International Public Health Commons^™

A Diagnostic Assessment Of The Health System's Response To Female Genital Mutilation/Cutting Management And Prevention In Kenya: A Case Study Of West Pokot County, Samuel Kimani

Reproductive Health

Female genital mutilation/cutting (FGM/C), a pervasive cultural practice in some contexts, is associated with negative impacts on women’s and girls’ health and rights. The health sector is well positioned to respond to the prevention of FGM/C and the management of its complications because of its primary role in disease prevention, health promotion, and curative services. In Kenya, the health sector’s role is anchored in national and county legal and policy instruments and guidelines that are adopted or customized from global or regional frameworks as well as skills support tools approved by the World Health Organization. This brief highlights findings from …

Improving The Documentation Of Female Genital Mutilation Or Cutting (Fgm/C) Abandonment Interventions And Their Evaluations, Caroline W. Kabiru

Reproductive Health

Female genital mutilation/cutting (FGM/C) is internationally recognized as a violation of human rights. Consequently, there have been extensive efforts to promote the abandonment of the practice. There is limited evidence on the impact of many of the efforts, in part because many interventions are implemented by small organizations with inadequate resources to document and evaluate their activities. The complex nature of FGM/C interventions, as with other interventions aimed at addressing violence against women and girls, also makes it difficult to adequately document what is done, how, when, and with what results. Nonetheless, it is important that implementing organizations make every …

Introduction Of Dmpa-Sc Self-Injection In Ghana: A Feasibility And Acceptability Study Using Sayana® Press, Dela Nai, Patrick Aboagye, Kamil Fuseini, Elizabeth Tobey, Aparna Jain, Nora Maresh, Rebecca Fertziger

Reproductive Health

This research report describes results from an implementation science study that explored the feasibility and acceptability of administering depot medroxyprogesterone acetate-subcutaneous (DMPA-SC) among health-care providers and family planning (FP) clients in Ghana. DMPA-SC is an injectable contraceptive method that can be self-administered. The study, conducted by the Population Council through the USAID-funded Evidence Project in collaboration with the Ghana Health Service, was implemented in rural, peri-urban, and urban areas of the Ashanti and Volta regions. A total of 150 health-care providers were trained to administer DMPA-SC and to train clients on self-injection. Clients assessed as being competent self-injected under the …

Reflections From Five Years Of Research On Fgm/C, Lori S. Ashford, Reshma Naik, Charlotte Greenbaum

Reproductive Health

From 2015 to 2019, the Evidence to End FGM/C research consortium took a fresh approach to examining the longstanding practice of female genital mutilation/cutting (FGM/C). The African-led program developed innovative research methods and uncovered new evidence about the practice and how it is changing—focusing on families and communities, and health and legal systems. This report documents the consortium’s research methods, the key lessons learned, capacity strengthening efforts, enhanced advocacy for research uptake, and recommendations. The research sheds light on key areas for future investments that would ensure that FGM/C policies and programs are informed by rigorous evidence. The recommendations stem …

Understanding Local Variation In How Female Genital Mutilation/Cutting Declines, Changes, Or Persists: Analysis Of Household Survey Data For Kenya, Nigeria, And Senegal, Population Reference Bureau

Reproductive Health

Efforts to eliminate female genital mutilation/cutting (FGM/C) intensified in many parts of Africa following a 2012 United Nations General Assembly Resolution, but change has been uneven. Important evidence gaps remain in our understanding of why the practice declines, changes, or persists in specific locations. Policymakers and program planners need such information to better tailor interventions to address local patterns and focus resources on abandonment efforts in areas with the greatest needs. To fill these gaps, researchers with the Evidence to End FGM/C consortium analyzed nationally representative household survey data for Kenya, Nigeria, and Senegal. The results of their research identify …

Female Genital Mutilation/Cutting In Nigeria: Is The Practice Declining? A Descriptive Analysis Of Successive Demographic And Health Surveys And Multiple Indicator Cluster Surveys (2003–2017), Ngianga-Bakwin Kandala, Glory Atilola, Chibuzor Christopher Nnanatu, Emmanuel Ogundimu, Lubanzadio Mavatikua, Paul Komba, Zhuzhi Moore, Dennis Matanda

Reproductive Health

This report gives insight into the scale and scope of the practice of female genital mutilation/cutting (FGM/C) among women aged 15–49 years and girls younger than 15 years in Nigeria. It also presents evidence on where FGM/C occurs and highlights the dynamics of change as well as the context surrounding the practice. The report explores in detail the practice of FGM/C from all available sources of nationally representative survey data from 2003 to 2017 and the most relevant contextual information on key factors associated over time with FGM/C. The ultimate objective of the report is to generate evidence to inform …

Associations Between Female Genital Mutilation/Cutting And Early/Child Marriage: A Multi-Country Dhs/Mics Analysis, Jamlick Karumbi, David Gathara

Reproductive Health

Over the last several decades, global efforts to end female genital mutilation/cutting (FGM/C) have intensified through the combined efforts of international and nongovernmental organizations (NGOs), governments, and religious and civil society groups. Evidence of the wider impacts of FGM/C and interventions for its abandonment is small but emerging. The practice of FGM/C has frequently been linked to a girl’s marriageability and is thought to be associated with child marriage, either directly, as a cause of early/child marriage, or vice versa, or indirectly, resulting from common causes. Evidence of the relationships between these two practices to inform programming and policy for …

Modelling And Mapping Of Regional Disparities Associated With Female Genital Mutilation/Cutting Prevalence Among Girls Aged 0–14 Years In Senegal: Evidence From Senegal (Sdhs) Surveys 2005–2017, Ngianga-Bakwin Kandala, Paul Komba, Chibuzor Christopher Nnanatu, Glory Atilola, Lubanzadio Mavatikua, Zhuzhi Moore, Dennis Matanda

Reproductive Health

Between 2005 and 2017, Senegal experienced a slight national decline in the prevalence of female genital mutilation/cutting (FGM/C) among women aged 15–49 years and girls younger than 15 years. However, significant differences in prevalence exist as a result of multifarious risk factors. Our previous research in Senegal described the national trends in FGM/C, showing where, when, and why FGM/C is practiced in Senegal. However, no recent study exists to analyze the geographical patterns of FGM/C and the effect of individual-and community-level risk factors on the likelihood of cutting among girls younger than 15 years. This working paper presents results from …

Modelling And Mapping Of State Disparities Associated With Female Genital Mutilation/Cutting Prevalence Among Girls Aged 0–14 Years In Nigeria: Evidence From Dhs And Mics 2003–2017, Ngianga-Bakwin Kandala, Paul Komba, Chibuzor Christopher Nnanatu, Glory Atilola, Lubanzadio Mavatikua, Zhuzhi Moore, Dennis Matanda

Reproductive Health

The practice of female genital mutilation/cutting (FGM/C) has been positioned as a gender and global development issue that national and international organizations must address for girls and women to thrive in good health and enjoy their fundamental rights. Consequently, many efforts have been made to promote the abandonment of the practice. Despite evidence of a decline in FGM/C, there are significant variations in its prevalence in many sub-Saharan African countries, where the practice persists due to the combined effects of factors among individuals as well as communities. This working paper presents findings from a study that analyzed existing data using …

Population Council Annual Evaluation Report: Opening Futures (Abriendo Futuros) For Indigenous Girls In Yucatan, Mexico, Silvana Larrea

Poverty, Gender, and Youth

This Population Council Annual Evaluation Report includes evaluation activities from December 1, 2015 to December 1, 2019, and future evaluation plans (2019–21), as part of the Opening Futures (Abriendo Futuros) project for indigenous girls in Yucatan, Mexico. The first section describes the finalized analysis of the impact evaluation of the pilot phase; the second section reports the progress of evaluation activities; and the third section includes an evaluation of future plans for the period December 1, 2019 to November 30, 2021.

The Impact Of Income On Nutrition: A Case Study Of Northern Mozambique, Hunter Swanigan, Lawton Lanier Nalley

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

In 2017, Mozambique ranked as one of the least developed countries in the world by measures of health, education, and income. With a minimal annual income, purchasing adequate food to meet recommended levels of nutrients for a healthy diet is difficult, leaving 40% of the country undernourished. This study analyzed what foods are available during the dry months (hungry season) of May through October in the Nampula province of Mozambique to determine if it is possible to meet recommended levels of nutrients from purchasing and growing food. Three different levels of income were used to determine what percentage of the …

Project Adkeyso: Addressing Female Genital Mutilation And Cutting In Somaliland, Ayanna Joyner

Capstone Showcase

Project Adkeyso: Addressing Female Genital Mutilation and Cutting in Somaliland

Ayanna Joyner

Faculty Advisor: Dr. Comfort Olorunsaiye

Female Genital Mutilation or Cutting (FGM/C) is the procedure of intentionally causing injury and altering the vulva of a young girl or woman for non-medical reasons. There are four types of FGM/C however, type III or infibulation, remains the most dangerous because the procedure consists of the narrowing of the vaginal opening by creating a seal with the labia majora through stitching. With infibulation, there will be a need for further surgeries or re-infibulation, which requires reopening of the stitches covering the vagina …

Mapping Misinformation In The Coronavirus Outbreak, Ana Santos Rutschman

All Faculty Scholarship

The coronavirus outbreak has sent ripples of fear and confusion across the world. These sentiments—and our collective responses to the outbreak—are made worse by rampant misinformation surrounding the new strain of the virus, COVID-2019. In this post, I survey some of the most pervasive areas of tentacular coronavirus-related misinformation that has proliferated online -- as well as the responses of social media companies like YouTube, Facebook, Pinterest and TikTok that may ultimately prove inadequate given the magnitude of the problem.

Les Pharmacies Privées Dans L’Offre De Services De Planification Familiale Au Sénégal : Une Étude Pilote, Fatou Mbow, Dela Nai, Sara Chace Dwyer, Aparna Jain, Babacar Mane

Reproductive Health

Sur la base de l'étude exploratoire menée par le Projet Evidence au Sénégal entre 2015 et 2016, avec un soutien financier supplémentaire de la Fondation William et Flora Hewlett, ce rapport technique documente les résultats d'une étude pilote sur l’offre des services de planification familiale (FP) par les pharmacies privées dans la région de Dakar. Le rapport détaille également les enseignements de valeur tirés de la mise en œuvre de l’étude dans le contexte du Sénégal. Ces résultats contribuent aux discussions politiques en cours au Sénégal concernant l'intégration des pharmacies privées dans la prestation des services de PF.

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Building …

La Comunicación Intercultural Entre Pacientes Bolivianos Y Trabajadores De Salud En Buenos Aires, Argentina / Intercultural Communication Between Bolivian Patients And Health-Care Workers In Buenos Aires, Argentina, Lilly Snellman

Independent Study Project (ISP) Collection

Según la Ley de Migraciones 25.871 de 2004, los inmigrantes en Argentina tienen el mismo derecho a la atención médica que los argentinos nativos. El sistema de salud argentina es uno de los más inclusivos en el mundo, pero todavía hay barreras al acceso para comunidades e individuos marginados. Muchas veces los migrantes bolivianos son discriminados en la sociedad argentina por sus rasgos raciales, bajo nivel socioeconómico y diferencias culturales. Tres clases importantes de barreras para el acceso a la atención médica para los migrantes son las económicas, estructurales y comunicativas. En este estudio, decidí enfocarme en las brechas de …

Middle East Respiratory Syndrome On Health Information Websites: How Much Credible They Are?, Shahabedin Rahmatizadeh, Saeideh Valizadeh-Haghi, Arefeh Kalavani, Nadereh Fakhimi

Library Philosophy and Practice (e-journal)

Background: The most recent MERS outbreak has raised questions about prevention and symptoms since there is currently no vaccine to prevent MERS. People can help protect themselves from this illness by taking everyday preventive actions. To do so, it is helpful to get medical information on the Internet about this illness. Regarding the importance of ensuring the provision of accurate online information, the aim of this study was to assess the credibility of health websites about MERS by using HONcode tool.

Materials and methods: The term “MERS” was searched in Google, Yahoo, and Bing and the first three pages …

An Overview Of The Health Profile Of Syrian Refugees Arriving In Kentucky From 2012-2017, Camila Calderon, Annie Rominger

Journal of Refugee & Global Health

Background:

The civil unrest in Syria has led to millions of displaced Syrians. The United States has relocated over 15,000 Syrian refugees, mostly arriving since 2015. Little is known about the health of Syrian refugees entering the United States.

Methods:

Syrian refugees in Kentucky who had a medical screening and documented RHA from October 2012 to September 2017 were included in the study. The information is collected and stored in the Arriving Refugee Informatics Surveillance and Epidemiology (ARIVE) database. This study is a retrospective review of the ARIVE database to describe the general health of the Syrian refugees …

Effectiveness Of Community Outreach Hiv Prevention Programs In Vietnam: A Mixed Methods Evaluation, Lora L. Sabin, Katherine Semrau, Mary Bachman Desilva, Le T T Loan, Jennifer J. Beard, Davidson H. Hamer, Jordan Tuchman, Ted Hammett, Nafisa Halim, Manisha Reuben, Aldina Mesic, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background

In 2014, Vietnam was the first Southeast Asian country to commit to achieving the World Health Organization’s 90–90-90 global HIV targets (90% know their HIV status, 90% on sustained treatment, and 90% virally suppressed) by 2020. This pledge represented further confirmation of Vietnam’s efforts to respond to the HIV epidemic, one feature of which has been close collaboration with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Starting in 2004, PEPFAR supported community outreach programs targeting high-risk populations (people who inject drugs, men who have sex with men, and sex workers). To provide early evidence on program impact, …

Barriers To Health Among Idps In Kabul, Afghanistan: A Qualitative Study, Yagana Parwak, Madhavi Dandu, Rohini J. Haar

Journal of Refugee & Global Health

Background: Forced displacement is a significant problem for regions experiencing prolonged humanitarian crises due to armed conflict. Afghanistan, having experienced over four decades of conflict, has an estimated 1.2 million internally displaced persons (IDPs), a majority of which are concentrated in urban centers. IDPs have limited resources and face challenges accessing health services through traditional channels, leading to a disproportionate burden of morbidity and mortality. Health care facilities created for and existing within IDP camps also face numerous challenges. We aim to understand the structural factors that negatively impact health and the specific barriers to healthcare access for IDPs using …

The Diffusion Of Telehealth: System-Level Conditions For Successful Adoption, Danika Tynes

Dissertations

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory. System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using multiple logistic regression.

Analyses included data from 84 states leveraging data from the World Health Organization, World Bank, ICT Index, …

High Stakes Require More Than Just Talk: What To Do About Corruption In Health Systems, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Reluctance to talk about corruption is an important barrier to action. Yet the stakes of not addressing corruption in the health sector are higher than ever. Corruption includes wrongdoing by individuals, but it is also a problem of weak institutions captured by political interests, and underfunded, unreliable administrative systems and healthcare delivery models. We urgently need to focus on corruption as a health systems problem. In addition to supporting research to better understand the context and implications of corruption in health systems, this article suggests actions that public health professionals can do now to fight corruption.

Vitamin Deficiencies Among Resettled Refugees In Buffalo, Ny, Tyler B. Evans, Myron Glick Md

Journal of Refugee & Global Health

Background

Vitamin deficiency in the developing world is a considerable public health issue that is often overlooked. Refugees are some of the most vulnerable populations, since they rely almost exclusively on the nutrition provided by refugee camps. Buffalo, NY resettles the fourth largest number of refugees per capita among cities in the United States (US).

Objective

We examined the prevalence of vitamin A, B2, B12, and D deficiencies among refugees who had been recently resettled to Buffalo, NY and referred to our practice for assessment. Our exploratory objective was to examine potential differences in the prevalence of vitamin deficiencies among …

Building Financial Management Capacity For Community Ownership Of Development Initiatives In Rural Zambia, Viviane Sakanga, Parker S. Chastain, Kathleen L. Mcglasson, Jeanette L. Kaiser, Misheck Bwalya, Melvin Mwansa, Kaluba Mataka, David Kalaba, Nancy Scott, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: Building financial management capacity is increasingly important in low- and middle-income countries to help communities take ownership of development activities. Yet, many community members lack financial knowledge and skills.

Methods: As part of a larger health intervention, we designed and conducted financial management training for 83 members from 10 community groups in rural Zambia. Change scores between pre- and post-tests on financial knowledge were calculated and multivariate linear regression models run. Qualitative feedback was elicited.

Results: The training significantly improved knowledge of financial concepts. Participants with some or more than some secondary education had greater improvements …

The Perception Of Iron-Deficient Anemia In Bolgatanga, Ghana Among Women Of Childbearing Age, Sydney Albrecht

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Objective: To understand the perception of anemia among the women of childbearing age in Bolgatanga, Ghana, and to correlate the reasoning with the high incidence of anemia in the area.

Method: This research was a qualitative study consisting of 67 interviews over the course of the three weeks that were spent in Bolgatanga. 50 of these interviews were women of childbearing age (15-49), 6 were health professionals, and 11 were women older than the age range provided. Interviews were taken from the maternity clinics nearby as well as from women in a rural area that was a 10-minute taxi ride …

Health On The Move: Health-Seeking Behavior Of Changpa Nomads In Ladakh, India, Maya Lubeck-Schricker

Independent Study Project (ISP) Collection

The goal of this study is to understand the health-seeking behavior of Changpa nomads in the Changthang region of Ladakh, India including what health issues these communities face, what they do when they fall sick, any preventative health behavior they implement, as well as the health infrastructure available to them. Very little literature exists on the health seeking-behavior of people in South Asia in general, much less among nondominant lifestyles such as that of nomadic or semi-nomadic people. As such, this research hopes to move towards closing that knowledge gap by conducting and analyzing 26 in depth semi-structured interviews and …

Z4, A Slow Puncture: An Autoethnographic Exploration Of Language, Embodiment, And Meaning-Making, Charlotte Rose Samuels

Independent Study Project (ISP) Collection

In my ISP, I explored language as it relates to the ways in which people living in Cato Manor make sense of HIV/AIDS in their community. With 7.1-7.2 million people living with HIV (PLWHIV) in South Africa, individuals across the country are either infected or affected by illness. KwaZulu-Natal (KZN), the province with the highest rate of HIV, is also the province that was surveyed with the disproportionately highest internal stigma rates for PLWHIV. High prevalence of HIV, particularly in KZN, calls for a constant contextualization of life in the presence of illness.

Throughout the world, metaphor and symbolism is …

A Qualitative Metasynthesis Of Published Research Exploring The Pregnancy And Resettlement Experience Among Refugee Women, Diana M. Kingsbury, Sheryl L. Chatfield

The Qualitative Report

The number of refugees and asylum seekers throughout the world continues to increase, leading to increasing challenges in meeting healthcare needs of these individuals. Women’s antenatal health is of particular concern due to their vulnerability to sexual violence and the substantial proportion of refugees consisting of women and girls of or nearing reproductive age. The purpose of this qualitative metasynthesis was to integrate and interpret findings from previously published research reports in which authors explored aspects of pregnancy among resettled refugee women. Following a systematic search process, we used Dedoose qualitative data analysis software to manage the process of extracting …

"Disgusted With Myself": Examining The Risk Factors And Vulnerabilities Of Hostesses At Karaoke Tv Venues In Phnom Penh, Cambodia, Glenn M. Miles, Daphne Alsiyao

Dignity: A Journal of Analysis of Exploitation and Violence

This exploratory study is one of a series of research projects interviewing survivors of sexual exploitation in southeast Asia. It assesses the risk factors and vulnerabilities of young women in Karaoke TV (KTV) venues in Phnom Penh, Cambodia. This research study assesses the risk factors and vulnerabilities of young women in these venues. A questionnaire-based survey was administered to 50 participants to gain a holistic view of the lives of young women working in Karaoke TV (KTV) venues. The survey consisted of a series of questions pertaining to demographics, family background, prejudice and discrimination, sexual risk factors, substance abuse, sexual …

Reaching Key Populations With Community-Based Hiv Test And Start Services In Lagos And Benue States In Nigeria: Baseline Findings, Project Soar

HIV and AIDS

Key populations (KPs), such as men who have sex with men (MSM), female sex workers (FSWs), and people who inject drugs, remain disproportionately affected by HIV compared to the general population. In Nigeria, HIV prevalence declined among the general population from 2007–18. Among key populations from 2007–14, HIV also decreased among FSWs, but increased among MSM. Evidence-based strategies to sustain the decline among the general population and FSWs, and mitigate the increase among MSM, are needed. Nigeria has adopted the World Health Organization’s “test and start” (TnS) strategy, which recommends initiating antiretroviral therapy (ART) by persons living with HIV as …

Meeting The Needs Of Orphans And Other Vulnerable Children: Learnings From Project Soar, Project Soar

HIV and AIDS

Orphans and other vulnerable children (OVC), including those living with HIV, often have a range of unmet needs, such as education, food security, psychosocial support, and access to health care. Project SOAR is documenting the unique vulnerabilities of OVC and their caregivers, and examining strategies to mitigate the impacts of HIV on them. This brief presents a summary of the SOAR portfolio, including a prospective cohort study of young people living with HIV in Zambia, an evaluation of an HIV risk screening tool among OVC in Tanzania, and a systematic review of promising interventions to support engagement and treatment adherence …