International Public Health Commons^™

Garment Sector Health Interventions In Cambodia: A Comprehensive Review, Molyaneth Heng, Ashish Bajracharya

Reproductive Health

As part of the WorkerHealth project, the Evidence Project/Population Council conducted a comprehensive review of garment sector health interventions, particularly reproductive health (RH) and family planning (FP)–focused projects, in Cambodia during the last five years. The results from the review support WorkerHealth’s objective of enabling evidence-based decisionmaking and programming related to the health and well-being of female garment factory workers in Cambodia, by documenting the range of garment sector health interventions and identifying best practices and gaps in programming and evaluation. This review identified a number of priority actions for current and future garment sector health interventions to consider in …

Health Needs, Health Seeking Pathways, And Drivers Of Health Seeking Behaviors Of Female Garment Factory Workers In Cambodia: Findings From A Qualitative Study In Phnom Penh And Kandal Provinces, Population Council, The Evidence Project

Reproductive Health

Existing information on Cambodian garment factory workers’ (GFWs) barriers to health services has generally come from project implementation documents or general baseline studies of these projects, rather than independent, rigorous studies that specifically examine the health needs and health-seeking behaviors of workers. Since previous studies did not include specific indicators related to workers’ health needs and health-seeking behaviors, they cannot offer a complete picture of these important issues. To fill this critical knowledge gap, in partnership with the National Institute of Public Health, the Evidence Project/Population Council conducted a formative qualitative study under the USAID-funded WorkerHealth project to improve the …

Indicators For Measurement And Improvement Of The Quality Of Family Planning Programs: The Philippines, 1997–1998, Population Council

Reproductive Health

Quality is a critical dimension of health service provision and this brief aims to highlight the creation and use of indicators for quality of care to enhance the achievement of the reproductive health goals in the Philippines and beyond. In response to the need for program managers to understand the quality of services at the field level, the Situation Analysis approach was developed. The research underscores the importance of a composite index when measuring quality. In the case of the Philippines, the evidence suggests the need for more quality-of-care monitoring in addition to expanded access to contraceptives. Investment in counseling …

Knowledge And Practices For Pre-Eclampsia And Eclampsia Care In Bangladesh, Kanij Sultana, Amy Dempsey

Reproductive Health

The Bangladesh Maternal Mortality Survey revealed that pre-eclampsia and eclampsia (PE/E) is the second most common direct cause of maternal deaths—between 1,000 and 1,200 maternal deaths (20 percent) each year. Early detection and treatment during antenatal care visits are instrumental in reducing deaths from PE/E. In Bangladesh, however, primary healthcare providers have limited knowledge of the condition, and in many cases are unaware of how to detect, manage, and treat it. This research brief presents the findings of a landscape analysis that was conducted to better understand service providers’ maternal health knowledge, attitudes, and practices, particularly around PE/E.

Increasing Access To Reproductive Health Care Through Improved Service Delivery, Gul Rashida, Iram Kamran, Muhammad Khalil, Zeba Tasneem, Rehan M. Niazi, Mumraiz Khan, Tahira Parveen

Reproductive Health

The study documented in this report examines the provision and utilization of public and private sector maternal and child health services in Punjab, Pakistan with a focus on family planning (FP) services. It is aimed at enabling a better understanding of the specific demand and supply dynamics leading to low contraceptive prevalence despite unmet need, and the opportunities that must be seized to enhance access to quality family planning services. The report is part of a larger project being implemented by the Population Council with the assistance of the Department for International Development, UK entitled “Sustaining Focus on Provincial Governments …

Knowledge Of Pre-Eclampsia And Eclampsia In Bangladesh, Kanij Sultana, Amy Dempsey

Reproductive Health

In Bangladesh between 1,000 and 1,200 women die every year from pre-eclampsia and eclampsia (PE/E), contributing to 20 percent of maternal deaths. It is the country’s second leading direct cause of maternal mortality. In addition to the burden of maternal mortality, when a mother dies her baby is at increased risk of dying during the first year of life. To fully understand community perceptions of PE/E, the Population Council conducted a landscape analysis in 12 upazilas in four districts. This brief presents those research findings, and concludes that stronger awareness of the importance of early antenatal care and of seeking …

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 …

Measuring Gender Equality In Education: Lessons From 43 Countries, Stephanie Psaki, Katharine Mccarthy, Barbara Mensch

Poverty, Gender, and Youth

Through the 2015 Sustainable Development Goals (SDG), governments committed to achieving universal secondary school completion, including eliminating gender disparities, by 2030. The period from 1997 to 2014 saw considerable progress in closing gender gaps in school enrollment and attainment in many, but not all, low- and middle-income countries. However, as this research brief explains, claims that gender parity in primary education now exists are premature, especially in the poorest countries and new gender gaps, or gender-related challenges, may emerge as attainment increases. Moreover, the extremely low levels of secondary school enrollment—and even moreso completion—demonstrate that the SDG target of universal …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …

Non-Medical Use Of Prescription Drugs, Stress, Cultural Orientation, Utilization Of Healthcare, And Protective Factors Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background: Non-medical use of prescription drugs (NMUPD) refers to the use of prescription drugs which are traditionally utilized to manage pain or treat psychiatric problems but without a doctor’s prescription. In 2010, an investigation by the Substance Use and Mental Health Services Administration (SAMHSA) revealed that 5.3% of young adults (18 to 25-year-olds) in the United States reported past-month NMUPD. NMUPD has become a growing concern owing to associations with consequences such as college dropout, poor academic achievement, and health jeopardizing behaviors. College students' NMUPD has been well documented in the United States. Limited studies, however, have been conducted among …

Diminished Quality Of Life Among Women Affected By Ebola, Jessi Hanson, Alexis Decosimo, Megan Quinn

Journal of Social, Behavioral, and Health Sciences

This article analyzes data collected from Liberian women afflicted by the Ebola virus disease, survivors of the virus and noninfected persons living in Ebola-affected homes. This research is one of the first statistical analyses examining factors diminishing quality of life: negative experiences, stigma, and psychosocial symptoms among females affected by the virus after the outbreak. The research presents a thorough literature review, including research related to other infectious diseases like HIV/AIDS, to inform the gap in studies on Ebola’s effects on quality of life. Women who are Ebola virus disease survivors demonstrate significant differences in stigma and psychosocial stress when …

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, …

Self-Perceptions Of Disability And Impairment In An Indian Prosthetic Population Using Jaipur Foot Technology, Litany Esguerra

Independent Study Project (ISP) Collection

Twenty-nine first time and repeat prosthetic users were interviewed over a period of three weeks to determine how they perceived their own disability at Bhagwan Mahaveer Viklang Sahayata Samiti, or Jaipur Foot, located in Jaipur, India. The questions delineated different aspects of people’s disabilities and impairment, and asked a multitude of questions regarding social, economic, political, and other contexts, influenced by the conceptual framework of the International Classification of Functioning (ICF). The study analyzed all of the factors as specified by the questionnaire and found that many varying trends over all types of prosthetic users. The study also used the …

The Road Into The Future Of Health Care: The Importance Of Addressing Access To Health Facilities In Transportation Infrastructure Investment Decisions, Nicola (Nikki) Van Den Heever

Independent Study Project (ISP) Collection

Background: One school of thought argues that transportation infrastructure is not an ultimate end goal of development and therefore shouldn’t be addressed within development funding decisions while the other argues that transportation infrastructure is the crucial foundation from which all development efforts are based and therefore needs to be addressed within development funding decisions. Within this framework, there is a lack of academic and other research addressing how physical access to health care for pregnant women can better be addressed when making decisions regarding funding of transportation infrastructure projects.

Purpose: To demonstrate the importance of considering access to health care …

A Sustainable Approach To Health Systems Strengthening In Developing Countries: Lessons From The Ebola Crisis, Prince Tarnah

Capstone Collection

The research paper started with emphasizing the importance of health security as an issue of global concern under the UNDP theory of human security. The research then proceeded with a focus on the approaches to health systems strengthening and a reflection on lessons learned from the Ebola virus outbreak to answer the question: How do we approach health systems strengthening (HSS) to achieve sustainable impact? Scholarly articles, and literature from other authoritative sources on health systems strengthening, like the World Health Organization (WHO) and the US Agency for International Development (USAID), were reviewed to determine a clear definition of HSS, …

Sociodemographic And Geospatial Correlates Of Stillbirths And Neonatal Mortality In Indonesia (1993–2007), Alka Dev

Dissertations, Theses, and Capstone Projects

Little research has focused on the determinants of stillbirth and neonatal mortality in Indonesia despite the fact that the country has one of the highest rates of stillbirths in the world and one of the highest rates of neonatal mortality in Asia. Several areas have not been explored due to data limitations, such as shared risk factors and measurement challenges, which can inform health policy and interventions and guide future research. This dissertation addresses this gap by comparing measurement challenges for stillbirth and neonatal mortality and identifying risk factors for both using Indonesian reproductive health survey data. Differences in estimates …