Maternal and Child Health Commons^™

Postpartum Family Planning In Burkina Faso, Marina Daniele

Reproductive Health

This is a formative study aiming to identify the main barriers to the provision and uptake of quality postpartum family planning (PPFP) services at the supply, access, demand, and policy levels in Burkina Faso. This study reveals that there are substantial shortfalls in the availability of quality PPFP at all these levels. Most of the difficulties observed in the provision of PPFP services are due to the failure to translate largely sound policies and guidelines into practice. This study contributes to identifying priority areas and makes recommendations for improvement in order to respond to unmet need for family planning in …

Summarizing Bodies Of Evidence On The Implementation And Effectiveness Of Fp/Rh Interventions, Ian Askew

Reproductive Health

No abstract provided.

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Participant's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. Workshop objectives outlined in the Participant’s Guide: Outline current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to respectful maternity care and …

Promoting Respectful Maternity Care: A Training Guide For Community-Based Workshops—Community Facilitator's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. The Community Facilitator’s Guide, designed to be used by facilitators to promote respectful maternity care at the community level, can be adapted to educate a variety of stakeholders in community settings (i.e., Community Health Extension …

Promoting Respectful Maternity Care (Rmc) At Birth: Orientation For Community-Based Workshops, Population Council

Reproductive Health

The goal of “Promoting Respectful Maternity Care (RMC) at Birth: Orientation for Community-Based Workshops” is to orient community-health workers on the RMC concept. Objectives of the workshop as indicated in this slide deck are: Outline the current status of maternal health in relation to RMC. Discuss rights-based approaches related to RMC. Discuss selected strategies that reduce disrespect and abuse (D&A). Discuss the role of the community in promoting RMC. Demonstrate knowledge and use of the Alternative Dispute Resolution mechanism. Develop action plans to support the implementation of RMC interventions at the community level. Summary: D&A deters facility-based childbirth and Skilled …

Typhoid Fever In Fiji: A Reversible Plague?, Corinne N. Thompson, Mike Kama, Shrish Acharya, Una Bera, John Clemens, John A. Crump, Aggie Dawainavesi, Gordon Dougan, W. John Edmunds, Kimberley Fox, Kylie Jenkins, M. Imran Khan, Josefa Koroivueta, Myron M. Levine, Laura B. Martin, Eric Nilles, Virginia E. Pitzer, Shalini Singh, Ratu Vereniki Raiwalu, Stephen Baker, Kim Mulholland

Centre of Excellence in Women and Child Health

Le pays des îles Fidji, avec une population d'environ 870 000 personnes, fait face à une charge croissante de plusieurs maladies transmissibles, y compris l'infection bactérienne de la fièvre typhoïde. Les données de surveillance indiquent que la fièvre typhoïde est devenue de plus en plus fréquente dans les zones rurales de Fidji et est plus fréquente chez les jeunes adultes. La transmission des organismes qui causent la fièvre typhoïde est facilitée par la contamination fécale des aliments ou de l'eau et peut être influencée par les pratiques comportementales locales dans les îles Fidji. Le Ministère fidjien de la Santé, avec …

Unintended Pregnancy By The Numbers: A Look At Kenya, Carol Mukiira, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara

Reproductive Health

This fact sheet summarizes data collated during the development of the STEP UP Country Profile Report on Unintended Pregnancies for Kenya, which presents a range of key evidence aimed at informing readers about the trends, magnitude, determinants, and consequences of unintended pregnancy in Kenya. The data shown in this fact sheet are drawn mainly from the 1993, 1998, 2003 and 2008/09 Kenya Demographic and Health Surveys (KDHS) as well as other secondary sources.

Maternal And Newborn Health Behaviors In Rural Uttar Pradesh: Findings From Learning Phase Baseline Survey 2013, M.E. Khan, Praween Kumar Agrawal, Avishek Hazra, Anvita Dixit, Isha Bhatnagar, Jaleel Ahmad, D.N. Ahmad

Reproductive Health

The Uttar Pradesh Community Mobilization Project (2011–16) aims to develop and scale up evidence-based interventions to improve reproductive, maternal, neonatal, and child health and nutrition health behaviors by an average of 10 percentage points among marginalized populations in Uttar Pradesh, India. The goal is to reduce neonatal mortality by improving maternal and child health behaviors through developing and scaling up a package of family health interventions and strengthening the management of Behavior Change Communication using self-help groups as the platform. The project is being carried out in two phases—a learning phase covering 10 blocks and a scale-up phase covering 100 …

Coverage And Quality Of Antenatal Care Provided At Primary Health Care Facilities In The ‘Punjab’ Province Of ‘Pakistan’, Muhammad Ashraf Majrooh, Seema Hasnain, Javaid Akram, Arif Siddiqui,, Zahid Memon

Centre of Excellence in Women and Child Health

Background: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In ‘Pakistan’ antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to ‘Divisions’ and ‘Districts’. By population ‘Punjab’ is the largest province of Pakistan having …

Cultural Factors Associated With Utilization Of Antenatal Care Services In Rural India, Anjali Om

UROP Posters

Despite vast economic growth in developing countries in the past few years, infant mortality continues to plague underdeveloped regions, particularly rural regions of India. Many of these deaths are caused by a lack of education and motivation in regard to utilization of antenatal and neonatal care services to prevent and treat consequences of unhygienic umbilical cord care.

For years, high incidences of neonatal tetanus have plagued rural areas of India as a result of cultural practices that encourage topical applications of cow dung to cut umbilical stumps either directly or by using ghee heated with cow dung to warm umbilical …

Immune Responses To Vi Capsular Polysaccharide Typhoid Vaccine In Children 2 To 16 Years Old In Karachi, Pakistan, And Kolkata, India, R. Leon Ochiai, M. Imran Khan, Sajid B. Soofi, Dipika Sur, Suman Kanungo, Young Ae You, Atif Habib, Shah Muhammad Sahito, Byomkesh Manna, Camilo J. Acosta, Mohammad Ali, Sujit K. Bhattacharya, Zulfiqar A. Bhutta, John D. Clemens

Department of Paediatrics and Child Health

The geometric mean concentration (GMC) and the proportion maintaining a protective level (150 enzyme-linked immunosorbent assay (ELISA) units [ELU]/ml) 2 years following a single dose of 25 μg of injectable Vi capsular polysaccharide typhoid vaccine was measured against that of the control hepatitis A vaccine in children 2 to 16 years old in cluster randomized trials in Karachi and Kolkata. The GMC for the Vi group (1,428 ELU/ml) was statistically significantly different from the GMC of the control hepatitis A vaccine group (86 ELU/ml) after 6 weeks. A total of 117 children (95.1%) in the Vi group and 9 (7.5%) …

Incidence And Outcome Of Small For Gestational Age Fetuses: An Experience From A Secondary Care Hospital, Riffat Bano, Nousheen Asim, Ammara Mushtaq, Mehreen Adhi, Noureen Afzal

Department of Obstetrics & Gynaecology

The objective of the study was to determine the frequency and outcome of Small for Gestational Age (SGA) foetuses, and its association with the mode of delivery, foetal birthweight, maternal age and gestational age. It was a hospital-based descriptive study, conducted at Aga Khan Hospital for Women, Karachi, from January 2009 to December 2010. Mode of deliveries, foetal birthweight, maternal age and gestational age of SGA foetuses were recorded and analszed. Of a total of 6024 deliveries during the study period, 722(11.98%) had SGA foetuses. Maternal age in such cased ranged between 20-40 years in 588(81.44%), while 406(56.23%) of these …

La Opinión Pública Sobre El Aborto En Chile: Conceptos Públicos De Moralidad Y De Derechos De Las Mujeres En Relación Con Aborto, Sarah Smith

Independent Study Project (ISP) Collection

Background: Abortion legislation in Chile is among the most restrictive in the world, with abortion being illegal without exception. However, while abortion remains completely illegal in Chile, there are an estimated 125,000-175,000 clandestine abortions being carried out each year. Illegal abortions account for about 30% of maternal deaths in Chile. It is important to understand public opinions on abortion in order to understand this discrepancy between legislation and reality.

Research Objectives:What is the public opinion of Chileans on the legal and moral status of abortion in Chile? Do Chileans relate the topic of abortion to the theme of women’s …

“Breastfeeding Perceptions And Practices” A Comparative Study Of Two Opposing Socio-Economic Level Quarters Within Yaoundé, Cameroon, Alexandria J. Ross

Independent Study Project (ISP) Collection

This research project aims to identify and analyze the conditions that influence breastfeeding perceptions and practices within two opposing socioeconomic level quarters of Yaoundé, Cameroon: Bastos and Madagascar. According to the World Health Organization recommendations for optimal infant and young child nutrition, mothers are advised to exclusively breastfeed for the first six months of life after birth before introducing complimentary feeding. Cameroon since 2005 has adhered to the International Code of Marketing of Breastmilk Substitutes. It is classified as a Category 1 as a country which discourages commercial pressures to feed alternative forms of nutrition known as breastmilk substitutes.

This …

Socio-Cultural Barriers To Family Planning Access, Aasha Jackson

Independent Study Project (ISP) Collection

This paper attempts to discern barriers to family planning access and use in the Manguier quarter of Yaoundé, Cameroon based on research collected during a three week period. Questionnaires and interviews were used to measure women’s use of and opinions towards family planning consultations and methods. The spread of rumors regarding negative side effects, mistaken beliefs about family planning, husband’s disapproval, and the availability of contraceptives elsewhere were found to be the major deterrents to the use of family planning by women in this study. This research shows the need for campaigns to educate women and men alike on the …

Impact Of Social Franchising On Contraceptive Use When Complemented By Vouchers: A Quasi-Experimental Study In Rural Pakistan, Syed Khurram Azmat, Babar Tasneem Shaikh, Waqas Hameed, Ghulam Mustafa, Wajahat Hussain, Jamshaid Asghar, Muhammad Ishaque, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society - a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in …

The Relationship Between Prenatal Stress, Depression, Cortisol And Preterm Birth: A Review, Kiran Shaikh, Shahirose Premji, Khurshid Khowaja, Suzanne Tough, Ambreen Kazi, Shaneela Khowaj

School of Nursing & Midwifery

Preterm birth is one of the most common adverse pregnancy outcomes. Maternal risk factors such as stress and depression have been associated with preterm birth. Preterm infants are at a higher risk of poor growth and neuro developmental outcomes. The objective of this paper is to examine the relationship between maternal stress, depression, cortisol level, and preterm birth. Preterm birth is one of the most common adverse pregnancy outcomes with a global prevalence of 9.6% and one of the major contributors to infant mortality and morbidity. The association between psychosocial stress and preterm birth, although examined for more than 25 …

Assessment Of Competence For Caesarean Section With Global Rating Scale, Rahat Najam Qureshi, Syeda Kauser Ali

Department for Educational Development

Objective: To establish as reliable and valid the nine-point global rating scale for assessing residents\' independent performance of Caesarean Section.

Methods: The validation study was conducted at the Department of Obstetrics and Gynaecology, Aga Khan University Hospital, from April to December 2008, and comprised 15 residents during 40 Caesarean Sections over 9 months. Independently two evaluators rated each procedure and the difficulty of each case.

Results: The observations per faculty ranged from 1-8 (mean 4.07± 2.56). The Year 4 residents were observed the most i.e. 32 (40%), followed by Year 3, 30 (37.5%); Year 2; 14 (17.5%); and Year 1, …

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

Reproductive Tract Infections Among Married Women In Peri-Urban Areas Of Karachi, Pakistan: A Population-Based Study, Neelofar Sami, Tazeen S. Ali, E. Khan

Community Health Sciences

Background: Reproductive Tract Infections (RTIs) is a major public health problem. In Pakistan, there is dearth of information about the prevalence of RTIs among women and their health seeking behavior. A study was conducted to determine the prevalence, number and types of RTIs among women residing in squatter settlements in Karachi and their health seeking behavior.
Methods: The respondents were married non-pregnant women aged 15–49 years residing in peri-urban areas of Karachi, Pakistan. The interviews with women were followed by their physical and pelvic examinations. Samples swabs collected from vagina and endocervix were tested in laboratory.
Results: Overall, 23.8% of …

Pregnant With Parasites: Assessing Parasitic Infections In Pregnant Women Of The Kwale District, Christina Hopkins Hopkins

Independent Study Project (ISP) Collection

Parasitic infections such as malaria and intestinal worms plague many tropical and sub-tropical regions. The Kwale district of Kenya is among one of these regions and provides many circumstances that make these parasites endemic to the area. Pregnant women are part of the major groups affected by parasites. Although clinical professionals are making great attempts at reducing the chances for parasitic infections in these women, there are still some factors that are out of their control. Most women do not receive their drinking water from a secure water source and a majority of the women did not have the financial …

Dipo Rites And Women’S Health: Tradition Empowering Krobo Female Identity And Reproductive Health In Manya-Krobo, Nina Kearin

Independent Study Project (ISP) Collection

Objective: To understand the meaning and process of dipo rites and the correlation (if any) to the reproductive health of women in Manya-Krobo. This led to the research being aimed at answering three major questions.

1. What are dipo rites? This is taking into consideration the history of the rites, meaning of the rites, the process of the rites, and who practices the rites.
2. What is the status of women’s reproductive health in Manya-Krobo?
3. How are the dipo rites and the reproductive health of the women who practice them interconnected?

Methodology: I lived in Manya Krobo for most of April, 2013 …

La Comunicación Entre Las Mujeres Embarazadas Y El Personal Médico Durante El Control Prenatal Enel Hospital Álvarezen La Ciudad De Buenos Aires, Argentina = The Communication Between Pregnant Women And Their Doctors During Prenatal Care In Hospital Alvarezin The City Of Buenos Aires, Argentina, Rebecca Oran

Independent Study Project (ISP) Collection

In recent years, maternal mortality has continued to be a problem in Argentina. Even after the passage of the United Nations Millennium Goals, Argentina continued to have maternal mortality rates three times as high as its’ neighbors, Chile and Uruguay. Although the majority of the literature does not demonstrate a connection between prenatal care and the reduction of maternal mortality, in situations of high mortality, there is consensus surrounding the need for contact and communication between the woman and their doctors during their pregnancy. This study attempted to examine how both doctors and patients see this communication and how, if …

Reaching Millennium Development Goal Target 5.A.: Progress Towards Improving Maternal Health, Christina Kang

Independent Study Project (ISP) Collection

In September 2000, 189 countries agreed upon striving to reach Millennium Development Goal 5, making great strides to improving maternal health by 2015. The indicators that would prove the goal’s success were determined to be directly correlated to a reduction of three-quarters of Maternal Mortality Ratio (MMR) from 1990 figures and having Skilled Birth Attendants (SBAs) present at all births by 2015 (United Nations, n.d.-a). Research has proven that while there has been a global trend towards reaching MDG 5, there is a large discrepancy amongst different regions and countries influencing its success. Through the usage of official United Nations …

Legislative Impact Of The Construction Of An “Abortion Culture”: A Comparative Analysis Of The Enaction And Impact Of Abortion Restriction Legislation In The Netherlands And The United States, Anna Schmitz

Independent Study Project (ISP) Collection

This study investigates the different socio-political causes leading to the implementation of similar abortion restrictions (mandatory parental notification for minors, mandatory counseling, and a waiting period) in the Netherlands and the United States. It first investigates the “abortion cultures” of the two countries, using personal interviews with Dutch and American citizens to analyze the social perceptions of abortion and a comparison of sexual health and legislation data to create a wider picture of abortion within both countries. It then investigates the political opportunity structure leading to the implementation of the restrictions of abortion in each country, and then investigates differences …

Social Franchising And Vouchers To Promote Long-Term Methods Of Family Planning In Rural Pakistan: A Qualitative Stocktaking With Stakeholders, Syed Khurram Azmat, Ghulam Mustafa, Waqas Hameed, Jamshaid Asghar, Aftab Ahmed, Babar T. Shaikh

Community Health Sciences

Background: The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes …

Performance And Measurement Of A Community-Based Distribution Model Of Family Planning Services In Pakistan, Syed Khurram Azmat, Shirin Ahmed, Waqas Hameed, Mohsina Bilgrami, Ayesha Khan, Adnan Ahmad Khan, Ghulam Mustafa

Community Health Sciences

Introduction: Community-based distribution (CBD) has been successfully applied to family planning (FP) services worldwide. It forms the basis for the large lady health worker (LHW) programme in Pakistan which serves a limited number of women with contraception services. Thus, the concept has seen limited application in Pakistan. We present the outcomes of a CBD model that was implemented in 49 districts across Pakistan by a non-government organization (NGO).
Methods: The Marie Stopes Society (MSS) developed a CBD model around its fixed centres and reached around half a million married women of reproductive age (MWRA) with services. The services provided included …

Weight Stigma In Maternity Care: Women’S Experiences And Care Providers’ Attitudes, Kate Mulherin, Yvette D. Miller, Fiona Kate Barlow, Phillippa C. Diedrichs, Rachel Thompson

Dartmouth Scholarship

Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims' psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Study One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from …

Iud Discontinuation Rates, Switching Behavior, And User Satisfaction: Findings From A Retrospective Analysis Of A Mobile Outreach Service Program In Pakistan, Syed Khurram Azmat, Waqas Hameed, Ghulam Mustafa, Wajahat Hussain, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: In Pakistan, the uptake rate for the intrauterine device (IUD) is very low at 2.5%. The most popular modern contraceptive methods in Pakistan are female sterilization and use of condoms. The Marie Stopes Society established its mobile outreach service delivery program with the aim of increasing use of modern quality contraceptive services, including the long-term reversible IUD, by women living in hard-to-reach areas. The present study attempts to assess IUD discontinuation rates and associated factors, including switching behavior and level of satisfaction with this type of service delivery.
Methods: Using a cross-sectional approach, we contacted 681 women who had …

Status Report On The Sexual And Reproductive Health Of Adolescents Living In Urban Slums In Kenya, Donatien Beguy, Joyce Mumah, Salome Wawire, Kanyiva Muindi, Lindsey Gottschalk, Caroline W. Kabiru

Reproductive Health

This report highlights the sexual and reproductive health (SRH) challenges faced by adolescents living in slums in Nairobi, Kenya, as well as the perceptions and strategies that adolescents adopt to deal with each of these challenges. The results point to the fact that there is a range of experiences among adolescents with regard to knowledge, attitudes, and behaviors. Age, education, and marital status were often strongly associated with certain adolescent sexual and reproductive health experiences, highlighting the fact that targeted programs are needed to reach adolescents with SRH services at different stages of need. Consistent and persistent poverty reduction strategies …