Medicine and Health Sciences Commons^™

Electrophysiological Retinal Changes In Aging And Its Implication In Alzheimer’S Disease, Samuel Jacob Haskins

ETDs from 2020-2029

Alzheimer’s disease remains one of the most expensive and fatal diseases facing medical practitioners to this day. According to the CDC, statistics show that it is the seventh leading cause of death worldwide. In addition to fatalities, there is a tremendous financial and emotional cost of dementia to the patient and surrounding caregivers. Improved screening techniques and new treatments for this disease are a priority of several institutes within the NIH. Early detection and early intervention are critical to improve the outcomes of patients worldwide. Amyloid beta plaques and neurofibrillary tangles (NFT) are two of the most important protein aggregates …

Comparative Evaluation Of Translucency, Fluorescence, And Structural Analysis Of 3d-Printed Vs. Conventionally Fabricated 3y, 4y And 5y Zirconia, Surabhi Chhabra

ETDs from 2020-2029

Statement of Problem: Additive manufacturing has emerged as an alternative to conventional milling for zirconia-based dental restorations because of its potential to reduce material waste and increase design flexibility. However, whether 3D-printed zirconia can provide optical and structural properties comparable with those of conventionally milled zirconia for esthetic applications remains unclear. Purpose: The purpose of this in vitro study was to compare the optical properties of 3D-printed zirconia and conventionally milled 3Y, 4Y, and 5Y zirconia, as measured by translucency and fluorescence, and to evaluate their structural characteristics, as measured by density, porosity, phase composition, and surface morphology. Materials and …

An Examination Of Physical Activity And Arterial Stiffness Among Urban And Rural Older Adults, Michael J. Hankes

ETDs from 2020-2029

Rural populations in the United States experience a disproportionate burden of cardiovas-cular disease, yet how rural‑urban context shapes physical activity (PA) and vascular health is not fully understood. Because vascular dysfunction links PA to cardiovascular risk, rural‑urban differences in movement may help explain disparities in cardiovascular health. Rurality is often treated as a static, binary exposure, which may obscure meaning-ful geographic variation and accumulated life course influences. The overarching goal of this dissertation was to examine associations among rural‑urban exposure, objectively measured PA, and vascular health using national cohort data and a pilot study. This dissertation begins with a conceptual …

Social Relationships, Mental Health, And Stigma: A Qualitative Study Of Social Networks And Hiv Disclosure In Western Kenya, Sarah Obatsa, Adel Mburia-Mwalili, Salvador Jauregui, Karla Wagner, Lukoye Atwoli, Francesca Odhiambo, Jayne Lewis-Kulzer, Suzanne Goodrich, Kara Wools-Kaloustian, Jennifer Syvertsen

Internal Medicine, East Africa

The disclosure of one’s HIV-positive status is a personal decision that can play an important role in engagement in HIV treatment and care. Social network approaches situate individuals within broader webs of social connections that influence health and wellbeing and thus hold the potential to elucidate key social factors shaping the process of disclosure. As part of a larger clinical study examining how substance use and mental health shape HIV outcomes, we recruited 61 individuals newly diagnosed with HIV at two clinics in Western Kenya to participate in an egocentric social networks study. We conducted a survey that generated a …

Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

The Putative Role Of Oral Microbiome In Premature Aging During Hiv Infection: What Do We Know?, Carlos Solá-Morlá, Daphne Alcalá-Zúñiga, Juan Araujo, Maria Da Gloria Bonecini-Almeida, Upal Roy, Josué Pérez-Santiago

Health & Biomedical Sciences Faculty Publications

Despite improvements in life expectancy, people with HIV (PWH) are at risk of developing HIV-associated comorbidities at a younger age when compared to HIV-uninfected individuals. This premature aging process can be attributed to various factors, such as the prolonged exposure to combination antiretroviral therapy (cART), inflammation, microbial perturbances and oxidative stress. Similarly to the gut, oral dysbiosis occurs in HIV-1 infection, with cART and inflammation playing a crucial role. This gives rise to an enrichment of pathogenic microorganisms that in turn, elicit an immune response tied to chronic inflammation. Consequently, cART exposure, dysbiosis and persistent inflammation in HIV-1 infection have …

Exploring Racial And Ethnic Diversity Trajectories And Diabetes Prevalence In The United States, Jiue-An Yang, Calvin P Tribby, Anna Dmowska, Qian Xiao, Marta M Jankowska

Faculty, Staff and Student Publications

This study investigates whether long-term changes in neighborhood racial and ethnic diversity are associated with adult diabetes prevalence across the contiguous United States. We calculated diversity indexes for US census tracts (n = 72,033) using decennial census data from 1990 to 2020. Five diversity trajectory clusters were identified using K-means clustering. Diabetes prevalence in 2019 was obtained from the CDC's PLACES dataset. Linear mixed models (LMMs) assessed global associations between diversity trajectories and diabetes prevalence, adjusting for age, sex, poverty, marital status, and public insurance. Geographically weighted regression (GWR) examined local variations in these associations. Compared to the reference group …

Bridging The Diagnostic Gap: Expanding Dementia Care Navigation For Timely Diagnosis, Lucille Carriere, Morgan Minyo, David Bass, Katherine L Possin, Rafael Samper-Ternent, Joel Salinas, Nicole Deaner

Faculty, Staff and Student Publications

Over half of dementia cases remain undiagnosed, with persistent disparities across racial, ethnic, and socioeconomic groups. Dementia care navigation (DCN) has demonstrated value in post-diagnosis settings. If implemented earlier, DCN could address diagnostic delays and care gaps. We define the diagnostic window as the period from initial symptom awareness through diagnosis and early care planning. Drawing on deliberations from the Alzheimer's Association Dementia Care Navigation Roundtable, we present a pre-diagnosis DCN framework organized across six domains and describe navigator roles across three phases: pre-evaluation, diagnostic assessment, and immediate post-diagnosis and transition. We address special considerations, including people without a care …

Barriers And Facilitators To The Implementation Of The Diabetes Prevention Program (Dpp) In Health Settings: Protocol For A Mixed Methods Systematic Review, Miquel Colom-Rosselló, Manuela Abbate, Laura Capitán-Moyano, Elena Pastor-Ramon, Maria E Fernández, Aina M Yañez, Miquel Bennasar-Veny

Faculty, Staff and Student Publications

This is the protocol of a Campbell Systematic Review. The objectives are as follows: to identify implementation determinants from the perspectives of both participants and implementers, and to assess their influence on specific implementation outcomes, thereby clarifying why certain aspects of the implementation process succeed or fail. If sufficient data is available, variations in perceived barriers or facilitators related to individuals and program characteristics will also be explored.

Evaluation Of A Novel Antegrade-To-Retrograde Femoral Sheath Conversion System: A Preclinical, Cadaveric Study, Ramakrishnan Ranganath, Kerry K Gilbert, Randy Hickle, Anuva Iyer, Ryan Um, Rex Johnson, Randall Torrence, Daniel I Sessler

Faculty, Staff and Student Publications

Background: Peripheral arterial disease often affects the lower extremities, is frequently bilateral, and typically involves multiple leg segments. Symptomatic disease is usually treated endovascularly. Antegrade access may be necessary in some cases and can be challenging compared with retrograde common femoral artery access. The ability to convert a conventional retrograde access to antegrade access would thus be valuable. We developed and tested a novel system, named as antegrade-to-retrograde converter. Our aim was to establish antegrade superficial femoral artery access from initial retrograde entry and reconvert to retrograde access.

Methods: We tested the antegrade-to-retrograde converter bilaterally in 15 fresh (unembalmed) human …

Legends, Lies, & Rewritten Lives: After The Little Bighorn: Forgotten Struggles Of Those Who Walked Away, 2nd Edition, Thomas B. Davidson

DU Textbooks

This Story surrounds an event that occurred one summer on June 25, 1876, along the banks of the Little Bighorn River in what is now the state of Montana. Seen from a 21st century perch, it is a story of a collision between two very different civilizations or empires. Both empire’s military fought in the manner of their society. This narrative will attempt to balance the believable truth of what happened in that contest between the military representatives of both societies while also trying to tell an engaging story, without drifting into naked partisanship, purple prose, or sensationalism. The narrative …

Dental Care Utilization Among Sexual And Gender Minority Individuals, Ishita Singh, Oladipo Afolayan, Sarah S Jackson, Irene Tamí-Maury

Faculty, Staff and Student Publications

Objectives: Sexual and gender minority (SGM) individuals can experience notable health disparities, including higher HIV prevalence, social isolation, substance abuse, lack of culturally competent providers, and poorer health outcomes compared to heterosexuals due to stigma and discrimination. This study aims to identify predictors of dental care utilization across sexual minorities using the 2023 TEXAS PRIDE Survey.

Methods: We analyzed data from 517 SGM individuals, assessing sociodemographic characteristics, health behaviors, and recent medical and dental visits. Multivariable logistic regression identified predictors of dental care utilization (i.e., a dental visit in the past year).

Results: Among sexual orientation groups, reported dental care …

Incidence And Risk Factors For Stillbirth In Kenya, Mozambique And The Gambia: The Precise Cohort Study, Grace Mwashigadi, Joseph Akuze, Angela Koech, Hawanatu Jah, Anna Roca, Geoffrey Omuse, Moses Mukhanya, Marleen Temmerman, Amina Abubakar, Patricia Okiro

Centre of Excellence in Women and Child Health

Background

Methods

Terminal Digit Preference And Threshold Avoidance In Digital Blood Pressure Measurements During Pregnancy: Secondary Analysis Of Data From The Clip And Precise Cohorts, Peter Dadelszen, Akshdeep Sandhu, Jeffrey Bone, Rahat Qureshi, Olukayode Dada, Ashalata Mallapur, Marleen Temmerman, Marie-Laure Volvert, Joseph Waiswa, Moses Mukhanya, Angela Koech

Centre of Excellence in Women and Child Health

Background:Screening for, detecting, and managing pregnancy hypertension is a core function of antenatal care. To reduce both training requirements and the risks of measurement error in blood pressure (BP) values, automated and semiautomated BP devices have been validated in pregnant women with normal BP and pregnant women with hypertension and introduced for serial antenatal measurement of BP.

Objectives:The study aimed to (1) determine whether or not repeated BP measurements reduced the presence of terminal digit preference and (2) discern whether or not there was evidence of threshold avoidance in the Community-Level Interventions for Preeclampsia (CLIP) trials compared with …

Ai In Healthcare: Regulatory Guidelines And Judge-Made Negligence Principles For Ai Implementers, Gary K. Y. Chan

Research Collection Yong Pung How School Of Law

The use of artificial intelligence (AI) in healthcare may, notwithstanding its potential benefits, result in harm to patients from allegedly negligent acts or omissions by hospitals and medical doctors. In such circumstances, how should the principles in the tort of negligence (duty of care, breach, causation, remoteness of damage, and defences) respond to AI innovations in healthcare? In particular, how may the standard of care expected of hospitals and medical doctors be informed by regulatory guidelines? We refer to case law precedents and regulatory guidelines on the roles and responsibilities of doctors and hospitals as AI implementers. Importantly, they prompt …

Cancer Workforce-A Global Crisis: A Lancet Oncology Commission, Hedvig Hricak, Zachary Ward, Fabio Moraes, Andrew Scott, Farouk Dako, Wilfred Ngwa, Cynthia Villarreal-Garza, May Abdel-Wahab, Stephen Avery, Miriam Mutebi

General Surgery, East Africa

No abstract provided.

Comparative Analysis Of Fixed Versus Variable Rate Of Regional Citrate Anticoagulation In Critically Ill Ecmo Patients On Continuous Kidney Replacement Therapy, Lisa Hall Zimmerman, Alexander Chen, Felcia Ivascu, Anthony Iacco, Jimmi Mangla, Wesley Barnes, Sean Masters

Conference Presentation Abstracts

Background: Continuous kidney replacement therapy (CKRT) is the preferred dialysis modality for critically ill patients with hemodynamic instability. Anticoagulation is often necessary to deliver CKRT effectively and prolong the circuit lifespan. The Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline for acute kidney injury 2012 recommends regional citrate administration during CKRT for patients without contraindications to prevent filter clotting. Citrate works by chelating calcium and interfering with the activation of the coagulation cascade. This study evaluated effectiveness and safety of fixed (FIX) versus variable citrate rate (VAR) in critically ill patients receiving CKRT. Methods: This single-center, retrospective study evaluated …

Left Bundle Branch Area Pacing Outcomes From An African Registry: Short-Term Findings From The Macop Study, Willy Mucyo, Marcus Ngantcha, Mzee Ngunga, Miriam Msunza, Justin Ragadu, Klindheer Rampersad, Jeilan Mohamed, Brian Vezi

Internal Medicine, East Africa

Background

Objective

Methods

Results

Alara+: Summit On Radiation And Orthopedic Risks In Fluoroscopic Laboratories: Endorsed By Acc, Acvp, Ase, Hrs, Scai, Sir, Snis, Svin, And Svs, Arash Salavitabar, Amit N. Vora, Dorothea Altschul, J. Fritz Angle, Chelsea Ballinger, Andrew Bojanowski, Anna E. Bortnick, Kyle Bugg, Emily Carpenter, Robert E. Foster, Joanna Ghobrial, Matthew Glogoza, Atul Gupta, James B. Hermiller, A. Kyle Jones, Summer L. Kaplan, Steven J. Kraus, Omar Khalique, Andrea Klein, Nick Morse, Preethi Ramchand, David G. Rizik, Lucy M. Safi, Cheryl C. Schultz, Kamala P. Tamirisa, R. Jay Widmer, Kristi Wilson, Jonathan X. Fang, Arnold Seto, Robert F. Riley

Department of Neurosurgery Faculty Papers

Occupational radiation exposure has a clear association with long-term health effects and has a particular impact on women, trainees, and supporting staff. There is a reliance on limited, traditional radiation protection and nonergonomic equipment, which carries associated orthopedic injury rates with adverse impacts on both individual career trajectories and health systems, and with significant challenges to widespread implementation of enhanced radiation protection devices. During the 2025 Society for Cardiovascular Angiography & Interventions Scientific Sessions in Washington, DC, a multidisciplinary Think Tank summit was convened and included representatives from multiple stakeholders, including other professional societies, advocacy groups, and industry partners. The …

Government Health Care Worker Training Needs For Intestinal Schistosomiasis Morbidity Management, Phyllis Isaiah, Betty Nabatte, Lauren Wilburn, John Oryema, Noah Ukumu, Morris Okumu, Juma Nabhonge, Hilda Kyarisiima, Prudence Beinamaryo, Christopher Opio

Internal Medicine, East Africa

Background Schistosomiasis causes substantial chronic morbidity in sub-Saharan Africa, yet case definitions, clinical management guidance, and health worker training for schistosomiasis-related morbidity remain limited.

Methods We conducted a qualitative needs assessment for schistosomiasis morbidity management. Workshops were held over one day in each of Pakwach, Buliisa, and Mayuge Districts in Uganda in October 2024. 105 government health workers participated including clinicians, nurses, laboratory technicians, sonographers, and district health managers from health facilities at different levels of care. The workshops comprised six structured sessions: presentations on schistosomiasis burden in Uganda and the SchistoTrack cohort, a clinical case report by an expert …

Cal Poly Rodeo Program, Keith J. Johnson

Agricultural Education: Graduate Internship Reports

The purpose of this project was to evaluate and improve livestock welfare practices within the Cal Poly Rodeo Program while supporting the program's core values of student success, western heritage, and program excellence. Livestock play a critical role in collegiate rodeo by providing educational opportunities, athletic competition, and hands-on learning experiences for students. As public awareness of animal welfare continues to increase, rodeo programs must demonstrate responsible stewardship and ethical animal management practices.

This project assessed current livestock management procedures, identified areas for improvement, and implemented educational and operational strategies designed to enhance animal health and welfare. Key performance indicators …

Updated 2026 Comprehensive Evidence-Based Guidelines For Facet Joint Interventions In The Management Of Chronic Spinal Pain: American Society Of Interventional Pain Physicians (Asipp) Guidelines, Laxmaiah Manchikanti, Mahendra R. Sanapati, Sheri L. Albers, Alan D. Kaye, Vinita Singh, Nebojsa Nick Knezevic, Rajesh Naidu Janapala, Amol Soin, Annu Navani, Adam M. Kaye, Ahad Mussarat, Alexander Bautista, Dajie Wang, Paul J. Christo, Maged Mina, Daneshvari R. Solanki, Devi Nampiaparampil, Gerard Limerick, John Manor, Kris Ferguson, Lynn Cintron, Michael Bottros, Shirley Chen, Shivam S. Shah, Vahid Grami, Douglas P. Beall, Shalini Shah, Sairam Atluri, Mittal S. Prajapati, Alaa Abd-Elsayed, Salahadin Abdi, Steve Aydin, Sanjay Bakshi, Joseph Cabaret, Aaron K. Calodney, Kenneth D. Candido, Christopher G. Gharibo, Mayank Gupta, Michael Harned, Standiford Helm Ii, Sachin Sunny Jha, Radomir Kosanovic, Vidyasagar Pampati, Ramarao Pasupuleti, Bradley W. Wargo, Hermant Kalia, Gary Schwartz, Joshua A. Hirsch

Department of Anesthesiology Faculty Papers

BACKGROUND: Chronic axial spinal pain is a major contributor to disability and healthcare expenditures, with facet joints recognized as one of the established sources of pain.

OBJECTIVE: To provide evidence-based guidance in performing diagnostic and therapeutic facet joint interventions.

METHODS: A multidisciplinary panel of experts from various medical and pharmaceutical disciplines, convened by the American Society of Interventional Pain Physicians (ASIPP), reviewed the available evidence, considered patient perspectives, and formulated recommendations for facet joint interventions in the management of chronic pain.The methodology included the development of key questions with evidence-based statements and recommendations. Grading of the evidence and recommendations followed …

Trust In Cancer Information Sources And Awareness Of Human Papillomavirus As A Cause Of Cervical Cancer Among Us Adults, Olajumoke Ope Oladoyin, Paula Cuccaro, Lara S Savas, Robert Yu, Joel Fokom Domgue, Sheryl Mccurdy, Sanjay Shete

Faculty, Staff and Student Publications

Importance: Religiosity, trust in physicians, and trust in government health agencies influence individual decision-making and behavior toward public health programs. However, trust in information about cancer from these sources and their association with public awareness of human papillomavirus (HPV) as a cause of cervical cancer remain understudied.

Objective: To assess the association of trust in cancer information sources with awareness that HPV causes cervical cancer among US adults.

Design, setting, and participants: This cross-sectional study used the nationally representative 2022 Health Information National Trends Survey (HINTS) data on noninstitutionalized US adults aged 18 years or older collected between March 7 …

Association Of Insulin Resistance And Fracture Risk In The Osteoporotic Fractures In Men (Mros) Cohort, Jeonghoon Ha, Li-Yung Lui, Kristine Ensrud, Qian Xiao, Andrew R Hoffman, Joy Y Wu

Faculty, Staff and Student Publications

Context: Insulin resistance (IR) is more prevalent in men than in women, but evidence directly linking IR to fracture risk in older men remains limited.

Objective: To evaluate the association between insulin resistance (IR), estimated using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and the triglyceride-glucose (TyG) index, and fracture risk in older men.

Methods: Data from 5994 men (≥65 years) in the MrOS cohort were analyzed. A total of 5416 participants were included in the HOMA-IR analysis and 5384 in the TyG index analysis. Fractures were self-reported and confirmed radiographically. Participants were grouped into quartiles based on IR …

Global Youth Development: Challenges And Remedies, Raymond Chimezie

Faculty Publications and Presentations

Young people have enormous potential for growth and innovation, but not all have access to resources and opportunities to explore, achieve their dreams, and contribute immensely to society. Absence or limited opportunities and resources pose great challenges to young people’s aspirations. Through a review of literature and study of some countries young people globally face challenges, though at varying degrees like unemployment, limited access to healthcare, social services, and education; lack of professional support, skills acquisition and retraining, and political exclusion; judicial inequity, loneliness, and poor parenting. There still exist policies, structures, or regulations that encourage racial and ethnic or …

Age And Sex Affect The Prevalence And Severity Of Periodontal Conditions In An Academic Setting, Karo Parsegian, Nikolaos Soldatos, Tonia C Carter, Nikola Angelov, Neel Shimpi, Krishna Kumar Kookal, David K Okano, Effie Ioannidou

Faculty, Staff and Student Publications

Background: The aim of the present study was to examine whether age and sex affected the prevalence and severity of periodontal conditions in patients attending an academic dental clinic.

Methods: Electronic health record (EHR) data on the demographic characteristics and periodontal conditions of patients presented for a comprehensive periodontal evaluation were extracted from the institutional dental EHR database. Retrospective analysis of independent associations of age, sex, and other subject characteristics with periodontal conditions was determined using multinomial logistic regression. The null hypothesis stating that age and sex were not associated with the increased prevalence and/or severity of periodontal conditions was …

Cytosignal Detects Locations And Dynamics Of Ligand-Receptor Signaling At Cellular Resolution From Spatial Transcriptomic Data, Jialin Liu, Hiroaki Manabe, Weizhou Qian, Shion Orikasa, Javid Ghaemmaghami, Yichen Wang, Yichen Gu, Angel Ka Yan Chu, Gaurav Gadhvi, Yuxuan Song, Patrick Mcclinden, Vibha N Lama, Noriaki Ono, Joshua D Welch

Faculty, Staff and Student Publications

Cells communicate through ligand-receptor (LR) signaling interactions, but identifying when and where these interactions are active remains challenging. We developed CytoSignal to infer the locations and dynamics of cell-cell communication at cellular resolution from spatial transcriptomic data. Here we show that our cellular resolution, spatially resolved signaling scores enable several important analyses-identifying spatial gradients in signaling strength, quantifying the locations of contact-dependent and diffusible interactions, detecting signaling-associated genes and identifying differential signaling across multisample data. Additionally, we can predict the temporal dynamics of a signaling interaction at each spatial location. We experimentally validate our results in situ by proximity ligation …

June 2026, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

• Fitness and Hydration Month

• Stress Management Tips for Bulldogs

• Bulldog Resources

• HYDRATION TRACKER

Voucher Model For Family Planning: Empowering Poor Women And Expanding Access To Family Planning Services In Punjab, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Pakistan continues to face significant inequalities in access to family planning (FP) services, with the poorest women bearing a disproportionate burden of unmet need. Financial constraints, transportation costs, limited mobility, restricted decision-making power, and inadequate access to quality services often prevent women from obtaining the family planning services they need.

To address these barriers, the Population Council, in partnership with the Benazir Income Support Programme (BISP) and the Punjab Population Innovation Fund (PPIF), designed and rigorously evaluated an innovative Family Planning Voucher Scheme.

The model linked social protection with reproductive health services, enabling poor women from Rahim Yar Khan (RYK) …

Assessing Family Planning Progress In Exemplar Countries: Development Of A Conceptual Framework And Case Study Methodology, Zahid Memon, Hina Najmi, Abeer Mian, Sacha Ahmad, Muhammad Islam, Kevin Samuel, Marleen Temmerman, Ali Mohammad Mir, Zeba Sathar

Centre of Excellence in Women and Child Health

Family planning (FP) is a critical component of reproductive health, enabling individuals to plan the number and timing of children through various contraceptive methods.

We outline the conceptual framework and country case study methodology used by the Exemplars in Family Planning (EFP) project. This was based on the wider Exemplars in Global Health programme, which uses mixed-methods to examine determinants of FP progress in countries that exceed expectations for health outcomes. The EFP project integrates findings from case studies on six such countries, including quantitative analyses of trends and drivers of modern contraceptive prevalence, systematic reviews, policy, programme and financing …