International Public Health Commons^™

Maternal, Environmental, And Social Context Predicts Diarrheal Infection Incidence In Young Children In Sundarbans, India, Sohini Mukherjee, Laura M. Glynn

Student Scholar Symposium Abstracts and Posters

Diarrheal infection is the third leading cause of childhood mortality in India and is responsible for 13% of all deaths per year in children under 5 years of age (Lakshaminarayan & Jayalakshmy, 2015). The Sundarbans in West Bengal is amongst the poorest regions of India and is the epitome of abject deprivation and the acute struggle against geographical and socioeconomic challenges. The incidence of diarrhea in this region is considerably high; about 42,000 reported cases occur per month, and one in five diarrhea cases are reported as severe (with blood in stool). In addition, 37% of children hospitalized for ailments …

Village Health Insurance, Michaela Domaratzky, Sean Roget

The International Undergraduate Journal For Service-Learning, Leadership, and Social Change

No abstract provided.

A Yellow Fever Epidemic: A New Global Health Emergency?, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop …

Needle Exchange Programs And Hiv/Aids: A Comparison Of The Use Of Harm Reduction Methods In Switzerland And The United States Of America, Margaret House

Independent Study Project (ISP) Collection

This paper explores the connections between needle exchange programs and rates of HIV/AIDS in Switzerland and the United States of America. While these two countries are very similar in their general political philosophies, they have some key cultural and historical differences which has shaped their responses to HIV/AIDS and injection drug use. Switzerland’s unique experience with a very open injection drug use scene in the 1980s guided this country to a more pragmatic, harm reduction-based response. By contrast, United States responded to the AIDS epidemic that struck violently in the 1980s with a mix of fear and denial. Though both …

Healthcare Access For Syrian Refugees Lacking Legal Documentation In Jordan, Caroline Flynn

Independent Study Project (ISP) Collection

The purpose of this study is to analyze the access and utilization of health care services by Syrian refugees lacking documentation. This study focuses on the current procedures utilized by healthcare providers for addressing lack of legal documentation in their Syrian refugee patients, as well as broader policies and strategies for addressing the status and protection of these undocumented individuals. This study grapples with the relationship between legal documentation and access to services. The increased costs and barriers to healthcare that come with stateless and refugee status may influence health outcomes and socioeconomic opportunities that impact these individuals for the …

Sub-Saharan Africa’S “Other Diseases”: A Comparison Of The Global Response To Neglected Tropical Diseases And Hiv/Aids In Ghana, Rebecca Brosch

Political Science: Student Scholarship & Creative Works

Neglected tropical diseases (NTDs) refer to a group of diseases that affect 1.4 billion people worldwide, most commonly in low and low-middle income nations. These conditions can cause disabling and disfiguring effects that keep those inflicted from escaping poverty, leading to increased economic losses in already impoverished areas in Ghana and the rest of Sub-Saharan Africa. Although NTDs affect significantly more of the Ghanaian population, more government resources are given to HIV/AIDS (which only affects an estimated 1.5% of citizens). This research identifies the current response to NTDs (including government policy and NGO support) as well as how more global …

Project Soar's Approach To Research Utilization, Project Soar

HIV and AIDS

Project SOAR (Supporting Operational AIDS Research) conducts operations research (OR) with the aim of producing a large, multi-faceted body of high-quality evidence that can guide the planning and implementation of programs and policies for HIV prevention, care, and treatment. OR provides the needed evidence to make sound policy and program decisions at national, subnational, and service-delivery levels by identifying practical solutions to challenges delivering program services. Translating OR findings into action at these levels requires two-way information exchange between people who can apply research findings and researchers. Project SOAR’s premise is that this exchange will bring about eventual use of …

Retrospective Review Of Task-Shifting Community-Based Programs Supporting Arv Treatment And Retention In Uganda, Sam Kalibala, Jerry Okal, Brady Zieman, Nrupa Jani, Lung Vu, Josephine Birungi, Stephen Okoboi, Jonathan Wangisi, Christine Nabiryo, Joanne Lyavala Okullu, Michael Etukoit, Lydia Buzaalirwa, Augustine Lubanga, Paul Kiyingi, Jonathan Ikapule, Syson Nakyeyune, Stephen Nakibinge, Penninah Lutung, Samuel Waliggo, Joseph Nsamba, Yashien Wamanga, Joseph Kamya, Robina Sentongo, Robert Yiga

HIV and AIDS

The purpose of this study was to examine examples of task-shifting programs in Uganda with the aim of generating data that could inform the development of task-shifting policies, guidelines, and practices. The overall purpose of the study was to contribute to the growing knowledge base about task-shifting by describing the service delivery approaches of three purposively selected major AIDS service organizations (ASOs) in Uganda that have adopted task-shifting. The study showed that in the three ASOs, almost all key tasks in antiretroviral therapy (ART), including determining eligibility, initiating ART, and dispensing antiretrovirals, can be feasibly shifted to lower-level cadres or …

Developing An Implementation Science Research Agenda To Improve The Treatment And Care Outcomes Among Adolescents Living With Hiv In Sub-Saharan Africa, Julie Denison, Audrey Pettifor, Lynne Mofenson, Deanna Kerrigan

HIV and AIDS

In February 2016, Project SOAR convened a Technical Advisory Network meeting, attended by more than 50 international and domestic thought leaders in adolescent HIV care research and a small group of youth from southern Africa who are living with HIV. To prepare the groundwork for the meeting, SOAR produced a background paper synthesizing the literature on HIV continuum of care outcomes among adolescents living with HIV (ALHIV) in sub-Saharan Africa, where most adolescent cases of HIV are concentrated. This report presents the findings from the literature review and highlights from the Technical Advisory Network meeting. The first section is a …

Strengthening Community-Based Services For Children And Families Affected By Hiv: An Evaluation Of The Zambia Family Program, Project Soar

HIV and AIDS

As the US President’s Emergency Plan for AIDS Relief (PEPFAR) pivots its focus to care and treatment, there is strong interest in learning to what extent community-based programs contribute to achieving the public health goals of getting people—including children and adolescents—tested, enrolled in care if infected, and adherent to treatment. This brief describes Project SOAR’s evaluation of the Zambia Family (ZAMFAM) program, which will generate critical evidence to help fill knowledge gaps. The evidence will also guide country and global decisionmakers in strengthening community-based services to better meet the care, support, and treatment needs of vulnerable children and their families.

Building Capacity In Implementation Science Research Training At The University Of Nairobi., George O Osanjo, Julius O Oyugi, Isaac O Kibwage, Walter O Mwanda, Elizabeth N Ngugi, Fredrick C Otieno, Wycliffe Ndege, Mara Child, Carey Farquhar, Jeremy Penner, Zohray Talib, James N Kiarie

Health Policy and Management Faculty Publications

BACKGROUND: Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science.

METHODS: This paper describes how the University of Nairobi leveraged resources from the Medical Education Partnership to develop an institutional program that provides training …

Understanding Hiv-Related Vulnerabilities And Stigma Among Egyptian Youth, Nahla G. Abdel-Tawab, Doaa Oraby, Sally Saher, Sarah Ismail

Poverty, Gender, and Youth

The overall objective of this study is to provide an evidence-based description and interpretation of the HIV-related risks and vulnerabilities faced by different subgroups of youth in Egypt. The report is part of a six-country study that was conducted by the Population Council in Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. The study examines social, economic, cultural, and legal factors that may contribute to youth’s increased vulnerability to HIV and documents the situation of the policy and programmatic responses. The study identified poverty, unemployment, delayed marriage, and gender inequality as examples of factors that increase young people’s risk-taking behavior …

Addressing Intimate Partner Violence And Power In Relationships In Hiv Testing Services: Results Of An Intervention Piloted In Nairobi, Kenya, Nicole Haberland, Charity Ndwiga, Katharine Mccarthy, Margaret Makanyengo, Rose Kosgei, Cecilia Choi, Julie Pulerwitz, Sam Kalibala

HIV and AIDS

The overarching goal of this study was to pilot an approach to HIV testing services (HTS) that addresses intimate partner violence (IPV) and sexual relationship power (SRP) inequalities, and explores the intervention’s potential for improving uptake and retention of antiretroviral therapy and prevention of mother-to-child transmission services. The project was implemented in Kenyatta National Hospital’s (KNH) antenatal care (ANC) clinic, and examined intermediate indicators of effect, as well as operational issues around incorporating attention to IPV in hospital procedures, especially in high-volume, high-need settings like KNH’s. The findings from this study suggest that providing some minimal IPV/SRP counseling to all …

An Integrated Peer Outreach And Clinic-Based Intervention To Improve The Sexual Health Of Young Men Who Have Sex With Men In Myanmar: A Link Up Evaluation, Population Council

HIV and AIDS

This brief describes an evaluation that assessed the impact of a peer-driven intervention for young men who have sex with men (MSM) in Myanmar, designed to improve the sexual health and rights of this marginalized community. The intervention and evaluation activities were conducted as part of Link Up, a global consortium led by the International HIV/AIDS Alliance aimed at improving sexual and reproductive health and rights among young vulnerable communities in Africa and Asia. In collaboration with the Burnet Institute, the Population Council–led evaluation study sought to assess whether the Link Up intervention improved sexual and health-seeking behaviors, and whether …

Impact Of Peer Education And On-Site Clinical Services For Female Sex Workers In Bangladesh Brothels: A Link Up Evaluation Study, Population Council

HIV and AIDS

This brief describes an evaluation of a brothel-based HIV and sexual and reproductive health and rights (SRHR) intervention that combined peer outreach with the provision of on-site clinical services in several Bangladesh brothels. The aim of this evaluation was to assess whether peer educator one-on-one or group sessions and on-site satellite clinics improved SRHR knowledge and behaviors among women who sell sex in three Bangladesh brothels. The study was conducted by the Population Council as part of the Link Up project, a global consortium led by the International HIV/AIDS Alliance aimed at improving the SRHR of young people. The findings …

Reducing Provider-Held Stigma And Improving Young Client Satisfaction In Bangladesh: Findings From A Link Up Evaluation, Population Council

HIV and AIDS

To address HIV stigma in Bangladesh, a training program was designed and evaluated among service providers as part of Link Up, a global project led by the International HIV/AIDS Alliance designed to improve the sexual and reproductive health and rights (SRHR) of young people. These trainings aimed at sensitizing healthcare providers to the needs and rights of young people at high risk of stigmatization—such as sex workers, sexual minorities, or young people who engage in premarital sex. The Population Council collaborated with Marie Stopes International Bangladesh (MSIB) to evaluate whether stigma-reduction trainings improved provider attitudes toward these young marginalized populations, …

Sexual And Reproductive Health And Rights Needs Of Young Men Who Live In The Streets In Dhaka City: A Link Up Exploratory Study, Population Council

HIV and AIDS

Under the Link Up project—a global consortium led by the International HIV/AIDS Alliance and supported by the Dutch Ministry of Foreign Affairs—the Population Council conducted an exploratory study of the HIV and sexual and reproductive health and rights (SRHR) needs of young men who live in the streets of Dhaka City, Bangladesh. The study investigated their knowledge, behaviors, needs, and service utilization related to HIV and SRHR. The findings elucidate the substantial vulnerabilities and risks faced by young men who live in the streets of Dhaka City, most notably in terms of sexual risk and physical violence. Participants reported very …

Using Peers To Improve Sexual And Reproductive Health And Rights Of Young People Living With Hiv In Uganda: Findings From A Link Up Evaluation, Population Council

HIV and AIDS

Link Up, a global consortium led by the International HIV/AIDS Alliance, sought to meet the immediate HIV care needs and also the broader sexual and reproductive health and rights (SRHR) for Ugandan young people living with HIV (YPLHIV), by creating linkages between comprehensive community- and facility-based HIV and SRHR services. In addition, Link Up delivered health education, counseling, and peer support tailored to the needs of YPLHIV in order to educate and empower them to recognize their rights, and feel confident in seeking health services. This brief presents findings from the Population Council’s evaluation of Link Up activities among YPLHIV …

Building Evidence To Guide Prep Introduction For Adolescent Girls And Young Women, Nanlesta Pilgrim, Sanyukta Mathur, Ann Gottert, Naomi Rutenberg, Julie Pulerwitz

HIV and AIDS

This document was developed by the Population Council, with support from the Bill & Melinda Gates Foundation, to provide DREAMS country teams with practical guidance on building evidence to guide pre-exposure prophylaxis (PrEP) introduction for adolescent girls and young women (AGYW). The primary audiences for this document are health policymakers and program planners who will be making decisions about how PrEP is introduced and the researchers who will assess AGYW’s specific needs and experiences. Our aim is to complement emerging global guidance on PrEP and ongoing work regarding delivery platforms, marketing, and policy and regulatory frameworks for PrEP introduction more …

How To Reduce Hiv Risk Among Adolescent Girls And Young Women In Sub-Saharan Africa? Implementation Science Around The Dreams Initiative, Population Council

HIV and AIDS

The Population Council, with funding from the Bill & Melinda Gates Foundation and the US Agency for International Development through Project SOAR, is leading the implementation science portfolio of the timely and innovative DREAMS partnership in 10 sub-Saharan countries, producing evidence to strengthen DREAMS activities and other community-based programming. The Council’s research focuses on how best to reach the most vulnerable adolescent girls and young women (AGYW) and their male partners and engage them in activities and services, and how to roll out pre-exposure prophylaxis (PrEP) for HIV prevention among AGYW. By examining these critical HIV prevention issues, the Council’s …

Impact Of A Community-Based, Hiv Intervention On Antiretroviral Treatment Retention And Adherence In Tanzania, Project Soar

HIV and AIDS

Project SOAR is contributing to the evidence base on community-based care models by conducting implementation research in Tanzania, a country where 1.5 million people are in need of HIV care services, and where clients eligible for antiretroviral therapy (ART) often drop out or are lost to follow up. While the country has a cadre of community-based HIV service (CBHS) providers, they remain largely informal. Project SOAR and its partners are evaluating a coordinated, integrated model in which CBHS providers deliver an enhanced service package to HIV-positive clients. The evaluation will advance understanding of the value of CBHS providers in improving …

Project Soar's Voluntary Medical Male Circumcision Portfolio, Project Soar

HIV and AIDS

Project SOAR has developed an extensive voluntary medical male circumcision (VMMC) portfolio to support multiple countries with data to make informed policy and programmatic decisions about VMMC that address their specific needs and environments. A critical component of this portfolio is research utilization. At the country level, Project SOAR seeks to generate data to support planning, implementing, and monitoring VMMC programs and increase access to and use of this data through user-friendly interfaces and dissemination strategies. Simultaneously, SOAR aims to advance VMMC as a vital prevention strategy by filling important data gaps in the global discourse around VMMC. This brief …

Barriers To Fistula Repair In Nigeria: A Formative Study, Population Council

Reproductive Health

A formative research study was conducted in Nigeria to better understand the barriers and enabling factors for fistula repair care delivery and access. This brief presents results from a literature review conducted to identify and understand the delays in accessing and receiving treatment and corresponding barriers, to document interventions that help to overcome barriers, and to specify gaps in the literature that require further research. The report concludes that women’s concern over healing and reintegration reflects their expectation that the holistic approach of hospitals will bring them back to normal life incorporating physical, sexual, psychosocial, and economic rehabilitation. Awareness, financial, …

Strengthening Factory Health Systems Under Levi Strauss & Co.'S Worker Well-Being Initiative In Egypt, Population Council, The Evidence Project

Reproductive Health

The pilot intervention described in this brief took place at an apparel manufacturing company, Lotus, located in Port Said, Egypt as part of the Worker Well-being Initiative. Worker Well-being is an initiative of Levi Strauss & Co. and the Levi Strauss Foundation that seeks to move beyond a “do no harm” compliance model of labor rights in its global supply chain. The interventions in Egypt have contributed to the overall development of a health system–strengthening approach to private workplaces, which is a new concept for management. The work in Egypt contributed to a collaboration between the Evidence Project/RAISE Health and …

Does Shifting Gender Norms On The Community Level Lead To Increased Hiv Services Uptake?, Project Soar

HIV and AIDS

Project SOAR and partners are building on an ongoing National Institute of Mental Health–funded randomized controlled trial being conducted in South Africa—Community Mobilization for Treatment as Prevention. Specifically, the study aims to strengthen and expand the gender content of the intervention to engage both women and men in critically examining gender norms and power inequalities. This brief presents the particularly timely study that will address a key question in the field as to how gender norms may operate to affect HIV service utilization. Building the evidence base in this area is vital for improving care outcomes as well as creating …

Estimating The Costs Of Providing Voluntary Medical Male Circumcision In South Africa, Project Soar

HIV and AIDS

The South African government introduced voluntary medical male circumcision (VMMC) as an HIV-prevention intervention in 2010, based on the compelling evidence that VMMC reduces men’s risk of becoming HIV infected by approximately 60 percent. To inform strategic planning for continued scale-up of its VMMC program and better understand cost drivers and cost variances across provinces, the South African National Department of Health in 2014 requested estimates of the unit cost of VMMC and the level of current spending for VMMC demand creation. The results of this study provide a comprehensive analysis of the unit cost of providing VMMC in South …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Multan, Population Council

Reproductive Health

This district profile of Multan is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Sukkur, Population Council

Reproductive Health

This district profile of Sukkur is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities, pharmacies, and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The …

Sexual And Reproductive Health Knowledge, Attitudes, And Practices Among Early Adolescents And Young Adults In Uganda: Findings From A Link Up Exploratory Study, Population Council

HIV and AIDS

The Population Council collaborated with Makerere University’s Child Health and Development Centre to conduct a study of males and females ages 10–24 to help inform future programs and policies affecting these young people. This study was conducted as part of the Link Up project, a global consortium led by the International HIV/AIDS Alliance that aims to improve the sexual and reproductive health and rights (SRHR) of young vulnerable people. Results indicate that adolescents and young adults have broad gaps in their knowledge about HIV and SRHR; early adolescents fared significantly worse in these areas than their older counterparts, suggesting that …

Youth In Pakistan: Priorities, Realities And Policy Responses, Zeba Sathar, Iram Kamran, Maqsood Sadiq, Sabahat Hussain

Poverty, Gender, and Youth

Youth is a pivotal stage during which the right policies and interventions in the health, social, educational, and economic sectors can protect young people against risks, and turn the trajectories of their lives toward a safe and productive path of growth. This report explores some of the key issues facing youth in Pakistan, in the main spheres marking their transition to adult roles. It also presents the results of an age-based segmentation analysis capturing where youth in Pakistan stand in terms of school enrollment, work force participation, and marriage, with a view to identifying the broad developmental priorities for each …