Maternal and Child Health Commons^™

A Critical Role For The Programmed Death Ligand 1 In Fetomaternal Tolerance, Indira Guleria, Arezou Khosroshahi, Mohammed Javeed Ansari, Antje Habicht, Miyuki Azuma, Hideo Yagita, Randolph J. Noelle

Dartmouth Scholarship

Fetal survival during gestation implies that tolerance mechanisms suppress the maternal immune response to paternally inherited alloantigens. Here we show that the inhibitory T cell costimulatory molecule, programmed death ligand 1 (PDL1), has an important role in conferring fetomaternal tolerance in an allogeneic pregnancy model. Blockade of PDL1 signaling during murine pregnancy resulted in increased rejection rates of allogeneic concepti but not syngeneic concepti. Fetal rejection was T cell

Project Child Health Impact Assessment, Unyi Agba, Kristina Chung, David Diehl, Marisol Olivera, Yolanda Perez

Emerging Leaders Program Team Projects

The 2005 Project Child Health Impact Assessment (CHIA) at the Boston Medical Center (BMC) for the UMass Emerging Leaders Program (ELP) is closely related to one that members of the 2004 ELP cohort assisted with. The 2004 project team provided BMC with preliminary research regarding similar concepts in Europe, Canada and the United States. With this research in hand, the Project CHIA team at BMC decided to research, develop, write and publish pilot analyses that illustrated the impact of public policy on children's health. The 2005 ELP team was asked to provide guidance regarding a communications strategy for these pilot …

Una Enfermedad De La Sociedad: Una Investigación De Las Causas, Los Tratamientos, Y La Prevención De La Desnutrición De Niños En El Centro De Nutrición Infantil, Albina R. De Patiño, Kimberly A. Mukerjee

Independent Study Project (ISP) Collection

Antes de empezar mi proyecto en el Centro de Nutrición Infantil, investigué los datos sobre la situación actual de desnutrición en Bolivia. Es importante incluir esta información para identificar los datos epidemiológicos de esta región de Cochabamba, y comparar con los datos obtenidos del país y de América Latina. Este es un resumen crítico de la información obtenida. La crisis de la pobreza en América Latina es un gran factor que afecta la salud de la población infantil. Cerca de un millón de niños latinoamericanos mueren al año víctimas de las condiciones inherentes a la pobreza, como la desnutrición, las …

Correlates Of In-Home Smoking Behavior Of Parents With Newborns, James Kyung Jo

Loma Linda University Electronic Theses, Dissertations & Projects

Secondhand smoke has been shown to have adverse health effects on young children. It is associated with various health effects such as respiratory infections, Sudden Infant Death Syndrome (SIDS), and asthma. Because of the dangers secondhand smoke poses to young children, there is a need for educating parents about the dangers of secondhand smoke as well as determining factors associated with secondhand smoke exposure among children. Understanding these factors may be first step toward developing strategies to reduce ETS exposure.

The study examined correlates of in-home smoking behavior of parents with newborns by analyzing 657 respondents who filled out the …

Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru

Reproductive Health

The Somali community living in Kenya (and in their native Somalia) has practiced the severest form of female genital cutting (FGC)—infibulation—for centuries. To understand the context within which the practice takes place, and how its complications are managed, the Population Council’s Frontiers in Reproductive Health Program undertook a diagnostic study that confirmed that FGC is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice: religious obligation, family honor, and virginity as a prerequisite for marriage; an aesthetic preference for infibulated genitalia was also mentioned. The study also found that the health …

Trends In The Timing Of First Marriage Among Men And Women In The Developing World, Barbara Mensch, Susheela Singh, John B. Casterline

Poverty, Gender, and Youth

The timing of first union merits investigation not only because of the close temporal link between marriage and the onset of childbearing, but also because the age when men and women marry has implications for the organization of family life and for gender relations within society. This paper begins by reviewing the contributions of various social science disciplines to an understanding of the timing of marriage. Using current status data from 73 countries provided by the United Nations Population Division and retrospective data from 52 Demographic and Health Surveys conducted between 1990 and 2001, we then examine recent trends in …

Trends In The Timing Of First Marriage Among Men And Women In The Developing World [Arabic], Barbara Mensch, Susheela Singh, John B. Casterline

Poverty, Gender, and Youth

The timing of first union merits investigation not only because of the close temporal link between marriage and the onset of childbearing, but also because the age when men and women marry has implications for the organization of family life and for gender relations within society. This paper begins by reviewing the contributions of various social science disciplines to an understanding of the timing of marriage. Using current status data from 73 countries provided by the United Nations Population Division and retrospective data from 52 Demographic and Health Surveys conducted between 1990 and 2001, we then examine recent trends in …

The Effect Of Community Nurses And Health Volunteers On Child Mortality: The Navrongo Community Health And Family Planning Project, Brian Wells Pence, Philomena Nyarko, James F. Phillips, Cornelius Debpuur

Poverty, Gender, and Youth

This report presents the child mortality impact of a trial of primary health-care service-delivery strategies in rural Ghana. After adjustment for sociodemographic factors, under-five mortality in areas with village-based community-nurse services fell by 16 percent during the five years of program implementation compared with mortality before the intervention. Reductions were observed in infant (6 percent), early child (20 percent), and late child (41 percent) mortality. Community involvement and training of a local health volunteer were associated with an 11 percent increase in mortality, primarily driven by a 124 percent increase in early child mortality. Areas with both nurses and volunteers …

The Impact Of Childhood Mortality On Fertility In Six Rural Thanas Of Bangladesh, Mian Bazle Hossain, James F. Phillips, Thomas K. Legrand

Poverty, Gender, and Youth

This Population Council working paper examines the causal structure of the relationship between child mortality events and subsequent fertility during a time of rapid decline in fertility in Bangladesh. Results lend support to the hypothesis of an insurance effect, while demonstrating that its demographic significance is likely to be less prominent than that of replacement behavior. Findings indicate that the insurance motive remains intact even after total fertility declined to fewer than three children per woman. The well-documented role of gender bias as a determinant of child health and survival is also a factor in child-replacement decisionmaking. Although the rapid …

Kutibu Majeraha, Kutia Matumaini: Ushirikiano Wa Watanzania Dhidi Ya Fistula Obstetrikia, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Improving The Ghanaian Safe Motherhood Programme, Ivy Osei, Bertha Garshong, Gertrude Banahene, John Gyapong, Placide Tapsoba, Ian Askew, Clement Ahiadeke, Richard Killian, Edward Bonku, Perle Combary, William Sampson

Reproductive Health

Prior to the Ghana Ministry of Health scaling up the country’s Safe Motherhood program, they requested support from the Population Council’s USAID-funded Frontiers in Reproductive Health program to undertake an operations research study to evaluate and compare the cost-effectiveness of two training approaches and other performance improvement interventions. The study measured and compared changes in provider knowledge and skills and the costs of implementing a three-week residential vs. self-paced learning (SPL) approach. The SPL approach costs more per trainer than the traditional residential approach, both in financial costs alone and when opportunity costs are added, however, a cost-effectiveness analysis showed …

Improving Access To Long-Term Contraceptives In Rural Guatemala Through The Ministry Of Health, Edwin Montufar, Carlos Morales, Ricardo Vernon, Carlos Brambila, Jorge Solorzano

Reproductive Health

The purpose of this study was to test a model to train nurse auxiliaries at health centers and posts in Guatemala and to determine whether these providers could deliver adequate, cost-effective services. The training model consisted of: a) selection of nurse auxiliaries; b) two-day group training; c) on-the-job training, including work with actual clients at the trainees’ work centers; and d) certification of trainees who had conducted at least five quality insertions under supervision. This study has shown that nonprofessional health providers can effectively provide quality IUD services in Guatemala. The main recommendation derived from the project is to scale …

Systematic Screening As A Strategy To Increase Services Integration And Revenues In Honduras, Ricardo Vernon, James R. Foreit, Fiorella Mancini, Suyapa Pavon, Jheisy Torres

Reproductive Health

This operations research study, undertaken by the Honduras Family Planning Association (Asociación Hondureña de Planificación de Familia—ASHONPLAFA), tested the effectiveness of systematic screening to increase the number of services and revenue per visit in a reproductive health program. Despite monitoring plans, provider compliance with the intervention was low; the overall proportion of clients screened was less than 11 percent, and the frequency of screening varied greatly by clinic contact point. Although the study did not show an increase in the mean number of services per client, the negative results could reasonably be attributed to lack of implementation of the intervention. …

Nursing Staff Dynamics And Implications For Maternal Health Provision In Public Health Facilities In The Context Of Hiv/Aids, Loveday Penn-Kekana, Duane Blaauw, Khin San Tint, Desiree Monareng, Jane Chege

Reproductive Health

This study, carried out in Limpopo, KwaZulu-Natal, and Mpumalanga provinces in South Africa, aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. The study found that a high percentage of nursing staff working in public facilities were demotivated, burnt out, and were considering leaving the facility where they were working. A range of factors, both financial and nonfinancial, were associated with nurses considering going overseas: inadequate pay, poor promotion, feeling unsupported by management, and having bad relationships at work were all associated with lack of organizational commitment. As a result …

Feasibility Of Introducing A Comprehensive Package Of Antenatal Care Services In Rural Public Clinics In South Africa, Jane Chege, Ian Askew, Nzwakie Mosery, Mbali Ndube-Nxumalo, Busi Kunene, Mags Beksinska, Janet Dalton, Ester Snyman, Wilem Sturm, Preshny Moodley

Reproductive Health

The Maternal, Child and Women’s Health Unit, in collaboration with the Population Council’s FRONTIERS in Reproductive Health (FRONTIERS) program, the Reproductive Health Research Unit of the University of Witwatersrand, and the Department of Medical Microbiology and Infectious Diseases of the Nelson Mandela School of Medicine, University of Natal, developed and then pilot-tested this revised model in KwaZulu-Natal, South Africa. The project’s objective was to develop and test an improved and integrated antenatal care program for public-sector clinics that would increase the range and quality of services received by pregnant women and improve their reproductive health behavior and status. Various problems, …