Public Health Commons^™

Justification For The Continuance Of A Pediatric Physician's Office Laboratory, Veronica C. Santilli

Seton Hall University Dissertations and Theses (ETDs)

The continued viability of the Physician's Office Laboratory (POL) has been questioned because of barriers imposed by managed care organizations, oversight by regulatory agencies and competition for professionally trained laboratory staff. Pediatricians view the POL as an important adjunct to quality healthcare services for children and do not consider the POL as a "profit center", whose priority is generation of revenues for the The practice. parents of pediatric patients consider an on-site laboratory a convenience and valuable service. Through an analysis of patients' satisfaction, physicians' perceptions of enhancement to quality care, managed care reimbursement data and costs associated with maintenance …

Key Health Issues Facing Latinas, Dharma E. Cortés, Helen Cajigas, Odilia Bermúdez

Gastón Institute Publications

Acknowledging the relationship that exists among health outcomes, socioeconomic factors, and access to health care is key to understanding the health status of Latinas in Massachusetts. For example, poverty disproportionately affects Latinos in Massachusetts, and they have the lowest rate of health insurance in the Commonwealth despite the fact that Massachusetts has one of the most inclusive and comprehensive public health insurance programs in the nation. This situation impacts access to regular health care for Latinos and affects their overall health status. This fact sheet provides information on the following health areas of particular concern to Latinas: maternal and child …

Ndola Demonstration Project: A Midterm Analysis Of Lessons Learned, Horizons Program

HIV and AIDS

This report summarizes baseline and midterm findings of an intervention pilot study conducted by Horizons, LINKAGES, National Food and Nutrition Commission, District Health Management Team, Hope Humana, and the Zambia Integrated Health Program in Ndola District, Zambia. The aim of the research is to investigate how integrating services for the prevention of mother-to-child transmission (PMCT) of HIV into low-resource maternal and child health (MCH) and antenatal care (ANC) settings influences women’s ability to make and implement informed decisions about HIV. The intervention strengthened routine services and introduced HIV voluntary counseling and testing and PMCT counseling and services into the MCH/ANC …

Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim

Poverty, Gender, and Youth

In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …

Grandparent Care In The United States: Comparisons By Race And Ethnicity, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to compare information on grandparent caregivers in the United States among members of five different racial and ethnic groups. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household.2 Data from the 2000 Census 5% Public Use Microdata Sample are used in our calculations. The …

Grandparent Care In The African-American Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on African-American grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: skipped-generation households, in which a …

Training Service Providers On Emergency Contraception: Lessons Learned From An Or Study, M.E. Khan, Sharif M.I. Hossain

Reproductive Health

The Bangladesh Directorate of Family Planning in collaboration with the Population Council, Pathfinder International, and John Snow, Inc. is conducting an operations research project to test the feasibility of introducing emergency contraceptive pills (ECP) in the national family planning (FP) program and to answer operational questions on implementing the use of ECP efficiently. In Bangladesh, 1.2 million births are unplanned and the number of menstrual regulation/abortions is increasing. ECP could be a good reproductive health intervention for women since it gives them a chance to avoid unwanted pregnancy. ECP does not induce abortion. In fact, it helps in reducing the …

Men In Maternity Study: Men Matter, Anjana Das, Leila Caleb-Varkey, Anurag Mishra, Emma Ottolenghi, Dale Huntington

Reproductive Health

The Population Council and the Employees’ State Insurance Company are collaborating in a Men in Maternity (MiM) study in India to test a model of antenatal and postnatal services designed to help thousands of couples, especially men, redefine their roles in reproductive health and improve birth outcomes and maternal health. This is part of a global study that will assess the impact of male partnership in improving pregnancy outcomes and reproductive health, primarily by reducing the prevalence of STIs and increasing postpartum family planning use. Studies suggest that the lack of men’s participation in reproductive health actually undermines women’s health. …

Men In Maternity Study: Results From The Pre-Intervention Survey Of Pregnant Women And Their Husbands At The Three Interventions, And Of Only Women At Three Control Employees' State Insurance Corporation Dispensaries In Delhi, India: Preliminary Findings, Anurag Mishra, Leila Caleb-Varkey, Emma Ottolenghi, Anjana Das, Dale Huntington, Susan E. Adamchak

Reproductive Health

The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council, is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). …

Men In Maternity Study: A Summary Of The Findings From Pre-Intervention Interviews With Women And Their Husbands Attending Antenatal Clinics At Esic Facilities In Delhi, Anurag Mishra, Leila Caleb-Varkey, Anjana Das, Emma Ottolenghi, Dale Huntington, Susan E. Adamchak, Shahina Begum

Reproductive Health

The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). …

Reproductive Health Care In The Postnatal Period In Guatemala, Erika Jacobs, Carlos Brambila, Ricardo Vernon

Reproductive Health

This operations research study aimed to develop and test a job aid to provide comprehensive care to mothers and children during the first year postpartum; to train physicians, nurses, auxiliary nurses, and social workers in its use; and to develop and test strategies and materials for training community health agents to promote services for new mothers during the first year postpartum. It also collected data to establish if these strategies were effective in improving the quality and comprehensiveness of the care received by mothers and children less than one year of age. Drawing from exit interviews, the intervention appeared to …

Institutional Support For A Program Of Activities Within The Pilot Health Project In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

This document contains reports on three activities undertaken by the Pilot Health Project (PHP) in order to upgrade antenatal and postpartum services for Palestinian women. Specifically, it includes results of a survey and a comprehensive assessment of the antenatal and postpartum care services, including family planning, that are currently provided at the project clinics. The findings show that the shortage of care provided to women during the perinatal period could be partially overcome by conducting home visits to provide information on many reproductive health issues, to help women and their families make decisions regarding their future fertility, and to provide …

Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil

Reproductive Health

The Center for Development in Primary Health Care (CDPHC), in collaboration with the Population Council’s FRONTIERS program, developed a 19-month training program to strengthen and improve existing maternal and children’s health and family planning services and to promote the establishment of the standardized basic package of services at Pilot Health Project (PHP) clinic sites in the West Bank and Gaza. There were four key start-up activities, including: 1) an assessment of standards of care provided at PHP clinics; 2) a review of formative research; 3) the development of clinical training manuals and curricula; and 4) the development of behavior change …

Grandparent Care In The Latino/Hispanic Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on Latino grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: skipped-generation households, in which a …

Grandparent Care In The American Indian/ Alaska Native Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on American Indian/Alaska Native (hereafter, Native American) grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: …

Grandparent Care In The Asian Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on Asian grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: skipped-generation households, in which a …

Grandparent Care In The Non-Hispanic White Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on White grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: skipped-generation households, in which a …

An Analysis Of The Changing Forces Behind Health Insurance Coverage Of Homebirth, Christina Anne Gasbarro

Dissertations and Theses

The expansion of managed care, which is premised on containing costs while maintaining market share, represents a radical transformation of the U.S. health care system. A central question for medical sociologists is to determine how the changes brought by managed care influence health insurance and health care options. In evaluating the impacts of managed care, obstetrics is a particularly important site of study. Part of this agenda involves gathering baseline data on a specific transformation in obstetrics practice new to the managed care scene: the emergence of health insurance coverage for the option of home birth. The research project detailed …

Is Science Ever Science? The Politics Of Child Care, Ibpp Editor

International Bulletin of Political Psychology

This article explores the political behavior of psychologists in the carrying out of scientific tasks.

Special Report On Children Born To Hiv Positive Parents In Nevada, 1991-1999, Drew Mather, Mary Guinan, Richard Whitley, Wei Yang

School of Public Health Faculty Research

Background:

This report encompasses an effort to look at the number of children born to HIV (Human Immunodeficiency Virus) and/or AIDS (Acquired Immunodeficiency Syndrome) infected parents during the years 1991 to 1999 in Nevada.

According to the Healthy People 2000 (HP 2000) Review for the years 1998- 1999, infants of untreated or undetected HIV positive women have been identified as a distinct population at risk for contracting the virus that causes AIDS.

The State of Nevada’s Bureau of Disease Control and Intervention Services in collaboration with the Bureau of Health Planning and Statistics has taken the initial step to “cross …

Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

La Organización Mundial de la Salud ha estipulado que la detección y tratamiento de sífilis para todas las mujeres embarazadas resulta eficaz en función de los costos si al menos el 0.1 por ciento de ellas están infectadas. Para atender el problema de la alta tasa de sífilis entre mujeres embarazadas (6.5–7.3%), el Concejo de la Ciudad de Nairobi (CCN) introdujo en 1989 la detección y tratamiento de sífilis materna en sus clínicas de atención prenatal. Sin embargo, su enfoque centralizado—que requiere llevar las muestras de sangre recolectadas a un laboratorio central para hacer la prueba—era ineficiente. Por lo tanto, …

Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur

Poverty, Gender, and Youth

For three decades, the Expanded Programme on Immunization (EPI) has been promoted as one of the key child health interventions in developing countries. Vaccines for six childhood diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, and tuberculosis) have been shown to be efficacious in preventing disease-specific morbidity and mortality, yet not all commentators are convinced that the EPI reduces all-cause child mortality. Numerous studies have found that measles vaccination programs substantially reduce all-cause child mortality, but recent findings from Guinea-Bissau suggest that diphtheria, pertussis, and tetanus (DPT) vaccine may increase all-cause child mortality. The present study uses five years of data from …

Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité discusses the Manuela Ramos Movement and its efforts to improve women’s health and well-being through a range of empowerment strategies in rural Peru. A joint project with USAID, named Reprosalud, demonstrates how combining the resources of an international donor with local women’s organizations allows a more organic and multifaceted family planning program to develop. Such programs can produce impressive improvements on a number of indicators, including contraceptive use.

A Case Study Of Nairobi City Council's Decentralised Syphilis Screening Programme In Antenatal Clinics, Baker Ndugga Maggwa, Ian Askew, Elizabeth Mugwe, Bilhah Hagembe, Rick Homan

Reproductive Health

It has long been known that syphilis is one of the more serious sexually transmitted infections (STI), especially during pregnancy when, if untreated, at least 60 percent of infected women will experience an adverse pregnancy outcome. There has been renewed interest in its control and prevention because of its proven link with HIV transmission. In 1992, the Nairobi City Council (NCC) pilot-tested a decentralized approach to syphilis screening and management in a sample of their antenatal clinics. A case study was carried out to assess the effectiveness, readiness, and cost effectiveness of the NCC’s antenatal care program, with a focus …

Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health

Reproductive Health

Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …

Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health

Reproductive Health

Aproximadamente la mitad de los partos en Honduras son atendidos en un hospital. Sin embargo, los hospitales generalmente no ofrecen servicios de planificación familiar a las pacientes en el posparto o el postaborto. En 1999, la Secretaría de Salud de Honduras (SSH) y el Population Council iniciaron un proyecto de dos años con el fin de ampliar el acceso a la consejería y a los servicios de planificación familiar después de un parto o de haber recibido tratamiento por un aborto incompleto. La intervención se realizó basándose en un proyecto previo del Population Council que mostró que el 30 por …

Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain

Reproductive Health

Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC …

Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of …

Setting Prices For Reproductive Health Services In A Public Hospital In Guatemala, John H. Bratt, Adrian Valdez, Roberto Molina, Mario Alfaro, Marco Antonio Barrientos, Carlos Brambila, Werner Figueroa

Reproductive Health

The Hospital Roosevelt is Guatemala’s largest hospital, and serves as a referral and training facility for the entire country. Within the Hospital Roosevelt, the Department of Obstetrics and Gynecology established a Reproductive Health Unit (RHU) to offer family planning information and services to obstetrics inpatients and OB/GYN outpatient clients, and to serve as a training site for medical residents completing their OB/GYN rotations. Hospital administrators requested assistance from the Frontiers in Reproductive Health (FRONTIERS) program to help establish a fee schedule for the RHU, with the goal of paying its own personnel costs after one year of operation. The FRONTIERS …

Expansion Of Postpartum/Postabortion Contraception In Honduras, Ruth Medina, Ricardo Vernon, Irma Mendoza, Claudia Aguilar

Reproductive Health

The Honduran Ministry of Health (MOH) and the Population Council’s INOPAL III Project tested the acceptability of postpartum/postabortion contraception at the Escuela Hospital, the largest in the country. The project showed that more than 30 percent of the women seen for a delivery or a complication due to abortion, were interested in adopting a contraceptive method prior to discharge from the hospital. Given the success of the project, the MOH asked the Population Council’s FRONTIERS program for technical and financial support to extend those services to five additional hospitals in the country. Important improvements were found for the four indicators …