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Articles 1741 - 1770 of 2205
Full-Text Articles in Public Health
Addressing The Needs Of Seasonal Migrants In Nashik, Maharashtra, Anjali B. Borhade
Addressing The Needs Of Seasonal Migrants In Nashik, Maharashtra, Anjali B. Borhade
Reproductive Health
In order to identify the opportunities and options available to address the vulnerabilities of and socioeconomic needs of seasonal migrants, an intervention project was launched by the Disha Foundation, a nongovernmental organization in Nashik city, Maharashtra, India. This report intends to use the project experience as a case study to provide a blueprint for interventions for seasonal migrants to access a range of basic services in areas of destination and to exercise their rights to access available services. The report documents the array of strategies used to enable seasonal migrants to recognize their entitlement and to access available public sector …
Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi
Informed Consent In Sterilisation Services: Evidence From Public And Private Health Care Institutions In Chennai, Raja Lakshmi
Reproductive Health
The objective of this paper is to explore the experiences of women undergoing a particular form of fertility regulation, namely sterilization or tubal ligation, in a variety of facilities in Chennai, India. The paper examines specifically the nature of information provided to clients, the consent-taking process, the nature of its documentation, and the extent to which clients made an informed choice. The findings underscore that although all the women respondents did wish to practice a method of contraception, and did want to adopt sterilization, several limitations were noted in the process of providing informed consent: inadequate information was provided to …
Young People's Sexual And Reproductive Health In India: Policies, Programmes And Realities, K.G. Santhya, Shireen J. Jejeebhoy
Young People's Sexual And Reproductive Health In India: Policies, Programmes And Realities, K.G. Santhya, Shireen J. Jejeebhoy
Reproductive Health
This paper presents an overview of key policies and government programmes intended to reduce HIV vulnerability and improve sexual and reproductive health among young people in India, and identifies the extent to which these policies and programmes have addressed the gamut of unique sexual and reproductive needs of young women and men. It also explores the extent to which programmes have been adapted to accommodate state-level differences in the sexual and reproductive vulnerability of youth; the review takes the examples of two states, namely, Andhra Pradesh, characterised by both early marriage and high HIV prevalence, and Madhya Pradesh, characterised by …
Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health
Kenya: Begin Community Dialogue On Fgm/C By Discussing Cultural Justification, Frontiers In Reproductive Health
Reproductive Health
Female genital cutting is strongly supported among the Somali ethnic community in Kenya, and the severest form (infibulation) is primarily practiced. This type of cut is associated with increased incidence and seriousness of obstetric and gynecological problems relative to uncut women and those with less severe forms of FGM/C. As stated in this brief, efforts to encourage abandonment should begin with community discussion about the socio-cultural reasons for cutting. Simultaneously, health-care providers need training in how to manage complications of FGM/C. In 2004, FRONTIERS collaborated with UNICEF on a four-month diagnostic study on FGM/C practices among the Somali community in …
Senegal: Mainstreaming Adolescent Health: Building On Local Support Systems, Frontiers In Reproductive Health
Senegal: Mainstreaming Adolescent Health: Building On Local Support Systems, Frontiers In Reproductive Health
Reproductive Health
In 1999, FRONTIERS began a three-year collaboration with the World Health Organization, the Center for Research and Training, the Population Training Group, and the Ministries of Health, Education, and Youth to test the feasibility, effectiveness, and cost of school-, clinic-, and community-based interventions to improve the reproductive health of youth aged 10–19. This adolescent reproductive health (ARH) study showed that the multisectoral, multidisciplinary approach increased knowledge about youth reproductive health among young people, the community, schools, and health-care providers. As noted in this brief, one of the guiding principles of the ARH study was to build sustainability through existing institutions, …
Community Mobility And Dementia: A Review Of The Literature, Nina M. Silverstein, Megan Vanderbur
Community Mobility And Dementia: A Review Of The Literature, Nina M. Silverstein, Megan Vanderbur
Gerontology Institute Publications
By the year 2030, 70 million Americans will be 65 or older. Approximately 80 percent of this population will likely be driving themselves. And without appropriate and timely interventions, many are likely to be driving with Alzheimer’s disease (AD). Current estimates suggest that 2 percent of the population 65 to 74, 19 percent of the population 75 to 84, and 47 percent of the population 85 and older are likely to suffer from Alzheimer’s disease or a related disorder. By the year 2050, the number of Americans with Alzheimer’s disease could range from 11.3 million to 16 million. This significant …
Examining The Structural Covariates Of Methamphetamine Use: A Social Disorganization Perspective, Justin Smith
Examining The Structural Covariates Of Methamphetamine Use: A Social Disorganization Perspective, Justin Smith
Masters Theses
There have been many anecdotal accounts describing the characteristics of individuals involved in methamphetamine use, trafficking and production. However, prior to the current study there was yet to be a macro-level analysis of methamphetamine use. The extant macro-level literature on drug use has suggested that areas with high levels of social disorganization experience high rates of drug use. It was expected that school-districts with low SES and high rates of ethnic heterogeneity, residential instability and family disruption will experience high rates of methamphetamine use. In addition, it was expected that rural school districts would show higher rates than urban and …
Strengthening Care And Support Services In The Era Of Treatment: Symposium Report, Horizons Program
Strengthening Care And Support Services In The Era Of Treatment: Symposium Report, Horizons Program
HIV and AIDS
Sub-Saharan Africa has been devastated by the AIDS epidemic, with almost 26 million people infected in the region. As international attention continues to focus on sub-Saharan Africa as the region most affected by AIDS, hopeful signs have emerged, such as increased access to antiretroviral therapy (ART). Although the availability of ART has greatly increased in South Africa, care and support services continue to play a critical role in the lives of people infected and affected by HIV. In response to a growing call from program managers and researchers in South Africa to engage in a dialogue with policymakers and donors …
Preparedness For Hiv/Aids Service Delivery: The 2005 Kenya Health Workers Survey, National Aids And Std Control Programme, Ministry Of Health Kenya
Preparedness For Hiv/Aids Service Delivery: The 2005 Kenya Health Workers Survey, National Aids And Std Control Programme, Ministry Of Health Kenya
HIV and AIDS
Kenya is one of the few countries that has succeeded in changing the course of the HIV/AIDS epidemic, and there is strong evidence of a decline in incidence. However, AIDS-related deaths now exceed new infections, and almost nine out of ten Kenyan adults do not know their HIV status. The expansion of HIV services in Kenya, including voluntary counseling and training and prevention of mother-to-child transmission programs, has enabled more Kenyans to learn their status. However, this leaves out many individuals who could benefit from HIV testing and counseling, such as hospital patients. Patients who present to a health-care facility …
Yaari Dosti: Young Men Redefine Masculinity, A Training Manual, Horizons Program, Coro For Literacy, Mamta, Instituto Promundo
Yaari Dosti: Young Men Redefine Masculinity, A Training Manual, Horizons Program, Coro For Literacy, Mamta, Instituto Promundo
HIV and AIDS
This training manual, developed by the Population Council in collaboration with Instituto PROMUNDO, CORO for Literacy, MAMTA, and DAUD promotes gender equity and addresses masculinity as a strategy for the prevention of HIV. Adapted from the “Program H: Working with Young Men Series” developed in Brazil by Instituto PROMUNDO, it promotes the positive aspects of masculinity, encourages men’s participation in sexual and reproductive health, promotes respect for sexual diversity, and improves understanding of the body and sexuality. In this manual, HIV prevention is addressed within the larger framework of gender roles and relationships. Gender disparity, widely prevalent in Indian society …
Shifting Support For Inequitable Gender Norms Among Young Indian Men To Reduce Hiv Risk And Partner Violence, Ravi K. Verma, Vaishali Sharma Mahendra, Julie Pulerwitz, Sujata Khandekar, Gary Barker, P. Fulpagare, S.K. Singh
Shifting Support For Inequitable Gender Norms Among Young Indian Men To Reduce Hiv Risk And Partner Violence, Ravi K. Verma, Vaishali Sharma Mahendra, Julie Pulerwitz, Sujata Khandekar, Gary Barker, P. Fulpagare, S.K. Singh
HIV and AIDS
India accounts for the second largest population of people living with HIV/AIDS (5.1 million), and almost half of new infections occur in young men below age 30. While there are multiple factors influencing young men’s HIV risk in India, one that is receiving increasing attention is early socialization about masculinity. Young men in India mature and develop in a male-dominated context, having little contact with female peers and virtually no sex education. In this context, most boys develop a sense of masculinity characterized by male dominance in the sexual arena and other areas. Although there is increasing awareness of the …
Understanding Barriers And Challenges To Effective Community Participation In The Rollout Of Hiv/Aids Treatment And Care Services: Report On Research Results Dissemination Meetings, Population Council, Health Systems Trust
Understanding Barriers And Challenges To Effective Community Participation In The Rollout Of Hiv/Aids Treatment And Care Services: Report On Research Results Dissemination Meetings, Population Council, Health Systems Trust
HIV and AIDS
The Population Council and Health Systems Trust conducted national, provincial, and community dissemination meetings in 2006 in KwaZulu Natal (KZN), Limpopo, and Gauteng provinces to share results from a 2005 research study: “Understanding barriers and challenges to effective community participation in the rollout of HIV/AIDS treatment and care services.” The objectives were to share the research findings with the communities and organizations that participated in the study; solicit participants’ input in understanding and utilizing the findings; facilitate interaction and exchange between stakeholders including community and facility-based providers involved in ART services; develop key strategies to operationalize findings and for development …
Understanding Barriers To Community Participation In Hiv And Aids Services: Final Report, Ashnie Padarath, Catherine Searle, Eka Esu-Williams
Understanding Barriers To Community Participation In Hiv And Aids Services: Final Report, Ashnie Padarath, Catherine Searle, Eka Esu-Williams
HIV and AIDS
In 2003, South Africa announced its intention to roll out possibly the largest HIV and AIDS treatment program in the world. Much attention is currently focused on supply-side issues, particularly drug procurement and pricing. Far less attention has been paid to demand for and delivery of treatment, care, and support services. Further, although the role of the community and community organizations is articulated in government policy there has been little active engagement with NGOs on the development of these roles or how to encourage community organizations to support and participate in the antiretroviral (ARV) rollout. As noted in this final …
Understanding Barriers To Community Participation In Hiv And Aids Services: Summary Report, Population Council, Health Systems Trust
Understanding Barriers To Community Participation In Hiv And Aids Services: Summary Report, Population Council, Health Systems Trust
HIV and AIDS
In 2003, South Africa announced its intention to roll out possibly the largest HIV and AIDS treatment program in the world. Much attention is currently focused on supply-side issues, particularly drug procurement and pricing. Far less attention has been paid to demand for and delivery of treatment, care, and support services. Further, although the role of the community and community organizations is articulated in government policy there has been little active engagement with NGOs on the development of these roles or on how to encourage community organizations to support and participate in the antiretroviral (ARV) rollout. This study collected data …
Reducing Stigma And Discrimination In Hospitals: Positive Findings From India, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly
Reducing Stigma And Discrimination In Hospitals: Positive Findings From India, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly
HIV and AIDS
People living with HIV (PLHIV) in India face stigma and discrimination in a variety of contexts. Stigma and discrimination against HIV-positive people is common in hospitals and acts as a barrier to seeking and receiving critical treatment and care services. Three New Delhi hospitals, SHARAN, and the Horizons Program collaborated on an operations research project to assess responses to hospital-based stigma and discrimination against PLHIV. A baseline survey to measure HIV/AIDS-related attitudes, knowledge, and practices was conducted in 2000 with a random sample of 884 health workers from four departments: medicine, STD and skin, obstetrics and gynecology, and surgery. Based …
Expanding Pediatric Access To Antiretroviral Therapy In South Africa, Desiree Michaels, Brian Eley, Lewis Ndhlovu, Naomi Rutenberg, Hena Khan
Expanding Pediatric Access To Antiretroviral Therapy In South Africa, Desiree Michaels, Brian Eley, Lewis Ndhlovu, Naomi Rutenberg, Hena Khan
HIV and AIDS
In sub-Saharan Africa, AIDS has become one of the leading causes of death among children under the age of five years. Yet, despite increased availability of antiretroviral therapy (ART), children have been largely ignored or excluded from treatment initiatives. While efforts to get more children on treatment are increasing, important information is lacking to guide program and policy implementation. To address these gaps, the Horizons Program and the University of Cape Town conducted a rapid situational analysis in 2005 of pediatric HIV treatment sites in South Africa. In 2003, the South African government approved a plan for a national HIV …
Yaari Dosti: Young Men Redefine Masculinity, A Training Manual [Hindi], Horizons Program, Coro For Literacy, Mamta, Instituto Promundo
Yaari Dosti: Young Men Redefine Masculinity, A Training Manual [Hindi], Horizons Program, Coro For Literacy, Mamta, Instituto Promundo
HIV and AIDS
This training manual, developed by the Population Council in collaboration with Instituto PROMUNDO, CORO for Literacy, MAMTA, and DAUD promotes gender equity and addresses masculinity as a strategy for the prevention of HIV. Adapted from the “Program H: Working with Young Men Series” developed in Brazil by Instituto PROMUNDO, it promotes the positive aspects of masculinity, encourages men’s participation in sexual and reproductive health, promotes respect for sexual diversity, and improves understanding of the body and sexuality. In this manual, HIV prevention is addressed within the larger framework of gender roles and relationships. Gender disparity, widely prevalent in Indian society …
Context And Dynamics Of Same-Sex Behavior Among Long-Distance Truckers In India: Findings From Qualitative Research, Vaishali Sharma Mahendra, Ravi K. Verma, Pertti J. Pelto, Sarat Chandra Pradhan, Vibha Singh, Asha Rao, Tarun Vij
Context And Dynamics Of Same-Sex Behavior Among Long-Distance Truckers In India: Findings From Qualitative Research, Vaishali Sharma Mahendra, Ravi K. Verma, Pertti J. Pelto, Sarat Chandra Pradhan, Vibha Singh, Asha Rao, Tarun Vij
HIV and AIDS
It is well established that truckers (drivers and helpers) have higher rates of nonmarital sex than any other occupational group. Because of this multipartner sexual activity, truckers form a key group of prevention efforts for HIV and sexually transmitted infections (STIs). Thus far, HIV/STI prevention interventions for truckers have been geared to providing risk-reduction information and services within a heterosexual context. Recent evidence suggests that a significant number of truckers engage in male-to-male (MSM) sexual activity that has implications for HIV/STI transmission. Therefore, information on the nature and extent of MSM activity among these populations is urgently needed for the …
Context And Dynamics Of Male-To-Male Sexual Behavior Of Truckers In India: Findings From A Multi-Site Qualitative Research Study, Ravi K. Verma, Vaishali Sharma Mahendra, Pertti J. Pelto, Sarat Chandra Pradhan, Vibha Singh
Context And Dynamics Of Male-To-Male Sexual Behavior Of Truckers In India: Findings From A Multi-Site Qualitative Research Study, Ravi K. Verma, Vaishali Sharma Mahendra, Pertti J. Pelto, Sarat Chandra Pradhan, Vibha Singh
HIV and AIDS
It is well established that truckers (drivers and helpers) have higher rates of nonmarital sex than any other occupational group. Because of this multipartner sexual activity, truckers form a key group for HIV/STI prevention efforts. Thus far, HIV/STI prevention interventions for truckers have been geared to providing risk-reduction information and services within a heterosexual context. Recent evidence suggests that a large number of truckers engage in male-to-male (MSM) sexual activity that has serious implications for HIV/STI transmission. Therefore, information on the nature and extent of MSM activity among these populations is urgently needed for the design and implementation of comprehensive …
Facts About Adolescents From The Demographic And Health Survey—Statistical Tables For Program Planning: Nigeria 2003, Population Council
Facts About Adolescents From The Demographic And Health Survey—Statistical Tables For Program Planning: Nigeria 2003, Population Council
Poverty, Gender, and Youth
The Population Council initiated its work on adolescents in the mid-1990s. At that time, those advocating greater attention to adolescent issues were concerned about adolescent fertility—particularly outside of marriage—and adolescent “risk-taking” behavior. As an international scientific organization with its mandate centered around the needs of developing countries, the Council sought a more nuanced and context-specific understanding of the problems confronting adolescents in the developing world. In working with colleagues inside and outside the Council, it became clear that information on adolescents, and the way data are organized, were limiting the ability to understand the diversity of their experiences or to …
Abcs For Hiv Prevention In Kenya: Messages, Beliefs, And Barriers, Julie Pulerwitz, Tiffany Lillie, Louis Apicella, Ann P. Mccauley, Tobey C. Nelson, Simon Ochieng, Peter Mwarogo, Karusa Kiragu, Edward Kunyanga
Abcs For Hiv Prevention In Kenya: Messages, Beliefs, And Barriers, Julie Pulerwitz, Tiffany Lillie, Louis Apicella, Ann P. Mccauley, Tobey C. Nelson, Simon Ochieng, Peter Mwarogo, Karusa Kiragu, Edward Kunyanga
HIV and AIDS
A great deal of attention has been focused recently on promoting the “ABCs” of HIV prevention— abstinence or delaying sex, being faithful to one sexual partner or reducing the number of sexual partners, and consistently using condoms during sex. Yet even as programs that focus on the ABCs to prevent sexual HIV transmission are rolled out, questions remain about how well different groups in varied cultural contexts understand the terms, as well as how best to address challenges to adopting the ABC behaviors. The Horizons Program and FHI/IMPACT developed a collaborative research study in 2004 to explore how adults and …
Baseline Household Survey: Jhelum District, Pakistan Initiative For Mothers And Newborns (Paiman)
Baseline Household Survey: Jhelum 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 …
Baseline Survey: Summary Report Of District Sukkur, Pakistan Initiative For Mothers And Newborns (Paiman)
Baseline Survey: Summary Report Of District Sukkur, Pakistan Initiative For Mothers And Newborns (Paiman)
Reproductive Health
This summary report presents some of the key findings of a 2005 baseline household survey in Sukkur district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …
Baseline Household Survey: Jaffarabad District, Pakistan Initiative For Mothers And Newborns (Paiman)
Baseline Household Survey: Jaffarabad 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 …
Promoting Gender Equity Among Young Brazilian Men As An Hiv Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento
Promoting Gender Equity Among Young Brazilian Men As An Hiv Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento
HIV and AIDS
There is growing evidence that social norms that promote unequal gender roles increase young men and women’s risk of HIV/STIs and partner violence. Thus, changing gender norms is increasingly recognized as an important strategy to prevent the spread of HIV infection. Few interventions to promote gender-equitable norms and behaviors among young men have been systematically implemented or evaluated, and little is known about how best to measure changes in gender norms and their effect on HIV/STI protective and risk behaviors. To address these gaps, the Horizons Program and Instituto Promundo examined the effectiveness of interventions designed to improve young men’s …
Understanding The Hiv/Sti Prevention Needs Of Men Who Have Sex With Men In Kenya, Washington Onyango-Ouma, Harriet Birungi, Scott Geibel
Understanding The Hiv/Sti Prevention Needs Of Men Who Have Sex With Men In Kenya, Washington Onyango-Ouma, Harriet Birungi, Scott Geibel
HIV and AIDS
Understanding the sexual behaviors of populations who are vulnerable to HIV is an important component in the battle against AIDS. Yet policymakers in developing countries, particularly in Africa, have often overlooked men who have sex with men (MSM) as a vulnerable group because of stigmatization of homosexual behavior and denial of the existence of MSM and the role they may play in HIV transmission. A growing body of literature not only documents the presence of this population in Africa but also the importance of reaching them with information and services to prevent HIV and other sexually transmitted infections (STIs). In …
Pregnancy-Related School Dropout And Prior School Performance In South Africa, Monica J. Grant, Kelly Hallman
Pregnancy-Related School Dropout And Prior School Performance In South Africa, Monica J. Grant, Kelly Hallman
Poverty, Gender, and Youth
Using data collected in 2001 in KwaZulu-Natal, South Africa, this working paper examines the factors associated with schoolgirl pregnancy, as well as the likelihood of school dropout and subsequent re-enrollment among pregnant schoolgirls. This analysis triangulates data collected from birth histories, education histories, and data concerning pregnancy to strengthen the identification of young women who became pregnant while enrolled in school and to define discrete periods of school interruption prior to first pregnancy. Given the increasing levels of female school participation in sub-Saharan Africa, our findings suggest that future studies will benefit from exploring the causal relationships between prior school …
Baseline Survey: Summary Report Of District Khanewal, Pakistan Initiative For Mothers And Newborns (Paiman)
Baseline Survey: Summary Report Of District Khanewal, Pakistan Initiative For Mothers And Newborns (Paiman)
Reproductive Health
This summary report presents some of the key findings of a 2005 baseline household survey in Khanewal district, one of the ten districts in Pakistan that are the focus of the PAIMAN project. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by the United States Agency for International Development. The project is committed to assisting the Government of Pakistan in implementing the full spectrum of interventions necessary to address maternal and neonatal health (MNH) issues. PAIMAN district survey results are presented individually for each of the ten districts. PAIMAN developed a monitoring and evaluation plan …
Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz
Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz
Reproductive Health
Female genital mutilation (FGM) is a traditional practice that affects women and girls in several African countries. It is practiced in a variety of ways, classified by WHO into four broad types all found in Kenya. In some communities it is associated with passage into maturity; in others, it is considered a symbol of ethnic identity, a religious obligation, or a necessary prerequisite for marriage, either through symbolizing attainment of womanhood or as a means of preserving and demonstrating virginity. FGM is considered a harmful traditional practice because it may be associated with a variety of short- and long-term health …
Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller
Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller
Reproductive Health
Maternal mortality in Pakistan is believed to be quite high, at about 350–500 maternal deaths per 100,000 live births. Reducing maternal mortality is one of the major objectives of the Government of Pakistan. Interventions required to address maternal mortality include safe motherhood, which means a woman’s ability to have a safe and healthy pregnancy and delivery. The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal and neonatal mortality in a predominantly rural district of Pakistan. The vast majority of maternal deaths are attributed to delays in …