International Public Health Commons^™

Maternal And Newborn Health Behaviors In Rural Uttar Pradesh: Findings From Learning Phase Baseline Survey 2013, M.E. Khan, Praween Kumar Agrawal, Avishek Hazra, Anvita Dixit, Isha Bhatnagar, Jaleel Ahmad, D.N. Ahmad

Reproductive Health

The Uttar Pradesh Community Mobilization Project (2011–16) aims to develop and scale up evidence-based interventions to improve reproductive, maternal, neonatal, and child health and nutrition health behaviors by an average of 10 percentage points among marginalized populations in Uttar Pradesh, India. The goal is to reduce neonatal mortality by improving maternal and child health behaviors through developing and scaling up a package of family health interventions and strengthening the management of Behavior Change Communication using self-help groups as the platform. The project is being carried out in two phases—a learning phase covering 10 blocks and a scale-up phase covering 100 …

Adolescence And Sexuality, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

The Global Health Security Agenda In An Age Of Biosecurity, Lawrence O. Gostin, Alexandra Phelan

Georgetown Law Faculty Publications and Other Works

Historically, the Oval Office has been a leader in global health assistance. From the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI) under the Bush Administration, to the Global Health Initiative launched by President Obama in 2009. However, unlike PEPFAR and PMI, the Global Health Initiative met an untimely end with the launch of a bold new global health measure by the Obama Administration: the Global Health Security Agenda (GHS Agenda). The GHS Agenda aims to “accelerate progress toward a world safe and secure from infectious disease threats” through a US-led diplomatic collaboration with 30 …

Governing For Health As The World Grows Older: Healthy Lifespans In Aging Societies, Lawrence O. Gostin, Anna Garsia

Georgetown Law Faculty Publications and Other Works

So much of global health governance focuses intensely on a brief moment in the human lifespan—from a safe birth to infant and child survival. Yet, with all the attention to this early window of life (infancy to age five), the opposite end of the life spectrum is comparatively neglected. The Millennium Development Goals (MDGs) do not mention a healthy lifespan or a healthy old age. This inadequate attention to the older years of the life appears to be a glaring omission given the universal challenges posed by aging societies. Aging is a demographic fact in almost all countries, but it …

Cultural Factors Associated With Utilization Of Antenatal Care Services In Rural India, Anjali Om

Undergraduate Research Posters

Despite vast economic growth in developing countries in the past few years, infant mortality continues to plague underdeveloped regions, particularly rural regions of India. Many of these deaths are caused by a lack of education and motivation in regard to utilization of antenatal and neonatal care services to prevent and treat consequences of unhygienic umbilical cord care.

For years, high incidences of neonatal tetanus have plagued rural areas of India as a result of cultural practices that encourage topical applications of cow dung to cut umbilical stumps either directly or by using ghee heated with cow dung to warm umbilical …

La Situación De Las Cataratas En La Ciudad De Buenos Aires: Un Estudio De Caso En El Hospital Ramos Mejía / The Situation Of Cataracts In The City Of Buenos Aires: A Case Study In Ramos Mejía Hospital, Katie Elizabeth Kessler

Independent Study Project (ISP) Collection

Background: When a person has cataracts his or her lens becomes clouded by proteins, causing diminished vision. Though cataracts cause poor vision or in more serious cases blindness, what is special about cataracts is that they are treatable. Surgery replaces the clouded lens with a new artificial lens called an intraocular lens. In Argentina in 2006 only 10% of cataract surgeries were realized in the public sector, and the Ministry of Health of the Nation decided to develop a program called Program Eye Health and the Prevention of Blindness to fight these and other inequities in the realm of visual …

Factors Influencing Access To Healthcare Services, Melissa Delia

Independent Study Project (ISP) Collection

Following several political upheavals, the country of Madagascar has become one of the poorest countries in the world. This level of poverty affects many aspects of life, especially access to healthcare services. The availability of both allopathic and traditional healthcare to the impoverished citizens of Madagascar was examined through discussions, interviews, and journal articles. It was found that although both the allopathic and traditional medicinal systems do not charge their patients for general consultations and care, there is a high cost for pharmaceutical medications in the allopathic system. These medications are sometimes too expensive for many Malagasy patients to afford. …

Fanta Fanafody: Malagasy Traditional Medicine In A Globalized World, Mary Buswell

Independent Study Project (ISP) Collection

This study investigates the relationship between traditional medicine and globalization in Madagascar. Information from interactions and interviews with both traditional and allopathic healers is used to study the current healthcare system and provide direction for the establishment of an Integrated Health Care System (IHCS). This study finds that traditional medicine and globalization have a closer and more reciprocal relationship than it would initially appear, and that traditional medicine is very adaptable to change. Because of this, it is proposed that globalization and technology could be tools to bring traditional and allopathic medicine together in an IHCS to resolve the health …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Community Built Environment And Multilevel Social Determinants Of Obesity: Evidence From China Health And Nutrition Survey, Libin Zhang, Tim F. Liao, Laura L. Hayman

Office of Community Partnerships Posters

The prevalence of overweight and obesity is highest in wealthy countries like the United States, but is rapidly increasing in less developed countries. From 1992 to 2002, China had an increase from 14.6% to 21.8% in overweight and obesity. Social determinants of obesity in developing countries remain poorly understood. Further, these associations may vary by community built environment (BE) of developing countries.

Awareness, Treatment And Control Of Hypertension In Kenya, Jacob Kariuki, Eileen M. Stuart-Shor, Samuel Kimani, James Muchira, Jessica Demita, Heather Milton, Mercy Kamau, Vincent Mutuma, Darren Golden, Peris Kariuki

Office of Community Partnerships Posters

The emerging epidemic of hypertension (HTN) in sub-Saharan Africa is predicted to worsen. Uncontrolled HTN is associated with CVD, high morbidity and premature mortality; hence early detection, treatment and control of HTN is critical to reduction of the associated sequelae. The study was guided by the Social Ecological Model and principles of Community Based Participatory Research.

Mirebalais, Haiti Planning Initiative, Jack Wiggin, Urban Harbors Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

The Mirebalais Planning Initiative (MPI), a joint project of the Urban Harbors Institute at UMass Boston, Boston University, and the University of the West Indies, is funded by the W.K. Kellogg Foundation. The initiative is a community-based participatory planning process designed to expand community leadership and decision-making capacity among community members in Mirebalais, Haiti.

Global Risk Assessment Of Cardiovascular Disease In Resource Constrained Settings, Jacob Kariuki, Eileen M. Stuart-Shor, Libin Zhang, Annya Volkova, Jaime Halliday, Shannon Sayer, Jessica Demita, Darren Golden, James Muchira, Samuel Kimani, Faith Maina

Office of Community Partnerships Posters

Cardiovascular disease (CVD) is an emerging problem in Sub-Saharan Africa. Many current guidelines recommend using global risk assessment (GRA) to quantify the risk for developing CVD and to guide treatment and policy. Most GRA tools require lipid measures which are not readily available in resource-constrained settings. Of the 3 most published non-laboratory based tools: Gaziano and Framingham substitute BMI for cholesterol; WHO does not include BMI or cholesterol.

A Climate For Swelling: The Social & Biological Impacts Of Lymphatic Filariasis On Males & Females In Developing Countries, Arezoo Nazari '13

Honor Scholar Theses

Neglected tropical diseases (NTD) impair physical and cognitive development. This impairment makes it difficult to earn a living, restricts quality of life, and limits productivity in the work force. As a result, neglected tropical diseases trap the poor in a cycle of disease and poverty. Lymphatic filariasis (LF), also known as elephantiasis, is an NTD. It starts when microscopic, thread-like parasitic worms (Wuchereria bancrofti, Brugia timori, and Brugia malayi) are transmitted by mosquitoes. These worms infect and block the lymph nodes in the body, causing edema. Blockage in the lymphatic system and build-up of tissue and blood flow often occur …

The Impact Of The Chinese Rural Healthcare System On Infectious Disease: A Study Of The History And Reform Of Chinese Healthcare, And The Global Implications Of Infectious Disease Control In China, John Barbadoro

Independent Study Project (ISP) Collection

China’s healthcare system has gone through significant changes in the 20^th and 21^st centuries. These changes have mirrored not only the political focus of the time, but also the social issues facing China. The NRCMCS for rural residents is a cheap annual fee that covers a percentage of medical costs. There are two urban equivalents, the BMIUE and BMIUR for urban employees through their job, and residency respectively. Despite the focus on cheaper healthcare for rural residents, the problems of income inequality and mistrust in the medical system are major problems that affect the health of this large …

From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit

HIV and AIDS

HIV treatment, care, and support, and PMTCT programs are most effective when based on the best available research evidence. This is the fundamental premise of evidence-based medicine. Equally well known is the dilemma of transforming evidence into practice, which is the subject of knowledge translation and implementation science. Even when the findings of clinical trials make their way into international and national program guidelines, they run up against competing priorities within public health and community programs, resource constraints, and institutional and human inertia. Understanding how to effectively change the approach used in program operations requires understanding how programs work in …

Documentation Of Hiv Prevention Research And Programmatic Learnings From India—Selected Peer-Reviewed Journal Publications From The Knowledge Network Project (Volume 1), Population Council

HIV and AIDS

Over the past decade (2000–11), India has achieved dramatic successes in reversing the HIV epidemic. These successes are largely due to the implementation of upscaled HIV-prevention interventions by the National AIDS Control Organization, two other donors, and nongovernmental organizations, under the National AIDS Control Program III. As the epidemic in India is concentrated in vulnerable subpopulations, these interventions were focused on high-risk groups. It is important to understand the lessons learned from the implementation of HIV-prevention programs and the vulnerabilities that need to be addressed to reach the goal of zero new infections. To support this understanding, the Population Council …

Prevalence Of Hiv, Hepatitis B And C, And Co-Infection In A Cohort Of Male Injection Drug Users In Delhi, Lopamudra Saraswati, Mary Philip Sebastian, Avina Sarna, Vartika Sharma, Ira Madan, Dean Lewis, Ibou Thior, Waimar Tun

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000 nationally with an HIV prevalence of 7.2 percent. Historically, the presence of IDU populations and associated HIV infection was concentrated in the northeastern states of the country. Recent evidence documents IDU populations in other parts of the country. Delhi has an estimated 17,000 IDUs and the second highest HIV prevalence in India at 18.3 percent. The probability of becoming infected with HIV after using an infected syringe ranges from 0.34 percent to 1.4 percent. By comparison, the risk for hepatitis C (HCV) ranges from 1.5 percent to 5 …

Linkage Politics And The Persistence Of National Policy Autonomy In Emerging Powers: Patents, Profits, And Patients In The Context Of Trips Compliance, Aseema Sinha, Tricia Olsen

CMC Faculty Publications and Research

The Trade Related Intellectual Property Agreement (TRIPS) has had a profound effect on industrialization and innovation, as well as access to medicines in cases of public health crisis such as HIV/AIDS. However, compliance with TRIPS has varied in developing countries, despite heightened international pressure. For instance, Brazil has pursued a coherent approach to its HIV/AIDS health crisis, while India has failed to take care of its HIV patients despite late compliance with the TRIPS agreement and the presence of business firms that produce the generic medicines for HIV/AIDS. This article suggests that divergence in TRIPS compliance is the result of …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …

Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga

HIV and AIDS

This study by the Population Council and the Zambia-Led Prevention Initiative was designed to examine the motivations of individuals volunteering as STEPS-OVC caregivers; to explore their experiences in service, including perceived barriers to carrying out their volunteer work and if, and how, their expectations for volunteering had been met or not; to assess individuals’ intent to continue caregiving; and to ascertain factors associated with volunteer productivity. Two main findings stand out from this study: that communitarian and religious helping values were virtually universal in the study population, and that a majority of the volunteers indicated economic and material interests and …

High Hiv Incidence Among Male Injection Drug Users In Delhi, India, Waimar Tun, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, Avina Sarna

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability …

Situation Analysis Of Programs To Meet The Hiv Prevention, Care, And Treatment Needs Of Persons With Disabilities In Ghana, Uganda, And Zambia, Waimar Tun, Jerry Okal, Katie D. Schenk, Meredith Sheehy, Emmanuel Kuffour, Selina F. Esantsi, Hilary Asiah, Grimond Moono, Felix Mutale, Rita Kyeremaa, Edson Ngirabakunzi, Atwijukire Justus

HIV and AIDS

National HIV strategic plans, HIV-related services, and HIV outreach efforts have tended to overlook persons with disabilities, and persons with disabilities are not reached by general HIV prevention, care, support, and treatment campaigns and services. To increase our understanding of how to make HIV programming more inclusive for persons with disabilities, HIVCore and partners conducted a three-country situation analysis (Uganda, Zambia, and Ghana). The study explored existing HIV services for persons with disabilities and determined the factors affecting their access to and use of HIV/sexual and reproductive health (SRH) services. Key findings: Persons with disabilities experience greater sexual vulnerability to …

A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland

HIV and AIDS

No standardized process exists for developing a set of agreed upon terms, definitions, and translations in local languages that ensures participants understand both technical and nontechnical terms used in a clinical trial context. HIV prevention trials deal with a disease that is stigmatized and with sexual behaviors that may not be openly discussed, thus care must be taken in the selection of words to ensure terms are appropriate for use in the context of a clinical trial and understandable but not offensive. The lack of a standardized process can make it difficult for researchers to decide which words to use, …

Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru

Reproductive Health

This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …

Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai

Reproductive Health

The objectives of this Population Council study were twofold: first to collect information on prevailing practices of abortion and post‐abortion care in Pakistan and, second, to gauge changes in the magnitude and quality of abortion‐related complications and care during the last decade (since the 2002 national study of “Unwanted Pregnancy and Post‐abortion Complications in Pakistan”). The study found that the level of post‐abortion family planning (FP) counseling in both public and private health facilities offering PAC services was inadequate. There has been no improvement over the decade in the level of counseling reported, and, even more disappointingly, only half of …

Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew

Reproductive Health

No abstract provided.

Hivcore Operations Research Workshop Summary Report, Nrupa Jani

HIV and AIDS

Over the past decade, unprecedented progress has been made in the scale-up of HIV treatment, care, and support, yet substantial coverage gaps remain. Targeted operations research and program evaluation can play a significant role in ensuring efficient and effective service delivery, scaling up to reach more clients and on a broader geographical scope, enhancing quality of care, and improving the health status and health systems in developing country settings. With funding from USAID, the Population Council and partners are responding to these critical service delivery issues through HIVCore. HIVCore improves the efficiency, effectiveness, scale, and quality of HIV and AIDS …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

Observations On Eye Care In Lamu, Kenya: Overlooked Needs And Proposed Interventions, Erick Henderson, Rebecca Gearhart

Scholarship

These notes draw attention to the underserved eye care needs of residents of Lamu, Kenya. They are comprised of observations that we, Rebecca Gearhart, an anthropology professor at Illinois Wesleyan University (IWU) and Erick Henderson, an IWU biology and pre-optometry major and president of the Optometry Club, made while volunteering at a clinic in Lamu, Kenya during the summer of 2011. Plans to establish a temporary eye clinic emerged after Rebecca discovered that Erick was an optometric technician who might use his portable optometry lens set to fit residents of Lamu Town on Lamu Island for glasses and teach them …