International Public Health Commons^™

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Evaluation Of The Impact Of Strengthening Union Health And Family Welfare Centers For Providing 24/7 Normal Delivery Services In Bangladesh, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan, Mohammed Sharif, Forhana Rahman Noor, Surojit Kundu, Shongkour Roy, Afsana Fatema Noor, Ubaidur Rob

Reproductive Health

In Bangladesh, the majority of the infant deliveries in rural areas take place at homes where there is a higher risk of morbidity and mortality. Most Union Health and Family Welfare Centers (UHFWCs) are unable to provide 24-hour normal delivery services in close proximity to most rural women. With this point of view, the Population Council has provided technical assistance to the Directorate General of Family Planning to implement an operations research (OR) study in 24 UHFWCs to test the effectiveness of a model to strengthen UHFWCs so that they can provide such services. This report presents the findings of, …

Landscape Analysis Of The Family Planning Situation In Pakistan: Brief Summary Of Findings, Population Council

Reproductive Health

This brief provides a summary of the Landscape Analysis of the Family Planning Situation in Pakistan carried out by the Population Council with the support of the Bill & Melinda Gates Foundation in 2015–16. The analysis provides a comprehensive assessment of consumer demand, contraceptive service provision, and contraceptive supply, and the provincial policy environment based on primary data collection in eight districts in Punjab, Sindh, and Khyber Pakhtunkhwa. Its aim is to identify investment opportunities to catalyze an escalation in contraceptive prevalence, enabling Pakistan to meet its FP2020 goals.

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

Reproductive Health

This district profile of Faisalabad is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the 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. The analysis, conducted by the Population Council, was supported by …

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

Reproductive Health

This district profile of Hyderabad is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of family planning, including other socioeconomic indicators, and consumers’ perspectives on barriers to use of family planning. While it notes the lack of information among men; it also finds limited access to public health facilities compounded by poverty—a hurdle for the urban poor. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Landscape Analysis Of The Family Planning Situation In Pakistan, Population Council

Reproductive Health

Pakistan faces a number of challenges to increasing modern contraceptive use. Although there are encouraging signs, such as improved male participation, the addition of about four million current FP users, from 2007 to 2013, and a responsive policy environment with demonstrated political and financial commitment to meeting the country’s FP2020 goals, the task that lies ahead is still huge. This report presents the findings of a landscape analysis of family planning (FP) in Pakistan by the Population Council in 2015 and 2016, with support from the Bill & Melinda Gates Foundation. This landscape analysis assesses both demand and supply side …

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

Reproductive Health

This district profile of Karachi is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of the use of family planning; use of antenatal and delivery care services; 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. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning. The analysis, conducted by the Population Council, was supported by the …

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

Reproductive Health

This district profile of Peshawar 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; 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 analysis, conducted by the …

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

Reproductive Health

This district profile of Rawalpindi is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of family planning and other socioeconomic indicators. It covers consumers’ perspectives on barriers to use of family planning noting the lack of information among men and women, especially migrants; problems of access among poor rural women; and difficulty in affording services, among poor couples. The factsheet concludes with a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by the Population Council, was supported by the Bill & Melinda Gates Foundation.

Understanding Married Women's Vulnerability To Hiv Infection In Egypt: An Exploratory Study, Doaa Oraby, Nahla G. Abdel-Tawab

Reproductive Health

This study examines the behavioral, sociocultural, economic, programmatic, and legal factors that aggravate Egyptian women’s vulnerabilities to HIV/AIDS. The study concludes that in low-prevalence settings like Egypt, targeted interventions are the most strategic and cost-effective: for example, HIV awareness-raising with a special focus on the preventive role of consistent, correct condom use, and creating a cadre of peers that could provide psychosocial support and HIV counseling to migrant workers. Furthermore, premarital and antenatal care programs should include HIV awareness-raising and provider-initiated counseling and testing after screening of women to identify those at risk for HIV infection. Concurrently, efforts should be …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Districts Haripur And Nowshera, Khyber Pakhtunkhwa, Population Council

Reproductive Health

Through its Reproductive Maternal and Neonatal Child Health project, GIZ Pakistan is assisting the Government of Pakistan in strengthening its health system’s capacities for ensuring effective, efficient, client-oriented, and affordable reproductive, maternal, newborn, and adolescent health care. GIZ engaged with senior national and provincial government officials who indicated their interest in applying the innovative Made-In/Made-For (Maternal Death, from Informants/Maternal Death, Follow On Review) methodology, a cost-effective alternative for generating reliable estimates of maternal mortality through community-based informant networks. This Population Council study in two pilot districts identified specific areas that need strong policy and programmatic interventions to improve maternal health …

Using The Community Informant-Based (Made-In And Made-For) Methodology To Estimate The Neonatal Mortality Rate (Nmr) In Nowshera, Khyber Pakhtunkhwa: A Feasibility Study, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, Rehan M. Niazi

Reproductive Health

Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

The International Right To Health: What Does It Mean In Legal Practice And How Can It Affect Priority Setting For Universal Health Coverage?, Rebecca Dittrich, Leonardo Cubillos, Lawrence O. Gostin, Ryan Li, Kalipso Chalkidou

Georgetown Law Faculty Publications and Other Works

The international right to health is enshrined in national and international law. In a growing number of cases, individuals denied access to high-cost medicines and technologies under universal coverage systems have turned to the courts to challenge the denial of access as against their right to health. In some instances, patients seek access to medicines, services, or technologies that they would have access to under universal coverage if not for government, health system, or service delivery shortfalls. In others, patients seek access to medicines, services, or technologies that have not been included or that have been explicitly denied for coverage …

Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353

Undergraduate Research Posters

Despite efforts of Vision 2020 in India, the Andhra Pradesh Eye Disease Study (APEDS) extrapolated, in 2000, approximately 18.7 million blind people in India and also, projected an increase to 31.6 million blind people by 2020. Within the state Andhra Pradesh itself, preventable corneal blindness increased to 1.84% from 1.5% in the late 1980s.

Numerous public health studies have been conducted to outline factors that cause and preclude treatment of avoidable corneal blindness in the India. Conclusively, the escalation of corneal blindness can be largely attributed to personal, social, and economic barriers in utilizing available eye-care services. However, due to …

Documento Faz Diferença, Carlos Eduardo Siqueira, Gabriella Barretosoares, Pedro L Araújo Neto, Maria N Tracy

Gastón Institute Publications

Brazilian immigrants in the United States experience various social, labor, and health challenges. This study aimed to analyze the profile of female Brazilian domestic workers in Massachusetts, USA, through a description of their working conditions and sel-frated health. This was a cross-sectional study of 198 domestic workers in Massachusetts, recruited with “snowball” sampling. The instrument addressed participants’ demographic characteristics, work conditions, and self-rated health. Data were analyzed with SPSS 21.0. Among the interviewees, 95.5% were women, 62.1% were 30 to 49 years of age, and 55.6% were undocumented. Documented and undocumented participants showed statistically significant differences in demographics, work conditions, …

A Cross-Sectional Study On Patients' Access To Healthcare In A Developing Nation, Pawan Bhandari

All Graduate Theses, Dissertations, and Other Capstone Projects

The objective of this research study was to gauge the current status of patients' access to health care services in a developing nation or least-developed country (as defined by the World Bank and United Nations), Nepal. Many patients are not privileged to have a hospital at a close proximity in Nepal. They are also forced to travel and wait for long hours due to their inability to pay for services offered by private healthcare institutions. A survey questionnaire was developed to get a snapshot of how long patients travel to get to a public hospital for an outpatient service. The …

Global Health Security Agenda Legal Landscape Assessment, Natasha M. Nussbaum

Master's Projects and Capstones

The Global Health Security Agenda (GHSA) was created on February 13, 2014, to improve country's ability to detect, prevent and respond to emerging health threats. Eleven action packages were created. The detection action package included antimicrobial resistance, zoonotic diseases, national biosafety/biosecurity and immunization. The prevention action package included establishing a national laboratory system, strengthening real-time biosurveillance, advancing timely and accurate disease reporting and establishing a trained global health security workforce.The response action package focused on establishing emergency operation centers, linking public health and law enforcement and enhancing medical countermeasures/personnel deployment.

The following paper summarizes the components performed for the GHSA …

The Sustainable Development Goals: One-Health In The World’S Development Agenda, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

The Sustainable Development Goals (SDGs), adopted by the UN General Assembly in September 2015, embody a One-Health strategy—healthy people living on a habitable planet. Extending beyond the social development emphasis of the Millennium Development Goals (MDGs), which accelerated progress globally, though unequally, the SDGs also encompass a range of environmental and economic goals, with a health goal that is far more comprehensive than the infectious diseases and maternal/child health focus of the MDGs.

To be achieved, the SDGs require resources and political commitment that is yet to be demonstrated. With a cost that could reach $5 trillion for the SDGs …

Postcolonialism And The Marshallese Diaspora: Structural Violence And Health In The Marshallese Community In Springdale, Arkansas, Alexander J. Hirata

Master's Theses

Despite moving to the United States for better healthcare, among other benefits, Marshallese Compact of Free Association (COFA) migrants residing in Springdale, Arkansas continue to face similar acute health problems as Marshallese living in the Republic of the Marshall Islands (RMI), and often without access to health services. These problems include high rates of noncommunicable diseases, such as type 2 diabetes and thyroid cancer, as well as rare conditions such as Hansen’s Disease.

To research this, I studied the limited texts surrounding the Marshallese diaspora, as well as relevant bodies of literature: postcolonialism, Pacific migration theory, and global health and …

Forced Migration, The Human Face Of A Health Crisis, Lawrence O. Gostin, Anna E. Roberts

Georgetown Law Faculty Publications and Other Works

Nearly 60 million refugees, asylum-seekers and internally displaced persons (IDPs) fled their homes in 2014, predominately from war-torn Syria, Afghanistan and Somalia. The global response to assisting this vulnerable group has been wholly incommensurate with the need given the profound health hazards faced by forced migrants at each stage of their journey. The majority of forced migrants are housed in lower-income countries that do not have the infrastructure to assist the significant numbers of individuals who are crossing their borders and the humanitarian organizations who seek to assist in the response are grossly underfunded and under-resourced.

Countries have varying responsibilities …

The International Health Regulations 10 Years On: The Governing Framework For Global Health Security, Lawrence O. Gostin, Mary C. Debartolo, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

The World Health Organization (WHO) and its global health security treaty, the International Health Regulations (2005) (IHR) have lost the world's confidence after the West African Ebola epidemic. The epidemic led to several high-level reviews of the IHR and global health security more broadly. Here, we propose a series of recommendations for operational and legal reforms to enhance the functioning of the FCGH. It is critical that WHO act on them quickly, before the window of opportunity for fundamental reform closes.

WHO should ensure that all states fulfill their obligations to develop national core surveillance and response capacities, including through …

Open Access Challenge, Amy Dailey, Janelle Wertzberger

Open Access Week at Gettysburg College

This class activity is designed to help health sciences students understand challenges to accessing public health information in a variety of settings. The exercise was created for students in Prof. Dailey’s Global Health class (HS 322) at Gettysburg College in Fall 2015.

The activity, as well as notes for instructors considering using this exercise, are both shared here.

Developing Maternal And Child Health Curriculum In Rural Uganda, Rebecca Newbrander, Md Candidate

CwiC Posters

Maternal and Child Health in Iganga District Uganda

Maternal and child health outcomes in the East Central Region of Uganda are especially poor compared to the rest of Uganda [1]:

• Only 32% of women (50.7% nationally) informed about signs of pregnancy or delivery complications
• Only 12% of women (62% nationally) received malaria prophylaxis during pregnancy

The “Three Delays Model” of barriers to care[3]:

• Knowing when to seek care and making the decision to do so
• Access to care once decision is reached to seek it
• Receiving quality care at a health center or hospital

Maternal and Child Heath Care in …

Jeffhealth Medical Student Exchange In Rwanda, Amanda Nemecz, Alexander Rowan, Talia Stark

CwiC Posters

Teaching Community Health Workers

In rural Rwandan villages, the communities are linked to healthcare through Community Health Workers (CHW). CHW are appointed based on village election and the requirement that they can read and write. The Rwandan Ministry of Health provides general health training to the CHW so that they can educate and advise the village on health related matters. CHW administer educational sessions at village meetings about prevalent health issues, and advise members of the village when they should go to the Health Center. JeffHEALTH’s teaching aims to supplement the Ministry of Health training. Topics are chosen and approved …

Clinical Experience At Pasteur Clinic Đà Lạt, Vietnam, Emma Howard-Young, Jordan Howard-Young, Ma

CwiC Posters

History of the Pasteur Clinic Đà Lạt

The Pasteur Clinic is associated with the Institut Pasteur, part of the international network of research institutes dedicated to the prevention and treatment of infectious diseases. The Đà Lạt branch of Vietnam’s Institut Pasteur was built between 1930 and 1936 under the direction of Dr. Alexandre Yersin, a physician remembered for identifying Yersinia pestis as the causative agent of Plague and a student of the eponymous French chemist and microbiologist Louis Pasteur. While many overt references to the French colonial tradition have been supplanted in Vietnam by nationalist sentiments, the Institut Pasteur …

Nested Partially-Latent, Class Models For Dependent Binary Data, Estimating Disease Etiology, Zhenke Wu, Maria Deloria-Knoll, Scott L. Zeger

Johns Hopkins University, Dept. of Biostatistics Working Papers

The Pneumonia Etiology Research for Child Health (PERCH) study seeks to use modern measurement technology to infer the causes of pneumonia for which gold-standard evidence is unavailable. The paper describes a latent variable model designed to infer from case-control data the etiology distribution for the population of cases, and for an individual case given his or her measurements. We assume each observation is drawn from a mixture model for which each component represents one cause or disease class. The model addresses a major limitation of the traditional latent class approach by taking account of residual dependence among multivariate binary outcome …

Unicef Communications For Development (C4d) Strategy For The Prevention Of Violence Against Children In South Africa., Marc C. Edberg, Rajiv N. Rimal, Hina Shaikh

Center for Social Well-Being and Development

No abstract provided.

Prevailing Against Polio: India's Holistic Development Strategy, Anonymous Submission

Ex-Patt Magazine

No abstract provided.

Socioeconomic Differences In Antenatal Care Between The United States And Scandinavia, Joshua B. Kiehl

Student Publications

Despite their analogous status as economically developed nations, the United States and Scandinavian countries have marked differences in their healthcare systems. In particular both areas discernibly differ in the antenatal treatment provided for expecting women and their babies. Sweden and Denmark’s healthcare systems are universal, run primarily on taxpayer dollars, and provide equal antenatal care regardless of socioeconomic status. The United States’ healthcare system is run on a combination of private and government run insurance, in which socioeconomic status often determines insurance coverage. This variability in insurance coverage often results in differing levels of antenatal care. An overarching question remains …