International Public Health Commons^™

(Video) Income-Related Inequalities In Utilization Of Health Services Among Private Health Insurance Beneficiaries In Brazil, Heitor Werneck

GW Research Days 2016 - 2020

Brazil’s 1988 health reform created the Unified Health System (SUS). SUS is a universal health system that emulates British National Health Service, featuring an open-ended benefit package and a major goal of health equity. An unforeseen consequence of the reform was that former beneficiaries of the social health insurance sought to sustain their privileged access to health services through private health insurance. Despite achievements in expanding healthcare access and improved health outcomes, recurring opinion polls suggest that Brazilians are skeptical about SUS’ capacity to delivery timely and quality health services, making private insurance a priority to most households. The literature …

Predictors Of Malnutrition In Different Geographic Regions Of Peru, Elizabeth Lacroix

GW Research Days 2016 - 2020

Malnutrition is responsible for over 3 million childhood deaths each year. Those who survive early nutritional deficiencies and the subsequent growth failure face life-long consequences, including long-term deficits in cognitive development, decreased academic achievement, and reduced economic opportunities later in life. Low height for age, or stunting, indicates chronic malnutrition, while low weight for height (wasting) indicates acute malnutrition. Caloric deficiencies, micronutrient deficiencies, intestinal parasites, and diarrheal diseases all directly contribute to acute and chronic undernutrition.

Peru is an ethnically and geographically diverse country that has experienced great economic growth and dramatic health improvements in the last decade. Nationally, stunting …

Unintended Pregnancies In Brazil - A Challenge For The Recommendation To Delay Pregnancy Due To Zika, Cynthia Schuck-Paim, Daniel Lopez, Lone Simonsen, Wladimir Alonso

Global Health Faculty Publications

Because of the potential link between the ongoing Zika virus outbreak and a surge in the number of cases of congenital microcephaly, officials in Latin America have recommended that women postpone pregnancy until this association is firmly established or the outbreak subsides. However, in all these countries a large proportion of babies are still born out of unplanned pregnancies. Teenage girls are particularly at high risk, as they often lack access to preventive contraception methods, or the knowledge to use them appropriately. To gauge the magnitude of the barriers preventing the implementation of such a recommendation in Brazil, the country …

Infant Vaccination Timing: Beyond Traditional Coverage Metrics For Maximizing Impact Of Vaccine Programs, An Example From Southern Nepal., Michelle M Hughes, Joanne Katz, Janet A Englund, Subarna K Khatry, Laxman Shrestha, Steven C Leclerq, Mark Steinhoff, James M. Tielsch

Global Health Faculty Publications

Background

Immunization programs currently measure coverage by assessing the proportion of children 12–24 months who have been immunized but this does not address the important question of when the scheduled vaccines were administered. Data capturing the timing of vaccination in first 6 months, when severe disease is most likely to occur, are limited.

Objective

To estimate the time to Bacillus Calmette–Guérin (BCG) (recommended at birth), diphtheria-tetanus-pertussis-H, influenza b-hepatitis B (DTP-Hib-HepB), and oral polio vaccine (OPV) (recommended at 6, 10, and 14 weeks) vaccinations and risk factors for vaccination delay in infants <6 months of age in a district in southern Nepal where traditional coverage metrics are high.

Design/methods

Infants enrolled in a randomized controlled trial of …

Knowledge, Attitude And Practices: Assessing Maternal And Child Health Care Handbook Intervention In Vietnam, Hirotsugu Aiga, Vinh Duc Nguyen, Cuong Dinh Nguyen, Tho Thi Thi Nguyen, Lien Thi Phuong Nguyen

Global Health Faculty Publications

Background

Maternal and Child Health (MCH) Handbook, an integrated MCH home-based record, was piloted in four provinces of Vietnam (Dien Bien, Hoa Binh, Thanh Hoa and An Giang). The study is aimed at assessing the changes in pregnant women’s behavior towards the frequencies of their antenatal care service utilizations and their subsequent breastfeeding practices up to six months of age, through the MCH Handbook intervention. This is because the levels of pregnant women’s knowledge, attitude and practices (KAP) towards their antenatal care service utilizations and exclusive breastfeeding practices have been previously neither analyzed nor reported in relation to MCH home-based …

The Impact Of Climate Variability And Conflict On Childhood Diarrhea And Malnutrition In West Africa, Gillian Dunn

Dissertations, Theses, and Capstone Projects

Objectives: This dissertation aims to contribute to our understanding of how climate variability and armed conflict impacts diarrheal disease and malnutrition among young children in West Africa. Two studies examine the associations between climate and diarrheal disease across the whole study area – ten countries in West Africa during the period 2008-2013. The third study examines diarrheal disease and malnutrition in Northeast Nigeria before (2008) and after (2013) the start of the current armed conflict in the area.

Methods: Outcome variables and child, caregiver, and household characteristics for these studies are from the Demographic and Health Surveys. Additional datasets include …

Access To Essential Medicines In African Countries: An Introduction, Peter G. Danchin, Diane Hoffmann

Faculty Scholarship

No abstract provided.

Schools Of Public Health In Low And Middle-Income Countries: An Imperative Investment For Improving The Health Of Populations?, Fauziah Rabbani, Leah Shipton, Franklin White, Iman Nuwayhid, Leslie London, Rajiv Rimal, +11 Additional Authors

Prevention and Community Health Faculty Publications

BACKGROUND: Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as …

Fragmented Implementation Of Maternal And Child Health Home-Based Records In Vietnam: Need For Integration, Hirotsugu Aiga, Vinh Duc Nguyen, Cuong Dinh Nguyen, Tho Thi Thi Nguyen, Lien Thi Phuong Nguyen

Global Health Faculty Publications

Background: Home-based records (HBRs) are globally implemented as the effective tools that encourage pregnant women and mothers to timely and adequately utilise maternal and child health (MCH) services. While availability and utilisation of nationally representative HBRs have been assessed in several earlier studies, the reality of a number of HBRs subnationally implemented in a less coordinated manner has been neither reported nor analysed.

Objectives: This study is aimed at estimating the prevalence of HBRs for MCH and the level of fragmentation of and overlapping between different HBRs for MCH in Vietnam. The study further attempts to identify health …

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 …

Detectable Viral Load In Late Pregnancy Among Women In The Rwanda Option B+ Pmtct Program: Enrollment Results From The Kabeho Study., Michelle M Gill, Heather J Hoffman, Emily A Bobrow, Placidie Mugwaneza, Dieudonne Ndatimana, Gilles F Ndayisaba, Cyprien Baribwira, Laura Guay, Anita Asiimwe

Epidemiology Faculty Publications

There are limited viral load (VL) data available from programs implementing "Option B+," lifelong antiretroviral treatment (ART) to all HIV-positive pregnant and postpartum women, in resource-limited settings. Extent of viral suppression from a prevention of mother-to-child transmission of HIV program in Rwanda was assessed among women enrolled in the Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) Study. ARV drug resistance testing was conducted on women with VL>2000 copies/ml. In April 2013-January 2014, 608 pregnant or early postpartum HIV-positive women were enrolled in 14 facilities. Factors associated with detectable enrollment VL (>20 copies/ml) were examined …

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.

Center For Global Health Newsletter, Center For Global Health, Old Dominion University

Center for Global Health Newsletter

January-June 2016 issue of Old Dominion University's Center for Global Health Newsletter.

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

Global Health 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 …

Attitudes And Factors Affecting Acceptability Of Self-Administered Cervicovaginal Sampling For Human Papillomavirus (Hpv) Genotyping As An Alternative To Pap Testing Among Multiethnic Malaysian Women., Mahirah Ma'som, Nirmala Bhoo-Pathy, Nazrila Hairizan Nasir, Jerome Bellinson, Shridevi Subramaniam, Yuntong Ma, Siew-Hwei Yap, Pik-Pin Goh, Patti Gravitt, Yin Ling Woo

Global Health Faculty Publications

OBJECTIVE: The objective of this study was to determine the attitudes and acceptability of self-administered cervicovaginal sampling compared with conventional physician-acquired Papanicolaou (Pap) smear among multiethnic Malaysian women.

METHOD: A cross-sectional study was carried out via interviewer-administered surveys from August 2013 through August 2015 at five government-run, urban health clinics in the state of Selangor. Subjects were participants from an ongoing community-based human papillomavirus (HPV) prevalence study who answered a standard questionnaire before and after self-sampling. The cervicovaginal self-sampling for HPV genotyping was performed using a simple brush ('Just for Me'; Preventive Oncology International, Hong Kong). Detailed data on sociodemographics, …

Relationship Of Suicide Rates With Climate And Economic Variables In Europe During 2000–2012, Konstantinos Fountoulakis, Isaia Chatzikosta, Konstantinos Pastiadis, Prodromos Zanis, Wolfram Kawohl, Eliot Sorel, +45 Additional Authors

Global Health Faculty Publications

Background

It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate.

Methods

Data from 29 European countries covering the years 2000–2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression.

Results

The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone …

Assessment Of Effectiveness And Scalability Of Unicef-Sponsored Projects To Prevent Violence Against Children And Women In Papua, South Sulawesi, And Central Java., Marc C. Edberg, Hina Shaikh, Leah Keller

Center for Social Well-Being and Development

No abstract provided.

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 …

A New Look At Care In Pregnancy: Simple, Effective Interventions For Neglected Populations, Stephen Hodgins, James M. Tielsch, Kristen Rankin, Amber Robinson, Annie Kearns, Jacquelyn Caglia

Global Health Faculty Publications

Background

Although this is beginning to change, the content of antenatal care has been relatively neglected in safe-motherhood program efforts. This appears in part to be due to an unwarranted belief that interventions over this period have far less impact than those provided around the time of birth. In this par, we review available evidence for 21 interventions potentially deliverable during pregnancy at high coverage to neglected populations in low income countries, with regard to effectiveness in reducing risk of: maternal mortality, newborn mortality, stillbirth, prematurity and intrauterine growth restriction. Selection was restricted to interventions that can be provided by …

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 …