Women's Health Commons^™

Coping With Unintended Pregnancies: Narratives From Adolescents In Nairobi's Slums, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara, Carol Mukiira

Reproductive Health

This qualitative study examined the challenges faced by adolescents in Kenya with regard to unintended pregnancies and how adolescents in urban slum settlements manage and cope with unintended pregnancies. The study’s findings suggest that high levels of unintended pregnancy among young people in Kenya’s urban slums are linked to myths and misconceptions about contraception. Other findings underscore the fact that many young people lack access to contraception and reproductive health services; indicate that unintended pregnancies are linked to sexual violence; and highlight the need for government to manage the high levels of school dropout as a result of an unintended …

Education Sector Response To Early And Unintended Pregnancy (Eup): A Review Of Country Experiences In East And Southern Africa, Harriet Birungi, Chi-Chi Undie, Francis Onyango

Reproductive Health

No abstract provided.

Achieving Mdgs 4 And 5 In Punjab: The Role Of Family Planning, Population Council

Reproductive Health

This brief focuses on the policy options available to the Punjab government to affect the province’s population growth by 2050 and its potential to achieve MDGs 4 and 5. Maternal mortality is a leading cause of death among women of reproductive age in Punjab—about 16 percent of the deaths in this age group are pregnancy-related. Approximately 6,000 women die each year in Punjab due to pregnancy-related factors. Pregnancies that occur too early, too late, or too frequently increase the risk of maternal death. Lowering fertility rates by increasing the use of family planning can help reduce pregnancy-related deaths. The good …

Provision Of Adolescent Reproductive And Sexual Health Services In India: Provider Perspectives, Shireen J. Jejeebhoy, K.G. Santhya, Santosh Kumar Singh, Shilpi Rampal, Komal Saxena

Poverty, Gender, and Youth

The recently launched Rashtriya Kishor Swasthya Karyakram (RKSK) program seeks to enable all adolescents and youth to realize their full potential by making informed decisions concerning their health and well-being and by accessing the services and support they need to implement their decisions. To realize this vision, the RKSK framework acknowledges the strengthening of Adolescent Friendly Health Clinics (AFHCs) and providing correct knowledge and information through counseling services as two of its seven critical components. As the government makes an effort to roll out the RKSK program at scale across the country, reviewing the experiences of the AFHCs established under …

Evaluation Of The Impact Of The Voucher Program For Improving Maternal Health Behavior And Status In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Syed Abu Jafar Md. Musa, Ashish Bajracharya, Kaji Tamanna Keya, Forhana Rahman Noor, Eshita Jahan, Md. Irfan Hossain, Jyotirmoy Saha, Benjamin Bellows

Reproductive Health

Vouchers, a demand-side financing (DSF) instrument for health-care services, were introduced in Bangladesh in 2006. The DSF program grants vouchers to pregnant women to receive free antenatal, delivery, and postpartum care services as well as free medicine, and financial assistance is provided for transportation. Deliveries with skilled service providers are financially incentivized and providers are reimbursed for their services from a special fund. After piloting DSF initially in 21 subdistricts (upazilas), the government expanded it to another 12 upazilas in 2007 (the second phase), and in its third phase in 2010 the program was expanded to another 11 upazilas. To …

Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis

DNP Projects

Purpose: To determine current provider adherence to the 2010 ACOG Emergency Contraception (EC) guidelines, specifically by assessing provider EC counseling with patients at well-woman annual exam visits or during contraceptive counseling visits. A second aim of this study is to identify provider facilitators and barriers of EC discussion with patients.

Methods: Using a retrospective design, 90 medical records of patients presenting to a university clinic within the previous year were reviewed for the discussion of EC during annual exams or contraceptive counseling. Forty-five medical records were reviewed prior to implementation of the Ambulatory Electronic Health Record (AEHR) and forty-five medical …

Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council

HIV and AIDS

The 2011 National Sentinel Surveillance estimated that 1.9 million people in India aged 15 and older were living with HIV. An estimated 39 percent are women. Given the urgent need for HIV-prevention options for women, a number of efforts are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a guide to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The guide includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. The …

Setting The Stage For Arv-Based Prevention For Women: A Snapshot Of The Zimbabwean Context, Population Council

HIV and AIDS

Zimbabwe, with an estimated population of 12.7 million people, is among the countries in sub-Saharan Africa most affected by the HIV epidemic. Given the urgent need for HIV-prevention options for women, a number of projects are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a toolkit developed by the Population Council to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The toolkit includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. …

The Influence Of Hip Strength On Lower-Limb, Pelvis, And Trunk Kinematics And Coordination Patterns During Walking And Hopping In Healthy Women, Jo Armour Smith, John M. Popovich, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Study Design

Cross-sectional laboratory study.

Objectives

To compare peak lower-limb, pelvis, and trunk kinematics and interjoint and intersegmental coordination in women with strong and weak hip muscle performance.

Background

Persons with lower extremity musculoskeletal disorders often demonstrate a combination of weak hip musculature and altered kinematics during weight-bearing dynamic tasks. However, the association between hip strength and kinematics independent of pathology or pain is unclear.

Methods

Peak hip extensor and abductor torques were measured in 150 healthy young women. Of these, 10 fit the criteria for the strong group and 9 for the weak group, representing those with the strongest …

A Mother's Paradox: Choosing A Birthing Method In The 21st Century, Jenae Franklin

Pitzer Senior Theses

Investigating childbirth, one of the biggest moments of a woman’s life, this thesis examines the reasons behind women’s preferred birthing methods. This research explores the fundamental decisions women make during the birthing process: the amount of prenatal care mothers will receive, the type of health care provider they will use, picking the place of delivery, views on technological and medical interventions, and outlooks on natural childbirth. In addition to an extensive literature review, in-depth interviews with mothers, midwives, and obstetricians are used to examine the various controversies of childbirth. This thesis begins with a review of the transition from midwives …

Money, Sex, And Religion--The Supreme Court's Aca Sequel, George J. Annas, Theodore Ruger, Jennifer Prah Ruger

All Faculty Scholarship

The Supreme Court decision in the Hobby Lobby case is in many ways a sequel to the Court's 2012 decision on the constitutionality of the Affordable Care Act (ACA). The majority decision, written by Justice Samuel Alito, is a setback for both the ACA's foundational goal of access to universal health care and for women's health care specifically. The Court's ruling can be viewed as a direct consequence of our fragmented health care system, in which fundamental duties are incrementally delegated and imposed on a range of public and private actors. Our incremental, fragmented, and incomplete health insurance system means …

Understanding Unintended Pregnancy In Senegal: Country Profile Report, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

As part of the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) research program, the Population Council has developed a Country Profile Report to understand unwanted pregnancies in Senegal. The Population Council conducted a literature review, analyzed available survey data, and conducted interviews to discuss some aspects in more detail with a number of key stakeholders. The Country Profile was discussed at a two-day workshop in Dakar bringing together key government actors at the central and regional levels, nongovernmental organizations, and civil society actors. The report is composed of six chapters, summarized in this evidence brief.

Measuring The Impact Of Contraceptive Use On Unintended Pregnancy And Other Health Outcomes, Step Up Research Programme Consortium

Reproductive Health

This brief describes several statistical models that have been developed to estimate the number of health outcomes that will be averted because of contraceptive use. Concerns have been expressed that this range of approaches—which overlap in the impacts they estimate, but sometimes use different inputs, mathematical algorithms, and assumptions, and may produce different results—may be confusing for policymakers, managers, and donors who want to measure or evaluate these impacts. To address these concerns, the STEP UP consortium convened two expert meetings to review the estimation methods used; come to consensus on methodologies and assumptions, where possible; and provide guidance to …

Breastfeeding Knowledge, Practice, Attitudes, And Influencing Factors: Findings From A Selected Sample Of Breastfeeding Mothers In Bemidji, Minnesota, Hadeel Adnan Tanash

All Graduate Theses, Dissertations, and Other Capstone Projects

Breastfeeding is generally considered by health professionals as the ideal feeding practice for infants. It is the first communication pathway between the mother and her infant. This study was designed to describe breastfeeding knowledge, attitudes, practice and influencing factors among breastfeeding mothers in Bemidji, MN. This cross-sectional study allowed the researcher to determine trends and other information about the sample in the Bemidji area. The participants for this study were breastfeeding mothers who gave a birth at Sanford Health located in Bemidji, MN. A written data collection instrument containing forty nine questions was used to collect data. The findings of …

Indian Parents Prefer Vaccinating Their Daughters Against Hpv At Older Ages, Purnima Madhivanan, Vijaya Srinivas, Laura Marlow, Soumyadeep Mukherjee, Doddaiah Narayanappa, Shekar Mysore, Anjali Arun, Karl Krupp

Faculty Publications

Increasing uptake of human papillomavirus (HPV) vaccine should be a priority in developing countries since they suffer 88% of the world’s cervical cancer burden. In many countries studies show that age at vaccination is an important determinate of parental acceptability. This study explores parental preferences on age-to-vaccinate for adolescent school-going girls.

A Risk Prediction Model For The Assessment And Triage Of Women With Hypertensive Disorders Of Pregnancy In Low-Resourced Settings: The Minipiers (Pre-Eclampsia Integrated Estimate Of Risk) Multi-Country Prospective Cohort Study, Beth A. Payne, Jennifer A. Hutcheon, J. Mark Ansermino, David R. Hall, Zulfiqar Ahmed Bhutta, Shereen Z. Bhutta, Christine Biryabarema, William A. Grobman, Henk Groen, Farizah Haniff, Jing Li, Laura A. Magee, Mario Merialdi, Annettee Nakimuli, Ziguang Qu, Rozina Sikandar Sultanali, Nelson Sass, Diane Sawchuck, D. Wilhelm Steyn, Mariana Widmer, Jian Zhou, Peter Von Dadelszen

Department of Obstetrics & Gynaecology

Background: Pre-eclampsia/eclampsia are leading causes of maternal mortality and morbidity, particularly in low- and middle- income countries (LMICs). We developed the miniPIERS risk prediction model to provide a simple, evidence-based tool to identify pregnant women in LMICs at increased risk of death or major hypertensive-related complications.

Methods and Findings: From 1 July 2008 to 31 March 2012, in five LMICs, data were collected prospectively on 2,081 women with any hypertensive disorder of pregnancy admitted to a participating centre. Candidate predictors collected within 24 hours of admission were entered into a step-wise backward elimination logistic regression model to predict a composite …

“Human Betterment”: The Fight For And Against 50 Years Of Sterilization In North Carolina, Kay Bielak Schaffer

Senior Projects Spring 2014

Senior Project submitted to The Division of Social Studies of Bard College.

Promoting Respectful Maternity Care (Rmc) At Birth: Orientation For Community-Based Workshops, Population Council

Reproductive Health

The goal of “Promoting Respectful Maternity Care (RMC) at Birth: Orientation for Community-Based Workshops” is to orient community-health workers on the RMC concept. Objectives of the workshop as indicated in this slide deck are: Outline the current status of maternal health in relation to RMC. Discuss rights-based approaches related to RMC. Discuss selected strategies that reduce disrespect and abuse (D&A). Discuss the role of the community in promoting RMC. Demonstrate knowledge and use of the Alternative Dispute Resolution mechanism. Develop action plans to support the implementation of RMC interventions at the community level. Summary: D&A deters facility-based childbirth and Skilled …

Validating Indicators Of The Quality Of Maternal Health Care: Final Report, Mexico, Karla Berdichevsky, Claudia Diaz, 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 help 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 the 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. …

Immune Responses To Vi Capsular Polysaccharide Typhoid Vaccine In Children 2 To 16 Years Old In Karachi, Pakistan, And Kolkata, India, R. Leon Ochiai, M. Imran Khan, Sajid B. Soofi, Dipika Sur, Suman Kanungo, Young Ae You, Atif Habib, Shah Muhammad Sahito, Byomkesh Manna, Camilo J. Acosta, Mohammad Ali, Sujit K. Bhattacharya, Zulfiqar A. Bhutta, John D. Clemens

Department of Paediatrics and Child Health

The geometric mean concentration (GMC) and the proportion maintaining a protective level (150 enzyme-linked immunosorbent assay (ELISA) units [ELU]/ml) 2 years following a single dose of 25 μg of injectable Vi capsular polysaccharide typhoid vaccine was measured against that of the control hepatitis A vaccine in children 2 to 16 years old in cluster randomized trials in Karachi and Kolkata. The GMC for the Vi group (1,428 ELU/ml) was statistically significantly different from the GMC of the control hepatitis A vaccine group (86 ELU/ml) after 6 weeks. A total of 117 children (95.1%) in the Vi group and 9 (7.5%) …