Public Health Commons^™

South Africa: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council

Reproductive Health

The South African government wishes to expand availability and use of counseling and testing (C&T) for HIV. One option is to integrate C&T into well-attended services, such as family planning (FP). In 2004, the Population Council began a three-year study with the Department of Health in North West Province. The study tested the feasibility, acceptability, and cost of two models for integrating HIV prevention services within established FP programs, and evaluated their quality against standard practice. In the testing-model clinics, providers provided C&T services at the same consultation; in the referral-model clinics, providers offered HIV counseling and referred clients to …

Increasing Women's Use Of The Iud For Family Planning, Ricardo Vernon

Reproductive Health

The intrauterine device (IUD) is highly effective, easy to use, and has few side effects. The device costs the provider about US$2 and offers a duration of protection that makes it the most cost-effective of the temporary methods if used for two years or more. The IUD's many advantages also make it a good alternative for reducing unmet need for long-term contraception around the world. Between 5 and 17 percent of all married women of reproductive age in 53 less developed countries do not want to have more children but are not using a contraceptive method. Because the IUD can …

Assessing Integration Methodology (Aim): A Handbook For Measuring And Assessing The Integration Of Family Planning And Other Reproductive Health Services, M. Estela Rivero-Fuentes, Saumya Ramarao, Ricardo Estrada, Charlotte E. Warren, Saiqa Mullick, Ian Askew, Harriet Birungi, John Townsend, Susana Medina

Reproductive Health

Several international statements over the past two decades have endorsed the integration of family planning (FP) services with other reproductive health (RH) services as a means of expanding availability and access for potential users. Many rationales underlie the move toward integrating FP with other services. First is that it provides benefits to the client and the program. Moreover, there is the expectation that the costs to the health system of configuring two or more services will cost less than providing them independently. However, there is still little empirical evidence available about integration of services. Over time, a number of methodologies …

Financial Capacity Building For Ngo Sustainability, John H. Bratt, Rick Homan, Barbara Janowitz, James R. Foreit

Reproductive Health

While demand for family planning and reproductive health services is increasing worldwide, a number of recent trends threaten the financial sustainability of donor-supported NGOs that provide these services. First, the U.S. Agency for International Development has seen its funding for population assistance decline since 1995. A second reason is the growth of government-funded programs that provide these services for low-income clients, which reduced the need for NGOs to focus programs entirely on the poor. Health-sector reform has created opportunities for NGOs via public–private partnerships in some countries, but sustained public-sector support is unlikely given limited economic growth in domestic economies …

Family Planning And Comprehensive Abortion Care Handbook For Medical Students And House Officers, Population Council

Reproductive Health

The persistently high maternal mortality and morbidity in Ghana is partly due to high rates of unwanted fertility, unsafe abortion, and relatively low use of modern contraception. In 2006, a consortium of agencies, including the Population Council, initiated the Reducing Maternal Mortality and Morbidity program. The program provides financial and technical resources that will enable the government to significantly expand women's access to modern family planning, contraception, and comprehensive abortion care (CAC) to reduce maternal mortality in Ghana. This handbook on FP and CAC was developed as part of the program. It updates a previous document produced more than ten …

Study Of Sexually Transmitted Infections Among Urban Men In Pakistan: Identifying The Bridging Population, Ali M. Mir, Laura Reichenbach, Abdul Wajid, Mumraiz Khan

Reproductive Health

Pakistan currently has low levels of HIV infection, however the country is considered at high potential risk for an HIV epidemic. In major cities there are large concentrations of individuals whose behaviors make them extremely vulnerable to the rapid spread of HIV and of classical sexually transmitted infections (STIs), including male and female sex workers, men who have sex with men, and injecting drug users. HIV can spread to the general population through individuals who have contact with both high-risk groups and the general heterosexual population (the “bridging population”). Identifying the bridging population and bridging behaviors among urban men and …

Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The World Health Organization estimates that 585,000 women die from pregnancy-related conditions each year. Pregnancy-related conditions, including dysfunctional labor, hemorrhage, infection, toxemia, and unsafe abortion, are the leading cause of death among women of reproductive age in many developing countries. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan, through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to …

Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to the hospital. PAIMAN is compiling data from three data sources and making efforts to improve the functioning of these Health Information Systems (HISs) for efficient management of health services at the district level through generation of quality data and their …

Clark County Child Death Review: 2008 Annual Report, Nevada Institute For Children’S Research And Policy, Tara Phebus, Denise Tanata Ashby, Karen Z. Silcott

Nevada Institute for Children's Research and Policy Reports

The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …

Kenya: Integrating Services For Fp And Hiv Improves Quality And Hiv Testing, Population Council

Reproductive Health

The Kenyan government’s reproductive health policy highlights service integration and quality of care. While integrating counseling and testing (C&T) for HIV into family planning (FP) can potentially increase the range of services to clients at risk from sexually transmitted infections (STIs) including HIV, few studies have documented the feasibility, effects, or costs of such integration. From 2005–07, the Population Council worked with the Kenyan Ministry of Health to test the feasibility of two models for integrating C&T into existing FP services. Both models featured client education on HIV prevention during FP visits. Providers were trained to routinely use the Balanced …

Profile Of Abortion Seekers In Ghana And Their Decision-Making Processes, Philomena Nyarko, Cletus Adohinzin, Saumya Ramarao, Placide Tapsoba, Ayorinde Ajayi

Reproductive Health

In 2006, a consortium of agencies, including the Population Council, came together to provide technical and financial support to the Government of Ghana in the rollout of comprehensive abortion care (CAC) services. The consortium collaborated with the government in expanding women’s access to modern family planning and CAC. The consortium’s program, Reducing Maternal Mortality and Morbidity (R3M), aims to reduce unwanted pregnancy and severe complications and deaths caused by unsafe abortion. The formative research in this report was undertaken to provide a profile of beneficiaries, their needs for information and services, their decision-making process in seeking care, and the quality …

Crude Birth Rates And Contraceptive Use By Racial/Ethnic Group In The U.S., 1990-2000, Victoria Stone

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report analyzes crude birth rates and contraceptive use among women in the three primary racial/ethnic groups, White, Black, and Latina, and further examines birth rates by age-specific groups in the United States between 1990 and 2000.

Methods: The data examined here was derived from the NYC Vital Statistics 2002 Report and the Census 2000 SF4 table on Sex by Age by race and Latino nationality. The birth rates were calculated by dividing live birth numbers (Vital Statistics report) by total population count by age and racial/ethnic group (Census 2000 data) and multiplying this number by 1000.

Results: In …

Racial Differences In Birth Outcomes: The Role Of General, Pregnancy, And Racism Stress, Tyan Parker Dominguez, Christine Dunkel Schetter, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: This study examined the role of psychosocial stress in racial differences in birth outcomes.

Design: Maternal health, sociodemographic factors, and 3 forms of stress (general stress, pregnancy stress, and perceived racism) were assessed prospectively in a sample of 51 African American and 73 non-Hispanic White pregnant women.

Main Outcome Measures: The outcomes of interest were birth weight and gestational age at delivery. Only predictive models of birth weight were tested as the groups did not differ significantly in gestational age.

Results: Perceived racism and indicators of general stress were correlated with birth weight and tested in regression analyses. In …

Timing Of Fetal Exposure To Stress Hormones: Effects On Newborn Physical And Neuromuscular Maturation, Lauren M. Ellman, Christine Dunkel Schetter, Calvin J. Hobel, Aleksandra Chicz-Demet, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The purpose of the study was to determine the specific periods during pregnancy in which human fetal exposure to stress hormones affects newborn physical and neuromuscular maturation. Blood was collected from 158 women at 15, 19, 25, and 31 weeks' gestation. Levels of placental corticotropin-releasing hormone (CRH) and maternal cortisol were determined from plasma. Newborns were evaluated with the New Ballard Maturation Score. Results indicated that increases in maternal cortisol at 15, 19, and 25 weeks and increases in placental CRH at 31 weeks were significantly associated with decreases in infant maturation among mates (even after con trolling for length …

Familialism, Social Support, And Stress: Positive Implications For Pregnant Latinas, Belinda Campos, Christine Dunkel Schetter, Cleopatra M. Abdou, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

This study examined the association of familialism, a cultural value that emphasizes close family relationships, with social Support, stress, pregnancy anxiety, and infant birth weight. Foreign-born Latina (n = 31), U.S.-born Latina (n = 68), and European American (n = 166) women living in the United States participated in a prospective study of pregnancy in which they completed measures of familialism, social support, stress, and pregnancy anxiety during their second trimester. As expected, Latinas scored higher on familialism than European Americans. Familialism was positively correlated with social support and negatively correlated with stress and pregnancy anxiety in the overall sample. …

Stress And Blood Pressure During Pregnancy: Racial Differences And Associations With Birthweight, Clayton J. Hilmert, Christine Dunkel Schetter, Tyan Parker Dominguez, Cleopatra M. Abdou, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

OBJECTIVE: To extend findings that African American women report greater stress during pregnancy, have higher blood pressure (BP), and are twice as likely to have low birthweight infants relative to white women. This study examines a) racial differences in associations between stress and BP during pregnancy, and b) the combined effects of stress and BP on infant birthweight in a sample of 170 African American and white women.

METHODS: A prospective, longitudinal study of pregnant women was conducted in which measures of BP, stress, and other relevant variables were collected. Multiple measures of systolic and diastolic BP were taken at …

Promoting Healthy Weight In The Preschool Years: A Portfolio And Planning Guide To Address Barriers In Primary Care, Margaret Miller, Renee Campbell-Pope, Lydia Hearn

Research outputs pre 2011

The rapidly rising incidence of overweight and obesity in Australia, particularly among young children has led to an urgent need for effective prevention. Recent figures indicate that 15% of preschool children in Australia are overweight, and a further 6% are obese1,2, with rates rising steadily especially among children from lower socioeconomic groups.

Family, childcare, primary health care, early childhood education and the community are influential environments for young children3-7 with the potential to engage in an integrated approach to promote healthy weight and development of healthy eating and active lifestyle habits during the pre-school years5,8,9.

In 2006, the Child Health …

A Qualitative Study Of Pregnancy And Maternal Mortality In Rural Senegal: An Examination Of The Pregnant Woman’S Experience, Megan Frances Harlow

Independent Study Project (ISP) Collection

Much prior research has focused on the problem of maternal mortality in Senegal, the factors that cause it, and the numerical trends that indicate either decline or increase in maternal mortality. Few studies, however, have captured the mentality, attitudes, or beliefs of Senegalese women in rural areas, or the rationality behind their behaviors during pregnancy, which ultimately have implications for the alleged contributors to maternal mortality. I conducted the bulk of my field research in Saraya, a small town in southeastern Senegal. Through study of prenatal consultation records, participant observation in multiple settings, and interviews with healthcare practitioners and recent …

The Realization Of The Rights To Health, Education And Social Welfare Among Disabled Youth In Ingwavuma And Bhambanana, Kwazulu Natal, Ali Mumford

Independent Study Project (ISP) Collection

This practicum based study was completed in an effort to explore the realization of the rights to health, education and social welfare for disabled children in Ingwavuma and Bhambana, KwaZulu Natal. Very little research has been done on disabled children in South Africa, and estimations of prevalence range from 3.3-6.4%. The absence of accurate data creates a situation where implementation of policy and delivery of services is slow and does not always address the most urgent needs. The new South Africa aimed to bring rights and freedom to all groups of people, but the question which this study attempts to …

Buscando La Luz: Changes In Partería And The Loss Of Feminine Autonomy In Oaxaca, Mexico, Hannah Ewert-Krocker

Independent Study Project (ISP) Collection

Birth is one of the most fundamental moments of every human being’s life, and women have long been honored in the world’s societies as sacred and vital due to their important roles as life-givers. Because of the importance of birth in the lives and societies of human beings, birth and birthing practices can reveal many values of a culture and of the women within that culture and also demonstrate how and why those values are changing. The choices women make between traditional health care and more “modern” Western models are almost always influenced by the socio-economic and cultural conditions of …

Southern Nevada Health District Childhood Lead Poisoning Prevention Program Lead Poisoning Elimination Plan, Southern Nevada Health District, Strategic Advisory Coalition

Nevada Institute for Children's Research and Policy Reports

On August 2, 2006, the Southern Nevada Health District (SNHD) was awarded a 5-year grant by the Center for Disease Control and Prevention (CDC) under its Childhood Lead Poisoning Prevention Program (CLPPP). The grant award was unprecedented in the State of Nevada and was made available to the SNHD via approval from the State to act as its bona fide agent. The primary goal of the grant was to develop this Childhood Lead Poisoning Strategic Elimination Plan (EP) in support of CDC’s overarching goal of eliminating childhood lead poisoning by the year 2010.

Planning Initiative Award – 2006-2007 Access To Reproductive Health Services For Low-Ses Pregnant/Parenting Teens In Clark County: A Comprehensive Needs Assessment, Nevada Institute For Children's Research And Policy Reports, Jennifer Zipoy, Tara Swanson, Jean Henry, Denise Tanata, Uzma Farmanali,, Karen Silcott

Nevada Institute for Children's Research and Policy Reports

The Planning Initiative Award (PIA) project was a collaborative effort between the Nevada Institute for Children’s Research and Policy (NICRP) and the Center for Health Promotion (CHP)/Department of Health Promotion, research centers in the School of Public Health. The purpose of the project was to conduct an assessment of the access to reproductive health services among lower SES pregnant and parenting teens in the Las Vegas Valley. The project was designed to identify gaps in existing services and assist researchers in developing communication networks between community members, providers, educators, and policymakers. The data collected during the project period has great …

Psychometric Evaluation Of An Instrument For Assessing Policy Outcomes For Families With Children Who Have Severe Developmental Disabilities: The Beach Center Family Quality Of Life Scale, Joni Taylor Mcfelea

Health Services Research Dissertations

The purpose of the study was to evaluate the psychometric properties of the Beach Center Family Quality of Life Scale (BCFQLS) in a sample of families with children who have severe developmental disabilities. The study sought to determine whether or not the scale could be used to measure the quality of life of such families and to differentiate between the quality of life of two family groups—those whose child lives in the family home and those whose child lives outside the family home.

The study used an observational, cross-sectional design and both qualitative and quantitative methods. Self-identified primary caregivers of …

Rethinking The Body Mass Index Initiative, Sarah C. Mckenzie, Gary W. Ritter

Policy Briefs

In February 2005, the Office for Education Policy published a fact sheet detailing Arkansans’ attitudes toward the Body Mass Index initiative (BMI) and found that the state was roughly divided on the issue. Since 2005, the results of BMI screening have been chronicled in a pair of government reports, and the General Assembly has acted to modify how BMI testing is undertaken. In this policy brief we outline what the research indicates after three years of BMI testing, and how the laws surrounding BMI have changed.

Low-Income Minority Mothers’ Reports Of Infant Health Care Utilisation Compared With Medical Records, Kennan D. Murray, Ayman El-Mohandes, M. Nabil El-Khorazaty, Michele Kiely

Publications and Research

This study aimed to investigate mothers’ reporting of the nature, location, frequency and content of health care visits for their infants, as compared with data abstracted from the infants’ medical records. It was part of a community-based parenting intervention designed to improve preventive health care utilisation among minority mothers in Washington, DC. Mothers 18 years old with newborn infants and with poor or no prenatal care were enrolled in the study. A total of 160 mother–infant dyads completed the 12-month study. Mothers were interviewed when the infants were 4, 8 and 12 months old, and were asked to recall infant …

Messages Of Maternity: The Relationship Of State And Ngo Institutions To Reproductive Health Services And The Construction Of Family In Jordan, Julia Shatz

Independent Study Project (ISP) Collection

This project examines the ways in which family planning and reproductive health services and the institutions that provide them contribute to constructing definitions of family and motherhood in Jordan. The study is based on personal interviews conducted with representatives at six institutions – the Ministry of Health, the Higher Population Council, the Jordanian Association for Family Planning and Protection, Queen Zein Al Sharaf Institute for Development, the Arab Women’s Organization, and the Jordanian Women’s Union. This paper addresses the issues of family planning as a method of population control, the integrated medical and educational approach currently popular in family planning …

A Case Study Of Pediatric Diarrhea At Murchison District Hospital In Port Shepstone, Kwazulu-Natal, South Africa, T. Smith

Independent Study Project (ISP) Collection

This study investigates pediatric diarrhea in children under 5 years old at Murchison District Hospital in Port Shepstone, South Africa. Hospital Child Pip data was used to determine the number of admissions to the hospital for pediatric diarrhea and its mortality rate. Characteristics of deceased patients including age, malnutrition, and HIV status, were then synthesized with information on patients’ access to clean water and improved sanitation obtained through 20 interviews of mothers of patients as well as caregivers’ infant feeding practices and hygiene practices, such as handwashing with soap. Treatment and prevention of diarrhea was also explored. Murchison’s management of …

Well Child Health Care In Wales: A Change Of Setting, A Shift Of Power, Jennifer Herman

Inquiry Journal 2007

No abstract provided.

Ambulatory Care Adverse Events And Preventable Adverse Events Leading To A Hospital Admission, Donna M Woods, Eric J Thomas, Jane L Holl, Kevin B Weiss, Troyen A Brennan

Faculty, Staff and Student Publications

BACKGROUND: Most healthcare in the US is delivered in the ambulatory care setting, but the epidemiology of errors and adverse events in ambulatory care is understudied.

METHODS: Using the population-based data from the Colorado and Utah Medical Practices Study, we identified adverse events that occurred in an ambulatory care setting and led to hospital admission. Proportions with 95% CIs are reported.

RESULTS: We reviewed 14,700-hospital discharge records and found 587 adverse events of which 70 were ambulatory care adverse events (AAEs) and 31 were ambulatory care preventable adverse events (APAEs). When weighted to the general population, there were 2608 AAEs …

Kematian Perinatal Di Indonesia Dan Faktor Yang Berhubungan, Tahun 1997-2003, Meidy Farenti Prameswari

Kesmas

WHO memperkirakan bahwa setiap tahun lebih dari 9 juta bayi meninggal pada periode perinatal dan hampir semua terjadi di negara berkembang. Kini angka kematian perinatal di Indonesia adalah 24 per 1.000 kelahiran, sekitar 77% merupakan sumbangan kematian neonatal. Tujuan penelitian ini adalah mengetahui faktor-faktor yang berhubungan dengan kejadian kematian perinatal di Indonesia dan memperkirakan program intervensi yang paling berperan dan menurunkannya. Studi ini menggunakan sumber data sekunder Survei Demografi Kesehatan Indonesia (SDKI) tahun 2002-2003. Desain penelitian yang digunakan adalah potong lintang (cross sectional). Hasil menemukan variabel yang berhubungan terhadap kematian perinatal di Indonesia selama periode 1997-2003 adalah jarak kelahiran; komplikasi …