Public Health Commons^™

Married Young Women And Girls' Family Planning And Maternal Heath Preferences And Use In Ethiopia, Aparna Jain, Elizabeth Tobey, Hussein Ismail, Annabel Erulkar

Reproductive Health

Married young women and girls are the primary users of youth-centered sexual and reproductive health services in Ethiopia and, given the health risks associated with early and closely-spaced pregnancies, represent an especially important population to reach with sexual and reproductive health services. This brief looks specifically at the needs and preferences for family planning and reproductive health services among married young women and girls, with recommendations for how to more effectively ensure that they have access to those services.

Modeling And Mapping Of Girls' Female Genital Mutilation/Cutting (Fgm/C) In The Context Of Economic, Social, And Regional Disparities: Kenya Demographic And Health Surveys 1998-2014, Ngianga-Bakwin Kandala, Damaris Kinyoki, Ahmed Sarki, David Gathara, Paul Komba, Bettina Shell-Duncan

Reproductive Health

The aim of this research study is analysis of successive household data for estimating and revealing trends, similarities, and differences in geographic patterns for the burden of female genital mutilation/cutting (FGM/C) and related risk factors among girls ages 14 and younger in Kenya. This Evidence to End FGM/C study, from a coalition led by the Population Council, is intended to contribute to a deeper understanding of the recent burden of FGM/C among the girls within this very young age group, and to enhance knowledge of the geographic distribution of this practice over time. The report will inform current elimination efforts …

Policies For Pre-Eclampsia And Eclampsia Prevention And Management In Bangladesh, Kanij Sultana, Amy Dempsey

Reproductive Health

Bangladesh experiences between 5,000 and 6,000 maternal deaths each year. Of those deaths, 20 percent are from pre-eclampsia and eclampsia (PE/E), the second most common direct cause of maternal mortality in the country. In Bangladesh, best practices to prevent PE/E using aspirin and calcium and managing it through task sharing and use of magnesium sulphate and anti-hypertensive drugs have not been optimally examined. To appreciate the enormity of the problem, the Population Council conducted a landscape analysis in 12 upazilas in four districts. The study was cross sectional, and data collection activities included in-depth interviews (IDIs) with policymakers, development partners, …

Quality Of Care In The Context Of Rights-Based Family Planning, Anrudh K. Jain

Reproductive Health

Over the past two decades, the quality-of-care framework has become a cornerstone of family planning (FP) programming. FP programs have been concerned about improving access and reducing the cost to the client but at the same time making services sustainable and improving their effectiveness and efficiency. Nevertheless, access to FP services is not equitable: educated, wealthier, or urban women have better access to the available services from a range of sources than their more vulnerable counterparts, who are less educated, poor, or live in rural areas. This policy brief suggests five modifications to the QoC framework, based on the comparison …

Rapid Evidence Assessment: Quality Of Studies Assessing Interventions To Support Fgm/C Abandonment, Tammary Esho, Jamlick Karumbi, Carolyne Njue

Reproductive Health

The last decade has seen increased focus and investment in interventions to eliminate female genital mutilation/cutting (FGM/C), along with the need to accelerate its abandonment. The UK Department for International Development (DFID) commissioned the Evidence to End FGM/C: Research to Help Girls and Women Thrive project to: 1) assess the quality of studies that have evaluated different interventions for the prevention of FGM/C, and 2) describe the FGM/C interventions that were evaluated by high-quality studies. The quality of evidence on the effectiveness and impact of FGM/C interventions is generally moderate to low. In addition, few baseline surveys are conducted prior …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Ebonyi, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Nigeria’s Ebonyi State found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Ebonyi. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Katsina, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Nigeria’s Katsina State found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Katsina. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Uganda, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Uganda found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Uganda. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and counseling, but …

Resilience And Community Response To Climate-Related Events: Case Studies From Four Countries, Aviva Klein Meyers, Karen Hardee

Reproductive Health

It is important for governments, aid organizations, and researchers to understand how developing communities respond to climate change and how their efforts can be improved within a framework of resilience thinking. This review explores the definition of resilience and, more specifically, community resilience and its components, then presents four case studies of community response to extreme weather events to illustrate community resilience in action. The review is intended to provide context for and inform more detailed exploration of community resilience in integrated programming (specifically, programming designed to improve health, environment, and population outcomes). It is also intended to capture references …

Results From Systematic Literature Review On Pe/E In Bangladesh, Karen Kirk, Amy Dempsey

Reproductive Health

By 2015, at the conclusion of the Millennium Development Goals, Bangladesh had achieved a reduction in maternal death from 550 per 100,000 live births in 1990, to 170 maternal deaths per 100,000 live births in 2015. Despite this progress, there are still between 5,000 and 6,000 maternal deaths every year in Bangladesh, where 20 percent are the result of pre-eclampsia and eclampsia (PE/E). This systematic review of peer-reviewed literature published between January 2000 and July 2016 identified interventions adopted to manage PE/E throughout Bangladesh. Specifically, it looked at issues around quality of care, gaps in the evidence, and barriers to …

Results From Systematic Literature Review On Pe/E In Nigeria, Amy Dempsey, Karen Kirk

Reproductive Health

Pre-eclampsia and eclampsia (PE/E), hypertensive disorders of pregnancy, are consistently cited as a leading cause of maternal and newborn morbidity and mortality in Nigeria. A recent, nationwide cross-sectional survey found that PE/E contributes to 28.2 percent of national maternal deaths. The other main contributors to maternal mortality are hemorrhage and pregnancy-related infection or sepsis. To fully understand the key challenges, gaps, and interventions related to the prevention and treatment of PE/E, the Ending Eclampsia project conducted a systematic review of papers on PE/E in Nigeria published between 2000–15. The methods, results, and recommendations are discussed in this brief.

Workplace Health And The Garment Sector In Cambodia, Bunmey Yat, Carolyn Rodehau, David Wofford, Ashish Bajracharya

Reproductive Health

In Cambodia, there has been considerable investment in improving the well-being of factory workers. Understanding the key stakeholders and their roles in improving worker health is essential for policy change and ensuring that interventions achieve sustainable, long-term impact in and around the workplace. This policy brief presents selected findings from a stakeholder and situational analysis undertaken by the Cambodia Worker Health Coalition (WorkerHealth) to understand the stakeholder landscape and policy environment for women’s health in the garment industry in Cambodia, with the objective of identifying leading stakeholders and their relationships, as well as strategies and opportunities for collaboration. Collaboration and …

Uganda Retail Audit: Analysis And Report, The Evidence Project

Reproductive Health

This brief presents results of a retail audit, carried out in January 2016, that was commissioned as part of PATH’s work under the USAID-funded Evidence Project to conduct a landscape assessment of the feasibility of a Total Market Approach (TMA) in Uganda. This project also involved key informant interviews with stakeholders on their attitudes toward TMA principles and the collection of a Uganda Market Research Summary of existing family planning knowledge. The approach is based on an understanding that equitably meeting the diverse needs of different population segments requires increased coordination across sectors, including the public, private for-profit, and not-for-profit …

A Month In Manila, Robin M. Lund

Posters

Describes a global health learning experience at Philippines Children's Medical Center in Manila.

South Africa: Combatting The Rise Of Hiv In Adolescents, Ryan Northrup

Posters

Describes a global health learning experience in South Africa in 2017, focused on educating teenagers in schools about sexual health and AIDS prevention.

Swaziland: A Journey Into Culture And Health Care, Claire Hickey

Posters

Describes a global health learning experience with Baylor International Pediatrics AIDS Initiative in Swaziland in 2017.

Sanibonani! A Global Health View Of The Hiv/Aids Epidemic In Swaziland, Angie Schmidt

Posters

Describes a global health learning experience with the Baylor International Pediatric AIDS Initiative in Swaziland.

Unconditional Government Cash Transfer In Support Of Orphaned And Vulnerable Adolescents In Western Kenya: Is There An Association With Psychological Wellbeing?, Sylvia Shangani, Don Operario, Becky Genberg, Kipruto Kirwa, Miriam Midoun, Lukoye Atwoli, David Ayuku, Omar Galárraga, Paula Braitstein

Community & Environmental Health Faculty Publications

Background

Orphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA counterparts. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is known about their impact on the psychological wellbeing of OVA.

Objective

Among OVA in western Kenya, we assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing.

Methods

We examined the likelihood of depression, anxiety, post-traumatic stress symptoms (PTSS) and positive future outlook among 655 OVA aged between 10 and 18 …

Global Health Elective: Swaziland, Africa, Jane Duong

Posters

Describes her learning experience providing care with the Baylor International Pediatric AIDS Initiative (BIPAI) in September 2017.

Measuring Gender Equality In Education: Lessons From 43 Countries, Stephanie Psaki, Katharine Mccarthy, Barbara Mensch

Poverty, Gender, and Youth

Through the 2015 Sustainable Development Goals (SDG), governments committed to achieving universal secondary school completion, including eliminating gender disparities, by 2030. The period from 1997 to 2014 saw considerable progress in closing gender gaps in school enrollment and attainment in many, but not all, low- and middle-income countries. However, as this research brief explains, claims that gender parity in primary education now exists are premature, especially in the poorest countries and new gender gaps, or gender-related challenges, may emerge as attainment increases. Moreover, the extremely low levels of secondary school enrollment—and even moreso completion—demonstrate that the SDG target of universal …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …

International Consensus (Icon) On: Clinical Consequences Of Mite Hypersensitivity, A Global Problem., Mario Sánchez-Borges, Enrique Fernandez-Caldas, Wayne R. Thomas, Martin D. Chapman, Bee Wah Lee, Luis Caraballo, Nathalie Acevedo, Fook Tim Chew, Ignacio J. Ansotegui, Leili Behrooz, Wanda Phipatanakul, Roy Gerth Van Wijk, Demoly Pascal, Nelson Rosario, Motohiro Ebisawa, Mario Geller, Santiago Quirce, Susanne Vrtala, Rudolf Valenta, Markus Ollert, Giorgio Walter Canonica, Moises A. Calderón, Charles S. Barnes, Adnan Custovic, Suwat Benjaponpitak, Arnaldo Capriles-Hulett

Manuscripts, Articles, Book Chapters and Other Papers

Since mite allergens are the most relevant inducers of allergic diseases worldwide, resulting in significant morbidity and increased burden on health services, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed by the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), the European Academy of Allergy and Clinical Immunology (EAACI), and the World Allergy Organization (WAO), has proposed to issue an International Consensus (ICON) on the clinical consequences of mite hypersensitivity. The objectives of this document are to highlight aspects of mite biology that are clinically relevant, to update the …

Non-Medical Use Of Prescription Drugs, Stress, Cultural Orientation, Utilization Of Healthcare, And Protective Factors Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background: Non-medical use of prescription drugs (NMUPD) refers to the use of prescription drugs which are traditionally utilized to manage pain or treat psychiatric problems but without a doctor’s prescription. In 2010, an investigation by the Substance Use and Mental Health Services Administration (SAMHSA) revealed that 5.3% of young adults (18 to 25-year-olds) in the United States reported past-month NMUPD. NMUPD has become a growing concern owing to associations with consequences such as college dropout, poor academic achievement, and health jeopardizing behaviors. College students' NMUPD has been well documented in the United States. Limited studies, however, have been conducted among …

Risk And Burden Of Adverse Intrapartum-Related Outcomes Associated With Non-Cephalic And Multiple Birth In Rural Nepal: A Prospective Cohort Study, Naoko Kozuki, Joanne Katz, Subarna Khatry, James M. Tielsch, Steven Leclerq, Luke C. Mullany

Global Health Faculty Publications

Objectives Intrapartum-related complications are the second leading cause of neonatal death worldwide. We estimate the community-level risk and burden of intrapartum-related fetal/neonatal mortality and morbidity associated with non-cephalic and multiple birth in rural Sarlahi District, Nepal.

Design Community-based prospective cohort study.

Setting Rural Sarlahi District, Nepal.

Participants Pregnant women residing in the study area.

Methods We collected data on maternal background characteristics, conditions during labour and delivery, fetal presentation and multiple birth during home visits. We ran log-binomial regression models to estimate the associations between non-cephalic/multiple births and fresh stillbirth, early neonatal mortality and signs of neonatal encephalopathy, respectively, and …

A Peer Evaluation Of The Community-Based Education Programme For Medical Students At The University Of Zimbabwe College Of Health Sciences: A Southern African Medical Education Partnership Initiative (Mepi) Collaboration, D. Michaels, I. Couper, M. Mogodi, J. Hakim, Zohray M. Talib, +Several Additional Authors

Global Health Faculty Publications

Background. The University of Zimbabwe College of Health Sciences (UZCHS), Harare, which has a long tradition of community-based education (CBE), has not been evaluated since 1991. An innovative approach was used to evaluate the programme during 2015.

Objectives. To evaluate the CBE programme, using a peer-review model of evaluation and simultaneously introducing and orientating participating colleagues from other medical schools in southern Africa to this review process.

Methods. An international team of medical educators, convened through the Medical Education Partnership Initiative, worked collaboratively to modify an existing peer-review assessment method. Data collection took the form of pre-visit surveys, on-site and …

Quality Of Care Assessment At A Resident-Based Primary Care Hiv Clinic, Amanda Lacue, Marshall Miller, Md

CwiC Posters

A quality improvement study based in a primary care resident-based HIV clinic, the Kendig Clinic, was conducted within Jefferson Family Medicine Associates. The study objectives were to

• Determine the percentage of the clinic patients meeting each quality measure

• Compare these calculated clinic measures to known national averages

• Use the data to determine areas to target for future quality improvement initiatives.

Barriers To Care Amongst Rural Indigenous Mayans In Guatemala’S Western Highlands, Nirali Butala

CwiC Posters

Information presented here is based on 5-week volunteering experience at Primeros Pasos clinic in the rural Palajunoj Valley outside the city of Quetzaltenango, Guatemala. Almost all of the patient population is rural, indigenous Quiche Maya. Guatemala has a relatively high GDP and patient-doctor ratio (1000:1) compared to its neighboring Latin American countries, but these resources are extremely localized to its capital, Guatemala City, where 70% of the country’s physicians work.

Only the wealthy are able to utilize private clinics and hospitals that are known to provide the highest quality care. At these clinics, patients pay out-of-pocket. Indigenous, rural communities typically …

The Public Health Crisis In Greece And Its Ties To A Failing Economy, Anna M. Carleen

CwiC Posters

In 2009 the Greek government admitted that the numbers it had been reporting to the European Union about its national budget deficit were artificially small. The deficit was actually huge, way larger than what the EU requires of member countries if they want to reap the benefits of being in this financial network. A benefit of being in the EU is that it makes it much easier for governments to take out large loans, because lenders trust that a member country will make good on its debts due to the security it has from being part of the union. This …

Jeffhealth: Helping East Africa Link To Health, Elizabeth Kuhn, Emily Zhang, Naveed A. Rahman, Rebecca Margolis, Savannah Coe

CwiC Posters

JeffHEALTH-Helping East Africa Link to Health is a student-run organization at Thomas Jefferson University dedicated to improving basic medical education and quality of life in Rwanda, which was devastated in 1994 by civil war and genocide. Working in partnership with the Rwanda Village Concept Project, a student organization at the National University of Rwanda, JeffHEALTH seeks to implement sustainable health initiatives in our partner villages. Graduate students from Thomas Jefferson University travel to Rwanda where we taught Community Health Workers from the Villages of Akarambi and Ruli the following topics: Nutrition and Vitamin Deficiencies, Family Planning, Prenatal care, HIV, Sexually …

An Interactive Curricula Experience (Ice) For Latino Immigrant Health, Kevin Molyneux, Ellen Plumb, Md, Martha Langley Ankeny, Med

CwiC Posters

The Interactive Curricula Experience (iCE) is an educational platform intended for interactive education utilizing multiple forms of media. It is being utilized at Thomas Jefferson University (TJU) in various classes, among them Global Health.

One of the pertinent global-health-at-home topics at TJU relates to Latino immigrant health. Latino immigrants number more than 20,000 in Philadelphia. They are located throughout the city, although the highest concentrations are in North and South Philadelphia. With respect to health care, Latino immigrants are less likely to have a regular health care provider than non-immigrant Latinos.

Education to provide culturally sensitive care to Latino immigrants …