Public Health Commons^™

Landscape Analysis: Preventing And Managing Pre-Eclampsia And Eclampsia In Pakistan, Population Council

Reproductive Health

The Ending Eclampsia project conducted a landscape analysis to identify policy and program activities, as well as gaps and challenges around the prevention and treatment of PE/E and use of magnesium sulphate at the provincial and district levels in Pakistan. The analysis assessed the practices for PE/E prevention and treatment, prevalence of PE/E, associated complications, and contribution to maternal mortality and morbidity. This landscape analysis was a major study and one of the first of its kind in the country, blending multiple perspectives on provision of care through the public health system for pregnant women facing, or at risk of, …

Life-Saving Medicines And Equipment In Facilities In Bangladesh, Kanij Sultana, Amy Dempsey

Reproductive Health

This research brief is a part of a larger landscaping analysis by Population Council, with support from USAID and the MacArthur Foundation. In Bangladesh, in 12 upazilas in four districts, it assessed the capacity of primary health facilities to manage pre-eclampsia and eclampsia (PE/E). This brief shares findings from 134 facilities on required infrastructure for providing maternal and newborn health (MNH) services, human resources, facility readiness, and MNH commodities and supplies. Facility readiness is vital to providing quality services to antenatal care (ANC) patients, especially to women with PE/E. Without functioning equipment, ANC/PNC registers, essential medicines, electricity, and running water, …

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

Uganda Retail Audit: Analysis And Report, The Evidence Project

Reproductive Health

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

Impact Of Social Support Networks On Level Of Stress And Self-Esteem Among Canadian Immigrants, Jackie Williamson

Walden Dissertations and Doctoral Studies

Immigration may be an effective survival strategy for individuals from countries involved in war or political unrest.However, the immigration process may exacerbate a number of physical and psychological health symptoms. There are limited data on the health status of new Canadian immigrants, and some social support networks are not formally connected to settlement programs.The purpose of this cross-sectional quantitative study was to assess the level of stress and self-esteem of 400 recent and older immigrants in Canada, and to investigate the impact of social support networks on the mental well-being of recent immigrants.Cultural care and general adaptation theory provided the …

Individual And Socioeconomic Factors Associated With Childhood Immunization Coverage In Nigeria, Obinna Ositadimma Oleribe

Walden Dissertations and Doctoral Studies

Immunization remains one of the most successful and cost-effective public health interventions worldwide. The purpose of this study was to examine the individual and socioeconomic factors that influence childhood immunization coverage in Nigeria. The health belief model and the social ecological model were used as the theoretical framework for the study, which examined the effects of individual, parental, and socioeconomic factors on complete immunization among Nigerian children. Univariate, bivariate, and multivariate tests were conducted within a secondary analysis of 2013 Nigerian National Demographic and Health Survey was done. Of 27,571 children aged 0 to 59 months, 22.1% had full vaccination …

Effect Of Intimate Partner Violence On Children Of Puerto Rican Women, Maria Natal-Gopin

Walden Dissertations and Doctoral Studies

Intimate partner violence [IPV] is a preventable and costly societal issue that has reached epidemic proportions. Women are often the victims of IPV, and millions of children are exposed to it annually. The purpose of this study was to explore experiences of Puerto Rican mothers and their perceptions of how IPV exposure may have impacted their children using resilience theory. Data were collected via audiotaped individual interviews with 9 Puerto Rican mothers who endured an array of escalating IPV, often exacerbated by the perpetrators use of alcohol or drugs, and had IPV-exposed children aged 6 -11 years. Data analysis integrated …

Rural Haitian Women's Experiences With Poor Health Through Poverty, Geralda Felix

Walden Dissertations and Doctoral Studies

People living in rural Haiti lack access to basic health care services due to poverty. Rural poverty in Haiti particularly affects women's health because Haiti has had the highest maternal mortality and infant mortality rates in the Americas, in addition to some of the worst health statistics in the Western Hemisphere. The purpose of this phenomenological study was to cultivate a greater understanding of the poverty factors that affect access to health care services specifically among poor women living in rural Haiti. This study was based on the social ecological model for population health development, theorizing that a person's health …

Poison In Pink, Sydney V. Cook

Graduate Student Theses, Dissertations, & Professional Papers

Humans slather, spray, mist, and cleanse their bodies with personal care products like lotion, hairspray, cologne, and shampoo every day. Our cupboards are stocked full of them, but few of us understand what is in those jars and bottles. We trust that if it’s on the shelf at the store, it’s safe. However, this is not always the case, and many personal care products contain chemicals that are harmful to human and environmental health.

My multi-disciplinary Environmental Studies thesis project combines evidenced-based research, interviews, nonfiction narrative, and science communication to create part of a book manuscript intended to educate general …

The Experiences Of African American Women Participating In Church-Based Weight Loss Programs, Mangle L. Shanks

Walden Dissertations and Doctoral Studies

While obesity is a nationwide phenomenon, African Americans - especially women - continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss …

Improving Fall Prevention Strategies In An Acute-Care Setting, Sylvia B. Boye-Doe

Walden Dissertations and Doctoral Studies

Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program …

Workers' Perceptions Of The Effect Of Three-Tier Shift Schedules On Community Functioning, Jillian Leigh Wallace

Walden Dissertations and Doctoral Studies

Shift work is commonplace in many fields that require around-the-clock employee coverage. There is ample evidence that two-tier shift work can detrimentally affect health and functioning. The purpose of this study was to understand the impact of three-tier shift schedules on physical and mental health and community functioning, a concept which refers to activities and behaviors performed by individuals or groups within a system. This study used a qualitative phenomenological design, and community functioning and recovery theory were central to the conceptual framework. In-depth interviews were used to explore the perceptions of three-tier shift workers on their functioning, relationships, mental …

The 1939 Dickinson-Belskie Birth Series Sculptures: The Rise Of Modern Visions Of Pregnancy, The Roots Of Modern Pro-Life Imagery, And Dr. Dickinson’S Religious Case For Abortion, Rose Holz

Women's and Gender Studies Program: Faculty Publications

This multidisciplinary essay examines the hugely influential—yet surprisingly overlooked—Birth Series sculptures. Created in 1939 by Dr. Robert L. Dickinson (obstetrician-gynecologist and leader of the Planned Parenthood Federation of America) and sculptor Abram Belskie, they illustrate the process of human development from fertilization through delivery. First displayed at the 1939–1940 World’s Fair in New York City, they were reproduced in a variety of forms and sent out across the United States and overseas. Hardly a brief fad, their popularity persisted into the 1980s. This essay has four purposes. First, it tells the stories of Dickinson and Belskie to appreciate their contributions …

Social Network And Health Seeking Behavior Of Men Of West African Descent, Opeyemi Odewale

Walden Dissertations and Doctoral Studies

Men are less likely than women to seek help from health services providers regarding the health issues they face. In the United States, of the various race/ethnicity populations, Black American men are least likely to seek health related help, which is reflected in the substantially higher mortality and morbidity rates in Black American men compared to other populations. Guided by the social epidemiological framework, this study examined the relationship between social network measure and health help-seeking behavior among foreign-born and U.S.-born Black American men of West African descent residing in the state of Rhode Island. A cross-sectional study design with …

Depressive Symptoms Among College Students: An Exploration Of Fundamental Cause Theory, Peter A. Carrico

Theses and Dissertations

Fundamental Cause Theory suggests that socioeconomic and demographic factors are causal to various illnesses, including depression. However, no known previously existing research has used Fundamental Cause Theory to create a model of depression among college students. To do this, the present study conducted a stepwise binomial logistic regression to examine how socioeconomic status and the sociodemographic variables of Gender, Race, and Sexual Orientation, and others predict depressive symptoms in a large sample of undergraduates when controlling for stressful life events and social support (N = 2,915). Results support the hypothesis that socioeconomic disparities in depressive symptoms are the result …

The Relationship Between Hispanics/Latino Men Who Have Sex With Men And Women Cultural Beliefs, Risk Behaviors And Self-Disclosure, Donnalee Maria Lawson-Williams

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate the relationships among cultural/spiritual beliefs, risk behaviors, and disclosure among Hispanic/Latino men who have sex with men and women (MSMW). Minority men who have sex with men are disproportionately affected by HIV, in particular MSM who are Hispanic/Latino or African American. Limited research is available on the link between Hispanic/Latino MSMW, their cultural/spiritual beliefs, risk behavior, and disclosure about risk behaviors to friends and family. The data were obtained from the SJS Project, which used survey methods to gather data on participants from all 50 states and Puerto Rico. Among the participants …

The Association Between Neighborhood Factors And Mexican Americans’ Mental Health Outcomes: A Systematic Review, Kai Wei, Jaime Booth

The Journal of Sociology & Social Welfare

This systematic review seeks to elucidate the association between neighborhood factors and Mexican American mental health outcomes. We searched PsycINFO and Academic Search Premier for studies related to neighborhood factors and mental health. Google Scholar was used to identify additional studies, followed by a manual inspection of the related work. Eleven studies were identified. Nine studies found that neighborhood factors had a significant impact on mental health among this group. Neighborhood compositional factors influenced mental health directly, among which minority concentration was found to be protective for Mexican American mental health. Neighborhood contextual factors influenced mental health directly and indirectly …

When ‘Places’ Include Pets: Broadening The Scope Of Relational Approaches To Promoting Aging-In-Place, Ann M. Toohey, Jennifer A. Hewson, Cindy L. Adams, Melanie J. Rock

The Journal of Sociology & Social Welfare

Aging-in-place is a well-established concept, but discussions rarely consider that many older adults live with pets. In a ‘pet-friendly’ city, we conducted semi-structured interviews to explore perspectives of community-based social support agencies that promote aging-in-place, and those of animal welfare agencies. Applying a relational ecology theoretical framework, we found that pets may contribute to feeling socially- situated, yet may also exacerbate constraints on autonomy experienced by some older adults. Pet-related considerations at times led to discretionary acts of more-than-human solidarity, but also created paradoxical situations for service-providers, impacting their efforts to assist older adults. A shortage of pet-friendly affordable housing …

Disparities In Infant Mortality: Are Sociocultural Risk Factors Shaped By Institutionalized Racism?, Madison Grimm

Honors Program Theses

The infant mortality rate (IMR) is an incredibly important indicator of the overall health of a nation. Because the IMR is so closely related with factors such as quality and accessibility of healthcare and socioeconomic conditions, it is helpful in evaluating a nation’s success. The United States (US) has one of the highest infant mortality rates among countries with a similar degree of economic development (those belonging to the OECD). In 2013, the IMR was 5.96 deaths per 1,000 live births, according to the Centers for Disease Control and Prevention, or CDC (Mathews, MacDorman, & Thoma, 2015). Furthermore, this rate …