Maternal and Child Health Commons^™

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Cross River State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Cross River State on post-intervention landscape changes in: programmatic …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Ebonyi State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Ebonyi State on post-intervention landscape changes in: programmatic and …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Kogi State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Kogi state on post-intervention landscape changes in: programmatic and …

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 …

Insights And Evidence Gaps In Girl-Centered Programming: A Systematic Review, Nicole Haberland, Katharine Mccarthy, Martha Brady

Poverty, Gender, and Youth

Increased attention to the needs of adolescent girls has led to a growing number of programs in low- and middle-income countries. Questions remain, however, about what aspects of program design are most effective. This hinders efforts to effectively allocate resources, scale up programs, and replicate results across settings. This review looks at how the number of program components, involvement of supporting actors who influence the lives of girls, supplemental “booster” activities, intervention exposure level, and community saturation level influenced outcomes for girls. While findings suggest the importance of multicomponent programs and longer program exposure, each area requires further rigorous research …

Comprehensive Neighborhood Portraits And Child Asthma Disparities Introduction, Ashley W. Kranjac, Rachel T. Kimbro, Justin T. Denney, Kristin M. Osiecki, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators. Using latent profile modeling techniques, we identified Advantaged, Middle-class, and Disadvantaged neighborhoods. We then used a modified version of the Blinder-Oaxaca regression decomposition method to …

Race, Age, And Neighborhood Socioeconomic Status In Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry, Sheryl L. Coley, Tracy R. Nichols

Journal of Health Disparities Research and Practice

Introduction: Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers.

Methods: Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial …

Preventing Pediatric Tuberculosis: A Randomized Trial Of Symptom-Based Screening Of South African Children Exposed To Tuberculosis, Population Council

HIV and AIDS

In South Africa, a country with one of the highest levels of HIV prevalence, HIV-positive adults are the source case for a large proportion of pediatric tuberculosis (TB) cases. Unfortunately, TB index cases are not consistently asked about their child contacts, not all child contacts present to the clinic for TB screening, and it remains unknown what proportion of child contacts receive isoniazid preventive therapy (IPT)—a highly effective treatment for preventing TB in these children, long recommended by the World Health Organization. Project SOAR is assessing whether a symptom-based screening approach by TB nurses in community health clinics is more …

Expanding Access To Integrated Family Planning Intervention Packages For Married Adolescent Girls In Urban Slums Of Dhaka, Bangladesh, Fauzia Akhter Huda, Hassan Rushekh Mahmood, Sadia Afrin, Anisuddin Ahmed, Nafis Al Haque, Bidhan Krishna Sarker

Reproductive Health

This research report describes an intervention study conducted among married adolescent girls aged 15–19 years in four urban slums of Dhaka, Bangladesh. Objectives of the study were to examine the acceptability and feasibility of forming married adolescent girls’ clubs, and involving community health volunteers (Shasthya Skebikas) and marriage registrars to increase access to family planning (FP) information and services, to promote the uptake of long-acting reversible contraceptive methods, and to provide FP information to newlywed couples at the time of marriage registration. The study findings revealed that a noteworthy number of married adolescent girls received FP-related information, mostly from the …

Effect Of A Family-Centered Model Of Hiv Care On Viral Suppression And Care Retention Among Hiv-Positive Children In Swaziland, Project Soar

HIV and AIDS

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has been supporting the Kingdom of Swaziland since 2003 to prevent mother-to-child transmission and to provide care and treatment services to HIV-positive children and adults. Project SOAR and the Swaziland Ministry of Health are leveraging EGPAF’s establishment of a family-centered care service delivery program (FAM-CARE) and a national rollout of viral load monitoring to assess their implementation and effect on viral suppression and retention in care among children living with HIV. This implementation science study is important because it will provide critical data to national and global policymakers about the model’s feasibility, acceptability, …

Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar

HIV and AIDS

In Malawi, and other resourced-constrained, sub-Saharan African countries with a high HIV burden, several service delivery models have emerged to increase prevention of mother-to-child transmission care retention by strengthening connections between health facilities and their surrounding communities. Yet there has been little documentation of the unique characteristics of each model and their comparative impact on mother-infant pair (MIP) care retention and other health outcomes. This brief describes how Project SOAR is responding to these knowledge gaps by conducting research to identify components of community-based MIP support that are associated with maternal care retention and infant HIV-free survival. This research will …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh [Hindi], Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Executive Summary—Understanding The Lives Of Adolescents And Young Adults (Udaya) In Bihar, India, K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Shilpi Rampal, A.J. Francis Zavier, Ashish Kumar Gupta

Poverty, Gender, and Youth

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have …

Executive Summary—Understanding The Lives Of Adolescents And Young Adults (Udaya) In Bihar, India [Hindi], K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Shilpi Rampal, A.J. Francis Zavier, Ashish Kumar Gupta

Poverty, Gender, and Youth

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have …

More Than Brides Alliance (Mtba): Mariage N’Est Pas Un Jeu D’Enfat, Rapport De Référence Mali, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Mouhamadou Gueye

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » vise à améliorer la vie des adolescentes et propose des interventions dans plusieurs domaines (la santé reproductive, l’éducation, les normes de genre et les moyens de subsistance, entre autres). Dans le cadre d’une évaluation des interventions visant à retarder l’âge du mariage, le Population Council a mené des enquêtes de référence sur les adolescentes dans les régions de Sikasso et Ségou au Mali. Les résultats suggèrent que des interventions sont nécessaires pour répondre aux vulnérabilités rencontrées par les filles qui vivent dans ces communautés. La collecte de données supplémentaires contribuera à examiner certains de …

More Than Brides Alliance (Mtba): Mariage N’Est Pas Un Jeu D’Enfat, Rapport De Référence Niger, Grace Saul, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Aissa Diarra, Chaibou Saadou

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » vise à améliorer la vie des adolescentes et propose des interventions dans plusieurs domaines (la santé reproductive, l’éducation, les normes de genre et les moyens de subsistance, entre autres). Dans le cadre d’une évaluation des interventions visant à retarder l’âge du mariage, le Population Council a mené des enquêtes de référence sur les adolescentes dans des zones sélectionnées dans deux régions au Niger (Tillabéry et Maradi). Les objectifs de l’étude de référence étaient les suivants : 1) fournir un point de référence permettant de mesurer les changements découlant de l’intervention à mi-parcours et à …

More Than Brides Alliance: Baseline Report, Niger, Grace Saul, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Aissa Diarra, Chaibou Saadou

Poverty, Gender, and Youth

The More Than Brides Alliance (MTBA) seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted baseline surveys of adolescents in select areas of two regions in Niger (Tillaberi and Maradi) as part of an evaluation of MTBA interventions to delay marriage. The goals of the baseline study were to: 1) provide a benchmark against which changes resulting from the intervention may be measured at the midline and endline periods; 2) provide information about the current situation and context for adolescent …

The Impact And Cost Of Child Marriage Prevention In Rural Burkina Faso, Annabel Erulkar, Girmay Medhin, Eva Weissman

Poverty, Gender, and Youth

The negative impact of child marriage, frequently prevalent in rural locations of poor countries, spans health, development, and demographic consequences. While evidence is limited, a systematic review of child marriage interventions in developing countries found that the most effective approaches in delaying child marriage were those that empower girls by offering incentives such as conditional cash transfers. However, most impact evaluations of community-based programs lack rigorous costing data, a particular weakness of cash transfer schemes where programmatic cost would affect the ability to scale up successful interventions for large populations. To address the limited information on cost and scalability of …

The Impact And Cost Of Child Marriage Prevention In Rural Ethiopia, Annabel Erulkar, Girmay Medhin, Eva Weissman

Poverty, Gender, and Youth

The negative impact of child marriage, frequently prevalent in rural locations of poor countries, spans health, development, and demographic consequences. While evidence is limited, a systematic review of child marriage interventions in developing countries found that the most effective approaches in delaying child marriage were those that empower girls by offering incentives such as conditional cash transfers. However, most impact evaluations of community-based programs lack rigorous costing data, a particular weakness of cash transfer schemes where programmatic cost would affect the ability to scale up successful interventions for large populations. To address the limited information on cost and scalability of …

The Impact And Cost Of Child Marriage Prevention In Three African Settings, Annabel Erulkar, Girmay Medhin, Eva Weissman

Poverty, Gender, and Youth

Girls in sub-Saharan Africa are disproportionately affected by child marriage; by 2050, half of the girls married during childhood will reside in Africa. The negative consequences of the practice are numerous and powerful, spanning health, welfare, development, and demographic domains. Yet, there is limited evidence on what works to delay child marriage in different cultural contexts and even less information on programmatic cost. This study develops and tests the most effective and minimum basic package approaches to delay marriage among older and younger adolescent girls, and estimates the cost and cost-effectiveness of implementing the different approaches, in Burkina Faso, Ethiopia, …

The Nia Project: Baseline Report, Eunice N. Muthengi, Emily Farris, Karen Austrian

Poverty, Gender, and Youth

The onset of puberty and menarche is a particularly vulnerable time for girls, when external pressures are exacerbated by their lack of knowledge of their bodies, their rights, and the implications of their decisions, and by their inability to manage puberty and adolescence safely and comfortably with appropriate menstrual health and hygiene management (MHM) products. Although several programs have previously been developed to address girls’ MHM needs globally, few have been evaluated, and where evidence does exist the results have been mixed. In collaboration with ZanaAfrica, the Population Council is evaluating the Nia Project, a set of interventions for adolescent …

The Nia Project: Baseline Survey Instruments, Karen Austrian

Poverty, Gender, and Youth

This document includes all of the Nia Project baseline survey instruments used to collect data in Kenya, providing a multidimensional description of a sample of the participating girls and the schools they attend. The Project is one of the first randomized controlled trials to explore the role of sanitary pad distribution and reproductive health education—individually and in combination—to improve girls’ educational and sexual and reproductive health outcomes. The study collected data from 3,489 girls from 140 schools in three rural Kilifi subcounties: Magarini, Kaloleni, and Ganze.

The Nia Project—Brief, Eunice N. Muthengi, Emily Farris, Karen Austrian

Poverty, Gender, and Youth

This brief provides highlights from the Nia Project conducted in Kenya. The study found that while gaps exist in girls’ capabilities, particularly knowledge and attitudes related to menstruation and reproductive health, the Nia Project has the potential to bridge those gaps. The Project is one of the first randomized controlled trials to explore the role of sanitary pad distribution and reproductive health education—individually and in combination—to improve girls’ educational and sexual and reproductive health outcomes. The findings of this study will make a critical contribution to filling an evidence gap in the field of menstrual health and hygiene management, and …

Understanding The Lives Of Adolescents And Young Adults (Udaya) In Uttar Pradesh, India (2015–16), K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Ashish Kumar Gupta, Shilpi Rampal, Santosh Kumar Singh, A.J. Francis Zavier

Poverty, Gender, and Youth

The goal of the program of research titled “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and to assess factors that influence the quality of transitions they make. The study is designed to provide robust insights on how investments in adolescents influence their life course by the time they reach young adulthood; enable evidence-based decisions on the types of programs worthy of scale-up; and furnish important baseline indicators against which the long-term impact of programs can …

Characteristics Of Married Adolescent Girls In Egypt [Arabic], Nahla G. Abdel-Tawab, May Gadallah, Doaa Oraby

Poverty, Gender, and Youth

Despite increases in the average age at marriage in Egypt, and laws mandating minimum marriage age, early marriage remains an issue, particularly in rural areas of the country where up to 33 percent of women marry before the age of 18. This brief describes characteristics of married adolescent girls, including health implications of early marriage on pregnancy and childbirth, risk of dangerous complications, and increased exposure to domestic violence.

The Impact And Cost Of Child Marriage Prevention In Rural Tanzania, Annabel Erulkar, Girmay Medhin, Eva Weissman

Poverty, Gender, and Youth

The negative impact of child marriage, frequently prevalent in rural locations of poor countries, spans health, development, and demographic consequences. While evidence is limited, a systematic review of child marriage interventions in developing countries found that the most effective approaches in delaying child marriage were those that empower girls by offering incentives such as conditional cash transfers. However, most impact evaluations of community-based programs lack rigorous costing data, a particular weakness of cash transfer schemes where programmatic cost would affect the ability to scale up successful interventions for large populations. To address the limited information on cost and scalability of …

Understanding The Lives Of Adolescents And Young Adults (Udaya): Uttar Pradesh, Population Council

Poverty, Gender, and Youth

This factsheet provides a comprehensive picture of adolescents’ situation and needs in Uttar Pradesh. Based on the “Understanding the lives of adolescents and young adults” (UDAYA) program of research conducted by the Population Council, the graphs and charts explore the situation and needs of younger (10−14 years) and older (15−19 years) adolescents; describe changes in their situation and needs over time; and assess factors that determine the quality of their transitions from adolescence to young adulthood. These graphs highlight findings on: education, employability and economic inclusion, agency, community and citizenship, entry into marriage and motherhood, health and nutrition, violence in …

Understanding The Lives Of Adolescents And Young Adults (Udaya) In Bihar, India, K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Shilpi Rampal, A.J. Francis Zavier, Ashish Kumar Gupta

Poverty, Gender, and Youth

The goal of the “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” program is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and to assess factors that influence the quality of transitions they make. The study is designed to provide robust insights on how investments in adolescents influence their life course by the time they reach young adulthood; enable evidence-based decisions on the types of programs worthy of scale-up; and furnish important baseline indicators against which the long-term impact of programs can be measured. This …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh, Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Executive Summary: Understanding The Lives Of Adolescents And Young Adults (Udaya) In Uttar Pradesh, India (2015–16), K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Ashish Kumar Gupta, Shilpi Rampal, Santosh Kumar Singh, A.J. Francis Zavier

Poverty, Gender, and Youth

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have …