Maternal and Child Health Commons^™

Preventing Skin Cancer In Adolescent Girls Through Intervention With Their Mothers, Mary K. Baker

Electronic Theses and Dissertations

Indoor tanning (IT) before the age of 35 increases one’s risk for melanoma by 75%, and epidemiological data show a 6.1% annual increase in the incidence of melanomas in white women younger than age 44 in the US. Population-based studies reveal that 15% of adolescents and 8% to 14% of their primary caregivers have engaged in IT in the past year.

The compelling case for IT being a significant risk factor for melanoma, together with the high rates of IT in teen girls and their mothers, provided a strong rationale for conducting an antitanning intervention directed at mother-daughter dyads. This …

2013 Children’S Legislative Briefing Book, Nevada Institute For Children’S Research And Policy, Children’S Advocacy Alliance, Denise Tanata Ashby, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

The purpose of this Legislative Briefing Book is to provide a quick snapshot of some of the most pressing issues facing Nevada’s children in order to provide advocates and policymakers with a stepping stone in creating positive changes to improve the lives of Nevada’s children. While this book will not cover every issue facing our children, it is intended to highlight some of those where state policy may have an impact, covering issues in education, health, safety and security, and the juvenile justice system. Diligent efforts need to be made during the 2013 Legislative Session to improve policies, procedures and …

Teen Pregnancy Prevention Program Year Three Outcome Evaluation Report For The Southern Nevada Health District, Nevada Institute For Children’S Research And Policy, Southern Nevada Health District, Dawn Davidson, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

In the fall of 2010 the Southern Nevada Health District (SNHD) was awarded funding from the Federal Office of Adolescent Health to implement an evidence based teen pregnancy prevention curriculum. They have partnered with the Department of Juvenile Justice Services, the Clark County Department of Family Services, and the City of Las Vegas to offer this curriculum to the youth in juvenile detention, probation, community centers, and life skills classes for youth aging out of the foster care system. The Nevada Institute for Children’s Research and Policy (NICRP) has been contracted to complete the outcome evaluation for this program and …

Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar

Poverty, Gender, and Youth

This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …

Race/Ethnicity As A Risk Factor Of Mother To Child Transmission Among Hiv Infected Mothers, Wei Yang, Fares Qeadan, Mona L. Brown, Michelle Chino, Scott Hall, Mary Guinan

Journal of Health Disparities Research and Practice

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were …

A Social Controversy: Autism Spectrum Disorder's Correlation To The Measles-Mumps-Rubella Vaccination, Lindsay A. Frye

Senior Honors Theses

A 1998 research study lead by Dr. Andrew Wakefield linked the measles-mumps-rubella (MMR) vaccination as a probable cause to autism spectrum disorder. This publication has started a significant debate among healthcare professionals and instigated an anti-vaccination movement within the general population. This vaccination controversy was started by parents who readily accepted Wakefield’s findings as truth and frequently would choose to withdrawal the administration of vaccinations from their children’s care plans. There has also been disapproval by healthcare professionals over Wakefield’s study since numerous research teams have been unable to replicate his findings. This disagreement surrounding the MMR vaccination is likely …

Teen Pregnancy Prevention Program Year Two Outcome Evaluation Report For The Southern Nevada Health District, Nevada Institute For Children’S Research And Policy, Southern Nevada Health District, Dawn Davidson, Tara Phebus, Alyson Baker

Nevada Institute for Children's Research and Policy Reports

In the fall of 2010 the Southern Nevada Health District (SNHD) was awarded funding from the Federal Office of Adolescent Health to implement an evidence based teen pregnancy prevention curriculum. They have partnered with the Department of Juvenile Justice Services and the Clark County Department of Family Services to offer this curriculum to the youth in juvenile detention, probation, and life skills classes for youth aging out of the foster care system. The Nevada Institute for Children’s Research and Policy (NICRP) has been contracted to complete the outcome evaluation for this program and is collecting data to help measure the …

Spatial Distribution Of Obesity Among West Virginia 5th Grade Children: Analysis Of The Socioeconomic, Physical, And Personal Environment, Sherry Roper

Theses and Dissertations (ETD)

Childhood obesity defined as a body mass index (BMI) at or above the 95th percentile for children of the same age and sex, is considered an epidemic in the United States. Biology and lifestyle behaviors have been identified as important factors in the development of childhood obesity; however, researchers are beginning to place more emphasis upon the impact that continual environmental exposures have upon obesity development. Environmental risk factors associated with obesity are distributed continuously over space, yet evidence suggests that burden of risk may not be evenly dispersed across a community. West Virginia (WV), a rural Appalachian community has …

The Effects Of Computer-Based Education On Children's Knowledge About Asthma, Matyt L. Adler

Evidence-Based Practice Project Reports

Asthma is a global health problem affecting people of all ages that can cause severe limitations when uncontrolled. In the United States, asthma was the most prevalent chronic disease among children and youth in 2008 (U.S. Department of Health and Human Services, 2009). Because day-to-day management of asthma is the responsibility of the child or the parent, education of patients is one of four crucial components to effectively provide quality asthma care. Changes in workload complexities with primary care visits has increased and visit duration decreased, resulting in less available time to address individual patient needs including the education aspect …

Effect Of Screening And Management Of Diabetes During Pregnancy On Stillbirths, Madiha Syed, Hasan Javed, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Diabetes during pregnancy is associated with significant risk of complications to the mother, fetus and newborn. We reviewed the potential impact of early detection and control of diabetes mellitus during pregnancy on stillbirths for possible inclusion in the Lives Saved Tool (LiST).

Methods:

A systematic literature search up to July 2010 was done to identify all published randomized controlled trials and observational studies. A standardized data abstraction sheet was employed and data were abstracted by two independent authors. Meta-analyses were performed with different sub-group analyses. The analyses were graded according to the CHERG rules using the adapted GRADE criteria …

Teen Pregnancy Prevention Program Year One Outcome Evaluation Report For The Southern Nevada Health District, Nevada Institute For Children’S Research And Policy, Southern Nevada Health District, Tara Phebus, Samantha Dawn Beecher, Alyson Baker, Taylor Oliver, Denise Tanata Ashby

Nevada Institute for Children's Research and Policy Reports

In the fall of 2010 the Southern Nevada Health District (SNHD) was awarded funding from the Federal Office of Adolescent Health to implement an evidence based teen pregnancy prevention curriculum. They have partnered with the Department of Juvenile Justice Services and the Clark County Department of Family Services to offer this curriculum to the youth in juvenile detention, probation, and life skills classes for youth aging out of the foster care system. The Nevada Institute for Children’s Research and Policy (NICRP) has been contracted to complete the outcome evaluation for this program and is collecting data to help measure the …

First Generation Of Gender And Hiv Programs: Seeking Clarity And Synergy, Judith Bruce, Nicole Haberland, Amy Joyce, Eva Roca, Tobey Nelson Sapiano

Poverty, Gender, and Youth

In the past decade, there have been expanding resources to address the underlying gender dimensions of HIV. This has been particularly urgent in sub-Saharan Africa as the female-to-male infection ratios in young populations has reached 3 to 1 and sometimes above. The phrase “gender and HIV” has become commonplace yet does not provide any specific guidance as to target audiences, content, or measurable results. It can include everything from microcredit programs for HIV-positive women, to workplace programs seeking to change negative male norms, to efforts to increase respect for diverse sexual and gender identities. This review, conducted by the Population …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Protecting Hope: Situation Analysis Of Vulnerable Children In Uganda 2009, Sam Kalibala, Lynne Elson

HIV and AIDS

The Government of Uganda has focused attention on the problem of orphaned and other vulnerable children through a number of policies, regulations, and initiatives. In 2004, the Ministry of Gender Labor and Social Development developed the National OVC Policy, aimed at improving the quality of life for poor and vulnerable children, such as children who have been orphaned, children who are living on the streets, children who are at risk of abuse, and children exposed to situations of armed conflict. However, despite the many efforts to improve the circumstances of vulnerable children in Uganda, policymakers, donors, and program managers still …

Rapids Evaluation Final Report 2005-2009 Key Findings, Louis Apicella, Katie D. Schenk, Hena Khan

HIV and AIDS

RAPIDS (Reaching HIV/AIDS Affected People with Integrated Development and Support) is an intervention funded by the United States Agency for International Development (USAID), and is designed to mitigate the impact of HIV/AIDS in Zambia. The overall goal of RAPIDS is to improve the quality of life of Zambians affected by HIV and AIDS by expanding successful community-based models of home-based care and support to orphans and vulnerable children and people who are chronically ill, as well as through interventions targeting youth with livelihood opportunities and life-skills training, focusing on initiatives supporting abstinence and being faithful.

Impact Of Parent’S Hiv Status On Their Uninfected Child—A Comparative Analysis Of The Child’S Healthcare Utilization, Access And Health Outcomes, Arijit Ganguli

Theses and Dissertations (ETD)

With the advent of effective antiretroviral medication and increased expectancy of life span among HIV-infected individuals has lead to an increase in the at-risk population of uninfected children living with their HIV-infected parent(s). The purpose of this study was to investigate the impact of parent’s HIV status on their child’s access to healthcare resources, healthcare utilization and health outcomes.

This was a cross-sectional study in which the information on the children of HIV seropositive parent(s) was collected through a face-to-face interview of the HIV-infected parents having children currently residing with them. The comparative group comprising of children of HIV seronegative …

Revisiting The Regulation Debate: The Effect Of Food Marketing On Childhood Obesity, Nicole E. Hunter

The University of New Hampshire Law Review

[Excerpt] “Despite the widespread concern regarding childhood obesity, there is broad divergence of opinion regarding responsibility for the crisis. Whether the government, food industry, or parents are accountable has become the focus of much debate. Public health groups have attempted various strategies to confront childhood obesity, such as litigation, legislation, and government regulation. While many researchers and advocates agree that government should play an affirmative role with respect to childhood obesity, they are very much divided over what that role should be. For example, although none of these acts has become law, eighty-six bills have been proposed regarding obesity since …

Prevention Of Mother-To-Child Transmission (Pmtct) Of Hiv In The Sub-Saharan Africa Region With A Focus On Uganda, Emily K. Franks

Senior Honors Theses

With the rise of the HIV/AIDS epidemic in the past thirty years, people of all ages, infants to elderly alike, all over the world, suffer from its adverse effects. Even an unborn baby in-utero can contract this virulent infection by means of mother-to-child transmission (MTCT) (Sweeney, 2005). Infants and children diseased in this way comprise 90% of the estimated 800,000 new cases of HIV in children seen each year, but the region hit hardest, however, is Sub-Saharan Africa, with the country of Uganda historically having the highest incident rate for a time (Stringer, E.M., et al. 2008). Therefore, the purpose …

Evaluation Of Hiv Counseling And Testing In Anc Settings And Adherence To Short Course Antiretroviral Prophylaxis For Pmtct In Francistown, Botswana, Carolyn Baek, Tracy Creek, Lee Ann Jones, Louis Apicella, Jennifer Redner, Naomi Rutenberg

HIV and AIDS

The vast majority of children infected with HIV are the result of mother-to-child transmission (MTCT) of the virus during pregnancy, labor, or breastfeeding. Botswana is one of the first countries in the developing world with a national prevention program (PMTCT) to reduce vertical transmission. The Horizons Program of the Population Council, in collaboration with the Centers for Disease Control and Prevention (CDC) and Premiere Personnel in Botswana, conducted an evaluation to describe the adherence of pregnant women to the current PMTCT regimen. The report recommends standardizing post-test counseling content through the use of job aids and adapting existing WHO materials, …

Type 1 Diabetes: A Non-Fiction Perspective/ Just A Kid: Emily’S Diabetes Story, Kristen Moody

Senior Honors Projects

How many people do you know with diabetes? Many Americans are living with this disease in our society today. As adults, acknowledging this prevalence seems to be an easy task. However, imagine yourself as a young elementary school child. How much do you know about diseases? What happens if a student in your classroom has a disease? What do you think of this person? For some children, these questions are an imminent reality, part of their everyday childhood life. Thinking about the answers to similar questions mentioned above, I understand the importance of a reliable, accurate, and knowledgeable source for …

Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan

HIV and AIDS

This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction …

If You Build It, Will They Come? Kenya Healthy Start Pediatric Hiv Study: A Diagnostic Study Investigating Barriers To Hiv Treatment And Care Among Children, Karusa Kiragu, Katie D. Schenk, Julie Murugi, Avina Sarna

HIV and AIDS

In Kenya the proportion of eligible HIV-positive children receiving ART treatment is only 11 percent. This study explored and documented possible barriers in the community to accessing pediatric HIV testing and treatment, to guide the development of new interventions to encourage uptake. The study identified barriers such as cost, use of traditional healers, low knowledge of treatment options, attitudinal barriers, stigma, unique treatment issues, and dissatisfaction with available services. Additionally, healthcare workers missed opportunities to provide services and cited numerous service-side challenges. The study recommends prioritizing community awareness, mobile clinics, strengthening capacity of healthcare workers, supporting family-based HIV testing, and …

The Potential For Sustainability Of Malaria In Pregnancy Initiatives In East And Southern Africa: Kenya And Malawi, Washington Onyango-Ouma, Sam Agatre Okuonzi, Doreen Ali, Harriet Birungi, Annie Mwangi

Reproductive Health

This study assesses the sustainability of initiatives to improve maternal and child health survival by preventing and treating illness from malaria, and documents best practices for promoting sustainability and lessons for replication in countries where malaria is endemic. The study applied the Child Survival Sustainability Assessment framework to initiatives in Kenya and Malawi to analyze progress toward sustainability, including not only a biomedical perspective but also the human, social, and organizational processes that influence sustainability of health projects. The report concludes that Malaria in Pregnancy (MIP) interventions were sustained within and beyond the project districts in both countries. Furthermore, both …

Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu

Reproductive Health

In Uganda, HIV/AIDS treatment, care and support programs are still organized around either adult or pediatric care and fail to adequately address the needs of adolescents, specifically perinatally-infected adolescents. This study, implemented jointly by the Population Council's Frontiers in Reproductive Health (FRONTIERS) program and the AIDS Support Organization (TASO), aimed to better understand the reproductive health and sexuality of this population group, and to identify anxieties or fears they have around entering social stages of adulthood. This study confirms that wide programmatic gaps exist in addressing the sexual and reproductive health needs of young people perinatally infected with HIV who …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In Nicaragua, Freddy Solis, Ana Del Carmen Rojas, Gadea Adilia, M. Estela Rivero-Fuentes, Ricardo Vernon

Reproductive Health

Between September 2005 and April 2007, FRONTIERS and Alva, a Nicaraguan consulting firm, conducted a situation analysis of the provision and use of contraceptive services in postpartum, postabortion and prevention of mother-to-child transmission of HIV (PMTCT) programs. The project‘s objective was to assess the degree to which contraceptive services were linked to postpartum, postabortion and PMTCT services and if this allowed the programs to meet the contraceptive needs of their clients. The project proposes recommendations for improving the quality of these programs.

Nevada Institute For Children's Research And Policy Public Health Bills- 2007 Session - Final, Nevada Institute For Children's Research And Policy Reports

Nevada Institute for Children's Research and Policy Reports

Nevada Institute for Children's Research and Policy Public Health Bills- 2007 Session - Final

Community-Based Approaches To Prevention Of Mother-To-Child Transmission Of Hiv: Findings From A Low-Income Community In Kenya, Susan Kaai, Carolyn Baek, Scott Geibel, Peter Omondi, Benson Ulo, Grace Muthumbi, Carol Nkatha, Naomi Rutenberg

HIV and AIDS

The Horizons program, in partnership with International Medical Corps and Steadman Research Services International, conducted an intervention study in Kibera, an urban slum in Nairobi, Kenya to determine what effect three different community-based activities had on utilization of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants and peer counselors as PMTCT promoters. Data from the study showed that there were positive trends during the study period in most of the PMTCT indicators, including knowledge of MTCT, …

Continuum Of Care For Hiv-Positive Women Accessing Programs To Prevent Parent-To-Child Transmission: Findings From India, Vaishali Sharma Mahendra, Rupa Mudoi, Archana Oinam, Venkat Pakkela, Avina Sarna, Sucheta Panda, Ashok Rau, L. Birendrajit Singh, Naomi Rutenberg

HIV and AIDS

This study examined the efforts of PPTCT programs in different cities in India to offer women a continuum of care, and shows that the programs have both strengths and shortcomings. The government launched a national treatment program that offers antiretroviral therapy (ART) to HIV-positive women, children below 15 years of age, and men. However, since the start-up of the ART program there have been concerns about limited access to and utilization of these services by women and children. To address these shortcomings, the PPTCT programs studied should strengthen their referral systems to public and private treatment and family planning services, …

Key Findings From An Evaluation Of The Mothers2mothers Program In Kwazulu-Natal, South Africa, Carolyn Baek, Vuyiswa Mathambo, Sibongile Mkhize, Irwin Friedman, Louis Apicella, Naomi Rutenberg

HIV and AIDS

The Horizons program of Population Council, in collaboration with Health Systems Trust, completed the first evaluation of mothers2mothers (m2m) as part of its introduction in KwaZulu-Natal Province, South Africa. It is the first external evaluation that provides quantitative evidence about the role of the well-known m2m program in complementing services to prevent mother-to-child transmission of HIV (PMTCT). m2m is a peer support program that aims to provide education and psychosocial support to HIV-positive pregnant women and new mothers, help women access existing health care, and follow up with mothers and babies to ensure they receive appropriate medical care after delivery. …