International Public Health Commons^™

The Perspectives Of Men In Mexico City About Vasectomy—Brief, Isabel Vieitez Martínez, Adriana Ramos

Reproductive Health

On November 17, 2017, Mexico City took part in the global World Vasectomy Day campaign promoting men’s participation in family planning, especially through no-scalpel vasectomy (NSV). During the event the Population Council Mexico conducted an exploratory study to better understand the reasons men chose NSV, as well as their concerns before and after the procedure. The study found that the principal reason for seeking NSV among men surveyed was their achievement of a desired family size, for themselves and their partners. The study further reveals the need to disseminate information through mass media, social networks, and all levels of the …

The Rationale And Relevance Of Existing Cadres Of Frontline Health Workers And Potential For New Mid-Level Cadres, Oladimeji Oladepo, Ekechi Okereke, Akinwumi Akinola

Reproductive Health

Front-line health workers (FLHWs) are expected to perform necessary maternal, newborn, and child (MNCH) services appropriately and effectively; however, few studies have investigated the extent to which FLHWs perform requisite primary health care (PHC) services. This study seeks to better understand not only FLHWs’ knowledge and performance of MNCH services, but the factors promoting and inhibiting their services in selected rural local government areas of Nigeria’s Bauchi and Cross River states. It also investigates the potential for a new PHC worker cadre, soliciting stakeholders’ perceptions about its feasibility for addressing maternal and newborn disease burdens in rural communities. The study’s …

Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan

Reproductive Health

In Kenya, there has been a steady and marked decline in the prevalence of female genital mutilation/cutting (FGM/C) but there is great variance in the prevalence of FGM/C across the country, with prevalence remaining high among certain ethnic groups such as Somali, Samburu, Kisii, and the Maasai. The objectives of this study were: 1) to explore whether and how unprogrammed factors or programmed FGM/C interventions (alternative rites of passage, legal and policy measures, religious-oriented approaches, promotion of girls’ education, intergenerational dialogues, use of rescue centers, and other undocumented approaches) influence community values deliberation in Narok and Kisii counties; 2) to …

Trends In Medicalisation Of Female Genital Mutilation/Cutting: What Do The Data Reveal?, Bettina Shell-Duncan, Carolyne Njue, Zhuzhi Moore

Reproductive Health

Despite the emergence of international consensus that female genital mutilation/cutting (FGM/C) is a violation of human rights, a focus on medicalization remains salient because of concerns that FGM/C is increasingly being performed by healthcare professionals and may be impeding progress toward abandonment of FGM/C. To investigate these claims, this study draws on nationally representative survey data from 26 countries, and addresses the following three questions: 1) What are the major patterns and trends in medicalisation? 2) Is there an association between medicalization and rates of change in prevalence of FGM/C? and 3) Is there an association between medicalization and support …

Understanding Medicalisation Of Female Genital Mutilation/Cutting (Fgm/C): A Qualitative Study Of Parents And Health Workers In Nigeria, Otibho Obianwu, Adetayo Adetunji, Osasuyi Dirisu

Reproductive Health

This community-based, cross-sectional qualitative study was conducted in four communities in Nigeria’s Delta, and was conceptualized to address gaps in our understanding of medicalization of female genital mutilation/cutting (FGM/C) and to provide critical evidence needed to effectively design abandonment interventions. The study findings reveal that the social norms driving FGM/C practice remain entrenched despite a shift to medicalization. They also reflect the tendency of parents and health workers to view FGM/C, whether traditional or medicalized, as a minor procedure with few complications and significant benefits that would positively impact a daughter’s future status as a wife and mother. Findings reveal …

Understanding The Key Elements For Designing And Implementing Social Marketing Campaigns To Inform The Development Of Creative Approaches For Fgm/C Abandonment In Sudan, Widad Ali A/Rahman, Samia Al Nagar, Randa H. Gindeel, Arwa Salah

Reproductive Health

Social marketing campaigns (SMCs) have gained prominence in female genital mutilation/cutting (FGM/C) abandonment efforts, but there is a dearth of information on how these programs are designed and implemented, and their perceived impact. Understanding the implementation process and the effectiveness of these campaigns is critical for drawing lessons to improve existing programs and inform the design and scale up of SMCs in other regions/countries. This mixed-method study sought to address this gap by assessing the design and implementation of existing SMC programs in Sudan. While the study findings demonstrate several strengths of existing programs, including strong partnerships and extensive needs …

Retrospective Cohort Study: Clinical Presentation And Outcomes Of Pre-Eclampsia And Eclampsia At Kenyatta National Hospital, Nairobi, Kenya, Charity Ndwiga, Alfred Osoti, Pooja Sripad, George Odwe, Omondi Ogutu, Charlotte E. Warren

Reproductive Health

Pre-eclampsia has two distinct subtypes: early onset pre-eclampsia, which occurs before 34 weeks of gestation, and late onset pre-eclampsia, which occurs after 34 weeks. Few studies examine and compare early and late onset pre-eclampsia in a low- and middle-income country setting. This study’s goal was to establish a profile of patients with hypertensive disorders in pregnancy, especially pre-eclampsia and eclampsia, over a two-year period. At Kenya’s national referral hospital, clinical presentation at admission was examined, as was management of complications, along with maternal and newborn health outcomes in the hospital’s maternity unit, to ascertain any differences in health outcomes for …

An Examination Of Socioeconomic Equity In Health Experiences In Six Latin American And Caribbean Countries, Jessica Greene, Frederico Guanais

Publications and Research

Objective: Most Latin American and Caribbean (LAC) countries are working toward the provision of universal health coverage, and ensuring equity is a priority for those nations. The goal of this study was to examine the extent to which adults’ socioeconomic status was related to health care experience in six LAC countries.

Methods: This cross-sectional study examined the relationship between educational attainment and seven health experience outcomes in three areas: assessment of the health system, access to care, and experience with general practitioner. For this work, we used data from an Inter-American Development Bank survey of adults in Brazil, Colombia, El …

Global Health Elective, Santiago, Dominican Republic, March 2018, July K. Jean Cuevas

Posters

Describes a global health learning experience to improve the knowledge of health care professionals and families about common developmental conditions, autism and ADHD.

Sawubona From Swaziland! - A Global Health View Of The Hiv/Aids Epidemic In Swaziland, Abby Hardin

Posters

Describes the learning experiences of a pediatric resident regarding how to practice evidence based medicine in low resource settings.

Family Planning And Hiv Interventions Among Women In Low-Income Settings, Steven P. Masiano

Theses and Dissertations

This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues.

This …

Factors Associated With Iron-Folic Acid Supplement Use Among Pregnant Women In Karu, Nasarawa State, Nigeria - A Cross Sectional Study Using Theory Of Planned Behavior, Toyin O. Akomolafe

College of Graduate Studies: Theses & Dissertations

Introduction: Iron-folic acid supplementation is one of the key interventions provided during antenatal care (ANC) services to reduce iron deficiency, maternal anemia, low birthweight and other pregnancy-related complications responsible for maternal and neonatal mortality. However, use of iron-folic acid supplements and adherence with recommended dosage in Nigeria is low. The purpose of this cross-sectional study was to examine factors associated with iron-folic acid supplements use among pregnant women in Karu local government area (LGA), Nasarawa, Nigeria. Methods: Questionnaires were administered in face-to-face interviews with 64 pregnant women (18 – 49 years old) and 19 healthcare providers in selected …

Three Essays On Maternal And Child Health, Mandar V. Bodas

Theses and Dissertations

This dissertation is a collection of three separate essays on the health of women and children. In the first essay, I along with my co-authors, analyzed the impact of two large, national-level health policies (the Janani Suraksha Yojana (JSY) and the National Rural Health Mission (NRHM)) on maternal health outcomes (proportion of institutional deliveries) in India. We used data from the India Human Development Survey (IHDS) and found that the JSY and the NRHM had a greater impact on institutional deliveries in high-focus states. We also found that the conditions of the public health facilities, did not change after the …

Sociocultural Interactions Of Cuban Doctors Participating In The More Doctors Program In Brazil, Joaquin Molina, Carlos Eduardo Siqueira, Leonardo Cavalcanti

Gastón Institute Publications

This book focuses on a different and underexplored attribute of the More Doctors Program by surveying doctors in the feld with the purpose of identifying important answers regarding the sociocultural interactions of Cuban doctors recruited by the program and of producing knowledge, while also making improvements in the participation, still limited, of foreign doctors in the primary care services offered by SUS. It proposes to induce perceptions, memories, and possible explanations to anyone who is somehow associated with the Program’s development, especially those committed to universal health care and primary assistance as the only paths to an effective health system. …

Women's Lives In Times Of Zika, Ana Rosa Linde, Carlos Eduardo Siqueira

Gastón Institute Publications

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. We conducted a qualitative study to address the impact of the Zika epidemic on the family life of women living in Brazil, Puerto Rico, and the US, who were affected by it …

Leadership In Community Public-Private Partnership Health And Social Care Initiatives, Hawa Yatera Mshana, Magdeline Aagard, Cheryl Cullen, Patrick A. Tschida

Journal of Sustainable Social Impact

Although the public–private partnerships in health have been adopted as the best pathway to improving health outcomes in many developing nations, implementation lacks collaborative leadership. The purpose of this empirical qualitative case study was to determine key factors that promote leadership synergy (LS) between partners that enhance ownership and accountability of community health and social initiatives in Tanzania. The diffusion of innovation theory and public–private integrated partnership module were the theoretical framework guided this study. Diffusion of innovation theory is based on the importance of effective communication to spread new ideas and foster change in behavior in a social group …

Scaling Out Evidence-Based Interventions Outside The U.S. Mainland: Social Justice Or Trojan Horse?, Melanie M. Domenech-Rodriguez, Ana A. L. Baumann, Alejandro L. Vázquez, Nancy G. Amador-Buenabad, Natalie Franceschi Rivera, Nydia Ortiz-Pons, J. Rubén Parra-Cardona

Psychology Faculty Publications

Global health disparities continue to widen as professional standards for effectiveness of mental health services provision become more precise and difficult to achieve across varied economic and social contexts. Within the U.S., health disparities are evident in Latinx populations. Globally, the health disparities are also evident in Latin America as compared to the U.S. and other economically affluent nations. The diversification of psychology in content and persons has led to a unique opportunity to build bridges that can help reduce disparities in- and outside of the U.S. mainland. Collaborations can be of great use in addressing health disparities internationally but …

Youth Paying For Sex: What Are The Associated Factors? Findings From A Cross-Sectional Study In Cambodia, Soaman Dizechi, Carinne M. Brody, Sovannary Tuot, Chhorvann Chhea, Vonthanak Saphonn, Kunthearith Yung, Siyan Yi

BACKGROUND: At-risk male youth in Cambodia who purchase sex are at greater risk for HIV compared to the general population. Factors associated with paying for sex among youth are poorly studied, both globally and in Cambodia. This study aimed to identify specific factors associated with transactional sex with women among most-at-risk male youth in Cambodia.

METHODS: This cross-sectional questionnaire survey was conducted with 405 sexually active male youth aged 16-24 recruited at 'hotspots' in the capital city of Phnom Penh and seven provinces. We collected data on demographic factors, sexual behaviors, HIV testing and other potential factors. Multivariable logistic regression …

Mobile Link - A Theory-Based Messaging Intervention For Improving Sexual And Reproductive Health Of Female Entertainment Workers In Cambodia: Study Protocol Of A Randomized Controlled Trial, Carinne M. Brody, Sovannary Tuot, Pheak Chhoun, Dallas Swendenman, Kathryn C. Kaplan, Siyan Yi

BACKGROUND: In Cambodia, HIV prevalence is concentrated in key populations including among female entertainment workers (FEWs) who may engage in direct or indirect sex work. Reaching FEWs with sexual and reproductive health (SRH) services has been difficult because of their hidden and stigmatized nature. Mobile-phone-based interventions may be an effective way to reach this population and connect them with the existing services. This article describes study design and implementation of a randomized controlled trial (RCT) of a mobile health intervention (the Mobile Link) aiming to improve SRH and related outcomes among FEWs in Cambodia.

METHODS: A two-arm RCT will be …

Social-Support Needs Among Adolescents Living With Hiv In Transition From Pediatric To Adult Care In Cambodia: Findings From A Cross-Sectional Study, Graham Toth, Gitau Mburu, Sovannary Tuot, Vohith Khol, Chanrith Ngin, Pheak Chhoun, Siyan Yi

BACKGROUND: Understanding the circumstances of adolescents living with HIV is critical in designing adolescent-friendly services that will facilitate successful transition from pediatric to adult care. This study describes access, utilization and ongoing social support needs among adolescents living with HIV aged 15-17 in transition from pediatric to adult HIV care in Cambodia.

METHODS: A cross-sectional study was conducted among 328 adolescents, randomly selected from 11 antiretroviral therapy (ART) clinics across the country. Descriptive analyses were conducted to summarize their characteristics, access to social support and ongoing support needs among male and female adolescents.

RESULTS: Mean age of the study participants …

Prevalence Of And Factors Associated With Utilization Of Herbal Medicines Among Outpatients In Primary Health Centers In Cambodia, Hattie Pearson, Tyler Fleming, Pheak Chhoun, Sovannary Tuot, Carinne M. Brody, Siyan Yi

BACKGROUND: Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia.

METHODS: A cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for …

Exposure To Gender-Based Violence And Depressive Symptoms Among Transgender Women In Cambodia: Findings From The National Integrated Biological And Behavioral Survey 2016, Siyan Yi, Sovannary Tuot, Srean Chhim, Pheak Chhoun, Phalkun Mun, Gitau Mburu

Background: Transgender women are at significant risk of HIV, and they face intersecting barriers to health, social, and legal services. However, data regarding the unique needs and experiences of transgender women are globally scant. This study examined the relationship between gender-based violence and depressive symptoms among transgender women in Cambodia.

Methods: This cross-sectional study included 1375 sexually active transgender women recruited by using the respondent-driven sampling method in the capital city of Phnom Penh and 12 provinces between December 2015 and February 2016. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale (CES-D). Multivariate regression analysis was …

Sexual Behaviors, Hiv Knowledge, Hiv Testing Attitudes And Recent Hiv Testing Among Female Entertainment Workers In Cambodia: A Cross-Sectional Study, Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Kolab Chhim, Chanrith Ngin, Carinne M. Brody

BACKGROUND: In Cambodian context, female entertainment workers (FEWs) are young women working at establishments such as karaoke bars, restaurants, beer gardens or massage parlors. FEWs may sell sex to male patrons and are considered a high-risk group for HIV. This study aimed to identify factors associated with recent HIV testing among FEWs in Cambodia to inform future prevention activities.

METHODS: Data were collected in 2014 as part of the evaluation of a larger HIV prevention project. A two-stage cluster sampling method was used to select participants from Phnom Penh and Siem Reap for face-to-face interviews using a structured questionnaire. A …

Social And Behavioural Factors Associated With Risky Sexual Behaviours Among University Students In Nine Asean Countries: A Multi-Country Cross-Sectional Study, Siyan Yi, Vannarath Te, Supa Pengpid, Karl Peltzer

While university students are potential human resources, this population group is particularly involved in health risk behaviours. Preventing risky sexual behaviours among them would contribute to prevention of HIV, sexually transmitted infections (STIs), and unwanted pregnancies, which have posed a great burden on population health. This study was therefore conducted to identify social and behavioural factors associated with risky sexual behaviours among university students in nine ASEAN countries. A multi-country, cross-sectional study was conducted in 2015 among university students by a network of researchers in the selected countries. A convenient sampling method and stratified random sampling procedures were employed to …

Factors Associated With Viral Non-Suppression Among Adolescents Living With Hiv In Cambodia: A Cross-Sectional Study, Kolab Chhim, Gitau Mburu, Sovannary Tuot, Ratana Sopha, Vohith Khol, Pheak Chhoun, Siyan Yi

Background

Adolescents living with HIV on antiretroviral therapy (ART) have worse treatment adherence, viral suppression, and mortality rates compared to adults. This study investigated factors associated with viral non-suppression among adolescents living with HIV in Cambodia.

Methods

A cross-sectional study was conducted in August 2016 among 328 adolescents living with HIV aged 15–17 years who were randomly selected from 11 ART clinics in the capital city of Phnom Penh and 10 other provinces. Clinical and immunological data, including CD4 count and viral load, were obtained from medical records at ART clinics. Adolescents were categorized as having achieved viral suppression if …

Social And Behavioural Factors Associated With Depressive Symptoms Among University Students In Cambodia: A Cross-Sectional Study, Chanrith Ngin, Khuondyla Pal, Sovannary Tuot, Pheak Chhoun, Rosa Yi, Siyan Yi

OBJECTIVE: To explore social and behavioural factors associated with depressive symptoms among university students in Cambodia.

DESIGN: Cross-sectional study.

SETTINGS: Two public universities-one in the capital city of Phnom Penh and another in Battambang provincial town.

PARTICIPANTS: This study included 1359 students randomly selected from all departments in the two universities using a multistage cluster sampling method for a self-administered questionnaire survey in 2015.

PRIMARY OUTCOME MEASURE: Depressive symptoms measured by using the Center for Epidemiologic Studies Depression scale. All measures in the study were self-reported.

RESULTS: The proportion of students with depressive symptoms and severe depressive symptoms were 50.6% …

Association Of Body Mass Index With Blood Pressure Among 1.7 Million Chinese Adults, Khurram Nasir

All Publications

No abstract provided.

Perceptions Of Health Professionals In Ghana On The Role Of The Community In Chronic Disease Management, Jesuseme Omoruan

College of Graduate Studies: Theses & Dissertations

The prevalence of chronic disease has been on the rise in various developing countries. This study is an exploratory investigation of the perceptions of health professionals in Kumasi, Ghana on the role of the community in chronic disease management. Using the Chronic Care Model as a framework, the objective of the study was to examine the extent of community-healthcare system in chronic disease management and to explore the barriers to and facilitators of community involvement in chronic disease management. By exploring the availability of community resources that positively contribute to the management of these patients, the study fills an existing …

Simulations For Designing And Interpreting Intervention Trials In Infectious Diseases., M Elizabeth Halloran, Kari Auranen, Sarah Baird, Nicole E Basta, Steven E Bellan, +Several Additional Authors

Global Health Faculty Publications

BACKGROUND: Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods.

DISCUSSION: Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process. In an increasingly complex world, simulations can explicitly represent transmission dynamics, …

Socio-Cultural Determinants Of Physical Activity Across The Life Course: A 'Determinants Of Diet And Physical Activity' (Dedipac) Umbrella Systematic Literature Review, Lina Jaeschke, Astrid Steinbrecher, Agnes Luzak, Anna Puggina, Katina Aleksovska, Christoph Buck, Con Burns, Greet Cardon, Angela Carlin, Simon Chantal, Donatella Ciarapica, Giancarlo Condello, Tara Coppinger, Cristina Cortis, Marieke De Craemer, Sara D'Haese, Andrea Di Blasio, Sylvia Hansen, Licia Iacoviello, Johann Issartel, Pascal Izzicupo, Martina Kanning, Aileen Kennedy, Fiona Chun Man Ling, Giorgio Napolitano, Julie Anne Nazare, Camille Perchoux, Angela Polito, Walter Ricciardi, Alessandra Sannella, Wolfgang Schlicht, Rhoda Sohun

Publications

Objective: Regular physical activity (PA) reduces the risk of disease and premature death. Knowing factors associated with PA might help reducing the disease and economic burden caused by low activity. Studies suggest that socio-cultural factors may affect PA, but systematic overviews of findings across the life course are scarce. This umbrella systematic literature review (SLR) summarizes and evaluates available evidence on socio-cultural determinants of PA in children, adolescents, and adults. Methods: This manuscript was drafted following the recommendations of the 'Preferred Reporting Items for Systematic reviews and Meta-Analyses' (PRISMA) checklist. The MEDLINE, Web of Science, Scopus, and SPORTDiscus databases were …