Public Health Commons^™

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Rawalpindi, Population Council

Reproductive Health

This district profile of Rawalpindi is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of family planning and other socioeconomic indicators. It covers consumers’ perspectives on barriers to use of family planning noting the lack of information among men and women, especially migrants; problems of access among poor rural women; and difficulty in affording services, among poor couples. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Understanding Married Women's Vulnerability To Hiv Infection In Egypt: An Exploratory Study, Doaa Oraby, Nahla G. Abdel-Tawab

Reproductive Health

This study examines the behavioral, sociocultural, economic, programmatic, and legal factors that aggravate Egyptian women’s vulnerabilities to HIV/AIDS. The study concludes that in low-prevalence settings like Egypt, targeted interventions are the most strategic and cost-effective: for example, HIV awareness-raising with a special focus on the preventive role of consistent, correct condom use, and creating a cadre of peers that could provide psychosocial support and HIV counseling to migrant workers. Furthermore, premarital and antenatal care programs should include HIV awareness-raising and provider-initiated counseling and testing after screening of women to identify those at risk for HIV infection. Concurrently, efforts should be …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Districts Haripur And Nowshera, Khyber Pakhtunkhwa, Population Council

Reproductive Health

Through its Reproductive Maternal and Neonatal Child Health project, GIZ Pakistan is assisting the Government of Pakistan in strengthening its health system’s capacities for ensuring effective, efficient, client-oriented, and affordable reproductive, maternal, newborn, and adolescent health care. GIZ engaged with senior national and provincial government officials who indicated their interest in applying the innovative Made-In/Made-For (Maternal Death, from Informants/Maternal Death, Follow On Review) methodology, a cost-effective alternative for generating reliable estimates of maternal mortality through community-based informant networks. This Population Council study in two pilot districts identified specific areas that need strong policy and programmatic interventions to improve maternal health …

Using The Community Informant-Based (Made-In And Made-For) Methodology To Estimate The Neonatal Mortality Rate (Nmr) In Nowshera, Khyber Pakhtunkhwa: A Feasibility Study, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, Rehan M. Niazi

Reproductive Health

Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

Creating A Community Of Practice To Prevent Suicide Through Multiple Channels: Describing The Theoretical Foundations And Structured Learning Of Pc Cares, Lisa Wexler, Diane Mceachern, Gloria Difulvio, Cristine Smith, Louis F. Graham, Kirk Dombrowski

Department of Sociology: Faculty Publications

It is critical to develop practical, effective, ecological, and decolonizing approaches to indigenous suicide prevention and health promotion for the North American communities. The youth suicide rates in predominantly indigenous small, rural, and remote Northern communities are unacceptably high. This health disparity, however, is fairly recent, occurring over the last 50 to 100 years as communities experienced forced social, economic, and political change and intergenerational trauma. These conditions increase suicide risk and can reduce people’s access to shared protective factors and processes. In this context, it is imperative that suicide prevention includes—at its heart— decolonization, while also utilizing the “best …

Organizing For Women And Children: Advocating For The ‘Reach Every Mother And Child’ Campaign, Laura E. Leslie

Capstone Collection

Every day families are left without mothers and children. Not only does this affect the family but it can have ramifications on the community. There is a link between the wellbeing of moms and that of their children, yet we lose thousands of women to maternal complications each year. Moreover, each day, thousands of children die before reaching their fifth birthday. The most tragic part is that most of these deaths are preventable. While these deaths have been halved in the last 15 years, there is still a lot of work to be done. There have been several initiatives which …

Capstone Revival, Mary Mesele, Ruochen Lu, Quilin Jiang

School of Professional Studies

The capstone project is a culminating experience whereby students choose to research a topic that is relevant in their field of study and have been highly regarded as important learning activities. The capstone allows students to use research, analytical, problem solving and evaluation skills they have learned in the course of the graduate program. McGill indicates the benefit of the completion of a capstone project not only in gaining knowledge in capstone but also in learning how to apply the knowledge gained in other courses in the major (McGill, 2012). Currently, COPACE (College of Professional and Continuing Education) has three …

Cross-Cultural Childbirth: Prioritizing The Healthcare Experiences Of Migrant Women In Competent Models Of Care, Emma Hall

Independent Study Project (ISP) Collection

In the context of the feminization of increasing global migration, it is impossible to understand maternal and child health in a given country without considering the experience of female migrants. As the total migrant population increases in the European Union, migration and its effects on health care provision in receiving countries and the experiences of immigrant populations must be recognized. Past research exposes an increased risk of complications and maternal mortality in migrant populations, but little information exists on the tangible programs that could respond to disparity. According to the World Health Organization, maternal health refers to the health of …

Exploring Community Health Through The Lens Of The Community Unit In Kariobangi North And The Surrounding Areas, Maya Paris-Saper

Independent Study Project (ISP) Collection

Healthcare is a challenge in countries of the Global South. Not only do climates and trends of rapid urbanization affect the health status of many negatively, but also many health facilities are inaccessible and not of good quality, they lack enough medical personnel and lack the resources to adequately provide for patients who do not have the resources them selves. As the wealth gap increases all over the world and resources continue to be distributed unequally communicable and non-communicable health issues plague those in urban and rural settings at an alarmingly high rate and as health innovation has worked to …

Maternal Health In Villages Of Northern Uttar Pradesh Assessing Options, Practices And Outcomes In Bahraich District, Elizabeth Curtis

India: Public Health, Policy Advocacy, and Community

Maternal mortality distinctly highlights a health burden women face, particularly in developing countries. For that reason, poor maternal outcomes in rural India are a field in which Public Health workers and researchers continue to question and study. This project aims to understand the reasons behind poor maternal health outcomes for village women in Bahraich District of Uttar Pradesh. The focus of this topic is the accessibility of available health services and the attitudes of various players who distribute or consume services of the health system. Through fieldwork with doctors, medical institutions, auxiliary health workers, traditional health workers, and village women, …

Abortion In Brazil - Todo Mundo Faz: An Analysis Of Social Movements And Social Support For The Liberalization Of Brazil’S Abortion Law In Salvador, Brazil, Maria Camila Caicedo

Independent Study Project (ISP) Collection

This study analyzed the current actions of feminist movements, black women’s movements, and other advocacy groups that have a stake in the current debate for the legalization of abortion in Brazil. The purpose of the study was to assess the current political avenues for approaching the legislative body available to marginalized groups who are disproportionately affected by the criminalization of abortion. It was built upon a comprehensive review of existing literature, which found very little information on the actions of feminist movements and black women’s movements in Northeast Brazil. The study was conducted over the course of four weeks in …

La Relación Entre El Desamparo Y La Salud: El Caso Del Campamento Japón En Santiago, Chile, Chaveli Concepción

Independent Study Project (ISP) Collection

En esta investigación se busca exponer más a fondo como la desigualdad social afecta la salud de aquellos que han sido menos favorecidos. En esta ocasión se analizó el caso de los habitantes del Campamento Japón, en la comuna de Maipú, de Santiago, Chile, con el objetivo de entender el fenómeno de la desigualdad social y cómo esta afecta la salud de las personas que la sufren. La metodología de este estudio cualitativo se constituyó de investigación bibliográfica previa, y posteriormente visitas y trabajos voluntarios al Campamento Japón para hacer observaciones y entrevistas a los activistas del campamento, a los …

La Santé Maternelle À Antsiranana Selon La Médicine Occidentale Et La Médicine Traditionnelle : Une Étude Des Traitements Opposés Pour Les Femmes Enceintes, Lauren Nguyen

Independent Study Project (ISP) Collection

Dans un pays comme le Madagascar, où des coutumes traditionnelles et le lien avec les ancêtres demeurent une grande partie de la culture, l’introduction des aspects « occidentales » présente un peu du désaccord. Cela est vu avec l’introduction de la médecine « occidentale », et le choix que font des Malagasy pour leurs soins médicaux. Spécifiquement dans le secteur de la médecine, la tension entre des pratiques occidentales et des pratiques traditionnelles est significative.

La présence des guérisseurs traditionnels et de la médecine traditionnelle sur l’île existait bien avant l’introduction de la médecine occidentale. Bien que de plus en …

Associations Between Family Functioning And Adolescent Health Behaviors, Megan S. Fleming

Senior Honors Projects

Background: The obesity epidemic has been a concern across the globe, affecting about 20% of adolescents in the U.S. Physical activity and nutrition-related behaviors that develop during adolescence carry through into adulthood. Adolescents’ perceptions of how their family functions may be associated with health behaviors, including physical activity and diet.

Objective: To determine whether there is an association between perceived family functioning and adolescent health behaviors among a national sample of adolescents aged 11 to 16 who participated in the 2009-2010 Health Behaviors of School-Aged Children survey.

Methods: Participants reported on demographics and measures of family function, which included …

Gathering Perspectives On Extended Family Influence On African American Children's Physical Activity, Natasha A. Brown, Katherine Clegg Smith, Rachel L.J. Thornton, Janice V. Bowie, Pamela J. Surkan, Darcy A. Thompson, David M. Levine

Journal of Health Disparities Research and Practice

Background: The family environment is a key determinant of children’s physical activity. The importance of the extended African American family is well established, but there is little research on its influence on school age children’s physical activity. Methods: We recruited eight families in which grandparents and other adult relatives played a central role in child supervision. Semi-structured interviews with parents, other adult relatives, and children revealed various perspectives on the influences of culture and families on children’s weight-related behaviors. Results: Children were between the ages of 6 and 11, and five of the families resided in neighborhoods in which at …

Herbs, Home Medicine, And Self-Reliance: A Study On The Current Status Of Traditional Home Medicine In Idukki District, Kerala, Richard Gaunt

Independent Study Project (ISP) Collection

Home medical knowledge, or knowledge of how one’s surroundings can be used to maintain and restore health, can be an important tool for health self-sufficiency in rural places as well as for the ecological conservation of important plants and natural materials. The Indian state of Kerala has a rich heritage of traditional medicine, found in the historically inter-related forms of codified Ayurveda and folk knowledge. In Idukki district, a region of Kerala nestled in the hills of the Western Ghats, rural households engage in small-scale home-gardening and agroforestry, which in addition to providing nutritionally diverse food is a source of …

Ouch, That Hurts: Childbirth-Related Pain Management And The Inappropriate Replacement Of Traditional Obstetrical Knowledge In Kumaon, Uttarakhand, India, Sabrina Zionts

Independent Study Project (ISP) Collection

Throughout India, obstetrical knowledge and practice has been developed and passed down by generations of women. In many Indian societies, traditional birth attendants, or dais, remain the gatekeepers of childbirth-related knowledge. Yet with the push towards institutional delivery, traditional knowledge and practices are being increasingly replaced with modern and Western ones. While the trend of hospital deliveries has yielded positive health outcomes, its socio-cultural consequences remain unclear. Situated in Uttarakhand’s Kumaon Himalayas, this study employs a bio-social framework and begins to reveal these consequences. Using labor pain management as an entry point, this study argues that the push towards institutional …

Ulaanbaatar’S Ger District Issues: Changes And Attitudes, David Engel

Independent Study Project (ISP) Collection

Several of Ulaanbaatar’s current issues are directly related to Ulaanbaatar’s sprawling Ger District. The Ger District is home to approximately 736,000 residents, 61% of Ulaanbaatar’s population (Galimbyek, 2015). The significant growth in Ulaanbaatar is shown by its 52.8% of residents who were born outside of the city, the majority of migrants moving into the Ger District due to a lack of housing. (Chilkhaasuren & Baasankhuu, 2012). The development of Ulaanbaatar has not kept up with the rapid growth leading to inadequate infrastructure in much of the Ger District. In turn, inadequate infrastructure has lead to high pollution levels, negatively affecting …

Deconstructing Unmade Examining The Capacity Of Ayurveda To Address India’S Mental Health Crisis, Cassie Sutten Coats

Independent Study Project (ISP) Collection

Though India does not have a credible, widespread system in place to recognize and focus on issues of mental health, especially in allopathic treatments, it is imperative to evaluate the existing practices and approaches in regards to mental health alongside the impact that these approaches may have on Indian society. In contrast to Westernized systems of medicine, the traditional Indian system of Ayurveda inherently addresses issues in mental health due to the holistic approach through mind-body medicine. This study evaluates the enormous potential that exists within Ayurvedic philosophy to provide adequate, culturally congruent, treatments and care in mental health, and …

Fighting The Obesity Epidemic: Challenges And Ethics, Grace Brown

Independent Study Project (ISP) Collection

In recent decades, a double burden of disease has emerged that requires public health workers to fight both hunger and obesity. The obesity epidemic is unlike other epidemics in that it is largely man-made and dependent on social factors and industry influences, making it difficult to fight. The high global prevalence of obesity is partially a result of globalization, which has encouraged development and the liberalizing of economies all around the world, which in turn has increased the marketing and consumption of obesogenic products. Policy solutions have been proposed and implemented in some countries, but an international solution has yet …

Confronting Cultural Challenges For Migrant Healthcare In Switzerland, Rebecca Weiss

Independent Study Project (ISP) Collection

Switzerland is home to many migrants, and migration exacerbates health risks. In addition to physical health problems, migrants are more likely than Swiss nationals to face mental health challenges and cultural barriers, which complicate their experiences seeking healthcare. Similarly, clinicians encounter numerous challenges related to the special circumstances of migrant patients. As a response to the specific health needs of migrants, hospital networks and migrant support organizations promote the migrant health situation. However, these services are not ubiquitous in Switzerland, partly due to the partial freedoms of each canton to create its own health policy. This paper explores the barriers …

Un Análisis Del Trabajo De Equipos Asistenciales De Salud Mental Que Acompañan A Los Hijos De Desaparecidos En El Proceso De Restitución De Su Identidad En Buenos Aires / An Analysis Of Mental Health Teams That Work With The Appropriated Children Of The Desaparecidos Throughout The Judicial Identity Restitution Process In Buenos Aires, Magdalena Jurczuk

Independent Study Project (ISP) Collection

Background: The Argentine national law of mental health (law 26.657) mentions human rights 11 times. This has particular importance in the context of the state of terrorism that the country was under surrounding the last “golpe militar” of 1976. Part of the implemented terror tactics included the kidnapping of 30,000 people—desaparecidos—who did not agree with state politics. The kidnappings were nondiscriminatory and included pregnant women. The babies, that were born in the clandestine centers of detention, torture and extermination, had their birth certificates falsified and became part of a systematic plan of appropriation. They were subsequently either taken in by …

Sexual And Reproductive Health Education For Boys In Kapchorwa, Uganda, Meredith Colleary

Independent Study Project (ISP) Collection

This study examines the systems by which adolescent boys receive sexual and reproductive health (SRH) education in Kapchorwa, Uganda. Teenage pregnancy and early marriage are epidemics that hinder Uganda’s development. As girls have consistently been the targets of interventions, this study considers how boys are included in these strategies. The objectives of the study are three-­‐fold: to research the ways that boys receive SRH education, to identify the successes and shortcomings of these education systems, and to seek ways for these systems to be improved.

The study was carried out over a six-­‐week period in the spring of 2015. The …

The Impact Of Vaccine Hesitancy On The Polio Vaccine In South Asia, Leah Everist

Independent Study Project (ISP) Collection

A disease that paralyzes hundreds of children each year, polio is incurable but also entirely preventable through vaccination. Though part of the reason some children are not reached for immunization is that they are in areas too volatile for healthcare workers to access, vaccine hesitancy is increasingly being recognized as an important player. The objective of this study is to ascertain the degree to which vaccine hesitancy affects polio vaccine campaigns in Afghanistan and Pakistan, the countries in South Asia where polio continues to be endemic, to assess the drivers behind hesitancy in this region, and to present recommendations for …

An Examination Of The Effect Of Vision-Related Factors And Availability Of Health Care Resources On Depression, Functional Status, And Falls Among New York City Senior Center Attendees, Lauren Evans

Dissertations, Theses, and Capstone Projects

There is substantial variability across different geographic regions and demographic groups in health outcomes and health resource availability. This dissertation examines the relationship between self-reported ocular disease and depression, functional status, and falls in a diverse sample of senior center attendees in New York City. Further, these analyses explored whether the availability of health care resources at the area level affects the observed relationship between ocular disease and these other adverse outcomes.

This dissertation project addresses two main gaps in the current research, specifically, the need to better understand elders' experiences with these conditions in different geographic regions and demographic …

Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council

HIV and AIDS

Nigeria, home to over 170 million people, has a disproportionately heavy youth population of 32 percent whose well-being is intricately tied to the country’s prospects for sustainable development. Nigeria has an HIV prevalence of 3.4 percent, the second highest number of infections in the world. In 2013, it was estimated that 160,000 adolescents in Nigeria were living with HIV. Although Nigeria has developed a national HIV strategic plan that forms a basis for the HIV response, national AIDS and related policies contain few youth-centered provisions. Overall, the national strategic plan targets youth as part of the general population. To fill …

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …

Addressing Mental Health Disorders And Hiv Vulnerability Of Marginalized Adolescents In Addis Ababa, Ethiopia, Nrupa Jani, Lung Vu, Sam Kalibala, Gebeyehu Mekonnen, Kay Lynn

HIV and AIDS

Ethiopia is experiencing an increasingly urban, female-centered HIV epidemic alongside a rise in rural migration of adolescents to Addis Ababa. Often these migrants are confronted by social challenges such as lack of education, inadequate housing, unstable employment conditions, and physical and sexual abuse. These difficult living circumstances contribute to psychological and mental health problems among these adolescents, potentially putting them at greater risk of acquiring HIV. However, knowledge about how targeted mental health interventions can impact HIV-related outcomes worldwide, and in Ethiopia, remains limited. The goal of this study was to pilot test a strategy for addressing mental health problems, …