International Public Health Commons^™

Effectiveness Of Interventions Designed To Prevent Or Respond To Female Genital Mutilation: A Review Of Evidence, Dennis Matanda, Melanie Croce-Galis, Jill Gay, Karen Hardee

Reproductive Health

Girls are one-third less likely to be subjected to female genital mutilation (FGM) today than 30 years ago. However, rapid population growth in some of the world’s poorest countries, where FGM persists, threatens to roll back progress. In 2020 alone, an estimated 4.1 million girls were at risk of being subjected to FGM. Without concerted and accelerated actions to end the practice, an estimated 68 million additional girls will have been subjected to FGM by 2030. Despite intensified global research efforts to inform strategies to address FGM, there has been little synergy between evidence generation and the implementation of programs …

Management Of Intimate Partner Violence In Health Care Settings: A Training Manual For Health Care Providers, Division Of Reproductive And Maternal Health

Reproductive Health

Intimate partner violence (IPV) is any behavior by an intimate partner that causes physical, sexual, or psychological harm. In healthcare settings where providers are well trained, caring, and sensitive, most survivors respond positively to being asked about their exposure to violence. Healthcare providers are in a unique position to identify survivors and offer appropriate management and referrals. The World Health organization developed clinical guidelines to provide evidence-based guidance to healthcare providers on the identification and appropriate response to IPV and sexual violence. Based on this guidance, the Ministry of Health developed a comprehensive training manual to empower healthcare providers with …

Barriers, Challenges And Fears From Immigrants In Access To Healthcare: A Proposal For Undocumented Immigrants To Being Insured, Jose Gonzalez-Ibarra

Community Engagement Student Work

Access to healthcare is a global issue that needs to be addressed. Worldwide organizations have put efforts in place to overcome this problem and offer solutions and recommendations to various countries. However, these efforts have not been entirely successful. Receiving the highest attainable standard of health or only receiving care is extremely difficult or impossible for individuals who are considered vulnerable such as immigrants, especially those who are undocumented immigrants. Through the recognition of barriers, challenges and fears from immigrants accessing healthcare and a shape of social determinants of health, institutions of government, nonprofit sector and community members organized could …

The Policy Of Substance Abuse In Liberia: Analysis And Recommendations, Yamah Dolo

Community Engagement Student Work

Countries all over the globe are affected by substance abuse. Substance abuse is a traumatic issue that people around the world battle. Substance use has occurred for many years and seems to keep increasing. According to Parekh, “Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence.” (Parekh, 2017). Substance abuse has a significant effect on health, an individual’s well-being, families, relationships, and the post-war community. However, with the information on Liberia, little is known about the substance abuse cases. Liberia is a country that has no health, and there …

Mortalidad Por Infarto Agudo De Miocardio En Guatemala 2018: Patrones E Inequidades, Alejandro Cerón, Gila Goldstein

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por infarto agudo de miocardio (IAM) en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir de IAM en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo de morir de IAM. …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

English Summary:
The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

[In Arabic] The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls.

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The …

Mortalidad Por Diabetes En Guatemala 2018: Patrones E Inequidades, Alejandro Cerón, Gila Goldstein

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por diabetes en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir de diabetes en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en mujeres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo de morir de diabetes. Este estudio …

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …

The Risks For Eating Disorders/Disordered Eating In Refugee & Immigrant Experiences And The Imperative Of Culturally Alert Screening, Chantal A. Bushelle

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Eating Disorders (ED)/Disordered Eating (DE) largely remain outside of global mental health agendas. There are limited data on the epidemiology EDs/DE in refugee and immigrant populations, and there is a paucity of research on refugee and immigrant experiences of EDs/DE. Study of acculturation issues in refugee and immigrant populations have historically missed investigating what role and impact experiences of stress and trauma (e.g., historical, chronic) along with cultural change and transition may have on their food attitudes and eating behaviors. While there has been some study of eating habits within refugee and immigrant populations, the focus is typically on food …

Decomposing Differences In Coronavirus Disease 2019-Related Case-Fatality Rates Across Seventeen Nations, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

As of 1 November 2020, estimated case-fatality rates associated with coronavirus disease 2019 are not uniformly patterned across the world and differ substantially in magnitude. Given the global spatial heterogeneity in case-fatality rates, we applied the Blinder-Oaxaca regression decomposition technique to identify how putative sociodemographic, structural, and environmental sources influence variation in case-fatality rates. We show that compositional and associational differences in country-level risk factors explain a substantial proportion of the coronavirus disease 2019-related case-fatality rate gap across nations. Asian countries fair better vis-à-vis case-fatality rate differences mainly due to variation in returns to sociodemographic, structural, and environmental sources among …

Experiences Among Adults And Adolescents During The Covid-19 Pandemic From Four Locations Across Kenya—Study Description, Timothy Abuya, Karen Austrian, Adan Isaac, Beth Kangwana, Faith Mbushi, Eva Muluve, Daniel Mwanga, Thoai Ngo, Mercy Nzioki, Rhoune Ochako, Jessie Pinchoff, Ben Tidwell, John Wanyungu, Corinne White

Poverty, Gender, and Youth

To control the spread of coronavirus, the COVID-19 National Emergency Response Committee (NERC) in Kenya, chaired by the Ministry of Health (MOH), has implemented prevention and mitigation measures. To inform the Government of Kenya’s shorter- and longer-term response strategies, the Population Council COVID-19 study team utilizes rapid phone-based surveys to collect information on knowledge, attitudes, practices and needs among a longitudinal cohort of heads of household sampled from existing prospective cohort studies. The first was carried out across five Nairobi urban informal settlements; the baseline survey (n=2,009) was conducted March 30–31 with subsequent follow-up surveys conducted April 13–14 (n=1,764), May …

Midline Report: Accelerating Action To End Child Marriage In Bangladesh, Masuma Billah, Eashita Haque, Surojit Kundu, Md. Saddam Hossain, Momoe Makino, Sajeda Amin

Poverty, Gender, and Youth

This report describes results from the midline survey of Accelerating Action to End Child Marriage in Bangladesh. The objective of the program is to identify effective and scalable approaches to end child marriage by empowering girls and communities. To bring about social norms change, the program experiments with alternative means of community engagement that can be offered in conjunction with skills-development opportunities for adolescent girls. The program is being assessed in a multi-arm cluster randomized trial. This report explores the impact on the prevalence of child marriage in two districts of Bangladesh as well as on a range of other …

Availability Of Over-The-Counter Antibiotics In Guatemalan Corner Stores, Purificación Moreno, Alejandro Cerón, Karen Sosa, Marinees Morales, Laura M. Grajeda, Maria Renee Lopez, John P. Mccraken, Celia Cordón-Rosales, Guy H. Palmer, Douglas R. Call, Brooke M. Ramay

Anthropology: Faculty Scholarship

Widespread availability of antibiotics without prescription potentially facilitates overuse and contributes to selection pressure for antimicrobial resistant bacteria. Prior to this study, anecdotal observations in Guatemala identified corner stores as primary antibiotic dispensaries, where people purchase antibiotics without prescriptions. We carried out a cross sectional study to document the number and types of antibiotics available in corner stores, in four study areas in Guatemala. A total of 443 corner stores were surveyed, of which 295 (67%) sold antibiotics. The most commonly available antibiotics were amoxicillin, found in 246/295 (83%) stores, and tetracycline, found in 195/295 (66%) stores. Over the counter …

Practice-Based Learning: Establishing Simple Monitoring Systems To Support Sgbv Programming In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Michael Gaitho, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

Implementers of sexual and gender-based violence programs in refugee settings are typically eager to learn about the extent to which their programs are making a difference in the lives of those they serve. Basic monitoring information can help address this imperative without unduly burdening program implementers with time-consuming evaluations. The Sauti/VOICE project is guiding adaptation and implementation of evidence-based SGBV interventions in refugee contexts. These interventions are implemented by UNHCR partners in eight countries in the East, Horn, and Great Lakes region of Africa. Although Sauti/VOICE is primarily focused on integrating tested SGBV interventions into refugee contexts, monitoring the implementation …

Practice-Based Learning: Medico-Legal Evidence Collection As Part Of Post-Rape Care In Refugee Contexts, Michael Gaitho, Ronald Kotut, Anne Ngunjiri, Jane T. Thiomi, Josephine Ngebeh, Chi-Chi Undie

Reproductive Health

Health care providers collect an array of documentation and specimens to support criminal investigations. Such documentation and specimens are referred to as “medico-legal” or “forensic” evidence, and in the case of rape, include a survivor’s documented injuries and emotional state at the time of examination, as well as samples and specimens from the survivor’s body or clothing. For survivors of rape and defilement who want to obtain legal justice, medico-legal evidence is critical. In African countries, health providers and the police are depended upon to ensure such evidence is collected, but medico-legal evidence collection can present challenges. Evidence-based interventions are …

Support Clubs For Children And Youth In Haiti Living With Hiv: A Case Study, Susan Settergren, Robert Philippe, Joanne St. Louis, Nathaniel Segaren, Sylvie Boisson, Tessa Lewis, Olbeg Désinor, Kesner François

HIV and AIDS

In Haiti, where an estimated 3,000 children and youth are receiving antiretroviral therapy (ART), Caris Foundation, with funding from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID), provides hospital-linked psychosocial support groups, known as Kids Clubs, for young people ages nine and older. The clubs are intended to help ensure that HIV-positive children and adolescents stay in contact with health services, and serve as a conduit for delivery of other services, including health messages and health products. In 2019, Project SOAR conducted a study to describe the Kids Club …

Mexico: Covid-19 Knowledge, Attitudes And Practices, Population Council

Poverty, Gender, and Youth

This brief presents responses from the first round of data collection among adults, adolescents, and community leaders in indigenous municipalities of Chiapas and Yucatan, Mexico, June 1–30, 2020. In total, 295 people from 17 municipalities were surveyed in Yucatan, and 83 people from 15 municipalities were surveyed in Chiapas. Adults and adolescents in both states identified the groups most at risk of suffering complications. Food insecurity may be a consequence of the pandemic. Regarding livelihoods, 51% of women and 63% of men in Yucatan have lost their work and/or their primary source of income since the start of the pandemic, …

México: Conocimientos, Actitudes Y Prácticas Relacionadas Con Covid-19, Population Council

Poverty, Gender, and Youth

Este informe presenta las respuestas de la primera ronda de recolección de información con personas adultas, adolescentes y autoridades comunitarios en las comunidades indígenas de Chiapas y Yucatán, México, del 1 al 30 de junio de 2020. En total, 295 personas originarias de 17 municipios fueron encuestados en Yucatán, y se encuestó a 83 personas de 15 municipios de Chiapas. Los adultos y adolescentes de ambos estados identificaron a los grupos en mayor riesgo de sufrir complicaciones. La inseguridad alimentaria puede ser una consecuencia de la pandemia Covid-19. En cuanto a los medios de vida, el 51% de las mujeres …

Lessons From A Five-Year Research Programme On Fgm/C And Their Relevance For Policy And Programmes In Kenya, Dennis Matanda, Agnes K. Meroka-Mutua, Samuel Kimani

Reproductive Health

The Sustainable Development Goals target the elimination of all forms of harmful practices, including female genital mutilation/cutting (FGM/C) by 2030. Kenya has made progress in addressing the elimination of FGM/C through ratification of global instruments and enactment of the Prohibition of FGM Act in 2011 and other supportive laws. The Act created the foundation for the establishment of the Anti-FGM Board, which provides policy leadership and coordination of anti-FGM/C programs in Kenya. More recently, the President of Kenya issued a decree for accelerated elimination of FGM/C by 2022. This synthesis report highlights how evidence generated over the last five years …

Effects Of Covid-19 On Nutrition In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

An extended nationwide lockdown and stoppage of economic activities resulting from COVID-19 caused substantial loss of income for many families in Bihar, India. One of the significant implications is a food shortage in households and a reduction in food intake. This nutrition shock may hit females harder than males due to the deep-rooted gendered culture prevalent in India. This study's key objectives are to understand the extent of food shortage in households, any changes in food intake, and coverage of government nutrition schemes. Half of the households in Bihar reported food shortages in the past month, causing most to reduce …

Self-Help Groups: A Potential Pivot Of Bihar's Response To Covid-19, Unicef, Population Council Institute

Poverty, Gender, and Youth

More than 10 million women in Bihar, India, are members of women’s self-help groups (SHGs), run by the Bihar Rural Livelihoods Promotion Society, Government of Bihar. The SHGs play a crucial role in the community by providing livelihood support and income-generating activities to their members. The key objectives of this study are to document SHG leaders’ engagement in community awareness and infection-prevention activities and the extent of support they give to their members through different funds and loans for livelihoods and income generation during the COVID-19 pandemic. About half of the SHG leaders were engaged in COVID-19–related community-awareness and prevention …

Covid-19 Times: Study Protocol For Rapid Assessment Of The Situation Of Women And Children In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

India reported its first COVID-19 case on January 30, 2020, and numbers began to rise in late March 2020. The containment measures implemented by the national and state governments, particularly the nationwide lockdown, have helped keep the COVID-19 pandemic at a relatively low level in India. Bihar, being one of the poorest states in India, is at particularly high risk of adverse health and economic effects of COVID-19 and the lockdown. The Population Council Institute, in partnership with UNICEF Bihar, is conducting a rapid longitudinal study that aims to inform the design and development of locally relevant suitable response mechanisms …

Returning Home: Effects Of Covid-19 On Migrant Households In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

Many migrants from metropolitan cities in India began to return to their native homes with the rise in COVID-19 cases in the cities and the extension of the lockdown. With relaxation of travel restrictions, Bihar started receiving migrants who were returning home. The government made arrangements for them to be quarantined before they traveled to their villages and homes. The key objectives of this study are to understand the extent of return migration, the impact of lockdown on migrant household livelihoods, and the opportunities for household economic revival through social protection schemes. Among migrant households, about half may experience return …

Effects Of Covid-19 On Livelihood, Employment, And Financial Resources, Unicef, Population Council Institute

Poverty, Gender, and Youth

COVID-19 and steps to break the chain of viral transmission led to certain economic challenges that triggered loss in livelihoods and income and constraints on financial resources in Bihar, India. Often, these effects were disproportionately experienced among the most marginalized. The key objective of this study is to assess the loss of income, livelihoods, and jobs among households in Bihar to help with program planning and implementation. Data were gathered May 13–22, 2020, from the existing study cohort of households under the UDAYA study. Interviews were conducted with a total of 794 participant households. About four-fifths of respondents said their …

Are More People Adopting Covid-19 Prevention Measures?, Unicef, Population Council Institute

Poverty, Gender, and Youth

Drawing on data from two rounds of COVID-19 knowledge, attitudes, and practices (KAP) telephone surveys conducted in Bihar, India, this research brief sheds light on the socioeconomic differentials and changes over time in the adoption of COVID-19 preventive measures. Though the adoption of preventive measures has increased, around two-fifths of males and one-quarter of females reported that they were currently practicing all four standard preventive measures. The better educated, wealthier, and those belonging to privileged castes were more likely than others to practice these measures, as were those who perceived moderate or high risk of COVID-19 in their neighborhood. Social …

Awareness Of And Receiving Social Protection Measures During Covid-19 Lockdown In Bihar, India, Unicef, Population Council Institute

Poverty, Gender, and Youth

Economic hardships caused by the nationwide lockdown to prevent the spread of COVID-19 have been reported across India. Social protection measures have been announced by the state and central governments to ease these hardships. The key objectives of this research brief are to examine the awareness and the social protection measures received during the COVID-19 lockdown in Bihar, and the socioeconomic differentials in receiving these measures. The majority of respondents (64%) reported a family member losing their job/income-earning opportunity and lacking resources to survive for long. Awareness of social protection schemes was high (88%). Among households, 68% reported having ration …

Demand For And Access To Family Planning Services Among Young Married Women During Covid-19 Crisis, Unicef, Population Council Institute

Poverty, Gender, and Youth

In Bihar, India, as a result of the COVID-19 lockdown and men returning home in large numbers and spending more time at home in high stress conditions, the need for contraceptive services could get greater. March to May are considered the “lean season” when demand is typically low for family planning (FP) programs in states like Bihar. However, higher demand caused by the lockdown and lack of access to health facilities has created a gap between demand and uptake. This could have negative consequences such as high numbers of unintended pregnancies, unsafe abortions, and maternal mortality. Current use of modern …

Important Lessons On Fgm/C Abandonment From Four Research Studies In Egypt, Nada Wahba, Nahla G. Abdel-Tawab, Abeer Salem

Reproductive Health

Female genital mutilation/cutting (FGM/C) continues to be a widespread practice in Egypt. According to the 2014 Egypt Demographic and Health Survey, the prevalence of FGM/C was 92 percent among ever-married women aged 15–49. However, Egypt continues to witness a drastic surge in the medicalization of FGM/C, with 74 percent of women aged 19 years and younger circumcised by medical practitioners, compared to 55 percent in 1995. This policy brief provides key results and recommendations of four studies conducted by the Population Council/ Egypt under the Evidence to End FGM/C project, in coordination with Egypt’s National Population Council. The four studies …