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Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project, an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan, was a three-year project (2003 to 2006) funded by the European Union. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas to accomplish its goals: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role …

Safe Motherhood Applied Research And Training (Smart) Report 3: Changes In Knowledge And Behavior Of Women And Families, Muhammad Shafique Arif, Peter C. Miller, Nayyer Munir, Irfan Masood

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was conceived as an operations research project designed to test the effectiveness of two different strategies for improving maternal and neonatal health in Pakistan. To evaluate the results of this test, several types of evaluative research were conducted, including qualitative studies of various types, health systems assessments, evaluations of specific components, and household surveys. The household surveys are the subject of this report, which is Report 3 (Changes in knowledge and behavior of women and families) in a series of six. The surveys are two types: a large-scale, before-after household survey …

Safe Motherhood Applied Research And Training (Smart) Report 4: Knowledge And Behaviour Of Service Providers, Zakir Hussain Shah, Saima Pervaiz

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role in decision-making and seeking care for their families in matters relating to maternal and newborn …

Reproductive Health Update Trainings For Health Workers In North Eastern Province, Garissa, Kenya Ministry Of Health, Population Council

Reproductive Health

The Somali community living in Kenya has practiced the severest form of female genital mutilation/cutting (FGM/C), infibulation, for centuries. To understand the context within which the practice takes place, and how its complications are managed, FRONTIERS undertook a diagnostic study in North Eastern Province and in the Eastleigh area of Nairobi. The study found that the health system is ill equipped to serve women who have been cut, and particularly infibulated women who are pregnant and delivering, stemming from an overall weakness in the availability and quality of maternal and neonatal heath services. Specific recommendations could strengthen these services so …

Strategies For Encouraging The Abandonment Of Female Genital Cutting In West Africa: Experiences From Senegal, Burkina Faso, And Mali, Nafissatou J. Diop, Ian Askew

Reproductive Health

This article explores efforts to encourage abandonment of female genital cutting (FGC) in Senegal, Burkina Faso, and Mali. The strategy of encouraging traditional practitioners to stop performing FGC is not effective as community-level support for the practice remains high. Training health staff significantly improved healthcare providers' levels of knowledge about FGC and its complications. Consequently, it was recommended that such training be incorporated into preservice medical training. The use of community-based strategies like the Village Education Program (VEP) showed the most promise, as their multifaceted approach addresses knowledge, attitudes, actions, and communal support in an integrated manner. The way forward …

Technical Assistance To Organizations In Guinea Seeking To Reduce Female Genital Cutting, Nafissatou J. Diop

Reproductive Health

This reports details the technical assistance the Population Council’s FRONTIERS program provided to WHO’s Africa Bureau to implement a project addressing medicalization of female genital cutting (FGC), and to support Tostan in replicating its program in Guinea. Technical assistance had several aims: to improve the effectiveness of strategies to abandon FGC in Guinea, to assist WHO in developing and implementing a project to reduce FGC medicalization by health providers, to build the capacity of Guinean organizations to appropriately monitor and evaluate their FGC-related activities, and to enable the Comité de Lutte contre les Pratiques Traditionnelles portant Atteinte aux Femmes (CPTAFE) …

Scaling Up A Reproductive Health Curriculum In Youth Training Courses, Laila Rahman, M. Mazharul Islam, Ubaidur Rob, Ismat Bhuiya, M.E. Khan

Reproductive Health

The Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Bangladesh Ministry of Health and Family Welfare, the Urban Family Health Partnership, and two nongovernmental service delivery partners, carried out the Global Youth project in northwestern Bangladesh from 1999–2003. The important lesson learned from that project was that reproductive health education could increase reproductive health knowledge in adolescents, particularly in areas related to reproductive biology, family planning, pregnancy, sexually transmitted infections, HIV, and AIDS. The population-based surveys further showed that contrary to common belief, reproductive health education does not increase sexual activity; instead it increases the use …

Costs Of Reproductive Health Services Provided By Four Christian Health Association Of Ghana (Chag) Hospitals, James Boateng, Henry Surnye, Alex Mensah, Bismark Boateng, Philomena Nyarko, Nzoya Munguti, John H. Bratt

Reproductive Health

The Christian Health Association of Ghana (CHAG) is a large faith-based NGO which currently serves an estimated 35 percent of the Ghanaian population, mainly in remote rural areas. This study built capacity within the CHAG secretariat to calculate the economic cost and cost recovery levels of selected reproductive health services in four CHAG-affiliated hospitals. Techniques learned in the study are applicable to most costing problems, not just to reproductive health. Information obtained in the study forms the basis for negotiating reimbursement under the Ghana National Health Insurance Scheme, and for setting cost recovery and containment policies. CHAG senior managers plan …

Priority Setting For Reproductive Health At The District Level In The Context Of Health Sector Reforms In Ghana, Harriet Birungi, Philomena Nyarko, Ian Askew, Ayorinde Ajayi, Gifty Addico, Edward Addai, Caroline Jehu-Appiah

Reproductive Health

This report outlines results of an in-depth assessment carried out in Ghana in order to provide a better understanding of key factors affecting reproductive health (RH) prioritization at the district level; and to make recommendations for policy dialogue, advocacy, resource allocation, and RH program implementation. In particular, the study examined whether or not districts are connecting to the central process of priority setting and reasons for not doing so. The report includes recommendations for bridging the policy implementation gap, including: ensuring that RH advocates participate in national policy dialogue; investing in systems development for procurement and delivery of drugs and …

Acceptability And Feasibility Of Introducing The Who Focused Antenatal Care Package In Ghana, Harriet Birungi, Philomena Nyarko, Margaret Armar-Klemesu, Daniel Arhinful, Sylvia Deganus, Henrietta Odoi-Agyarko, Gladys Brew

Reproductive Health

The main objective of this study, undertaken by Noguchi Memorial Institute for Medical Research in collaboration with the Ghana Health Service and FRONTIERS, with USAID funding, was to examine the extent to which adaptation of the WHO focused antenatal care (ANC) package influenced quality of care received by pregnant women and its acceptability to both providers and clients. The results indicate that national-level support for focused ANC is high. The package appears to have been well accepted by both clients and providers because of its comprehensiveness and the individualized care. The process of stimulating changes in focused ANC service delivery …

Acceptability And Sustainability Of The Who Focused Antenatal Care Package In Kenya, Harriet Birungi, Washington Onyango-Ouma

Reproductive Health

The objectives of this study were to assess the Kenyan Ministry of Health’s capacity to adapt focused antenatal care (ANC) at the service delivery level so that it can be sustained, and to examine the extent to which adaptation of the package has increased coverage and quality of key ANC services and the overall quality of care received by pregnant women. The study showed that focused ANC is acceptable to both clients and providers and the approach has also received tremendous support from both the government and health development partners. However, the sustainability of the focused ANC package is contingent …

Cost Analysis Of Reproductive Health Services In Pcea Chogoria Hospital, Kenya, Nzoya Munguti, Moses Mokua, Rick Homan, Harriet Birungi

Reproductive Health

Presbyterian Church of East Africa Chogoria Hospital is a faith-based nongovernmental organization providing a wide range of healthcare services. The organization faces a number of challenges related to sustainability: declining donor support (especially for reproductive health services), low cost recovery levels, and increasing poverty levels among its clientele. In response to these concerns, a team from Chogoria Hospital attended a one-week workshop on financial sustainability held in Ghana and developed a small-scale operations research project to determine the cost of providing a selected number of reproductive health (RH) services and to evaluate their cost recovery levels. The study found that …

Correlates Of Inter-Birth Intervals: Implications Of Optimal Birth Spacing Strategies In Mozambique, Saumya Ramarao, John Townsend, Ian Askew

Reproductive Health

The Optimal Birth Spacing Initiative (OBSI) was created under the auspices of USAID to place optimal birth spacing on the global leadership priority agenda. As part of this initiative, Advance Africa documented a pilot intervention to introduce the new spacing message in Mozambique. The FRONTIERS program of the Population Council collaborated with Advance Africa providing technical input, and assistance in the conceptualization of intervention design and evaluation. This paper was written to inform Advance Africa’s efforts in Mozambique and includes a short review of correlates of birth intervals; a presentation of results from analysis of Mozambique-DHS 1997 data that identify …

Developing Regional Capacity In Operations Research And Economic Evaluation In South Asia, M.E. Khan, Sohini Roychowdhury, James R. Foreit, Sharif M.I. Hossain, Geetha Vaithyanathan

Reproductive Health

This project contributed significantly to the capacity-building of regional professionals in planning, implementing, and monitoring of reproductive health programs in South Asia. During 2001–05, professionals from 17 countries received training in various aspects of reproductive health in nine workshops, including operations research, economic evaluation, qualitative research methods, proposal writing, and process documentation and enhancing the utilization of research findings in reproductive health programs. Forty-three percent of workshop participants were program managers from government health programs and nongovernmental organizations. Success in leveraging resources from other collaborating agencies and other donors helped the project to organize more workshops than originally planned and …

Cost Of Training Programs And Willingness To Pay For Training: An Application Of Break-Even Analysis In Uganda, Nicholas Mugumya, Juliana K. Nyombi, Michael Matsiko, Rick Homan, Harriet Birungi, Nzoya Munguti

Reproductive Health

The AIDS Support Organization (TASO) provides care and support to persons living with HIV/AIDS in Uganda. The organization has also developed a large number of training courses related to AIDS care and counseling that are offered to local and regional organizations. To explore alternatives for increasing the sustainability of the training center, a team from TASO attended a one-week workshop on financial sustainability and developed an operations research study to determine ways in which the training center could increase its revenues and reduce costs. The report finds that with updated fees as well as changes to the structure of some …

Operations Research To Improve Financial Sustainability In Three Bolivian Ngos, Martha Merida, Javier Arce, Douglas Moscoso, Carlo Ramirez, Patricia Riveros, John H. Bratt

Reproductive Health

The FRONTIERS project worked with three Bolivian NGOs (Prosalud, the Center for Research, Education and Services or CIES, and the Association of Rural Health Programs or APSAR) to improve their ability to conduct research on market analysis and cost recovery. Following a one-week workshop on conducting cost studies, staff from the three NGOs designed operations research studies to help with decisions on planning and cost recovery. Study findings showed that cost recovery varied from high (Prosalud, 83-109%) to low (CIES, 38-46%) and very low (APSAR, 10-25%), depending on the service. All three studies focused on alternative options to client fees, …

Sexual Harassment In The Workplace: Experiences Of Women In The Health Sector, Paramita Chaudhuri

Reproductive Health

The objective of this report is to explore sexual harassment of women in the health sector in Kolkata, West Bengal, India. Specifically, it explores women’s perceptions of the occurrence of sexual harassment in hospital settings, and probes women’s own experiences of sexual harassment and incidents of sexual harassment in the hospital environment about which women are aware. The study also investigates the nature of action taken to seek redress, and the extent to which working women are aware of the complaint mechanism outlined by the Supreme Court. Findings confirm the persistence of sexual harassment in the workplace, the reluctance of …

Guide To A Successful Pregnancy: A Resource Manual For Pregnant And Parenting Young Women In Las Vegas, Nevada Institute For Children's Research And Policy Reports

Nevada Institute for Children's Research and Policy Reports

A Guide to a Successful Pregnancy.

• Are you Pregnant? Taking a pregnancy test
• First steps of Pregnancy: Options of pregnancy, health plans, obtaining medical care such as a doctor
• Months 1, 2, 3: Maintaining a healthy diet, what you should stay away from, exercise, symptoms of danger, and normal symptoms of pregnancy
• Months 4, 5, 6: Following a routine, classes available during pregnancy, normal pregnancy symptoms
• Months 7, 8, 9: Following a routine, normal pregnancy symptoms
• Labor and Delivery: Symptoms of labor, symptoms of danger
• Parenting: Normal symptoms after birth, Routine to follow to return to normal state, Breast feeding …

Mental Illness And Barriers To Health Care Access, Charlene Powell

MPA/MPP/MPFM Capstone Projects

Statement of Problem

Access to health care in the United States is major concern, despite the fact that the country spends more per capita on health care than any other country. Individuals with mental illness may face greater access problems than the general population.

Research Question

• Does mental illness predict greater difficulties with access to health care?

Methodology

The 2004 National Health Interview Survey (NHIS) was used to examine the barriers to health care among individuals reporting a mental illness diagnosis. Nine questions relating to health access problems were drawn from the survey and combined into an access index. Multivariate …

Baseline Household Survey: Dadu District, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development (USAID). PAIMAN is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health issues. USAID has provided a grant to implement PAIMAN in ten districts of Pakistan’s four provinces. The goal of the project is to reduce maternal, newborn, and child mortality. The project calls for a multipronged and integrated strategic approach combining individual health care with public health and community-based interventions. To ensure that success is properly …

Molecular Epidemiology Of Antibiotic Resistant Salmonella Enterica Strains From Different Animal And Human Sources In Ireland, David George Lee

Theses

In this study, 176 isolates of Salmonella were collected from different laboratories in Ireland. All isolates were confirmed to be of the genus Salmonella by performing bacteriological and biochemical tests. Briefly, all isolates were cultured onto XLD agar after which pure cultures were verified and stocked at this institute. Definitive identification was carried out using the API 20-E system and a separate urease test was also performed on all isolates. After confirmation of the genus, all isolates were prepared for antibiotic susceptibility testing and r-types were determined using sixteen antibiotics. Depending on the antibiotic resistance profiles, isolates were selected for …

Factors Associated With Prolonged Prehospital Delay Of African Americans With Acute Myocardial Infarction, Angela D. Banks, Kathleen Dracup

Nursing and Health Professions Faculty Research and Publications

BACKGROUND: Delays in seeking treatment for signs and symptoms of acute myocardial infarction are longer for African Americans than for whites.

OBJECTIVE: To determine factors associated with prolonged delay and the extent to which perceived racism influences prehospital delay in African Americans with acute myocardial infarction.

METHODS: Sixty-one African Americans with acute myocardial infarction were interviewed within 1 month of hospital admission. Delay times were calculated on the basis of the interviews. Independent t tests and chi(2) tests were used to determine factors associated with prolonged delays. RESULTS: Median delay was 4.25 hours and did not differ significantly between women …

Community Reactions To Campaigns Addressing Crystal Methamphetamine Use Among Gay And Bisexual Men In New York City, Jose Nanín, Jeffrey T. Parsons, David S. Bimbi, Christian Grov, Justin T. Brown

Publications and Research

Crystal methamphetamine (aka “crystal meth”) use with high-risk sex has become an emerging health problem for gay and bisexual men in New York City since the late 1990s. Public health campaigns were eventually developed to encourage gay and bisexual men to avoid or reconsider using crystal meth. Reactions to three campaigns were measured with a cross-sectional survey administered in 2004. Among an ethnically-diverse sample of 971 gay and bisexual men, 61.8% reported seeing the campaigns. Those who reported ever using crystal meth, recent use, and recent use with sex were significantly more likely to have seen the campaigns. In …

The Association Between Breast Feeding And Being Overweight In Children, Naja Jamil Eldanaf

Theses and Dissertations

Purpose: Obesity/Overweight in children is an epidemic and the most common disorder of childhood in the developed world. Prevalence is increasing, leading to short- and long-term complications. Breastfeeding may protect against childhood obesity, but the debate is ongoing. The main purpose of this project was to assess the relationship between breastfeeding and being overweight in early childhood.Methods: Data were collected from the State and Local Area Integrated Telephone survey; National Survey of Children's Health, 2003. Overall, 16,358 children, ages 3 to 5, were included in the sample. SPSS Complex Sample software was utilized to generate for all analyses. Complex samples …

Correlation Between Acculturation And Health Promotion Behavior Among Hispanics/Latinos In Black Hawk County, Iowa, Ki-Hyung Park

Dissertations and Theses @ UNI

The elimination of the health disparities between different segments of population such as ethnic or racial minority groups in the United States is one of the principal goals of Healthy People 2010. Since 2002, the Hispanic/Latino population has been the largest minority group in the United States, and currently Hispanic/Latinos are the largest minority group in Iowa. The study assesses the relationships among health status, health promoting behavior, and acculturation of Hispanic/Latino immigrants in Black Hawk County, Iowa. A community sample of 54 adults completed a face-to-face structured interview. The instrumentation included the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II), …

Psycho-Social Consequences Of Secondary Infertility In Karachi., Neelofar Sami, Tazeen Saeed Ali

Community Health Sciences

OBJECTIVE:

To explore the experiences of social consequences among women suffering from secondary infertility.

METHODS:

Descriptive case series of 400 women with secondary infertility attending tertiary care hospitals in Karachi, Pakistan.

RESULTS:

More than two thirds (67.7%) of women stated that their inability to give live births or give birth to sons had resulted in marital dissonance. The respondents had been threatened for divorce (20%), husband's remarrying (38%) or to be returned to their parent's home (26%) by their in laws or husbands. Majority (68%) of the women threatened did not have any live births. However, those who had live …

Process Evaluation Of A School- And Home-Based Sun Safety Education Intervention, Robyn S. Johnston

Theses: Doctorates and Masters

Effective interventions that reduce children's sun exposure are likely to reduce melanoma incidence in the longer term. However, for such interventions to have an impact they must be adequately implemented. School-based sun protection programs have been evaluated to determine their effectiveness in changing behaviours, however, few studies have assessed the implementation of such programs, or the effect of their implementation on outcomes. Kidskin was a five-year intervention trial designed to assess the effectiveness of a multicomponent intervention in reducing sun exposure in children in Perth, Western Australia. This thesis describes the process evaluation of the school- and home-based educational components …

Dump Truck Driver Dies After Unintentional Release Of Asphalt, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On June 6, 2005 a 55-year-old male dump truck driver (Driver 1) died when he was buried waist deep in 400-degree Fahrenheit asphalt. Driver 1 stopped along the highway to help another dump truck driver (Driver 2), (both were independent truck drivers), who had experienced brake problems. As the two men were examining the pneumatic brake system at the rear of the disabled dump truck, the tailgate opened unexpectedly, spilling hot asphalt onto the decedent who was under the rear of the truck.

To prevent similar incidents, the following recommendations have been made:

Recommendation No. 1: Tailgate chains should always …

Redesigning Practice To Improve Care Delivery (Boston), Laura A. Dummit, Lisa Sprague

National Health Policy Forum

This site visit focused on how the practice of medicine is changing or can be changed to improve care delivery across the spectrum of patient populations. Regarded as a “medical Mecca,” Boston is home to the academic health centers and teaching hospitals where many of the nation’s physicians are trained. As a center of innovation, Boston prides itself on its high bar with respect to standards of care. Panels addressed the used of clinical information technology (IT) in the physician’s office, in the hospital, and community-wide. Participants observed how IT is being used to further the mission of community health …

Eating Behavior And Obesity Risk Of Youth Living In The City Of San Bernardino, California, Carolyn A. Corder

Loma Linda University Electronic Theses, Dissertations & Projects

Adolescents living in the City of San Bernardino, California, are susceptible to health risks due to high rates of violence, suicide, teen pregnancy, and poverty, which place them among the most vulnerable in the Nation to disability, early death, unhealthy offspring, illiteracy, economic disadvantage, and chronic disease. This study analyzed data from the Youth Risk Behavior (YRBS) and local surveys conducted in the City’s Unified School District from 1999 through 2001. The investigators focused on the relationship, if any, of dietary and anthropometric factors to the priority adolescent behaviors targeted for intervention by the Healthy People 2010 objectives: accidental injuries …