International Public Health Commons^™

Exploring Significant Impacts Of Global Health On Nursing Education And Resource-Poor Communities: An Integrative Literature Review, Kimberly Elkayam, Elizabeth Del Cimmuto

Grace Peterson Nursing Research Colloquium

Exploring Significant Impact of Global Health Experienced by Nursing Educators: An Integrative Literature Review

Elizabeth Del Cimmuto & Kimberly Elkayam

Faculty Sponsor: Young-Me Lee, PhD, RN

Background: Nursing education in the United States is largely focused on health promotion at the local and community level. Modern advances in communication technology have facilitated a movement in nursing to gradually adopt a global health perspective in both practice and education.

Objective: to explore what research has been done regarding how nurse educators are impacted by adopting global health perspectives in nursing education and to suggest one potential way to add to this …

Addressing Hydrocephaly In Viet Nam: A Plausible Prevention And Intervention Medical Support Program Proposal, Chelle Mcintyre-Brewer

UNO Student Research and Creative Activity Fair

Families affected by hydrocephalus in Viet Nam have few options for sustainable treatment for a myriad of reasons, primarily centering on barriers to care prevalent to minority, underserved, and economically disadvantaged populations. High morbidity and abandonment rates often result from these circumstances. An interdisciplinary examination of the factors contributing to causal concerns reveals unique cultural considerations, language and literacy barriers, ethnic and geographic differences, as well as economic and governmental issues greatly impacting patient outcome for this condition. The author contends that a program that addresses sociological concerns, along with the medical treatment of the patient, proffers the opportunity for …

Stigma Gets In My Way: Factors Affecting Client-Provider Communication Regarding Childbearing Among People Living With Hiv In Uganda., Jolly Beyeza-Kashesya, Rhoda K. Wanyenze, Kathy Goggin, Sarah Finocchario-Kessler, Mahlet Atakilt Woldetsadik, Deborah Mindry, Josephine Birungi, Glenn J. Wagner

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda.

METHODS: 400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis.

RESULTS: 75% of the sample was female; 61% were on antiretroviral therapy; …

Somalia: Rift Valley Fever, Alyson Meeks

Global Public Health

This walks readers through the basic demographics of Somalia, a country located in the horn of Africa. After learning about the government in Somalia and the problems that the people of the country face, this focuses on the problem of Rift Valley Fever. Rift Valley Fever is a virus that year after year strikes Somalia and surrounding countries. Weather patterns seem to help predict when Rift Valley Fever will be at the highest risk for an outbreak. This outlines the steps the current government and people are trying to take to help prevent outbreaks of RVF. But the solutions currently …

Russian Federation: Alcoholism, Hannah Vercellotti

Global Public Health

The Russian Federation, better known as Russia, is the largest nation in the world. While the country faces numerous internal and external challenges, one of the most prevalent public health issues is alcoholism and excessive alcohol use. This is particularly concerning since, in addition to direct mortalities, alcoholism leads to Russia’s leading cause of death, coronary heart disease. The research compiled in this brief examines general information about the country, a few common public health issues faced, basic epidemiology, and previous interventions targeted at reducing alcoholism and excessive alcohol use. The project then proposes a future intervention aimed at resolving …

Leadership In Community Public-Private Partnership Health And Social Care Initiatives, Hawa Yatera Mshana, Magdeline Aagard, Cheryl Cullen, Patrick A. Tschida

Journal of Sustainable Social Impact

Although the public–private partnerships in health have been adopted as the best pathway to improving health outcomes in many developing nations, implementation lacks collaborative leadership. The purpose of this empirical qualitative case study was to determine key factors that promote leadership synergy (LS) between partners that enhance ownership and accountability of community health and social initiatives in Tanzania. The diffusion of innovation theory and public–private integrated partnership module were the theoretical framework guided this study. Diffusion of innovation theory is based on the importance of effective communication to spread new ideas and foster change in behavior in a social group …

Using Evidence To Improve Quality Of Pharmacy-Delivered Medical Abortion, Katharine Footman, Nancy Termini Lachance

Reproductive Health

The goal of family planning and reproductive health operations research is to generate evidence that helps policies and programs maximize access to and quality of services for women and their families. Yet the crucial step of ensuring the utilization of that evidence often receives inconsistent or inadequate attention. The goal of this case study is to document an activity of Marie Stopes International (MSI) in Kenya, part of the STEP UP research program consortium, which resulted in successful evidence utilization. STEP UP research on quality of care for medical abortion, particularly on pharmacy provision of medical abortion, has provided the …

Perceptions Of Health Professionals In Ghana On The Role Of The Community In Chronic Disease Management, Jesuseme Omoruan

College of Graduate Studies: Theses & Dissertations

The prevalence of chronic disease has been on the rise in various developing countries. This study is an exploratory investigation of the perceptions of health professionals in Kumasi, Ghana on the role of the community in chronic disease management. Using the Chronic Care Model as a framework, the objective of the study was to examine the extent of community-healthcare system in chronic disease management and to explore the barriers to and facilitators of community involvement in chronic disease management. By exploring the availability of community resources that positively contribute to the management of these patients, the study fills an existing …

Challenges In Delivering Refugee Health Services, Thy Vo, Fabiana Kotovicz

Journal of Patient-Centered Research and Reviews

Background: Aurora Health Care is the major health care system providing care to refugees in Milwaukee, where half of Wisconsin’s refugee population resides. Like many other institutions caring for refugee patients, Aurora faces significant challenges when trying to address refugee health needs. Even with the assistance of medical interpreters, cultural differences, language barriers and limited patient health literacy, as well as lack of knowledge of refugee patients’ backgrounds, are major obstacles encountered by health care providers in this setting.

Purpose: This quality improvement study aims to assess Aurora providers’ perceptions of the benefits and barriers to working with refugee …

Community-Based Distribution Of Iron-Folic Acid Supplementation In Low- And Middle-Income Countries: A Review Of Evidence And Programme Implications., Justine A Kavle, Megan Landry

Prevention and Community Health Faculty Publications

The present literature review aimed to review the evidence for community-based distribution (CBD) of iron–folic acid (IFA) supplementation as a feasible approach to improve anaemia rates in low- and middle-income countries.

The literature review included peer-reviewed studies and grey literature from PubMed, Cochrane Library, LILAC and Scopus databases.

Low- and middle-income countries.

Non-pregnant women, pregnant women, and girls.

CBD programmes had moderate success with midwives and community health workers (CHW) who counselled on health benefits and compliance with IFA supplementation. CHW were more likely to identify and reach a greater number of women earlier in pregnancy, as women tended to …

Refugee Policy Implications Of U.S. Immigration Medical Screenings: A New Era Of Inadmissibility On Health-Related Grounds., Mi-Kyung Hong, Reshma E Varghese, Charulata Jindal, Jimmy T Efird

Medicine Faculty Publications

Refugees frequently face extended delays in their efforts to enter the United States (U.S.) and those who are successful, in many cases, encounter overwhelming obstacles, inadequate resources, and a complex system of legal barriers. Travel restrictions based on equivocal health concerns and a drop in refugee admittance ceilings have complicated the situation. The authors retrieved and analyzed peer-reviewed journal articles, government agency press releases, media postings, epidemiologic factsheets, and relevant lay publications to critically assess U.S. policy regarding refugee resettlement based on health-related grounds. While refugees arguably exhibit an increased incidence of measles and tuberculosis compared with the U.S. population, …

Refugee-Centered Medical Home:A New Approach To Care At The University Of Louisville Global Health Center, Rahel Bosson, Ruth M. Carrico, Anupama Raghuram, Paula Peyrani, William A. Mattingly, Rebecca Ford, Stephen P. Furmanek, Julio A. Ramirez

Journal of Refugee & Global Health

Refugees arrive to the United States with a full spectrum of health conditions, many of which involve intense case management requiring significant financial investments and use of healthcare resources. Kentucky receives more than 3,000 new refugees each year and ranked 10th in the nation for numbers of new arrivals resettled during 2015. These refugees arrive from diverse countries representing different cultures and speaking different languages. In addition, they arrive with diverse health conditions and medical needs. The aims of this paper are to share experiences from the University of Louisville Global Health Center regarding conceptualization, implementation and evaluation of a …

Do Marketing Strategies Impact Condom Sales In Uganda?, Meyhar Mohammed

Master's Theses

What attracts people to buy condoms? HIV/AIDS remain one of the biggest health dangers of the world, especially in Sub-Saharan Africa. A lot of efforts have been pursued in the past two decades to drastically reduce prevalence of HIV and increase awareness about preventive mechanisms. In order to prevent relapse of success achieved so far, it is important to recognize transformation of consumer behavior due to growth in social networks, education and awareness over time. There are a lot of behavioral triggers captured by social marketing interventions in the field of public health. In an attempt to investigate the role …

Equity And Community-Based Health Insurance: How Does Insurance Coverage Affect Health Seeking Behavior Among Disadvantaged Groups In India?, Hazel Hering

Independent Study Project (ISP) Collection

The objective of this study is to examine how Community-Based Health Insurance (CBHI) can promote equity by improving health seeking behavior across gender and geography. Using a CBHI scheme from the Self-Employed Women’s Association (SEWA) as a case study, trends in claims filed between October 2016 and March 2017 are compared to the distribution of memberships in order to investigate whether health insurance coverage positively impacts health seeking behavior among disadvantaged groups, and what barriers to access exist when the burden of medical costs are reduced. This study concludes that the number of male and female claims in the sample …

A Comparative Study On The Impact Evaluation Of World Vision’S Water, Sanitation And Hygiene Program In Malawi, Mozambique, And Zambia: Analyses Using Lives Saved Tool, Chulwoo Park, Armen Martirosyan, Erin A. Jones, Ashley Labat, Yvonne Tam, Emmanuel Opong

GW Research Days 2016 - 2020

Background

According to the World Health Organization, diarrheal disease is the second top killer of children under five years of age (U5), claiming around 760,000 young children’s lives every year, and 88% of diarrheal disease is attributed to unsafe water supply, inadequate sanitation and hygiene. The humanitarian aid organization, World Vision, launched community-based water, sanitation and hygiene (WASH) project in 76 Area Development Programs (ADPs) for 506,019 target U5 population across Southern Africa Region (SAR): Malawi, Mozambique and Zambia in 2010.

Objective

This study estimated the retrospective health impact of the project between 2010 and 2014 to measure how effectively …

Victims Or Heroes? How Did Journalists Frame The Ebola Crisis In Liberia?, Tamah Kamlem, Nwanneamaka Ume, Skylar Lisse, Eme Udoh, Jialin Meng

GW Research Days 2016 - 2020

The Ebola Virus Disease epidemic in West Africa in 2014 with over 11,000 deaths made headlines worldwide, causing fear and posing a challenge to traditional media, entrusted with the task of reporting about the spread of the disease. Individuals and communities rely on media to obtain health information, including decisions related to disease prevention and behavior to protect their health. Therefore, frames used by the media to report about health emergencies impact public perceptions. Mass media framing during crises has been associated with emotional and behavioral responses that are consistent with the thematic depiction of unfolding events. Moreover, message frames …

Improving Health Outcomes In Trafficking Survivors Through Core Skills Development In The Workplace: Experience From The Philippines, Melinda A. Gill

Dignity: A Journal of Analysis of Exploitation and Violence

Whilst an emerging body of research documents the adverse physical and mental health outcomes of victims of trafficking following rescue, there is little research or guidance regarding interventions which improve these outcomes. In this article, I describe my experience as physician involved in a computer-based social enterprise for survivors of trafficking and slavery in the Philippines, and outline my evolving understanding of the requirements for health behavior change and improved outcomes. I conclude that while meaningful vocational skills, economic security, and adequate health-related knowledge are foundational, it is necessary to develop core skills to achieve improved health outcomes and that …

Utilizing Three Years Of Epidemiological Data From Medical Missions In Cambodia To Shape The Mobile Medical Clinic Formulary, Jeany Kim Jun, Junia S. Koo, Amy Y. Kang, Deborah B. Chien, Albert Shim, Dale Knutson, Eda M. Kim

Pharmacy Faculty Articles and Research

Objective: The purpose of this project was to gather epidemiological data on common diseases and medications dispensed during medical mission teams to Cambodia to shape the mobile medical clinic formulary.

Methods: Data for patients seen during week-long, mobile, medical clinics was collected in Cambodia during Septembers 2012 to 2014. Patient’s gender, age, weight, blood pressure, glucose, pertinent laboratory values, diagnoses, and medications dispensed were collected. Blood pressure and glucose were measured in patients 18 years and above. Data collected onto paper intake forms were transferred onto spreadsheets without patient identifying information and analyzed for aggregate means, common diseases, and most …

The Scoping Review Method: Mapping The Literature In “Structural Change” Public Health Interventions, Rosie Hanneke, Yuka Asada, Lisa D. Lieberman, Leah Christina Neubauer, Michael C. Fagan

Department of Public Health Scholarship and Creative Works

This case discusses how we used scoping review methodology to map the literature in an emergent area of research, “structural change” public health interventions. Scoping reviews are similar to systematic reviews in both scale and rigor; both of these literature review methodologies are comprehensive approaches to reviewing the literature on a topic. However, while a systematic review attempts to answer a specific, targeted research question, a scoping review is designed to map and categorize all of the literature on a broad topic. For this reason, it is an excellent method to employ in emergent research areas, in which researchers have …

Challenges To Estimating Vaccine Impact Using Hospitalization Data., Cynthia Schuck-Paim, Robert J Taylor, Lone Simonsen, Roger Lustig, Esra Kürüm, Christian A W Bruhn, Daniel M Weinberger

Global Health Faculty Publications

Because the real-world impact of new vaccines cannot be known before they are implemented in national programs, post-implementation studies at the population level are critical. Studies based on analysis of hospitalization rates of vaccine-preventable outcomes are typically used for this purpose. However, estimates of vaccine impact based on hospitalization data are particularly prone to confounding, as hospitalization rates are tightly linked to changes in the quality, access and use of the healthcare system, which often occur simultaneously with introduction of new vaccines. Here we illustrate how changes in healthcare delivery coincident with vaccine introduction can influence estimates of vaccine impact, …

Implementation Science To Accelerate Clean Cooking For Public Health., Joshua Rosenthal, Kalpana Balakrishnan, Nigel Bruce, David Chambers, Jay Graham, Darby Jack, Lydia Kline, Omar Masera, Sumi Mehta, Ilse Ruiz Mercado, Gila Neta, Subhrendu Pattanayak, Elisa Puzzolo, Helen Petach, Antonello Punturieri, Adolfo Rubinstein, Michael Sage, Rachel Sturke, Anita Shankar, Kenny Sherr, Kirk Smith, Gautam Yadama

Environmental and Occupational Health Faculty Publications

Clean cooking has emerged as a major concern for global health and development because of the enormous burden of disease caused by traditional cookstoves and fires. The World Health Organization has developed new indoor air quality guidelines that few homes will be able to achieve without replacing traditional methods with modern clean cooking technologies, including fuels and stoves. However, decades of experience with improved stove programs indicate that the challenge of modernizing cooking in impoverished communities includes a complex, multi-sectoral set of problems that require implementation research. The National Institutes of Health, in partnership with several government agencies and the …

Trinidad & Tobago : Hiv Epidemic, Madison Caldwell

Global Public Health

Trinidad and Tobago are twin islands located in the Caribbean off the coast of Venezuela. In the recent years since about 1990, citizens of this country have been greatly affected by the HIV epidemic. HIV stands for human immunodeficiency virus and is spread through infected seman, blood, or vaginal fluids usually through sexual intercourse. As this virus continues to progress in the body, it will eventually turn into AIDS, which stands for acquired immunodeficiency syndrome. Once HIV progresses to AIDS, the outcome is ultimately fatal, hence why there is a dire need to promote awareness and methods of intervention to …

Namibia : Hiv As A National Issue, Elisabeth Vlasak

Global Public Health

Namibia is located on the southwestern coast of Africa, bordering Angola, Botswana, Zambia, South Africa, and the Atlantic Ocean. Namibia has a population of 2,265,000, as of 2016. Namibia has many challenges, including food insecurity and malnutrition, access to health services, unequal distribution of wealth, but HIV/AIDS is one of the country’s leading challenges. It is estimated that the overall adult infection rate of HIV/AIDS is 15.4% and it is the leading cause of death in Namibia. Adults ages 18-24 are the most at-risk for the disease. Some of the major risk factors are declining condom use, misinformation, social stigma, …

Zimbabwe : Malaria, Ashton Hutcheson

Global Public Health

Zimbabwe, a developing country in southeastern Africa, has a population of over 15 million people. The large majority of this population is at risk for various prevalent infectious disease including the significant threat that is Malaria. Zimbabwe is a country within what the World Health Organization determines as the “WHO African Region.” This region is where 90% of Malaria deaths occur worldwide. This brief provides reasons why malaria is such a major problem including the country’s general lack of clinics and key risk factors associated with contracting malaria. It was found that those most at-risk for malaria live in houses …

Christians’ Cut: Popular Religion And The Global Health Campaign For Medical Male Circumcision In Swaziland, Casey Golomski, Sonene Nyawo

Anthropology

Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom’s three ecumenical organisations, showing how a diverse group people singly glossed as ‘Christian’ in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision’s promotion and …

Changing Hearts And Minds: Results From A Multi-Country Gender And Sexual Diversity Training, Tonia Poteat, Chulwoo Park, Diego Solares, John K. Williams, R. Cameron Wolf, Noah Metheny, Andrea Vazzano, Juan Dent, Ashley Gibbs, Bareng Aletta Sanny Nonyane, Nora Toiv

Faculty Publications

Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- …

Breast Is Best: Determinants Of Breastfeeding In Bali, Leah Hardenbergh

Independent Study Project (ISP) Collection

Breastfeeding greatly benefits the health of newborns, providing them with needed antibodies and protection from numerous diseases, including some of the leading causes of infant mortality. This paper explores breastfeeding practices in Bali, and the wide array of factors that have led to these practices. After discussing how breastfeeding fits into the larger context of maternal and newborn health, I explain factors in Bali that affect a woman’s decision to breastfeed and experience while breastfeeding. Determinants include those related to health, financial position, and social status. I explore the history of formula companies and formula as an alternative to breastmilk, …

Exploring Determinants Of Handwashing With Soap In Indonesia: A Quantitative Analysis, Mitsuaki Hirai, Jay P. Graham, Kay Mattson, Andrea Kelsey, Supriya Mukherji, Aidan Cronin

Environmental and Occupational Health Faculty Publications

Handwashing with soap is recognized as a cost-effective intervention to reduce morbidity and mortality associated with enteric and respiratory infections. This study analyzes rural Indonesian households’ hygiene behaviors and attitudes to examine how motivations for handwashing, locations of handwashing space in the household, and handwashing moments are associated with handwashing with soap as potential determinants of the behavior. The analysis was conducted using results from a UNICEF cross-sectional study of 1700 households in six districts across three provinces of Indonesia. A composite measure of handwashing with soap was developed that included self-reported handwashing, a handwashing demonstration, and observed handwashing materials …

A Livelihood Intervention To Improve Economic And Psychosocial Well-Being In Rural Uganda: Longitudinal Pilot Study, Bernard Kakuhikire, Diego Suquillo, Elly Atuhumuza, Rumbidzai Mushavi, Jessica M. Perkins, Atheendar S. Venkataramani, Sheri D. Weiser, David Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV and poverty are inextricably intertwined in sub-Saharan Africa. Economic and livelihood intervention strategies have been suggested to help mitigate the adverse economic effects of HIV, but few intervention studies have focused specifically on HIV positive persons. We conducted three pilot studies to assess a livelihood intervention consisting of an initial orientation and loan package of chickens and associated implements to create poultry microenterprises. We enrolled 15 HIV-positive and 22 HIV-negative participants and followed them for up to 18 months. Over the course of follow-up, participants achieved high chicken survival and loan repayment rates. Median monthly income increased, and severe …

Unicef Kid Power: Empowering Kids To Get Active And Save Lives, Emily L. Gudaitis

Master's Projects and Capstones

UNICEF Kid Power is a program aimed at increasing U.S. children’s activity levels by tapping into children’s intrinsic desire to do good. Through their activity levels, kids earn points, which unlocks funding from partners that will support treatment for a malnourished child. This one-of-a-kind program was implemented in the Bay Area in Spring 2016 with 7,800 youth participants. The attached paper is a summary of a 300-hour fieldwork experience at the U.S. Fund for UNICEF assisting with the UNICEF Kid Power implementation in the Bay Area. The fieldwork included program implementation and evaluation, presentations at participating schools in the area, …