Public Health Commons^™

Ascertainment Of The Estimated Excess Mortality From Hurricane Maria In Puerto Rico, Carlos Santos-Burgoa, Ann Goldman, Elizabeth Andrade, Nicole Barrett, Uriyoan Colon-Ramos, Mark Edberg, Alejandra Garcia-Meza, Lynn Goldman, Amira Roess, John Sandberg, Scott Zeger

Global Health Faculty Publications

No abstract provided.

High-Risk Advanced Maternal Age And High Parity Pregnancy: Tackling A Neglected Need Through Formative Research And Action., Khadidiatou Ndiaye, Erin Portillo, Dieneba Ouedraogo, Allison Mobley, Stella Babalola

Global Health Faculty Publications

Pregnancy among women of advanced maternal age (those 35 years or older) or among women of high parity (those having had 5 or more births) is linked to maternal and infant mortality. Yet little is known about the drivers of these pregnancies as they are often neglected in existing family planning and reproductive health programs. To better understand the context in which advanced maternal age and high parity pregnancies occur and the acceptability of discussing associated pregnancy risks, the Health Communication Capacity Collaborative (HC3) conducted formative qualitative research between January and March 2015 on the perception and determinants of such …

Perceptions, Careseeking, And Experiences Pertaining To Non-Cephalic Births In Rural Sarlahi District, Nepal: A Qualitative Study., Naoko Kozuki, Luke C Mullany, Subarna K Khatry, James M Tielsch, Steven C Leclerq, Caitlin E Kennedy, Joanne Katz

Global Health Faculty Publications

BACKGROUND: In low-resource settings, a significant proportion of fetal, neonatal, and maternal deaths can be attributed to intrapartum-related complications. Certain risk factors, such as non-cephalic presentation, have a particularly high risk of complications. This qualitative study describes experiences around non-cephalic births and highlights existing perceptions and care-seeking behavior specific to non-cephalic presentation in rural Sarlahi District, Nepal.

METHODS: We conducted in-depth interviews with 34 individuals, including women who recently gave birth to a non-cephalic infant and female decision-makers in their households. We also conducted two focus groups with mothers (have two or more children, with at least one child under …

Characterizing Performance Improvement In Primary Care Systems In Mesoamerica: A Realist Evaluation Protocol [Version 1; Referees: 1 Approved], Wolfgang Munar

Global Health Faculty Publications

Background. Improving performance of primary care systems in low- and middle-income countries (LMICs) may be a necessary condition for achievement of universal health coverage in the age of Sustainable Development Goals. The Salud Mesoamerica Initiative (SMI), a large-scale, multi-country program that uses supply-side financial incentives directed at the central-level of governments, and continuous, external evaluation of public, health sector performance to induce improvements in primary care performance in eight LMICs. This study protocol seeks to explain whether and how these interventions generate program effects in El Salvador and Honduras.

Methods. This study presents the protocol for a study …

Modeling The Relationship Between Women’S Perceptions And Future Intention To Use Institutional Maternity Care In The Western Highlands Of Guatemala, Emily Peca, John Sandberg

Global Health Faculty Publications

Background

Despite global gains, women in hard-to-reach areas are at a relatively higher risk of death and disability related to childbirth. Traditional methods of measuring satisfaction may mask negative experiences (such as disrespect and abuse) that can drive down demand for institutional care. Better measurement of women’s perceptions of care quality, especially among marginalized populations with historically low utilization of institutional care, are needed to inform how to improve services and foster greater utilization of (potentially life-saving) clinical care.

Methods

A population-based household survey was conducted in 15 purposively selected villages in the rural Western Highlands of Guatemala among women …

Why It Worked: Participants' Insights Into An Mhealth Antiretroviral Therapy Adherence Intervention In China., Lora L Sabin, Lauren Mansfield, Mary Bachman Desilva, Taryn Vian, Zhong Li, Xie Wubin, Allen L Gifford, Yiyao Barnoon, Christopher J Gill

Global Health Faculty Publications

Background: Few Antiretroviral Therapy (ART) adherence trials investigate the reasons for intervention success or failure among HIV-positive individuals.

Objectives: To conduct qualitative research to explore the reasons for effectiveness of a 6-month mHealth (mobile health) trial that improved adherence among ART patients in China. The intervention utilized Wireless Pill Containers (WPCs) to provide, real-time SMS reminders, WPC-generated adherence reports, and report-informed counseling.

Methods: We conducted in-depth interviews with 20 intervention-arm participants immediately following the trial. Sampling was purposeful to ensure inclusion of participants with varied adherence histories. Questions covered adherence barriers and facilitators, and intervention experiences. We analyzed data in …