Public Health Commons^™

Delivering Contraceptive Vaginal Rings: Review Of Postpartum And Postnatal Care Programs In Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku

Reproductive Health

Postpartum family planning is a major component of postpartum care services. The Population Council is working to introduce an additional method of contraception in Nigeria—the Progesterone Contraceptive Vaginal Ring (PCVR). The PCVR is administered vaginally but acts systemically to inhibit ovulation. The PCVR contains natural progesterone and is meant for breastfeeding women to augment lactational amenorrhea. As the Council conducts a series of activities as a prelude to eventual introduction of the PCVR in sub-Saharan Africa, including Nigeria, the detailed evaluation of the postpartum program environment is very important. Understanding the prevailing postpartum and postnatal care landscapes will be crucial …

Delivering Contraceptive Vaginal Rings: Review Of Postpartum Service Packages In Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time, yet this is the most neglected period for the coverage and provision of quality care. The building blocks of the WHO health systems model were applied in describing the status and health system structures that support the provision of postpartum and postnatal care (PNC) services in Kenya. Many opportunities exist for facilitating the delivery of the Population Council’s Progesterone Contraceptive Vaginal Rings (PCVR) within PNC services in Kenya, such as integration with other primary health care …

Emerging Priorities In Reproductive, Maternal, And Newborn Health, Population Council

Reproductive Health

The Population Council’s Ending Eclampsia project seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. Ending Eclampsia is working in Nigeria and Bangladesh to assess the level of program activities, gaps, and challenges around prevention and treatment of PE/E and magnesium sulfate (MgSO4). The project will build upon this landscape analysis to expand services to detect and manage PE/E, develop and support implementation of strategic plans for replicating the intervention package, and increase global PE/E evidence shared through knowledge and learning platforms. …

Landscape Analysis Of Pre-Eclampsia/Eclampsia In Nigeria, Charlotte E. Warren, Salisu Mohammed Ishaku, Ayodeji Oginni, Gloria Adoyi, Karen Kirk, Amy Dempsey

Reproductive Health

The Population Council’s Ending Eclampsia project, with support from USAID, seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. The Council conducted a landscape analysis on PE/E in Nigeria in 2015. Its main objectives were to understand the level of programmatic and policy support for PE/E prevention and treatment; to analyze gaps in providers’ competence to prevent, detect, and manage PE/E; to determine capacity at primary health facilities to manage PE/E; to assess community awareness, beliefs, and experiences around PE/E; to understand …

Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council

Reproductive Health

Fear of disrespect and abuse along with misconceptions about procedures required to assist women during childbirth often negatively influence the decision to seek care at a health facility. Maternity Open Days provide an opportunity for pregnant women and their families to interact with health care providers and visit maternity units to demystify birthing practices and mitigate fears regarding childbirth in a facility. Such an approach brings together women, their families, and providers to enable pregnant women to understand what happens in a maternity unit. This brief is part of a Respectful Maternity Care Resource Package developed by the Kenya Heshima …

Promoting Respectful Maternity Care Resource Package—Alternative Dispute Resolution: Resolving Incidents Of Disrespect And Abuse, Population Council

Reproductive Health

Alternative Dispute Resolution (ADR) is a process whereby an independent and impartial third party facilitates negotiation between disputing parties, in this case to resolve incidents of disrespect and abuse (D&A) in a health care setting. In Kenya, ADR was originally used to settle land disputes and inheritance issues at the community level. The voluntary ADR mechanism brings the aggrieved parties together with an opportunity to solve problems in a locally acceptable way. ADR supports both providers’ and clients’ rights and obligations by ensuring each side is heard. This Respectful Maternity Care (RMC) resource provides guidance on the sequence of steps …

Promoting Respectful Maternity Care Resource Package—Debriefing Sessions: Caring For The Carers, Population Council

Reproductive Health

Caring for the Carers is an activity aimed at reducing work-related stress—a major driver of disrespect and abuse (D&A) during facility-based childbirth. Pregnancy, labor, and delivery are expected to be joyous moments for the mother, her family, and the service providers. However, this is not always the case due to maternal complications or even death. Maternity units often have high workloads. This, coupled with lack of professional support for staff and providers, and poor governance and leadership, may lead to work-related stress. These critical incidents can accumulate and contribute to staff stress and emotional exhaustion, which ultimately prevents provision of …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Facilitator’S Guide, Population Council

Reproductive Health

This training guide was produced by the Population Council as part of the Respectful Maternity Care (RMC) Resource Package developed by the Kenya Heshima Project. The Heshima Project, as part of the USAID Translating Research into Action (TRAction) project, was tasked with determining the manifestations, types, and prevalence of disrespect and abuse (D&A) in childbirth; identifying and exploring the potential drivers of D&A; and designing, implementing, monitoring, and evaluating the impact of interventions for reducing D&A including generating lessons for scale-up. The Resource Package is based on the most effective interventions, and provides practical, low-cost, and easily adaptable strategies for …

Summary Report Of The Measuring And Monitoring Quality Of Care Meeting, Population Council

Reproductive Health

At the request of the Packard Foundation, the Population Council organized a meeting at its office in Washington, DC, on December 16, 2014, to establish links with key stakeholders interested in quality of care, and to refocus attention on challenges in measuring and monitoring diverse dimensions of quality of care. Thirty experts from donor, service, and research organizations participated. This summary report, based on the deliberations at the meeting, is intended as a preamble to the formation of a community of practice for advancing quality of care agenda globally. The key message is that improved quality in service delivery is …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Partie 2: Rapport De Synthese, Fatou Mbow, Leslie Dubent, Nafissatou Diop, Fatou Ndiaye Turpin, Bocar Mamadou Daff, Babacar Mane

Reproductive Health

Le Plan d’Action National de Planification Familiale 2012–15 (PANPF 2012–15) du Sénégal est basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où le PANPF 2012–15 arrivait à terme, et qu’un nouveau plan était élaboré, le Population Council a mené une étude pour documenter la mise en œuvre et les réalisations de l’Approche 3D en relation avec le PANPF. Cette étude documente l’Approche 3D en relation avec le PANPF à travers une revue documentaire et une recherche qualitative. Elle décrit les leçons apprises de sa mise en œuvre et partage les bonnes pratiques que d’autres pays pourraient adopter, en particulier …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Partie 1: Revue Documentaire, Leslie Dubent, Fatou Mbow, Nafissatou Diop, Fatou Ndiaye Turpin, Bocar Mamadou Daff, Babacar Mane

Reproductive Health

Le Plan d’Action National de Planification Familiale 2012–15 (PANPF 2012–15) du Sénégal est basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où le PANPF 2012–15 arrivait à terme, et qu’un nouveau plan était élaboré, le Population Council a mené une étude pour documenter la mise en œuvre et les réalisations de l’Approche 3D en relation avec le PANPF. Cette étude documente l’Approche 3D en relation avec le PANPF à travers une revue documentaire et une recherche qualitative. Elle décrit les leçons apprises de sa mise en œuvre et partage les bonnes pratiques que d’autres pays pourraient adopter, en particulier …

Expanding Access To Rights-Based Family Planning: Activity Brief, The Evidence Project

Reproductive Health

The human rights dimensions of family planning programs have been recognized for nearly half a century and affirmed in numerous declarations, conventions, and treaties endorsed by governments and the international community. While discourse about respecting, protecting, and fulfilling these rights is growing, a gap persists between human rights rhetoric and integrating rights in family planning policy, programs, and practice. Governments and programs struggle with defining and operationalizing a rights-based approach to family planning. Overall, there is scant evidence on: how to implement rights-based family planning (RBFP) programming, how to measure rights-based programming and outcomes, and the effect on family planning/reproductive …

Reducing Maternal And Child Mortality In Sindh: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Sindh, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. Evidence shows that FP is one of the most powerful tools at the government’s disposal for a rapid reduction in maternal, infant, and child mortality. FP’s wider health benefits include reduced anemia among women; lower …

Reducing Maternal And Child Mortality In Khyber Pakhtunkhwa: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family Planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why family planning must be prioritized in Khyber Pakhtunkhwa, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 37 percent of maternal deaths and 57 percent of infant deaths. FP’s wider health benefits include reduced …

Reducing Maternal And Child Mortality In Balochistan: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This brief explains why FP must be prioritized in Balochistan, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 41 percent of maternal deaths, 35 percent of infant deaths, and 74 percent of young child deaths. FP’s wider health benefits include reduced …

Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council

Reproductive Health

Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.

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This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …

Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi

Reproductive Health

In collaboration with the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Programme Consortium, the Population Council implemented a project to increase the demand for secondary school education in Homa Bay County, Kenya—an area characterized by high, unintended teenage pregnancy and female school drop-out rates. To foster awareness of the school re-entry policy, the Population Council collaborated with the Homa Bay County Department of Education (Ministry of Education) to convene a policy dialogue for all principals of public, day, girls-only, and co-educational secondary schools in the area. The policy dialogue helped to create visibility around the issue of …

The Relationship Between Opportunity For Physical Activity And Classroom Behavior In School Aged Children., Kortney Lee Aeikens

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study is to determine the relationship between physical activity and students' classroom behavior. This descriptive study explored student classroom behavior. This study is to find answers to the following research question: What is the relationship between negative classroom behavior and the amount of time spent in daily physical activity?

Understanding the effects of physical activity on student classroom behavior can help school teachers and administrators in their creation of school scheduling and policy. A sample of students from grades kindergarten thru second grade was used from Pine Island Public Schools. The data was analyzed using aggregate …

Preliminary Nutritional Profile Analysis Of Box Tops 4 Education Food Products, Hannah Griffith

Williams Honors College, Honors Research Projects

The marketing of unhealthy food to children is often cited as a cause of the obesity epidemic.¹ However, most studies that examine this issue evaluated the marketing of food through print or television advertising. This project investigates the marketing of food products to children through incentive based programs, specifically General Mill’s Box Tops 4 Education. This study undertakes a preliminary systematic analysis of Box Tops food items to determine their healthfulness. A subset of all Box Tops food products was selected for review and a basic quantitative content analysis of priority nutrients was performed. Priority nutrients were identified …

Social Contexts Of Infant Feeding And Infant Feeding Decisions, Ellen J. Schafer, Natalie A. Williams, Siri Digney, Marion E. Hare, Sato Ashida

Department of Child, Youth, and Family Studies: Faculty Publications

Background: Infant feeding takes place within a network of social relationships. However, the social context in which infant feeding advice is received remains underresearched.

Objective: The objective of this study was to evaluate the social contexts of infant feeding by examining individual and relationship characteristics of mothers and network members associated with advice to exclusively breastfeed, exclusively formula feed, or use a combination of breast milk and formula.

Methods: Information about 287 network members was reported by 80 low-income mothers during a one-time survey. Characteristics of relationships associated with mothers receiving advice (exclusively breastfeed/formula feed, combination feed) from each network …

Bridging Evidence, Policy, And Practice To Strengthen Health Systems For Improved Maternal And Newborn Health In Pakistan, Atsumi Hirose, Sarah Hall, Zahid Memon, Julia Hussein

Centre of Excellence in Women and Child Health

Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. …

'Makin' It Out': The Cost Of Dropping Out Of High School On The Health Status Of Afro-American Women In Urban Slums, Sesa E. Bakenra-Tikande

CMC Senior Theses

“We carry our histories in our bodies, how could we not?” – Nancy Krieger

In the United States and abroad, socioeconomic status (income, education, and occupation) greatly impacts health outcomes for a given population. There is a strong and consistent socioeconomic gradient within health outcomes which has been documented as far back as in Ancient Egypt and China (Krieger, Willains, & Moss, 1997; Liberatos, Link, & Kelsey, 1988) The general trend shows that individuals with higher socioeconomic status generally enjoy lower rates of morbidity (disease) and disability, which can ultimately lead to higher mortality rates (House et al. (1992) and …

La Paradoja Hispana Epidemiológica: Investigando Las Preconcepciones Y Generalizaciones, Maya H. Sandalow

CMC Senior Theses

En los Estados Unidos, los latinos suelen tener menos acceso a la educación, el trabajo, y el seguro médico en comparación con los blancos no-latinos, pero aun así el grupo parece superar ciertos obstáculos de la salud. Las estadísticas de la población latina muestran mayor longevidad y otras tasas favorables en comparación con los blancos no-latinos. Los expertos han titulado esta contradicción “La Paradoja Hispana Epidemiológica”.

Desafortunadamente, la investigación de la paradoja está llena de generalizaciones y presuposiciones erróneas sobre la población latina diversa. Esta tesis investiga los participantes que producen generalizaciones sobre la supuesta paradoja para mostrar que estas …

Impact Of A Community-Based Perinatal And Newborn Preventive Care Package On Perinatal And Neonatal Mortality In A Remote Mountainous District In Northern Pakistan, Zahid Memon, Gul N Khan, Sajid Bashir Soofi, Imam Y Baig, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: There is limited evidence from community-based interventions to guide the development of effective maternal, perinatal and newborn care practices and services in developing countries. We evaluated the impact of a low-cost package of community-based interventions implemented through government sector lady health workers (LHWs) and community health workers (CHWs) of a NGO namely Aga Khan Health Services on perinatal and neonatal outcomes in a sub-population of the remote mountainous district of Gilgit, Northern Pakistan.
Methods: The package was evaluated using quasi experimental design included promotion of antenatal care, adequate nutrition, skilled delivery and healthy newborn care practices. Control areas …

Breast-Feeding And Postpartum Maternal Weight Trajectories, Laura Mullaney, Amy O'Higgins, Shona Cawley, Rachel Kennedy, Daniel Mccartney, Michael J. Turner

Articles

We examined whether breast-feeding, and in particular exclusive breast-feeding, was associated with maternal weight and body composition changes at 4 months postpartum independently of other maternal variables.

A Call For Better Care: The Impact Of Postnatal Contact Services On Women’S Parenting Confidence And Experiences Of Postpartum Care In Queensland, Australia, Yvette D. Miller, Aimée C C. Dane, Rachel Thompson

Dartmouth Scholarship

BackgroundUniversal postnatal contact services are provided in several Australian states, but their impact on women’s postnatal care experience has not been evaluated. Furthermore, there is lack of evidence or consensus about the optimal type and amount of postpartum care after hospital discharge for maternal outcomes. This study aimed to assess the impact of providing Universal Postnatal Contact Service (UPNCS) funding to public birthing facilities in Queensland, Australia on women’s postna

Addressing Health Disparities In Refugees, Claire E. Lopez

Master's Projects and Capstones

I completed the required 300 hours of my fieldwork internship at the International Rescue Committee (IRC) in Oakland, CA. The International Rescue Committee (IRC) is a non-profit international organization that responds to the world’s worst humanitarian crises and aids displaced individuals in rebuilding their lives in new countries by providing support in health care, finance, education, infrastructure, and resettlement.

I worked as a Health Access/Intensive Case management Intern. As a Health Access Program Intern, it was my job to ensure that refugees coming to the United States had a place to seek medical care, advice, and preventative services. In order …

Improving Birth Outcomes: Women’S Oral Health Project, Dilem Polat

Master's Projects and Capstones

Improving Birth Outcomes: Women’s Oral Health Project is a new project housed within the Child Health and Disability Prevention, CHDP Program. The main goal of the project is to improve the birth outcomes of high-risk pregnant women and their children, by educating participants within the Maternal Child and Adolescent Health Section at the San Francisco Department of Public Health. The educational component will focus on the importance of oral health and the impact of oral disease on perinatal health. Following the educational component, referrals for appropriate dentists will be provided for participants to they may begin improving their oral health. …

Culturally-Appropriate, Family- And Community-Based Physical Activity And Healthy Eating Intervention For African-American Middle School-Aged Girls: A Feasibility Pilot, Daheia J. Barr-Anderson, Alexis W. Adams-Wynn, Sofiya Alhassan, Melicia C. Whitt-Glover

Journal of Adolescent and Family Health

This study tested the feasibility and acceptability of a physical activity, healthy eating, and social support intervention. Twelve African-American daughter-mother dyads (BMI percentile: daughters=92.6±12.79; BMI: mothers=38.8±5.81 kg/m2) met weekly during the 8-week Intensive Phase; throughout the 6-month Maintenance Phase, participants received monthly newsletters for 3 months and attended monthly face-to-face sessions for 3 months. Daughters and mothers reported positive feedback about intervention activities and educational curriculum. Post-intervention daughter survey results revealed positive trends towards increasing PA; increasing breakfast, water, and fruit/vegetable intake; and reducing sugar sweetened drink consumption. Mothers reported similar behavioral changes. This unique intervention was highly enjoyed by …

Nutrition-Related Conditions Among Children Of Migrant And Seasonal Farmworkers In The United States: Causes And Solutions, Rebecca Halvorson

Food Science and Nutrition

The purpose of this literature review is to determine the prevalence of nutrition-related conditions among children of migrant and seasonal farmworkers (MSFW) compared to national averages, as well as effectiveness of strategies for minimizing any health discrepancies. MSFW live under harsh conditions, engage in long hours of physically demanding labor, and receive insufficient income. Compounding demographic characteristics create insurmountable barriers to quality health care and nutrition education resulting in disproportionately unhealthy children within the MSFW population as compared to the greater US population. The prevalence of overweight, obesity, diabetes mellitus, cardiovascular disease, and numerous infections is higher among MSFW children. …