to identify five Maine counties with the highest rates of child poverty according to the national average. Comparison of poverty rates between counties were analyzed along with two leading health indicators – mental and physical distress. This study used 2016 county-level childhood poverty estimates, assessed by the American Community Survey …

Strengthening In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

This brief details Council efforts to develop effective, and costed, in-service training and continuing education modules for frontline health workers in Bauchi and Cross River states in Nigeria. This project was funded by WHO to aid the training and development of Nigeria's public health worker sector.

Gender And Power Metrics Database, Population Council

Reproductive Health

This compendium of gender- and power-related scales used in social health and behavioral science research includes unique scales, many tested in multiple settings, that come primarily from the areas of sexual and reproductive health, family planning, STIs/HIV, and intimate partner violence. The database includes multi-item scales and single-item questions that reflect gender norms, personal views or beliefs about gender roles and norms, related feelings or emotions, gender role stress, gendered-dynamics, power and control in relationships, and individual-level agency and self-efficacy, among others. The database facilitates the identification of validated scales for use in a given population or setting, fosters exchange …

Prévention Du Mariage D’Enfants Dans La Région De L’Est, Burkina Faso, Gisele Kaboré, Julien Ouedraogo, Annabel Erulkar, Sara Chace Dwyer

Reproductive Health

En collaboration avec la Direction Provinciale de la Femme, de la Solidarité Nationale et de la Famille du Burkina Faso et des partenaires communautaires de la région orientale du Burkina Faso, le Projet Evidence a mis à l'échelle des approches éprouvées pour retarder le mariage des jeunes filles en sensibilisant aux effets négatifs du mariage précoce. Les approches étaient basées sur des preuves produites dans une étude menée par le Population Council de 2013 à 2016 dans la province de Léraba. Dans cette étude, le report de l'âge du mariage pour les filles de 15 à 17 ans et la …

Antihypertensive Drugs, Population Council

Reproductive Health

Pre-eclampsia (PE) is a condition in pregnant women marked by an increase in blood pressure and protein in the urine after 20 weeks gestation. Eclampsia is a life-threatening condition characterized by convulsions in women with PE. PE/E and other hypertensive disorders in pregnancy increase risk of preterm births. Providing high-quality and regular antenatal care improves the prevention and early detection of PE and can prevent its progression to eclampsia. Prescribing low-dose aspirin and calcium to at-risk women can prevent PE and eclampsia. PE and eclampsia can be managed by administering antihypertensive drugs and magnesium sulphate (MgSO4). MgSO4 is the safest …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Nigeria, Pooja Sripad, Charity Ndwiga, Charlotte E. Warren

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically subordinate women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

Assessing The Effect Of A Primary Health Care Intervention For Improving Pre-Eclampsia And Eclampsia Knowledge And Practice In Bangladesh, Sharif M.I. Hossain, Shongkour Roy, Kanij Sultana, Charlotte E. Warren

Reproductive Health

In resource-poor countries such as Bangladesh, proven life-saving commodities for pregnant women have not been optimally examined, such as magnesium sulphate (MgSO4) to manage severe pre-eclampsia/eclampsia, use of anti-hypertensives to manage high blood pressure during pregnancy, aspirin prophylaxis for pregnant women at high risk of PE/E, as well as task shifting to lower health-worker cadres, and community involvement. There has been no systematic review of research and programming on PE/E prevention, early detection, and treatment in Bangladesh. With support from USAID, the Ending Eclampsia project has been expanding access to proven, underutilized interventions and commodities for PE/E prevention, early detection, …

Feasibility And Acceptability Of Community Health Extension Workers To Identify And Treat Hypertension Associated With Pregnancy: Implementation Research Report, Emmanuel Nwala, Udochisom Anaba, Pooja Sripad, Salisu Mohammed Ishaku, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy, experienced by 10 percent of women globally, are major contributors to maternal and newborn mortality, morbidity, and disability. Task shifting essential health services to mitigate insufficient human resources is recommended to strengthen and expand the health workforce and rapidly increase access to quality services. Nigeria’s task-shifting policy recommends that community health extension workers administer a loading dose of magnesium sulphate for severe pre-eclampsia or eclampsia prior to referral to a higher-level facility. This study tested the feasibility and acceptability of community health extension workers at primary health care facilities in Ebonyi state in detecting and managing …

"No To Circumcision": The Road To Effective Social Marketing Campaigns In Egypt, Salma Abou Hussein, Sarah Ghattass

Reproductive Health

To inform the design and scale up of initiatives that can drive a change in attitudes and behaviors toward FGM/C abandonment, there is a rising need to understand the perspectives of individuals who are exposed to social marketing campaigns (SMCs), which are a key intervention to promote the abandonment of the practice. This working paper presents the findings of a study that sought to understand how, where, and why SMCs for FGM/C abandonment are working, and with what impact, to inform design and scale-up of campaigns that can foster new perspectives, expectations, and behaviors.

Post-Intervention Analysis Of Pre-Eclampsia And Eclampsia In Three Nigerian States, Salisu Mohammed Ishaku, Emmanuel Nwala, Gloria Adoyi, Charles Nwigwe, Solomon Kongyamba, Udochisom Anaba, Caroline Johnson, Karen Kirk, Pooja Sripad, Charlotte E. Warren

Reproductive Health

In the last three decades, global maternal mortality has decreased by almost 45 percent, but approximately 830 women still die daily from largely preventable pregnancy complications. Since 2015, the Ending Eclampsia project, with support from USAID, has been working to expand proven, underutilized interventions and commodities for pre-eclampsia/eclampsia (PE/E) prevention, early detection, and treatment, and to strengthen global partnerships for care of hypertensive disorders in pregnancy (HDP), of which PE/E are the severest forms. A systematic review of the literature identifies a number of articles reporting PE/E burdens within set populations, common risk factors, adverse outcomes, and mortality rates, but …

Situation Analysis Of Reproductive Health Of Adolescents And Youth In Pakistan, Iram Kamran, Rehan M. Niazi, Kiren Khan, Faisal Abbas

Reproductive Health

This report presents a situation analysis of the reproductive health of adolescents and youth in Pakistan. It is intended to contribute to evidence-based policies and programs for realizing reproductive rights and choices for young people through health information and services, education programs, and strategic partnerships. The study included a literature review, secondary analysis of data from the Pakistan Demographic Health Surveys and Multiple Indicator Cluster Surveys, and a qualitative study of perspectives of unmarried adolescent boys and girls (aged 15–19), including both school-going and out-of-school individuals, as well as boys and girls with disabilities, in peri-urban areas of Islamabad, Lahore, …

The Girl Roster: A Practical Tool For Strengthening Girl-Centered Programming, Population Council

Poverty, Gender, and Youth

This brief describes the Girl Roster^TM, a practical tool designed by the Population Council to help practitioners understand their program areas and elicit foundational information to intentionally link girls—especially highly marginalized adolescent girls—to the vital resources, facilities, and services to which they are entitled but often have limited or no access. The tool is a user-friendly, efficient, and cost-effective way to collect program-relevant information about girls in a community, using a mobile phone–based questionnaire (or, where resources do not permit, paper and pencil). The tool enables users to see a fuller view of girls’ lived realities in defined …

Providing Occupational Therapy To Those Who Are Homeless: A Beneficial Support, Francesca Petracco

Petersheim Academic Exposition

No abstract provided.

Collaboration With The University Of Calabar For Human Resources For Health Management Training For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

A pool of knowledgeable staff is required within middle and senior management for long-term human resources for health (HRH) planning and effective management at all levels of the health system—federal, state, and local. This brief reports on the training by the Population Council, in partnership with the World Health Organization in Nigeria, of 105 key personnel on HRH planning, management, policy dialogue, advocacy, and resourcing for the HRH project “Enhancing the Ability of Frontline Health Workers to Improve Health in Nigeria.” Critical HRH-related capacities were built among key Nigerian health system personnel and managers, most significantly in the states of …

Fgm/C And Ecm: Drawing Lessons From Research, Jacinta Muteshi-Strachan

Reproductive Health

No abstract provided.

Practice-Based Learning: Observations On One-Stop Centers In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Joanina Karugaba

Reproductive Health

One-Stop Centers’ (OSCs) have grown in popularity for responding to sexual and gender-based violence (SGBV) in the East, Horn, and Great Lakes regions of Africa. OSCs attempt to provide an integrated, multisectoral response to SGBV survivors’ needs in one location. In resource-constrained settings, the most common services offered at OSCs include health care, psycho-social support, police and judicial services, as well as social support. Studies demonstrate that health-facility-based OSCs that are owned and run by health-facility staff are more effective than NGO-run OSCs in achieving the broadest range of desired health and legal outcomes for SGBV survivors. In collaboration with …

Hypertensive Disorders In Pregnancy: Assessing Postnatal Quality Of Care And Outcomes For Women And Their Infants In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Salma Rouf, Rabeya Akter, Shongkour Roy, Sumaiya Anwar, Karen Kirk, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy (HDPs) are the second leading cause of maternal mortality in Bangladesh, responsible for 24 percent of maternal deaths. Various factors, such as lack of health-care provider capacities for detecting, preventing, and managing pre-eclampsia and eclampsia (PE/E), late referrals, late (or lack of) antenatal care (ANC), and poor awareness of PE/E, are factors in most of these deaths. While some information was available on the prenatal and postnatal periods, an evidence gap existed in information after delivery through the first year postnatal, and beyond. In this prospective cohort study, the Ending Eclampsia project recruited married women ages …

Enhancing Customer Satisfaction For Health Services, Deepa Rajamani, Saumya Ramarao

Reproductive Health

The Family Planning (FP) 2020 global partnership has achieved significant gains since its inception, and while it strives to accelerate uptake of voluntary FP services, women in developing countries continue to face an unmet need for modern contraceptive services. Critical opportunities for action exist in the area of understanding the effects of quality of family planning services and continued contraceptive use. Measuring and tracking the quality of FP services is an important aspect of improving service delivery, and client feedback also offers critical insight into the design of demand generation and uptake strategies for a contraceptive. In this report, we …

Positioning Family Planning Quality Within Health Financing For Uhc: Connecting The Discourse, Gabrielle Appleford, Saumya Ramarao, Benjamin Bellows, Leah Jarvis

Reproductive Health

Financing is a major challenge and concern for the future of the delivery of voluntary family planning (FP) services to clients, particularly in low- and middle-income countries with high unmet need and limited method choice. As countries commit to universal health coverage (UHC), it is crucial that UHC schemes include FP and other reproductive health (RH) services. Strategic purchasing of quality FP services from public and private—including for profit and not-for-profit—health-care providers could accelerate progress toward UHC. It is increasingly recognized that the FP2020 goals will not be met without adequate attention to quality, and that a sustained focus on …

Examining Early Marriage In India: Qualitative Findings, Neelanjana Pandey, Komal Saxena, Andrea J. Melnikas

Poverty, Gender, and Youth

The More Than Brides Alliance (MTBA) implements the “Marriage: No Child’s Play” program (2016–20) in India, Malawi, Mali, Niger, and Pakistan. The MTBA is a holistic program that addresses early marriage through multiple strategies, including: sexual and reproductive health and rights, livelihoods, education, and prevalent community social norms around marriage. Furthermore, the program operates at multiple levels (girl, family, community, block, and district) to address individual, familial, and structural barriers to reducing child marriage in these communities. This report first looks at the legal environment in which programs operate by examining participants’ awareness of laws, acts, and programs related to …

More Than Brides Alliance: Midline Evaluation Report, Andrea J. Melnikas, Grace Saul, Santosh Kumar Singh, James Mkandawire, Mouhamadou Gueye, Aissa Diarra, Sajeda Amin

Poverty, Gender, and Youth

The More than Brides Alliance (MTBA) was formed to bringing together the strengths of a diverse team skilled in adolescent program implementation and research. The goal of the research presented in this report is to promote an evidence-based programmatic approach to delaying marriage in India, Malawi, Mali, Niger, and Pakistan by gathering detailed quantitative and qualitative information from the program areas over time to examine the impact of the present intervention and inform future strategies. This report highlights data from the midline survey on a set of outcomes approximately midway through the MTBA intervention and compares them with the same …

Health Financing And Family Planning In The Context Of Universal Health Care: Connecting The Discourse In Kenya, Gabrielle Appleford, Saumya Ramarao

Reproductive Health

Financing is a major challenge and concern for the future of family planning (FP) programs. As countries commit to increasing access to and quality of FP services and to universal health care (UHC), it is crucial that UHC schemes include FP and other reproductive health services. This brief aims to: 1) document trends in UHC and health financing, drawing out implications for policymakers and programmers; and 2) identify opportunities for the FP community of practice to advocate for the inclusion of quality FP services within UHC and health financing discussions. With this brief, we aim to highlight experiences in Kenya, …

Storytelling And Policy Change In Africa's Great Lakes Region, Chi-Chi Undie, Nathan Byamukama, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

In April 2019, the International Conference on the Great Lakes Region’s Regional Training Facility (ICGLR-RTF) organized a regional meeting entitled “Sensitization Meeting for Police Chiefs and National Reproductive Health Heads in the Great Lakes Region.” Held in Kigo, Uganda, the meeting brought together chiefs of police and heads of reproductive health departments (Ministries of Health) from nine ICGLR member states, namely: Burundi, Central African Republic, Democratic Republic of Congo, Kenya, Republic of Congo, South Sudan, Sudan, Uganda, and Zambia. The meeting was sponsored by the Population Council, Kenya. Sauti/VOICE Program Brief 2 describes the preamble to ICGLR-RTF’s meeting resolutions and …

Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya—Brief, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan

Reproductive Health

This policy brief summarizes key findings from a study that examined whether there are shifts in norms and practices related to FGM/C among communities in Narok (predominantly inhabited by Maasai) and Kisii (predominantly inhabited by Abagusii) counties in Kenya. Although Kisii and Narok are FGM/C hotspots, practicing communities in these counties are reassessing norms and traditions in light of the current social and legal climate. These changes may provide a useful starting point for intervention programs that seek to create dialogue and critical reflection on the practice of FGM/C in an effort to accelerate its abandonment. Programmatic recommendations include: engaging …

The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council

Reproductive Health

This evidence brief summarizes key findings from a study that sought to understand the shifts in FGM/C including medicalization among several communities Kenya. The study finds that medicalization is increasing because: 1) it is perceived to be safer because the procedure is reportedly performed under sterile conditions by trained health professionals; 2) it is believed to shorten the recovery period; and 3) it is a response to the law prohibiting the practice because it allows FGM/C to be performed in secret. These findings indicate that medicalization is an adaptation to awareness of the health complications associated with FGM/C and the …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Bangladesh, Pooja Sripad, Sharif M.I. Hossain, Charity Ndwiga, Charlotte E. Warren

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically subordinate women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care (ANC) use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. …