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Perinatal Periods Of Risk: Examination Of Data Quality & Inclusion Criteria, New Unbiased Reference Groups, And A Nationwide County-Level Analysis, Carol S. Gilbert

Theses & Dissertations

Records of births, infant deaths, and fetal deaths are compiled by the US Vital Records System and used to monitor population health and guide health policy. The Perinatal Periods of Risk Approach (PPOR) relies on vital records data to address fetal and infant mortality in US cities. It uses reference groups to estimate preventable mortality by risk period. To avoid biased analyses due to poor data quality for small and early infant and fetal deaths, an expert committee recommended that PPOR analyses exclude fetal deaths delivered at gestational age (GA) <24 >weeks, and infant deaths and live births with birthweights (BW) …

Effect Of Community-Based Kangaroo Mother Care Package On Neonatal Mortality Among Preterm And Low Birthweight Infants In Rural Pakistan: Protocol For A Cluster Randomized Controlled Trial, Shabina Ariff, Atif Habib, Zahid Memon, Tayyaba Arshad, Tariq Samejo, Ikram Maznani, Muhammad Umer, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Neonatal mortality due to preterm birth and low birthweight remains a significant challenge in Pakistan. Kangaroo mother care (KMC) is a unique, low-cost intervention proven to reduce neonatal mortality and morbidity and increase exclusive breastfeeding rates. However, KMC has not been attempted in community settings in Pakistan. We aim to implement and evaluate the effectiveness of a community-based KMC package to reduce neonatal morbidity and mortality among preterm and low birthweight (LBW) infants, which will provide evidence for policy development and the large-scale implementation of KMC across the country.
Objective: The primary objective of this trial is to reduce …

Anemia Among Women Of Reproductive Age: An Overview Of Global Burden, Trends, Determinants, And Drivers Of Progress In Low- And Middle-Income Countries, Aatekah Owais, Catherine Merritt, Christopher Lee, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Relatively little progress has been made in reducing anemia prevalence among women of reproductive age (WRA anemia). Interventions, policies and programs aimed at reducing WRA anemia have the potential to improve overall not only women's, but also children's health and nutrition outcomes. To our knowledge, this is the first review that aimed to compile evidence on the determinants and drivers of WRA anemia reduction in low- and middle-income countries (LMICs). We synthesized the available evidence on the determinants and drivers, including government policies and programs, of WRA anemia and their mitigation strategies across a wide range of countries and geographies, …

The Development And Implementation Of A Culturally Safe Survey For Measuring Knowledge, Attitudes And Values Around Fasd And Alcohol Use During Pregnancy In A Remote Australian Aboriginal Community Setting, Martyn Symons, David Tucker, Kaashifah Bruce, Annalee Stearne, Annette Kogolo, Maureen Carter, June Oscar, Glenn Pearson, James P. Fitzpatrick

Australian Indigenous HealthBulletin

Fetal Alcohol Spectrum Disorder (FASD) describes a lifelong neurodevelopmental disability caused by prenatal alcohol exposure that has a devastating impact on individuals, families and communities. The prevalence of FASD is high in some Indigenous communities around the World and the only active case ascertainment prevalence study conducted in Australia found a rate of 19.44 per 100 children in the remote Fitzroy Valley region of Western Australia. Following this study community led FASD prevention activities were implemented under the Marulu (“Worth Nurturing”) Strategy in the Fitzroy Valley.

A Knowledge, Attitudes and Practices survey was designed to assess the impact of the …

The Importance Of Explicit And Timely Knowledge Exchange Practices Stemming From Research With Indigenous Families, Elizabeth J. Cooper, S Michelle Driedger

The Qualitative Report

Ethical research practice within community-based research involves many dimensions, including a commitment to return results to participants in a timely and accessible fashion. Often, current Indigenous community-based research is driven by a partnership model; however, dissemination of findings may not always follow this approach. As a result, products may not be as useful to participants who were motivated to be involved in the research process. We conducted a seven-week workshop on three occasions with different First Nations and Metis women and girls (age 8-12) in Winnipeg, Manitoba. The workshop explored participants’ perspectives around health, safety, and family wellbeing using a …

Psychological Impact Of Covid-19 And Lock Down Measures: An Online Cross-Sectional Multicounty Study On Asian University Students, Karuthan Chinna, Sheela Sundarasen, Heba Bakr Khoshaim, Kamilah Kamaludin, Mohammad Nurunnabi, Gul Mohammad Baloch, Syed Far Abid Hossain, Areej Sukayt, Nevi Dalina, Zahid Memon

Centre of Excellence in Women and Child Health

The COVID-19 pandemic and the lockdown measures have taken a toll on every level of the society, worldwide. This study examines their psychological impact on university students in Asia. A cross-sectional online survey was conducted between April and May 2020 in Malaysia, Saudi Arabia, Pakistan, Bangladesh, China, India and Indonesia. The Zung's self-rating anxiety scale (SAS) and questions on adaptive and maladaptive coping strategies were used in this study. A total of 3,679 students from the seven countries participated in this study. Overall, 21.9% and 13.7% of the students in this study experienced mild to moderate and severe to extreme …

Biopsychosocial Factors During The Perinatal Period: Risks, Preventative Factors, And Implications For Healthcare Professionals, Ashley J. Blount, Charmayne R. Adams, Ann L. Anderson-Berry, Corrine Hanson, Kara M. Schneider, Gurudutt Pendyala

Office of Health Promotion Scholarship

Women face risks to their wellbeing during the perinatal period of pregnancy. However, there is a dearth of information on perinatal risk factors within the biopsychosocial paradigm. Emphasis is often placed on biological components associated with pregnancy and women’s health. However, psychological and social determinants of health are integral during the perinatal period, and mental wellness is often a determinant for positive maternal and neonatal health outcomes. This article reviews risk factors of perinatal wellness (e.g., physical and nutritional concerns, trauma, discrimination, adverse childhood events) and highlights protective factors for women in their perinatal period. Healthcare professionals can support perinatal …

Factors Affecting Maternal-Care During Labour At Maternity Centres Of Karachi, Pakistan: Exploratory Study, Nirmal Shahzaib, Tazeen Saeed Ali, Nousheen Pradhan, Farina Abrejo, Shahnaz Shahid Ali, Amir Ali Samnani

School of Nursing & Midwifery

Globally 529,000 women die every year due to harmful consequences of childbirth. This study aimed to explore the barriers and facilitators that influence the provision of quality care during labour at maternity centres in Karachi, Pakistan. The qualitative exploratory study design was used to study such factors from public and private maternity health facilities of Karachi, Pakistan. A total of 12 in-depth interviews were conducted through purposive sampling by using validated semi-structured interview guide. Data was analysed using content analysis manually. Among major barriers, unhygienic environment, lack of basic equipment, supplies and medicine, unprofessional attitude of staff, physical infrastructre and …

Probabilistic Measures Of Hiv-1 Transmission In Different Hiv-1 Key Population Groups Of Larkana, Pakistan, Syed Rizwan-Ul-Hasa, Abiha Abdullah, Shakil Arshad Siddiqui, Shakil Ahmed, Sharaf Ali Shah, Fatima Mir, Syed Hani Abidi

Medical College Documents

Objective: To estimate the probability of human immunodeficiency virus (HIV)-1 transmission from different key HIV population groups using probabilistic modelling.
Methods: This study was conducted in December 2020. A probabilistic model was used to estimate the probability of HIV-1 transmission from different key HIV population groups in Larkana. Our model was run on three probabilistic assumptions: 1) each replication gave two conceivable results: 'true' or 'false'; 2) the chance of giving a 'true' result is the same for each replication; and 3) the replications are independent - 'true' in one will not impact the likelihood of 'true' in another.
Results: …

Frequency Of Primiparous Mother Initiated Breastfeeding Earlier After Birth And Factors Associated With It In Sindh, Pakistan: A Secondary Analysis, Asma A. Bham, Sucheta Sharma, Akash Sardool, Umer F. Mujahid, Amrat Ayaz, Komal Valliani, Nawaal Maredia

Community Health Sciences

Background: Initiation of breastfeeding within one hour after delivery plays a vital role in a newborns life by not only increasing their survival rate but also reducing many life-threatening diseases in the newborn. The aim of the study was to determine frequency of early initiation of breastfeeding among primiparous mothers in a rural district of Thatta, Pakistan.
Methods: This study was conducted using survey data extracted from a cross-sectional study conducted in 2019 on prevalence of exclusive breastfeeding and factors associated with it among women in Thatta. The outcome was early initiation of breastfeeding. To determine factors associated with it, …

The Ability And Safety Of Community-Based Health Workers To Safely Initiate Lifesaving Therapies For Pre-Eclampsia In Ogun State, Nigeria: An Analysis Of 260 Community Treatments With Mgso4 And/Or Methyldopa, Akinmade A. Adepoju, Marianne Vidler, Adebayo A. Akadri, Ebun Jaiyesimi, Chimaobi C. Nwankpa, Oluwafayokemi O. Odubena, Sumedha Sharma, Larry Li, Domena Tu, Zulfiqar Ahmed Bhutta

Woman and Child Health

Objectives: To evaluate community-based health workers' ability to identify cases of hypertension in pregnancy, safely deliver methyldopa and magnesium sulphate and make referrals when appropriate.
Study design: This was part of Nigeria Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial (NCT01911494). Community-based Health Workers (CHW) recruited pregnant women from five Local Government Areas (clusters) and used mobile health aid for clinical assessment of pre-eclampsia.
Main outcome measures: The primary outcome was the number of adverse events that occurred after the administration of magnesium sulphate and/or methyldopa to pregnant women by CHWs.
Findings: Of 8790 women receiving mobile …

Impact Of Simple Breastfeeding Initiatives Led By Nurses In A Primary Care Setting, Jessica Semin, Carolyn Hanus, Megan Scott, Amy Ford, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Background: Breastfeeding is recognized by health experts as the preferred infant feeding method. Health professionals, especially nurses, play a vital role in influencing mothers’ infant feeding decisions. This quality improvement project designed, implemented, and evaluated by nurses explores how the implementation of three simple initiatives impacted healthcare staff’s attitudes, beliefs, and perceptions related to breastfeeding.

Materials and Methods: The project was led by three Doctor of Nursing Practice (DNP) students with guidance from their DNP prepared advisor. It took place in a primary care setting at a federally qualified health center. Prior to and after implementation, staff were …

Trends In Hysterectomy In Hospital And Ambulatory Settings In Kentucky 2017-2020., Felicia A. Pugh

Electronic Theses and Dissertations

Hysterectomy is the most common treatment for benign uterine conditions in the United States. Data suggest that one in nine women will have the procedure in their lifetime (1). Previous studies indicate that abdominal hysterectomy rates for non-malignancies are declining as alternative methods are increasing for decades; however, those trends do not apply for all women in the country (2-5). In this cross-sectional study, hysterectomy procedures completed between 2017-2020 are described in Kentucky Cabinet for Health and Family Services data. Multivariable logistic regression is used to assess the odds of abdominal hysterectomy for benign indications in Kentucky. Conclusion: Rates of …

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial., Melissa S Bauserman, Carla M Bann, K Michael Hambidge, Ana L Garces, Lester Figueroa, Jamie L Westcott, Jackie K Patterson, Elizabeth M Mcclure, Vanessa R Thorsten, Sumera Ali Aziz, Sarah Saleem, Robert L Goldenberg, Richard Derman, Veena Herekar, Manjunath Somannavar, Marion W Koso-Thomas, Adrien L Lokangaka, Antoinette K Tshefu, Nancy F Krebs, Carl L Bose, Shivaprasad Goudar, Sangappa Dhaded, Bhalchandra Kodkany, Omrana Pasha, Abhik Das, Menachem Miodovnik, N K Raju Tonse

Global Health Articles

BACKGROUND: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.

OBJECTIVE: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.

METHODS: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Blood Pressure Thresholds In Pregnancy For Identifying Maternal And Infant Risk: A Secondary Analysis Of Community-Level Interventions For Pre-Eclampsia (Clip) Trial Data, Jeffrey N. Bone, Laura A. Magee, Joel Singer, Hannah Nathan, Rahat Qureshi, Charfudin Sacoor, Esperança Sevene, Andrew Shennan, Mrutyunjaya B. Bellad, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Blood pressure measurement is a marker of antenatal care quality. In well resourced settings, lower blood pressure cutoffs for hypertension are associated with adverse pregnancy outcomes. We aimed to study the associations between blood pressure thresholds and adverse outcomes and the diagnostic test properties of these blood pressure cutoffs in low-resource settings.
Methods: We did a secondary analysis of data from 22 intervention clusters in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials (NCT01911494) in India (n=6), Mozambique (n=6), and Pakistan (n=10). We included pregnant women aged 15-49 years (12-49 years in Mozambique), identified in their …

Operational Experiences Associated With The Implementation Of Near Point-Of-Care Early Infant Diagnosis Of Hiv In Myanmar: A Qualitative Study, Win Lei Yee, Hla Htay, Yasmin Mohamed, Claire E. Nightingale, Htay Htay Tin, Win Thein, Latt Latt Kyaw, Win Win Yee, Moe Myat Aye, Stanley Luchters

Population Health, East Africa

Background: Timely diagnosis and early initiation of life-saving antiretroviral therapy are critical factors in preventing mortality among HIV-infected infants. However, resource-limited settings experience numerous challenges associated with centralised laboratory-based testing, including low rates of testing, complex sample referral pathways and unacceptably long turnaround times for results. Point-of-care (POC) HIV testing for HIVexposed infants can enable same-day communication of results and early treatment initiation for HIV-infected infants. However, complex operational issues and service integration can limit utility and must be well understood prior to implementation. We explored and documented the challenges and enabling factors in implementing the POC Xpert® HIV-1 …

Effectiveness Of Typhoid Conjugate Vaccine Against Culture-Confirmed Salmonella Enterica Serotype Typhi In An Extensively Drug-Resistant Outbreak Setting Of Hyderabad, Pakistan: A Cohort Study, Mohammad Tahir Yousafzai, Sultan Karim, Sonia Qureshi, Abdul Momin Kazi, Hina Memon, Amber Junejo, Zohra Khawaja, Najeeb Ur Rehman, Muhammad Sajid Ansari, Rafey Ali, Heera Mani Lohana, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Salmonella enterica serotype Typhi (S Typhi) is a major public health problem in low-income and middle-income countries. We aimed to investigate the effectiveness and impact of the typhoid conjugate vaccine Typbar-TCV against S Typhi among children in an outbreak setting of extensively drug-resistant (XDR) S Typhi in Pakistan.
Methods: This cohort study was done from Feb 21, 2018, to Dec 31, 2019. A census survey of all households located in the Qasimabad and Latifabad subdistricts of Hyderabad, Pakistan, was done at baseline, and 174 005 households were registered in the census. The Typbar-TCV immunisation campaign was initiated at temporary …

Predicting The Environmental Suitability For Onchocerciasis In Africa As An Aid To Elimination Planning, Elizabeth A. Cromwell, Joshua C P. Osborne, Thomas R. Unnasch, Maria-Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where …

More Than Brides Alliance—Marriage: No Child’S Play, Endline Evaluation Brief, Population Council

Poverty, Gender, and Youth

This brief summarizes key results from the endline evaluation of the More than Brides Alliance (MTBA) project “Marriage: No Child’s Play” (MNCP) in India, Malawi, Mali, and Niger. The MTBA consists of partners Save the Children Netherlands, Simavi, Oxfam Novib, and the Population Council, along with 25 local implementing partners. The MNCP project—which took place from 2016 to 2020—aimed at being holistic and targeting pathways to child marriage on multiple levels simultaneously, treating communities as either having the full MNCP package or no intervention. The Population Council’s MNCP evaluation was designed to estimate program impact and trends among girls at …

Covid-19 Deliveries: Maternal Features And Neonatal Outcomes, Viviana Zlochiver, Blair Tilkens, Ana Cristina Perez Moreno, Fatima Aziz, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 weeks (IQR: 37.3–40.0), respectively. Of the 85 SARS-CoV-2–positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented …

Risk Of Infection And Transmission Of Sars-Cov-2 Among Children And Adolescents In Households, Communities And Educational Settings: A Systematic Review And Meta-Analysis, Omar Irfan, Jiang Li, Kun Tang, Zhicheng Wang, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: There is uncertainty with respect to SARS-CoV-2 transmission in children (0-19 years) with controversy on effectiveness of school-closures in controlling the pandemic. It is of equal importance to evaluate the risk of transmission in children who are often asymptomatic or mildly symptomatic carriers that may incidentally transmit SARS-CoV-2 in different settings. We conducted this review to assess transmission and risks for SARS-CoV-2 in children (by age-groups or grades) in community and educational-settings compared to adults.
Methods: Data for the review were retrieved from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, China National Knowledge Infrastructure (CNKI) Database, WanFang Database, Latin …

Role Of Community Engagement In Maternal Health In Rural Pakistan: Findings From The Clip Randomized Trial, Zahra Hoodbhoy, Sana Sadiq Sheikh, Rahat Qureshi, Javed Memon, Farrukh Raza, Mai-Lei Woo Kinshella, Jeffrey N. Bone, Marianne Vidler, Sumedha Sharma, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Community-based strategies to promote maternal health can help raise awareness of pregnancy danger signs and preparations for emergencies. The objective of this study was to assess change in birth preparedness and complication readiness (BPCR) and pregnant women's knowledge about pre-eclampsia as part of community engagement (CE) activities in rural Pakistan during the Community Level Interventions for Pre-eclampsia (CLIP) Trial.
Methods: The CLIP Trial was a cluster randomized controlled trial that aimed to reduce maternal and perinatal morbidity and mortality using CE strategies alongside mobile health-supported care by community health care providers. CE activities engaged pregnant women at their homes …

Using Amanhi-Act Cohorts For External Validation Of Iowa New-Born Metabolic Profiles Based Models For Postnatal Gestational Age Estimation, Sunil Sazawal, Kelli K. Ryckman, Harshita Mittal, Muhammad Imran Nisar, Usma Mehmood, Amina Barkat, Farah Khalid, Muhammad Ilyas, Ambreen Nizar, Fyezah Jehan

Department of Paediatrics and Child Health

Background: Globally, 15 million infants are born preterm and another 23.2 million infants are born small for gestational age (SGA). Determining burden of preterm and SGA births, is essential for effective planning, modification of health policies and targeting interventions for reducing these outcomes for which accurate estimation of gestational age (GA) is crucial. Early pregnancy ultrasound measurements, last menstrual period and post-natal neonatal examinations have proven to be not feasible or inaccurate. Proposed algorithms for GA estimation in western populations, based on routine new-born screening, though promising, lack validation in developing country settings. We evaluated the hypothesis that models developed …

Longitudinal Association Between Parental-To-Child-Maltreatment And Self-Reported Generalized Anxiety Disorder Symptoms In Pakistani Adolescents, Maryam Pyar Ali Lakhdir, Ghazal Peerwani, Salman Muhammad Soomar, Apsara Ali, Salima Farooq, Naureen Akber Ali, Asif Khaliq, Muhammad Masood Kadir, Syed Iqbal Azam

Community Health Sciences

Background: Parent-to-child maltreatment is considered one of the risk factors for Generalized Anxiety Disorder (GAD) symptoms, but this hypothesis has not been adequately tested in Pakistani settings.
Aim: This study aimed to examine the association between parent-to-child maltreatment and the risk of developing GAD symptoms among adolescents.
Methods: The association of none to rare, occasionally, and frequently parent-to-child maltreatment with the incidence of GAD symptoms was investigated in a sample of 800 adolescents aged 11-17 years who were followed for two years. Parent-to-child maltreatment was assessed using ICAST-C (International child abuse screening tool). GAD Symptoms were determined by SCARED (Screen …

Effectiveness Of Peer Counseling And Membership In Breastfeeding Support Groups In Promoting Optimal Breastfeeding Behaviors In The Philippines, Ofelia P. Saniel, Veincent Christian F. Pepito, Arianna Maever L. Amit

Ateneo School of Medicine and Public Health Publications

Background

The prevalence of early initiation of breastfeeding and exclusive breastfeeding (EBF) at 6 months remain low in the Philippines. To help meet the 90% early initiation of breastfeeding target and to improve infant and young child feeding practices in the Philippines, the Millennium Development Goals - Fund 2030 Joint Programme (JP) on Ensuring Food Security and Nutrition for Children 0–24 months old was implemented. We aimed to determine the effectiveness of visits by peer counselors during pregnancy and after delivery, and membership in breastfeeding support groups in promoting these optimal breastfeeding practices.

Methods

We used data from the Endline …

Momhealth: A Feasibility Study Of A Multibehavioral Health Intervention For Pregnant And Parenting Adolescent Mothers., Karen A. Wambach, Ann M. Davis, Eve Lynn Nelson, Kelli Snow, Annie Yungmeyer, Rachel Muzzy, Karman Romero, Megan Murray

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: In 2016, 209,809 babies were born to mothers 15 - 19 years of age, for a live birth rate of 20.3 per 1,000 in this age group. Many health issues surround adolescent mothers and their infants, many of which can be addressed through behavioral change. The main purpose of this study was to examine the feasibility, acceptability, usability, and relevance of momHealth, an innovative multiple health behavior change (MHBC) education and support mHealth intervention, focused on breastfeeding, healthy eating and active living, and depression prevention among pregnant and parenting adolescents. We also evaluated the proposed online surveys and physical …

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …

Management Of Maternal Depression: Qualitative Exploration Of Perceptions Of Healthcare Professionals From A Public Tertiary Care Hospital, Karachi, Pakistan, Makkiya Jawed, Nousheen Pradhan, Rozina Mistry, Amirah Nazir, Sualeha Shekhani, Tazeen Saeed Ali

Community Health Sciences

The lack of implementation and routine screening of management techniques at tertiary care hospitals leads to an increased burden of maternal depression. The consequences are borne emotionally, physically, and mentally by the mother, the child, the overall family, and society. Hence, it is vital to contextualize this mental disorder to design and implement effective healthcare interventions. The study is aimed to assess the knowledge and practices of healthcare professionals, in a tertiary care setting, who deal with depressive symptoms amongst mothers. It gauges whether a psychological screening criterion is being implemented by the clinical staff during prenatal and postnatal visits …

Sociodemographic Inequities In Nurturing Care For Early Childhood Development Across Brazilian Municipalities, Gabriela Buccini, Stefanie Eugênia Dos Anjos Coelho Kubo, Jéssica Pedroso, Juracy Bertoldo, Alberto Sironi, Marcos Ennes Barreto, Rafael Pérez-Escamilla, Sonia Isoyama Venancio, Muriel Bauermann Gubert

Environmental & Global Health Faculty Research

Providing an enabling nurturing care environment for early childhood development (ECD) that cuts across the five domains of the Nurturing Care Framework (i.e., good health, adequate nutrition, opportunities for early learning, security and safety and responsive caregiving) has become a global priority. Brazil is home to approximately 18.5 million children under 5 years of age, of which 13% are at risk of poor development due to socio-economic inequalities. We explored whether the Early Childhood Friendly Municipal Index (IMAPI) can detect inequities in nurturing care ECD environments across the 5570 Brazilian municipalities. We examined the validity of the IMAPI scores and …

Health And Ideations Of Married Female Adolescents, Breakthrough Research

Reproductive Health

This brief provides rigorous evidence-based insights to implementers and researchers of social and behavior change (SBC) programs that seek to improve knowledge, attitudes, norms, and behaviors of married female adolescents. The brief focuses on married adolescents’ uptake of services and health knowledge in Kebbi, Sokoto, and Zamfara states in northwestern Nigeria using a subset of data from a household survey of married women ages 15–49 years. It is one of a series of briefs that present findings from a Breakthrough RESEARCH study that uniquely captures data on a wide range of psychosocial drivers of behavioral outcomes in the areas of …